Ukususwa Manual of placenta: izindlela zokusebenza nemishini nokusebenza

Placenta - isitho evumela nomntwana esizalweni. It ihambisa izakhi ezingenzeka embungwini, ivikela ke kusukela imvelo yangaphakathi umzimba sika umama amahomoni adingekayo ukuze zikwazi sokukhulelwa, futhi eningi imisebenzi ehlukene, thina Akekho owaziyo.

kumiswa placenta

kumiswa placenta iqala okwamanje lapho iqanda eselivundisiwe inamathela odongeni lesizalo. Endometrium ikhula kanye iqanda eselivundisiwe, uvalwe kokulilungisa odongeni kwesibeletho. Ngesikhathi iphuzu contact we zygote futhi placenta lwamafinyila ikhula njengoba isikhathi siqhubeka. Okubizwa ngokuthi placentation iqala ngesonto yesithathu yokukhulelwa. Kuze ngesonto wesithupha igobolondo embryonic ubizwa ngokuthi chorion.

Ngaphambi ngesonto weshumi nambili ka-placenta ayinakho histological ecacile futhi isakhiwo yokwakheka, kodwa ngemva, kwaze kwaba maphakathi yokuthathu yesithathu, ine uhlobo disc enamathiselwe odongeni lesizalo. Ohlangothini sangaphandle yona ingane umzanyana kwelula, icala langasezantsi libe bangaphakathi ebusweni nge Imicu yotshani okuyinto ukuntanta igazi kwabakhulelwe.

umsebenzi esinomhlapho

isihlalo Ingane yakha isixhumanisi phakathi umbungu nomzimba kamama ngokusebenzisa exchange of igazi. Lokhu kubizwa ngokuthi yi isithiyo gematoplatsentarny. Morphologically kuba ezitsheni ezincane enezindonga mncane akha villi esihle ngaphesheya kwamanzi esinomhlapho. Ziyakwazi ukuxhumana izikhala elise odongeni kwesibeletho, futhi igazi ukhiphela phakathi kwazo. Le ndlela yokwenza osinikeza nemisebenzi igunya:

1. Negesi lokushintshisana. Oxygen nge samanje igazi likamama lingahlangani uwela ezingenzeka embungwini, ibuye ithwale emuva carbon dioxide.
2. Ukudla Ukukhetha. Kungenxa placenta kuya ingane ithola yonke adingekayo ukuze ukukhula nokuthuthuka izithako: amanzi, amavithamini, amaminerali, electrolyte. Futhi emva umbungu agaya nabo urea, creatinine, nezinye izingxube zamakhemikhali zonke isebenzisa placenta.
3. umsebenzi kwama-hormone. I-placenta bukhipha ama-hormone anomthelela sokukhulelwa: progesterone, human chorionic gonadotropin, prolactin. Okwakuhlalwa kuzo lapho kusaqalwa lo indima livele libe umzimba ophuzi, elise esibelethweni.
4. Ukuvikelwa. isithiyo Gematoplatsentarny kuvimbela antigen kusukela egazini likamama singene igazi womntwana, ngaphezu, placenta aluphumeleli izidakamizwa eziningi, amaseli zabo omzimba bese esakazwa izakhiwo mzimba. Nokho, kuyinto permeable izidakamizwa, utshwala, i-nicotine, nama-virus.

I degree of ukuvuthwa umzanyana

I degree of nokuvuthwa umzanyana kuncike isikhathi yokukhulelwa. Lokhu umzimba uyakhula kanye nezithelo ngemva kokuzalwa kwakhe. Kukhona ama-degree amane ukuvuthwa umzanyana:

• Zero - ngokuhamba evamile yokukhulelwa ihlala izinyanga eziyisikhombisa enqunywa ngokuthwasa kwenyanga. Kubiza mncane, njalo kwandisa futhi kudala izikhala ezintsha.
• Okokuqala - oluhambisana lwesishiyagalombili lwenyanga sokukhulelwa. ukukhula esinomhlapho zamabhasi, kuba mkhulu. Lona omunye nezikhathi ezibucayi kakhulu ekuphileni umzanyana, futhi ngisho kokungenela okuncane kungabangela lamabutho ngwengwzi.
• Okwesibili - uyaqhubeka kuze kube sekupheleni sokukhulelwa. I-placenta usuqalile ukuba siguge, kulandela izinyanga eziyisishiyagalolunye zengozi kokusebenza kanzima imini yonke, usekulungele ukushiya ingaphakathi lesizalo emva ingane.
• Okwesithathu - kungabonakala nasemkhakheni kusukela ngesonto omathathu anesixhenxe sokukhulelwa, kukonke. Lena umzimba ukuguga yemvelo, okuyinto eye wafeza umsebenzi walo.

esinomhlapho

Iningi ngokuvamile itholakala nge placenta obondeni emuva kwesibeletho noma wokushintsha odongeni ohlangothini. Kodwa-ke nakanjani kungenzeka ukuthola kuphela uma izingxenye ezimbili kwezintathu zezinkonzo sokukhulelwa iphelile. Lokhu kungenxa yokuthi kwesibeletho ikhula ngobukhulu futhi lishintshe indlela elakheke ngayo, futhi placenta esihamba ngayo.

Ngokuvamile phakathi zamanje ultrasound, udokotela amanothi indawo placenta futhi ukuphakama kwalo ngokuphathelene ukunamathela lesizalo emphinjeni. Ngokuvamile, placenta usodongeni emuva kuphezulu. amasentimitha Okungenani eziyisikhombisa kufanele kube phakathi onqenqemeni kwangaphakathi womphimbo eyesithathu senyanga placenta. Ngezinye izikhathi wayeze inyonyoba phansi kwesibeletho. Nakuba ochwepheshe bakholelwa ukuthi leli lungiselelo, futhi, akuqinisekisi ukulethwa yimpumelelo. Uma lesi sibalo ephansi, ngakho-ke obstetricians udokotela ukhulume ongaphakeme-amanga-placenta. Uma endaweni emphinjeni ijwabu placenta abakhona, kuba ibufakazi isethulo yayo.

Kukhona izinhlobo ezintathu previa:

1. Okugcwele lapho emihlathini kwangaphakathi ivaliwe placenta. Ngakho ukuthi uma kwenzeka lamabutho nisebancane ukopha okukhulu, okuyinto Kwakuyohlanganisani ukufa fetus.
2. A praevia ngokwengxenye kusho ukuthi elachitheka imbozwe kungekho abangaphezu kwengxenye yesithathu.
3. previa Asemphethweni isethwe lapho onqenqemeni esinomhlapho ifinyelela umlomo wakhe, nokho akusho iya kuyo. Lona umphumela omuhle kakhulu.

izinkathi ukulethwa

Jwayelekile ukulethwa bokuphila iqala ngesikhathi ukubonakala Kufinyeta njalo ngezikhawu ezithile phakathi. Ngo zokubelethisa, kukhona ezintathu nezikhathi zomsebenzi.

Isikhathi sokuqala - a dilatation wesibeletho. Ukuzalwa canal kufanele lilungiselwe yokuthi i-fetus zizosuka kubo. Badinga ukuze sandise futhi babe nezimo ngaphezulu futhi ethambile. Ekuqaleni kwesikhathi sokuqala dilatation wesibeletho - amasentimitha amabili nje, noma omunye umunwe obelethisayo, futhi ekupheleni kufanele sifinyelele amasentimitha ayishumi noma ngisho nambili futhi sidlule isibhakela. Kuphela kulokhu ikhanda umntwana angazalwa. Ezimweni eziningi, ekupheleni kwesikhathi kwenzeka ukuvezwa amniorrhea. Ubude isinyathelo sokuqala ihlala phakathi ayisishiyagalolunye nambili amahora.

Isikhathi yesibili ibizwa ngokuthi ukuxoshwa umbungu. I Kufinyeta esikhundleni imizamo eziyize ezingenakusiza nezingenakophula, fundus encishisiwe kakhulu futhi odlulela ingane. Isithelo eshayela phakathi kwezinye emgudwini wokuzala, ukuvula ngokuvumelana anatomy of ukhalo. Kuye isethulo ingane angazalwa ikhanda noma imbongolo, kodwa obelethisayo kufanele ukwazi ukumsiza ukuba azalwe yisiphi isimo.

Isikhathi sesithathu libizwa ukulandelana futhi aqala ngokuthi lokuzalwa futhi iphela ukubukeka placenta. Ngokuvamile kuthatha isigamu sehora, futhi emva kwemizuzu eyishumi nanhlanu placenta okuhlukana odongeni lesizalo futhi imizamo yokugcina axoshwe esibelethweni.

Ukubambezeleka kulandele ngokuhlukana

Izizathu ukubambezeleka umzanyana phakathi komgodi lesizalo kungenzeka hypotension anyuswe placenta yayo, isakhiwo noma indawo umzanyana anomaly, i-fusion esinomhlapho nge lesizalo udonga. Izinto eziyingozi ezingabangela i kulokhu kukhona izifo sokuvuvukala endometrium, izibazi kusuka Ukubeletha, lesizalo fibroids, kanye umlando libangela ukuphuphuma kwezisu.

Agcinwayo placenta uphawu is ukopha esigabeni sesithathu zomsebenzi futhi ngemva kwaso. Ngezinye izikhathi igazi akusho flow ngokushesha, futhi aqoqana kwesibeletho. igazi okunjalo okulumba kungaholela oluhambisana ukushaqeka.

placenta anyuswe

Placenta accreta ngokuthi okunamathiselwe wakhe Friend odongeni lesizalo. I-placenta kungaba abalale mucosa, lingene shí odongeni lesizalo ukuba bahlasele ungqimba kwemisipha futhi wangiqinisa kuzo zonke izingqimba, ngisho ngokuthinta peritoneum.

ukususwa manual umzanyana kungenzeka kuphela uma lokuqala degree ziyakhula, okungukuthi, uma ebambelela ngokuqinile ukuba le mucosa. Kodwa uma anyuswe ifinyelele degree wesibili noma wesithathu, ngakho-ke kuyodingeka ukuhlinzwa abanye. Ngokuvamile, i-ultrasound kungaba avelele njengoba isihlalo sengane unamathele odongeni lesizalo, futhi kusengaphambili ukuze kuxoxiswane ngalokhu iphuzu nge umama esizayo. Uma indawo enjalo umzanyana kwezinso udokotela ifunda ebeletha ke kufanele kuthathe ngesixazululo kwesibeletho ukususwa.

Izindlela sokususwa ibhukwana placenta

Kunezindlela eziningana ukuze enze ukususwa manual umzanyana. Kungaba ukusetshenziswa phezu kowesifazane esiswini ukhulelwe, lapho owokugcina njengoba extruded ezingadingekile esibelethweni, futhi kwezinye izimo, odokotela bephoqeleka ukuba ngokoqobo isandla ukuze uthole umzanyana nge ulwelwesi.

Okuvame kakhulu iyona reception Abuladze, lapho obelethisayo owesifazane ngobumnene ukubhucungwa odongeni kwamathumbu ngeminwe yakho, bese linikeza yakhe push. Ngokwakhe okwamanje egcina esiswini ngesimo emphethweni longitudinal. Njengoba ukucindezela ngaphakathi komgodi ukwanda kwesibeletho, futhi kukhona kungenzeka ukuthi placenta ngokwayo izalwa. Ngaphezu kwalokho puerperas cannulated esinyeni kuyasivusa ukusikwa imisipha lesizalo. Faka oxytocin emthanjeni ukuze sikhuthaze zabasebenzi.

Uma ukususwa manual umzanyana ogangeni besisu inefficiently isebenzisa obelethisayo ukuze egumbini elingaphakathi.

okwalandela ngokwahlukana amasu

Technique ukususwa manual umzanyana ukuthatha out ke kusukela izingcezu lesizalo ingaphakathi. Udokotela e a igilavu oyinyumba yethula isandla sakhe esibelethweni. Iminwe nge esiphezulu inikezwe nomunye sendlala. Ukuze touch ngaphambi kokuthi placenta nokukhanya ngokucophelela lokuqobela ukunyakaza, ihlukanisa ogangeni esibelethweni. ukususwa Manual of placenta kufanele niqaphele kakhulu ukuba usike ogangeni kwesibeletho kanye ukopha okukhulu. Udokotela unika yisibonakaliso umsizi, ngakho wadonsa intambo bavale isihlalo ingane bese uhlole phambili. Umbelethisi okwamanje uyaqhubeka ukuzizwa kwesibeletho ukuze ususe noma ikuphi Indwangu ngokweqile futhi uqinisekise ukuthi ngaphakathi kwesokunxele placenta izingcezu, ngoba lokho kungase kuvuse ukutheleleka kwangemva kokubeletha.

ukususwa manual umzanyana kanye kuhilela massage kwesibeletho, uma isandla umuntu ngaphakathi udokotela kanye nezinye ngobumnene odlulela phandle. sabakhuthaza Ngakho kwesibeletho receptor, futhi kuyehla. Inqubo wenziwa ngaphansi izinzwa jikelele noma lendawo ngaphansi kwezimo aseptic.

Izinkinga kanye sequelae

Izinkinga zibandakanya ukopha esikhathini kwangemva kokubeletha, futhi oluhambisana ukushaqeka, elihlobene ne omkhulu igazi ukulahleka emikhunjini placenta. Ngaphezu kwalokho, ukususwa manual umzanyana kungaba yingozi lesizalo perforation kanye nokuthuthukiswa kwangemva kokubeletha endometritis noma sepsis. Ngaphansi kwezimo ezinzima kakhulu, abesifazane engozini hhayi kuphela empilweni yabo kanye nekhono ukuba nezingane esikhathini esizayo, kodwa futhi ekuphileni.

zokuvimbela

Ukuze ugweme izinkinga nalapho esesikwa, kudingeka alungiselele kahle umzimba wakho ukuthi abakhulelwe yini. Okokuqala, ingane kufanele kuhlelwe, ngoba isisu kwephula ngezinga elithile isakhiwo se-endometrium, kuphumele okunamathiselwe Friend lezihlalo ingane e ukukhulelwa okwalandela. Kuyadingeka ukuba ngesikhathi esifanele nokwelapha lesi sifo ngaphambi kokuphela kwalesi simiso genitourinary, njengoba kungathinta umsebenzi zokuzala.

Kunconywa ukuba ngakususi benza ubulili bebe bengathandani ngaphandle kokusebenzisa izindlela okuvimbelayo inzalo, ukuze bagcine siqu inhlanzeko umbuso futhi ukusekela izivikeli mzimba esikhathini ekwindla-entwasahlobo.

Kufeza indima ebalulekile nesikhathi ebhukwini sokukhulelwa. Ukushesha, ngcono ingane. Odokotela obstetricians singaphoqi uvakashelwa njalo emtholampilo ngesikhathi sokukhulelwa. Qiniseka ukuthi athobele izincomo, ukuhamba, umsoco, ukulala okunempilo nokuvivinya umzimba, nokugwema imikhuba eyingozi.