Yini izinzwa kangcono sesigaba cesarean: izinhlobo, izimpawu, contraindications, ukubuyekezwa

Omama kwesigaba - ukuhlinzwa, lapho usana olusanda kuzalwa isuswa ukuncishiselwa at kodonga besisu futhi kwesibeletho. Ngenxa yalesi inqubo unyaka ngamunye bazalwa ezinkulungwane ezingane, ngakho umbuzo kanjani lo msebenzi wenziwa, ekujabulisayo abazali abaningi okhulelwe. Kulokhu, enye yezinto ezibaluleke kakhulu kufanele ucabange ngaphambi kokuzalwa, uhlobo izinzwa.

izinzwa Ngakho lokho kangcono sesigaba cesarean? Kusukela sihloko, ungathola ulwazi oluyisisekelo mayelana nezinhlobo ezisetshenziswa kakhulu ukubulawa kwezinzwa ngesikhathi ukusebenza, amathuba abo main kanye nobubi obuthile.

iyona ukuhlinzwa kanjani?

Ngaphambi siyathola ukuthi izinzwa kangcono Ukubeletha, kufanele ukusho amazwi ambalwa mayelana nohlobo zokuhlinzwa.

Phakathi kwesigaba cesarean usana ayibonakali ukukhanyisa ngendlela yemvelo (ngokusebenzisa emgudwini wokuzala), futhi isuswe ngokusebenzisa imbobo encane ukuthi udokotela ohlinza kwenza odongeni lesizalo. Ezibhedlela zesimanje imbobo senziwa esiswini aphansi, okwenza isibazi emva kokuhlinzwa cishe imperceptible. Le ndlela bokubeletha ajwayelekile kakhulu elisetshenziswa umkhuba kabanzi emazweni athile aseYurophu, ezifana Germany, ngale ndlela kufika ku-40% izingane.

Zimbili izinhlobo zokuhlinza: isimiso kanye eziphuthumayo. Esokuqala siwukuthi uma kunobungozi ngesikhathi sokubeletha zemvelo nanoma yiziphi izinkinga ezisongela ukuphila nempilo umama nengane. Ngu izinkomba kulo msebenzi kukhona ukhalo umama lincane kakhulu sika, usongo hypoxia, bebeletha, lwaqala ngasekuqaleni, nokukhulelwa izingane eziningi ngasikhathi, nokunye. D. Ngokwemvelo, ukuhlinzwa evamile samuntu encomekayo ngoba kukhona isikhathi sokulungiselela oluzayo ukuhlinzwa obelethayo.

ukusebenza eziphuthumayo wenziwa kunjalo uma kukhona yezinkinga eziyingozi ngesikhathi sokubeletha zemvelo. Kulokhu, i ukuhlinzwa eziphuthumayo ezimweni eziningi kwenziwa ngokusebenzisa izinzwa, omunye izinzuzo main of okuyinto ukuqala okusheshayo umphumela izinzwa: lokhu kubaluleke kakhulu, ngoba ngezinye izikhathi phakathi akhawunti zaphazamisa zabasebenzi uyaqhubeka umzuzu.

Ngokwemvelo, ukuhlinzwa okunjalo kuyinto engacabangeki ngaphandle kokusebenzisa izinzwa, ngaphandle kwalokho isiguli ngeke usinde shock ezibuhlungu.

Yiziphi izinhlobo izinzwa esetshenziselwa Ukubeletha?

Kunezinhlobo ezimbili eziyisisekelo izinzwa engasetshenziswa kule nqubo ye kwesigaba cesarean: esiFundeni kanye ukubulawa kwezinzwa okuvamile. Eyokuqala ophika ngokuphelele nozwela kuphela Ingxenye engezansi umzimba, kuyilapho ngesikhathi ukwazi jikelele isiguli unqamukile ngokuphelele, futhi uphumule imisipha yakhe. Kukhethwa indlela elungile futhi ofanele kakhulu izinzwa kungenziwa kuphela udokotela ikhumbula izici yokukhulelwa, ukubeletha okunempilo, nezinye izinto eziningi.

Izinhlobo ngokusungula indlela yokubulala izinzwa ngoba Ukubeletha:

• ukubulawa kwezinzwa okuvamile;
• umgogodla;
• epidural.

Izinzuzo main nemibi ngamunye kuchazwe lapha ngezansi.

Lapho kukhethwa esivuna ukubulawa kwezinzwa okuvamile kungenziwa?

Ingqikithi ukubulawa kwezinzwa okuvamile ukuthi ngenxa amalungiselelo eziyinkimbinkimbi zazo busuka emithambo yegazi ukugeleza kwegazi noma usebenzise tube ufakwa umgudu, isiguli ngokuphelele ukwazi unqamukile, futhi iyeke ubuhlungu. Kubalulekile ukwazi ukuthi ngaphansi izinzwa jikelele kukhona muscle, ukuvumela ukudala i obelethisayo-udokotela ohlinza izimo zokusebenza elula.

Lolu hlobo lwe-ukukhululeka ubuhlungu kwabesifazane kufanele Ukubeletha, khetha abavamile. Isidingo ukubulawa kwezinzwa okuvamile kungenzeka kulezi zimo ezilandelayo:

• contraindication kwezinye izindlela ezikhona kakade ukuze analgesia;
• khona omama ukukhuluphala;
• hypoxia fetus kwatholakala ukuthi unesifo;
• nokwenqaba abesifazane kwezinye izinhlobo izinzwa;
• malposition kwesibeletho, prolapse ka umzanyana kanye nezinye oluphuthumayo isimo azoya.

Namuhla ukubulawa kwezinzwa okuvamile ngoba Ukubeletha osebenza esimweni kunesidingo ezokhipha ku izinkomba eziphuthumayo, futhi kugcina kungenele kuhlinzwa iyadingeka ukuqala ngokushesha ukulondoloza impilo yomama nezingane. Sibangelwa yokuthi ukubulawa kwezinzwa okuvamile has ezithile ezingathandeki abalulekile.

I yokuntula ukubulawa kwezinzwa okuvamile

izinzwa Yini engcono kwesigaba cesarean? Ngaphambi kokuba siphendule lo mbuzo, ake sixoxe amaphutha ayo. Odokotela uzame ukugwema lolu hlobo izinzwa ngoba Ukubeletha, ngoba izinzwa anganika yezinkinga abaningi ukwedlula ezinye izindlela ukukhululeka ubuhlungu. Phakathi ezivamile wukunikeza:

• hypoxia parturient, okuyinto kubangelwa yokuthi lapho umuntu ebulawe izinzwa encishisiwe wamaphaphu umthamo futhi ngakhula ukufunwa umoya-mpilo;
• ingozi eliphezulu nenshisekelo, okusho ukuthi uhogele lokuqukethwe isisu ngendlela, uma ongudokotela obulala izinzwa akuyona ngesikhathi esifanele ukuxilonga kulesi simo, imiphumela ingase ibe mibi kakhulu;
• abesifazane abaningi abakhulelwe ingcindezi liphume phakathi ukubulawa kwezinzwa okuvamile.

Izinzwa kungaholela ukuhlukumeza umsebenzi zokuphefumula ngayo lapho usana, kanye nethonya ezicindezelayo ngeke isimiso sakhe sezinzwa ngokuqondene Ukungena we amaphilisi ezinhlungu placenta. Kugcine kuyingozi ikakhulukazi endabeni ukubulawa kwezinzwa okuvamile isetshenziswa preterm zabasebenzi. Nokho, hhayi kakhulu wesabe: izidakamizwa yesimanje kunganciphisa ingozi nemiphumela emibi ingane ukuba ubuncane, owayesanda kuzalwa esifanayo uthola imithi ekhethekile, ukhulula imiphumela ukubulawa kwezinzwa okuvamile.

Ngakho, lokho kungcono ukukhetha izinzwa sesigaba cesarean kukuwe nodokotela wakho, kodwa khumbula ukuthi ukubulawa kwezinzwa okuvamile - ezingasehlela akuyona indlela engcono ukuze izinzwa imisebenzi resort kuze kufanele kuphela uma kwenzeka ukuthi ezinye izinketho whatever izizathu, ungalilahli it uhlala. Ngokwesibonelo, uma kwenzeka ukuthi obelethayo ine ingqondo engazinzile noma ukuhlupheka kusuka kunoma iyiphi nkinga bayakwazi, lo msebenzi ungenziwa kuphela eyenziwa ngaphansi izinzwa jikelele, njengoba ingozi eliphezulu ukuthi owesifazane ngeke ukwazi sihlale sizolile ngesikhathi ukusebenza futhi uzoyeka izenzo nodokotela ohlinzayo.

Okuningi ngokuvamile ekusebenzeni epidural futhi izinzwa emgogodleni, okungukuthi, amasu analgesia lesifunda - lezi zinhlobo kuphephe kakhulu ukuvumela obelethayo esimweni ukwazi ecacile. Lokhu kubalulekile, hhayi kuphela ngoba kungenzeka ukuba ngokushesha ukuthatha ezandleni ezisanda kuzalwa. Phakathi caesarean kwesigaba obelethisayo obulala izinzwa singalondoloza contact njalo isiguli, okwenza kube lula ukuhlonza yezinkinga kungenzeka.

Inqubo ngokusungula indlela yokubulala izinzwa epidural

, Kufanele ucacise ukuthi ziyini Ngaphambi kokuba siphendule lo mbuzo, lokho kungcono ukwenza izinzwa ngoba cesarean izinzwa epidural. Lena inqubo lapho kubulawe izinzwa is injected isikhala epidural yomgogodla esifundeni lumbar. Ngemva izinzwa akhiqizwa ngale ndlela, obelethayo ngesikhathi ukusebenza kule ukwazi, kodwa akusho ubuhlungu.

izinzwa wendawo ngoba Ukubeletha ivumela owesifazane ukuthatha ukuhlanganyela ngenkuthalo inqubo bokubeletha: ukuxhumana abasebenzi bezokwelapha, noma ekhona Chamber umyeni wakhe, ngokushesha thatha izandla olusana bese ulinamathisela esifubeni. Kulokhu, owesifazane umsiko engazizwa, esikhathini esithile a ukungakhululeki kancane phakathi nokuhlinzwa.

Nokho, kukhona into eyodwa ebaluleke kakhulu. Abesifazane abaningi kunzima nasengqondweni ukunquma ukuhlala egumbini lokuhlinza, besaba ukuthi phakathi kwesigaba cesarean, zibe ziphapheme futhi ungazizwa isigamu umzimba wakhe. Ngokuvamile omama ukufuna njalo ukubulawa kwezinzwa okuvamile. ukwesaba kwabo uyelulekwa ukuxoxa nodokotela wakho futhi izinzwa, ubani ozokhuluma ngokuningiliziwe ukuthola ukuthi uqhubeke kanjani inqubo izinzwa.

Izinzuzo izinzwa epidural

Phakathi izinzuzo main of izinzwa epidural yilezi ezilandelayo:

• ukusebenza nzile esimiso senhliziyo nemithambo yegazi, ukuntuleka umfutho okhuphuka ngokungazelelwe.
• It is kulondolozwa kungenzeka ukuba sifeze ukunyakaza.
• Akhishiwe ngukulimala elingenhla ipheshana zokuphefumula futhi akukho ingozi nenshisekelo.
• Isikhathi eside ngomphumela imithi ebulala izinzwa. Uma kudingekile, izinzwa lungaboniswa nganoma yisiphi isikhathi, okuyinto ebaluleke kwenzeka kakhulu ukuthi ngemva kwesigaba cesarean kuyadingeka ukwenza noma yikuphi ukuqhutshwa okwengeziwe, isibonelo, ukukhiqiza Ligation esibeletho.
• Owesifazane ngokushesha ophumela ngaphandle kweminyango izinzwa, post-op isikhathi yokutakula kuyehla: amahora angu-24 kuphela ngemva kokuhlinzwa, iziguli eziningi ingakwazi suka futhi nyakazo! Emhlabeni.
• Ingane kungathatha ngezingalo zakhe * bafake webele ngokushesha ngemuva kokuhlinzwa.
• Kungenzeka ekunciphiseni izinhlungu ngemva kokubeletha, engena epidural isikhala amaphilisi ezinhlungu.

Okumbi ngokusungula indlela yokubulala izinzwa epidural

Naphezu kwakho konke zako, imiphumela ngokusungula indlela yokubulala izinzwa epidural ngoba Ukubeletha kungenzeka esidumazayo. Lokhu nakanjani kudingeka wazi ngayinye womama esizayo:

• Uma ngizwa is injected akuyona onekhono, ingozi ngokwanele eliphezulu kokuthola izidakamizwa egazini. Ngesikhathi esifanayo ukuthuthukisa Ukudlikizela, ngokucijile encishisiwe blood pressure kanye ukwazi engasenamahloni. Umphumela ungaba ukufa komama noma kokulimala isimiso sezinzwa.
• Cishe 17% of the izinzwa akusho uvimbe abanye imizwa, ngenxa lokho obelethayo ngesikhathi ukulethwa cesarean ihlangabezana ukungakhululeki. Ngakho-ke, ngaphambi kokuqala ukusebenza, hlola ukuzwela usebenzisa ekhethekile ukuhlolwa esithinta izinzwa, ezifana kwabathinta pin. Uma ngizwa aluzange lusebenze kahle, kudingeka ukuphatha ngokuphindaphindiwe zomuthi.
• Uma nomuthi ngenxa ipayipi ayilungile ithole ngaphansi arachnoid umgogodla, singenzeka block umgogodla, okuyinto evame ngenxa yokwehluleka umgudu wokuphefumula. Ukuze ugweme lokhu, waqale wangena umthamo encane izidakamizwa: ithimba kuhlinzwa idinga imizuzu emibili nje ukulinda ukucacisa ukuthi inqubo wenziwa ngendlela efanele.

Ngeshwa, izinzwa epidural sesigaba cesarean kuyinto kubenzima, nempumelelo yayo ngokuvamile kuxhomeke ekutheni isipiliyoni kanye namakhono okhokhelwayo. I ukuthola ethintekayo isikhala epidural kuyinto ngempela ongaqondakali, kanti uma izinzwa emgogodleni umaka esinokwethenjelwa okukhipha phezu i-cerebrospinal fluid. Ngakho-ke kubalulekile ukuba ukhethe udokotela esibangela obathembayo, futhi ngokucophelela ukufunda izibuyekezo umsebenzi esibhedlela lapho ingane yakho ozozalwa.

izinzwa emgogodleni

Ekuqaleni epidural kwakubonakala insindiso yangempela, ngoba ikuvumela, hhayi nje kuphela inqubo kokuba ingane ezalwe ngaphandle kobuhlungu ngokuphelele, kodwa wanika abesifazane ithuba singalahlekelwa acabanga ngokucacile kanye nombono ngesikhathi kokuzalwa umntwana eside elindelwe. Nokho, ngenxa Izimo eziningi futhi ematfuba eziningana imiphumela engemihle engenhla, epidurals kancane kancane enikeza entendeni umgogodla. Abaningi baye bame kwelokuthi lokhu iyona izinzwa kangcono kwesigaba cesarean.

izinzwa Spinal kuyinto nokuphathwa izinzwa phakathi lumbar emuva ahlukaniswe. Umuthi engena isikhala subarachnoid ka emgogodleni. Kulokhu, umphumela zombili izinhlobo izinzwa kuyafana: nesikhathi esithileko ngemva kokubunjwa umjovo we obelethayo iyeke uzizwe ingxenye engezansi yomzimba wakhe, futhi lo dokotela ungakwazi uqhubekele izinqubo ezidingekayo kuhlinzwa.

Buhle izinzwa emgogodleni

Uyini izinzwa kangcono kwesigaba cesarean? Phendula lo mbuzo kunzima ngempela, njengoba bonke ngamunye. Kodwa singakwazi ukubona izinzuzo main of izinzwa emgogodleni:

• Ayikho inguquko anobuthi. cishe ningagcini, futhi akukho ingozi enganeni uma contact kwephutha izinzwa lwalo emfudlaneni igazi ukusabela inhliziyo noma isimiso sezinzwa.
• Ngemva kokuhlinzwa, umzimba walulama ngokushesha.
• analgesia Quality: obelethayo phakathi nokuhlinzwa ubuhlungu.
• izinzwa Spinal okwengeziwe ephumula imisipha, okuyinto kusiza umsebenzi udokotela.
• Ngu operation usungaqala kwamaminithi ambalwa ngemva kokuphathwa, ngakho ukuphazamiseka kuthatha isikhathi esingaphansi.
• izinzwa Spinal senziwa lula kakhulu ukwedlula epidural. Ngaphezu kokuphathwa obulala izinzwa esebenzisa umjovo ohlabayo okuningi, ukuze ingozi kuhlasimulise emgogodleni noma ukuphatha kwabantu okonakele of izinzwa lincane.
• Odokotela abaningi bayaqaphela ukuthi izinzwa emgogodleni kwaba esiphelele kakhulu izinzwa Ukubeletha.

izinzwa Spinal sesigaba cesarean: Izimo, nobuthaka ezinkulu

Ngeshwa, izinzwa emgogodleni has ezithile:

• Izenzo izidakamizwa emahoreni amabili, ngakho lolu hlobo izinzwa ngeke isebenze, kudingeka enze noma yimuphi ukuxhaphaza ezengeziwe, futhi uma ngesikhathi yezinkinga ukuhlinzwa kuphakama, kungase kudingeke izinzwa owengeziwe.
• izinzwa Spinal akunakwenzeka ebukhoneni isiguli kohlobo oluthile balimala eqolo.
• umfutho wegazi lingase lehle ngenxa ukuqala okusheshayo izinzwa.
• Uma amathuluzi ngawo ukujova izidakamizwa, awazange disinfected ngokuphelele, kungase kube ezihlukahlukene yezinkinga ezithathelwanayo ezifana-meningitis.
• Ngemva kokuhlinzwa, abesifazane abaningi awayona waphawula zekhanda ezinamandla ukuthi ingahlala izinsuku eziningana noma amasonto.
• Ngenxa ipayipi ayilungile kungalimaza isikhungo kwenzwa okuthiwa "Ponytail". Lokhu kungaba isizathu bona aphule innervation we sacrum kanye lumbar nomgogodla ngeke.
• izinzwa Spinal akunakwenzeka kwezinye izinhlobo deformity umgogodla.
• izinzwa Spinal akunakwenzeka nge lamabutho kwanoma placenta nezinye izimo azoya.

Nakuba hhayi nemiphumela ethile engathandeki ngenhla, izinzwa emgogodleni kubhekwa omunye amasu engcono nephephile ngokusungula indlela yokubulala izinzwa ngoba Ukubeletha.

Anesthesia sesigaba cesarean: Izibuyekezo

izinzwa Yini engcono kwesigaba cesarean? Izibuyekezo ngalokho imizwa abesifazane ababhekana nakho phakathi uhlobo oluthile izinzwa, kuyosisiza ukuba sithole impendulo yalo mbuzo.

omama abasakhula ziye zaphawula ukuthi le nqubo nomkhiqizo izinzwa jikelele kubuhlungu ngokwanele: kukhona umuzwa isiyezi, isicanucanu, ubuhlungu bekhanda, lapho ukhwehlela nobuhlungu bomzimba. Ngaphezu kwalokho, akunakwenzeka ngokushesha emva kokuzalwa ukuthatha ingane ngesandla. Kunenye umphumela omubi ukubulawa kwezinzwa okuvamile: ngokuvamile ngemva ingane yakho ine ukucindezeleka umsebenzi zokuphefumula.

Iyiphi i-anesthesia engcono ngesigaba sokudla? Ukubuyekezwa mayelana ne-anesthesia ye-epidural iningi kakhulu. Abesifazane abaqaphele ukuthi emva kokuba inqubo ayikho imizwa engathandeki, futhi ingane ingafakwa ngokushesha esifubeni. Kodwa-ke, njengoba ubufakazi bufakazela, ukuzwa okungajabulisi emkhakheni wokufaka amalungiselelo kuvame ukuphawulwa, futhi emahoreni ambalwa okuqala ngemuva kwesigaba sokuqeda isikhumba lapho isifo sokubulala umzimba sinqunywa emzimbeni, isigamu esingaphansi somzimba sigubha kakhulu. Kodwa-ke, usuku olulandelayo emva kokusebenza, ungahlala uwedwa, uhambele futhi unakekele ingane yakho esanda kuzalwa.

I-anesthesia yomgogodla ngokubukwa kwesigaba se-caesarean, ngokuvamile, kufanelekile. Iziguli ziphawula ukuthi azizange zizwe ubuhlungu ngesikhathi sokusebenza. Kodwa-ke, ezimweni ezimbalwa amasonto amaningana, abesifazane bahlushwa ikhanda nokuzwa okungathandeki esiswini.

Indlela yokukhetha i-anesthesia?

Ngakho iyiphi i-anesthesia engcono kwesigaba se-caesarean? Lesi sihloko sihlose ukuzazi omama esikhathini esizayo ukuthi yiziphi izinhlobo ze-anesthesia ezisetshenziselwa ukuhlinzekela isisindo se-cearean. Kodwa khumbula, kunoma yikuphi okungafanele ukuqondiswa yilwazi olungenhla uma ukhetha i-anesthesia! Udokotela kuphela onayo yonke idatha emphakathini wezempilo wesifazane osebenzayo angakhetha ngokufanele uhlobo lwe-anesthesia. Yiqiniso, izifiso zesiguli azikwazi ukunakwa. Ngakho-ke, ngaphambi kokunquma ukuthi yikuphi ukuhlinzekwa kwe-anesthesia okusemandleni okwenza isigaba se-cearean, kufanele ulinganise zonke izinzuzo nezindleko zendlela eyodwa noma enye, bese uthintana nodokotela ohlinzayo nodokotela we-anesthesiologist.

Ukuthi i-anesthesia ekhethiwe idlulile ngokuphumelelayo, kubalulekile ukufeza zonke izinkomba zochwepheshe abazokweluleka indlela yokudla ngesikhathi sokusebenza lapho bevuka ngemva kwesigaba se-cearean nokuthi yini okufanele bayenze ukuze umzimba uphinde ubuyiselwe ngokushesha ngangokunokwenzeka.