Lokhu kungenxa yokuthi abesifazane ababelethayo bayazi ukuthi yini leyo mizwa, futhi abesifazane, abakhulelwe okokuqala, bangakwazi ukuxuba ukunyakaza kwe-fetal ngenkathi bengakabi kakhulu, ngokubambisana kwamathumbu, ukugesi kwegciwane esiswini noma isisu somzimba. Ngaphezu kwalokho, lapho ukhulelwe, udonga lwangaphakathi lwesisu lunwetshiwe futhi lubucayi. Abesifazane abaningi abaphelele banomuzwa wokuthi i-fetch of the fetus ingakapheli kakhudlwana kunezondlo. Imininingwane mayelana nokunyakaza kwesisu esiswini somama, thola ku-athikili ethi "Izibonakaliso zokuqala zokuhamba kwengane."
Ngakho-ke, ngesikhathi sokukhulelwa kokuqala, abesifazane bazizwa ukuhamba kokuqala kwe-fetus, ngokuvamile ephakathi kwamasonto angu-18 no-22 (ngokuvamile emavikini amasonto onke), futhi amabhu angazizwa ukuhamba komntwana ozayo kusukela emasontweni angu-16. Uma omama bekusasa baqala ukuzwa ukunyakaza kwezinsana zabo, banemibuzo eminingi nokungabaza: ingane kufanele ihambe kangaki? Ingabe ihamba ngokunamandla ngokwanele? Kumele kukhunjulwe ukuthi zonke izinyane lizimele futhi zikhula ngokwayo, futhi imithetho ephathelene nokunyakaza kwe-fetus inokungafani kakhulu.
Umlingiswa wezingqinamba
I-trimester yokuqala. Esigabeni sokuqala sokukhulelwa, ukukhula okunamandla kakhulu kwengane engakazalwa kuvele. Okokuqala, iqembu lamaseli lihlukanisa ngokushesha, likhula futhi liba umbungu ohlangene nodonga lwe-uterine futhi luqala ukukhula, oluvikelwe yi-amniotic fluid, i-membrane yesisu kanye nodonga lwesisu. Ngamaviki angu-7-8 ngesikhathi sokuhlolwa kwe-ultrasound, kungenzeka ukulungisa indlela ukuphela kwe-embryo ukuhamba ngayo. Lokhu kungenxa yokuthi isimiso sakhe sezinzwa sesivele sesivuthiwe ngokwanele ukuze senze izimo zesibindi emisipha. Ngalesi sikhathi, i-embryo ishukunyiswa ngokweqile, futhi ukunyakaza kwayo kubonakala kungenalo incazelo. Futhi, kunjalo, kusengaphansi kakhulu, futhi ukunyakaza kubuthakathaka ukungazizwa. I-trimester yesibili. Emasontweni angu-14-15 okukhulelwa, ingane ikhule futhi izingalo zayo ziye zahlukanisa ngokuphelele (zijwayele kithi ngesimo nokubunjwa kwamapeni nemilenze), ukunyakaza sekukhulile futhi kusebenza. Phakathi nalesi sikhathi, umntwana ukhululeka ngokukhululekile ku-amniotic fluid futhi uphenduka ezindongeni zesisu. Yiqiniso, usemncane kakhulu, ngakho-ke lezi zimpendulo zibuthakathaka futhi umama wesikhathi esizayo akazizwa.
Ngamaviki angu-18-20 i-fetus ikhula, futhi ukunyakaza kwayo kubonakala kakhudlwana. Lokhu kuthinta kokuqala okulula abesifazane besifazane abakhulelwe bachaza ngokuthi "ukuqhuma izimvemvane", "inhlanzi yokubhukuda." Njengoba i-fetus ikhula, izinzwa zihluke ngokwengeziwe, futhi ngamaviki angu-20 kuya ku-22, njengombuso, bonke abesifazane abakhulelwe bazizwa ngokunyakaza kwengane yabo. Ku-trimester yesibili, omama abazayo bangakwazi ukuzwa "ukuthuthumela" kwengane ezingxenyeni ezihlukene zesisu, ngoba kungakafiki endaweni ethile esibelethweni futhi kukhona isikhala esanele sokuba iguqule kuzo zonke izikhombisi. Izingane zenzani uma zisesiswini sikamama? Ngokusho kokubheka okwenziwa ngesikhathi sokuhlolwa kwe-ultrasound, izinsana ezingakazalwa zinemisebenzi eminingi ehlukene: ziphuza i-amniotic fluid (nge-ultrasound kubonakala ukuthi umhlathi ophansi uhamba kanjani), vula ikhanda, ugobe emilenzeni, ukuphatha kahle ukuqonda imilenze, umunwe nokuqonda umthambo. Njengoba isikhathi sokubeletha sanda, umntwana ukhula futhi uqina. Ukushaqeka okukhanyayo sekuvele kushintshwe "ukukhahlela" okuqinile, futhi lapho ingane iphenduka ngaphakathi kwesibeletho, ibonakala kusuka ngaphandle, njengoba isisu sishintsha ukucushwa kwayo. Ngesikhathi esifanayo, umama angabhekana neqiniso lokuthi ingane yakhe "iyayibamba". Ngesikhathi esifanayo, owesifazane unomuzwa wokuthi ingane iyathuthumela ngezikhathi ezithile. Ukunyakaza kwe-Icicle kuhlotshaniswa neqiniso lokuthi isithelo sinamandla ngokugwinya i-amniotic fluid futhi i-diaphragm yayo iqala ukubambisana ngenkuthalo. Ukunyakaza okunjalo kwe-diaphragm kuyimzamo yokucabanga yokukhipha uketshezi. Lokhu kuphephile ngokuphelele futhi kuyinto evamile. Ukungabi khona kwe "hiccups" nakho okuhlukile kokujwayelekile.
I-trimester yesithathu
Ekuqaleni kwe-trimester yesithathu, isithelo singakwazi ukuguqula futhi sijikeleze futhi ngamaviki angu-30-32 sinezikhundla ezihlala njalo emgodini wesibindi. Ezimweni eziningi, itholakala ekhanda phansi. Lokhu kubizwa ngokuthi isethulo sekhanda le-fetus. Uma umntwana ehlelwa phansi ngemilenze noma glutes, lokhu kubizwa ngokuthi isethulo se-pelvic ye-fetus. Ngesethulo sekhanda, ukunyakaza okusebenzayo kuyabonakala engxenyeni engenhla yesisu, nasesifundazweni sezintambo, ngokuphambene nalokho, bazizwa ezingxenyeni eziphansi. Ku-trimester yesithathu, owesifazane okhulelwe naye angabona ukuthi umntwana unemijikelezo ethile yokulala nokuvuka. Umama ozayo uzokwazi ukuthi yikuphi isimo somzimba ingane ikhululekile kakhulu, ngoba uma umama esesimweni esingenakulungele ingane, ngokuqinisekile uyovumela lowo muntu ukuba azi ngalokhu nge-perturbations enobudlova, obukhulu. Lapho owesifazane okhulelwe elele emhlane wakhe, lesi sibeletho sinomcindezelo emithanjeni yegazi, ikakhulukazi kulawo igazi eliphethwe yi-oxygenated engena esibelethweni nasesithombeni. Uma kucindezelwa, ukugeleza kwegazi kwehla, ngakho-ke ingane iqala ukuzwa ukungabi nciphisa oksijini, lapho iphendula khona ngokuhlukunyezwa okubudlova. Ngokusondela ekuzalweni, ukuphazamiseka kubonakala ikakhulukazi endaweni lapho kutholakala khona umkhawulo wengane, ngokuvamile kunesidumbu esiphezulu esifanele (njengokungathi iningi le-fetus libheke phansi futhi libuyele ngakwesobunxele). Izindlela ezinjalo zingakwazi ngisho nokubangela ukuhlupheka komama esikhathini esizayo. Kodwa-ke, uma uncike phambili kancane, umntwana uzoyeka ukuxosha kakhulu. Lokhu kungachazwa ngeqiniso lokuthi kule ndawo ukugeleza kwegazi kuthuthuka, oksijeni engeziwe ingena emntwaneni futhi "iyancipha."
Ngokushesha ngaphambi kokuqala komsebenzi, ikhanda lomntwana (noma izintambo, uma ingane isethubeni lesisindo) icindezelwa ngokumelene nokungena kwesikhumba esincane. Kusukela ohlangothini kubonakala sengathi isisu "sanyuka". Abesifazane abakhulelwe bayaqaphela ukuthi ngaphambi kokubelethwa komzimba we-fetus kunciphisa, Lokhu kuchazwa ukuthi ekupheleni kokukhulelwa i-fetus isivele inkulu kakhulu kangangokuthi ayinayo isikhala esanele sokunyakaza okusebenzayo futhi kubonakala sengathi "iphelile". Abanye abomama esikhathini esizayo, ngokuphambene nalokho, babone ukwanda kwemisebenzi eyenziwa yi-fetus, ngoba ekunciphiseni kwemishini yokusebenza kwezinye izingane, ngokuphambene nalokho, uphendule ngendoda enobudlova obuningi bokuphazamiseka.
Ingane encane ivuselela kaningi?
Imvelo yesenzo semoto ye-fetus iyinhlobo "yomsindo" wenkambo yokukhulelwa. Ngokuthi ngokuzikhandla futhi kaningi kangakanani ukuphazamiseka okuzwakalayo, ungakwazi ukwahlulela ngokuqondile ukuthi ukukhulelwa kwenzekani nokuthi ingane izwa kanjani. Cishe kuze kube sekupheleni kweviki lesibili, ngenkathi ingane isengumncane kakhulu, umama olindayo angabonisa izikhathi eziningana (kuze kube usuku) phakathi kweziqephu zokunyakaza kwesisu. Lokhu akusho ukuthi ingane ayihambisani kakhulu. Kuyinto nje ukuthi owesifazane akakwazi ukubona ezinye izinkinga, ngoba ingane ayinamandla ngokwanele, futhi umama ozayo akafundile ngokwanele ukubona ukunyakaza kwengane yakhe. Kodwa kusuka emavikini angu-26-28 kuyalelwa ukuthi izithelo kufanele zihambise izikhathi ezingu-10 phakathi kwamahora amabili kuya kwamathathu.
Izifo zokuzivikela-izazi zezinkinga zezinzwa ziye zahlakulela "ikhalenda ekhethekile yokunyakaza kwesisu". Phakathi nosuku, lo wesifazane ubala ukuthi ingane yakhe ishukunywe kangaki, futhi uloba isikhathi lapho kuqhuma khona inkani yeshumi. Uma ingane ekhulelwe ibonakala ifile, kubalulekile ukuthatha isikhundla esiphuthumayo, phumula, udle okuthile (kukholelwa ukuthi ngemva kokudla umshini womzimba we-fetus ukwanda) futhi kungakapheli amahora amabili phawula izikhathi eziningi ngalesi sikhathi ingane idluliselwe. Uma kunezinguquko ezingu-5-10, ngakho-ke akukho lutho lokukhathazeka ngalo: umntwana ulungile. Uma umama engacabangi ukuthi ingane ivuselela amahora amabili, kufanele uhambe noma ukhuphuke futhi wehle ezitebhisini, bese ulala phansi. Njengomthetho, le misebenzi iyasiza ekusebenziseni i-fetus, futhi ukuphazanyiswa kuzoqala kabusha. Uma lokhu kungeke kwenzeke, kufanele ubone udokotela emahoreni angu-2-3 alandelayo. Umlingiswa we-perturbations ubonakalisa isimo somsebenzi we-fetus, ngakho-ke kuyadingeka ukuba ulalele. Uma umama okhulile eqaphela ukuthi ezinsukwini ezimbalwa zokugcina umntwana waqala ukuhamba kancane, kufanele uxoxe nodokotela ukuze uhlole ukuthi ingane izwa kanjani.
Nge-trimester yesithathu yokukhulelwa, omama esikhathini esizayo, njengomthetho, sebeyazi kakade uhlobo lokunyakaza kwezingane zabo futhi bangabona noma yikuphi ushintsho "ekuziphatheni" kwezingane. Kwabaningi besifazane, isibonakaliso esiphazamisayo siyishukumisayo esinamandla, esinamandla. Kodwa-ke, ukukhuphuka komsebenzi wemoto akuyona i-pathology futhi ngokuvamile kuvame ukuhambisana nesimo esingakhululekile somama ozayo, lapho ingane ithola oksijithi encane ngenxa yokwehla kwegazi. Kuyaziwa ukuthi uma owesifazane okhulelwe elele ngemuva noma ehlezi, elele kakhulu emuva, ingane iqala ukuhamba ngenkuthalo kunokujwayelekile. Lokhu kungenxa yokuthi isibeletho esithintekayo sinyakaza imithwalo yegazi, leyo, ikakhulukazi, ethwala igazi esibelethweni nase-placenta. Uma kucindezelwe, igazi ligeleza emntwaneni ngokusebenzisa umthamo womzimba ngevolumu encane, ngenxa yalokho, ithola ukungabi khona kwe-oxygen futhi iqala ukuhamba ngenkuthalo. Uma ushintsha isimo somzimba, isibonelo, hlala phansi ngokugxila noma ulale eceleni, khona-ke ukugeleza kwegazi kuzobuyiselwa, futhi ingane ihambe ngokusebenza kwayo evamile.
Kufanele ngikhathazeke nini?
Isibonakaliso esabekayo nesesabekayo ukunciphisa ukusebenza komsebenzi noma ukunyamalala kokunyakaza kwengane. Lokhu kusikisela ukuthi ingane ivele ihlushwa yi-hypoxia, okungukuthi, ukuntuleka kwe-oxygen. Uma uqaphela ukuthi ingane yakho isencane kakhulu ukuhamba, noma awuzizwa ukunyakaza kwakhe amahora angaphezu kuka-6, kufanele usheshe uthintane nodokotela wakho wezifo. Uma kungenakwenzeka ukuthi uvakashele udokotela emhlanganweni wesiguli, kungenzeka ukuthi ubangele "usizo lokuqala". Okokuqala, udokotela uzolalela ukushaya kwenhliziyo yesisu ngokusizwa nge-stethoscope ye-obstetric, ngokuvamile kufanele kube yi-120-160 beats ngomzuzu (ngokwesilinganiso - 136-140 ukushaya ngomzuzu). Ngisho noma ngesikhathi sokuvuthwa okuvamile (ukulalela) isigqi senhliziyo ye-fetal sinqunywa ngaphakathi kwemingcele yesijwayelekile, kubalulekile ukwenza enye inqubo - i-cardiotocography (CTG). I-KTG - indlela evumela ukuthi uhlole ukushaya kwenhliziyo kwe-fetus kanye nombuso wayo osebenzayo, ukuze uhlole ukuthi ingane ibhekene ne-hypoxia (ukuntuleka kwe-oxygen). Ngesikhathi sokucwaninga, inzwa ekhethekile eboshiwe ehlanganiswe nodonga lwangaphakathi lomzimba ngemuva kwengane ekuqaliseni kwenhliziyo yakhe. Le sensor inquma i-fetal rate rate yehliziyo. Ngesikhathi esifanayo, owesifazane okhulelwe ubamba inkinobho ekhethekile esandleni sakhe, okumele ucindezelwe lapho ezwa ukuthi ingane ihamba. Eshadini, lokhu kuboniswa ngamalebula akhethekile. Ngokwejwayelekile ekuphenduleni ukuphazamiseka, isigqi senhliziyo yesisu siyanda ukwanda: lokhu kubizwa ngokuthi i-reflex motor-cardiac. Lokhu kubonakala ngemuva kwamaviki angu-30-32, ngakho-ke ukubamba i-CTG ngaphambi kwalesi sikhathi akusizi ngokwanele.
I-CTG yenziwa imizuzu engu-30. Uma ngalesi sikhathi kungekho ukunyuka okukodwa kwenani lenhliziyo ekuphenduleni ukuphazamiseka, udokotela ucela owesifazane okhulelwe ukuba ahambe isikhashana noma izikhathi eziningana ukuze akhuphuke izitebhisi, bese eqhuba enye yokurekhoda. Uma izakhiwo ze-myocardial zingabonakali, lokhu ngokungaqondile kubonisa u-hypoxia we-fetus (ukungabi ne-oxygen). Kulesi simo, futhi, uma ingane iqala ukuhamba kabi esikhathini esingangamaviki angama-30-32, udokotela uzobeka isifundo seDoppler. Phakathi nalolu cwaningo, udokotela ulinganisa ijubane lokugeleza kwegazi ezitsheni zezintambo zomzimba nakwezinye izitsha ze-fetus. Ngokusekelwe kulolu datha, kungenzeka futhi ukuthi unqume ukuthi ngabe umntwana uthola yini i-hypoxia.
Uma kunezibonakaliso ze-hypoxia ye-fetal, ama-stracric tactics anqunywa ngezinga lobukhulu be-hypoxia. Uma izimpawu ze-hypoxia zincane futhi zingaboniswa, owesifazane okhulelwe uboniswa ukubonwa, i-CTG kanye ne-Doppler ukuhlolwa nokuhlola imiphumela yabo ku-dynamics, kanye nokuqokwa kwemithi ethuthukisa ukujikeleza kwegazi nokudla kwe-oksijeni nezondlo kumntwana. Njengoba ukwanda kwezimpawu ze-hypoxia, kanye nokuba khona kwezibonakaliso ze-hypoxia, ukulethwa okusheshayo kufanele kwenziwe, njengoba kungekho mithi yokwelapha ephumelelayo ehlose ukuqeda hypoxia yesisu. Kuzoba nokusebenza kwesigaba se-cearean noma ukulethwa kwezidakamizwa zokuzalwa zemvelo, kuncike ezintweni eziningi. Phakathi kwabo - isimo somama, ukuzimisela komsele wokuzalwa, isikhathi sokukhulelwa kanye nezinye izici. Lesi sinqumo senziwa ngumjozi wezifo ngabanye kuleso simo ngasinye. Ngakho-ke, wonke owesifazane kufanele alalele ukuphazamiseka kwengane yakhe. Uma kukhona ukungabaza mayelana nenhlalakahle ye-fetus, ungalibali ukuvakashela kudokotela, njengoba isikhalazo esifike ngesikhathi kunomdlavuza wezifo zogciwane kungavimbela imiphumela yokukhulelwa engalungile. Manje uyazi ukuthi yiziphi izimpawu zokuqala zengane ezithinta esibelethweni.