Ngokuvamile, umama wesikhathi esizayo, owaziwa ngokuthi yi-obstetric term, okungukuthi, usuku lokudilizwa ebalwa udokotela, uyabingelela esibhedlela ngala mazwi: "Uma singavali ngeviki elingama-41 - sizokhuthaza!" Maye, ukugqugquzelwa komsebenzi emithini yethu kwenzeka kaningi Kubonakala sengathi ukuxilongwa kokukhulelwa okukhulelwe kusongela isigamu sezingane, kodwa ake sibone uma kusabisa ngempela uma umsebenzi ungaqali emva kweviki elingama-41, yimuphi ingozi yokukhulelwa okungapheli ngempela? Iqiniso liwukuthi lapho ingane ingekho esibhedlela I-placenta, ehlinzeka ngokudla, ikhula, okungukuthi, ekugcineni iba yimbi kakhulu, ngoba uhlelo lwayo lokujikeleza aluklanyelwe impilo ende. zihlupheke ekuthuthukiseni kwayo: isibonelo, zinenkinga ohlelweni lwezinzwa, futhi lubukeka luzobukeka lufana nendoda endala: isikhumba ngaphandle kokugcoba, ukumiswa, "ukugeza izandla" - kusukela ekugeza okude. Yingakho kunengqondo ukuqinisekisa ukuthi ingane ayithinteki.
Izibalo zibonisa ukuthi phakathi kwezinsana ezizalwe ngemuva kwesonto lama-41 lokukhulelwa, kunezinhlanzi eziningi eziye zahlushwa esibelethweni kunalabo abazalwa ngeviki lama-38-41. Kodwa-ke, izibalo, njengoba zisho, "ukushisa okuvamile esibhedlela." Ngokuvamile, ngesonto lama-42 noma ngisho ne-43, abantwana abathandekayo nabanempilo bavela ngaphandle kokubonakaliswa okuncane kokukhuthazela, noma kunjalo, izibhedlela eziningi zisacabanga ukuze kube nomthetho: emva kwesonto lama-41, kubalulekile ukuphoqelela ukulethwa. "Ngokusobala, ingane" engavuthiwe "ngeke ihlupheke ekubelethweni okuvuselelwe, futhi ingozi yokungaphezu kweqanda kufanele igwenywe - ukuze iqinisekiswe kabusha.
Kungani kungaphumeleli?
Konke lokhu kubonakala kunengqondo uma nje sibona ukukhulelwa nokubeletha njengomkhiqizo wokuhambisa ohlobo olufanayo lwezingxenye. Eqinisweni, konke kuyinkimbinkimbi kakhulu ekugqugquzelweni komsebenzi, insizakusebenza yomsebenzi we-placenta. Ukuvuthwa kwe-fetus akuyona nje ikhono layo lokuphefumula ngokuzimela, ukuncelisa nokulawula ukushisa komzimba wayo (njengoba ochwepheshe ngokuvamile bacabanga). Kubuye kube nokuzimisela komuntu ukuvela, okuhlanganisa ukuvuthwa kwesistimu yezinzwa nezinye izinkomba ezizosiza ingane ukuba ivumelane nokuphila ngaphandle kwesisu somama. Kungani ingane eyodwa izalwa ekuqaleni, kanti enye ingemva kwesikhathi? Isayensi, ngeshwa, ayikwazi ukuphendula ngokugcwele lo mbuzo. Kukhona neze-hredity factor kule ndaba: ingane iphindaphinda umlando wokuzalwa komunye wabokhokho.
Isibonelo, abanye omama abakhulu bathi, isibonelo, umfana "uhlala" isikhathi eside futhi uthola ikhophi kayise, naye owazalwa ngeviki 42. Umzimba wengane udinga ukuhlala isikhathi eside esibelethweni ukuze uqinise okuthile bese uyagcwalisa Isici sesibili yisimo sompilo womama, isimo sakhe sengqondo, lesi sici singashintsha isimo sokuzalwa esihlotsheni esisodwa noma esinye. Isici sesithathu yiyona ekhethekile yenkambo yokukhulelwa, isibonelo, abanye omama bayazi ukuthi babeletha ngokushesha uma behola kanye nokuphila okusebenzayo futhi adle ngokufanele. Mhlawumbe owomile owayehola impilo enempilo nonina, ngokushesha walungisa ukungena kuleli zwe kunomfowabo, owayengumuntu "ovilapha" esiswini. Ngakho-ke, akuyona yonke indlela ukukhulelwa okungapheli kwamasonto angama-41 okubeka ingozi ethile kumntwana nonina. Ababelethisi abanekhono bahlukanisa ukubeletha kwasekupheleni kwaba yizigaba ezimbili: ukukhulelwa isikhathi eside (okuhlukile kwesimiso somzimba, isibonelo, kulabo besifazane abanomjikelezo omude wokuya esikhathini kwezinsuku ezingu-30-35) nokukhulelwa okukhulelwe ngempela (uma ukukhubazeka kokuzalwa kwenzeka ekubunjweni okuvamile). Kubalulekile ukuthola ukuthi kwenzekani ngempela umama nengane.
Maye, lokhu kungumkhuba
Kodwa-ke, empilweni yesimanje yezokwelapha, kulokhu futhi kaningi ukugqugquzelwa kwabasebenzi kuyasetshenziswa ngokungakhethi. Kunalokho kuphelile?
Ukulenga "usongo lokuvuselela" kuphazamisa umama futhi kumvimbele ukuba aphile impilo egcwele. Uhlala ekhungathekisa ingane, ucabanga ngokungenelela kwezokwelapha, okungukuthi, usesimweni sokucindezeleka.
Ukukhuthazwa kokubeletha kuvame ukuholela ekusetshenzisweni okuqhubekayo kwezinzuzo zezokwelapha, okungukuthi, ukubeletha kuyaphela ukuba kungokwemvelo, okuthinta isimo somama nengane. Ngokuvamile izinzuzo azikho ekudaluleni ngesikhathi esibelethweni somlomo wesibeletho, ngakho-ke kufanele uqhubekele kusigaba esiphuthumayo sokuphumula.
Ukukhuthazwa komsebenzi, isisetshenziswa somsebenzi we-placenta ngokuvamile siqala nge-amniotomy (i-autopsy ye-fetal bladder), ephikisana ngokuthi ngale ndlela kukhona ithuba lokubangela inqubo yokuzalwa ngaphandle kokusebenzisa ama-droppers. Maye, uma umntwana engazange azalwe, isidumbu somama sasingakulungele ukubeletha. Ngakho-ke, i-amniotomy ayishukumisi ukuqala kwenqubo yokuzalwa, kodwa ezimweni eziningi iqinisekisa ukucindezeleka okunamandla kumama (ngokwengqondo lokhu kuyinkqubo engathandeki kakhulu - uma umgodi wenziwa esikhwameni), kuholele emathanjeni ekhanda lomntwana (njengoba lisuswe "umcamelo wamanzi").
Ukubeletha okukhuthazayo kubangela ukucindezeleka kakhulu kunomama kanye nemvuthu, kuthwala ingozi enkulu empilweni yabo bobabili. Ukukhuthazwa kufanele kwenziwe kuphela kulawo macala uma yonke imiphumela emibi ingalungile. Akuyona into engacacile "ngemuva kwesonto lama-41 kufanele ivuselelwe," kodwa ngesimo somama othile nomntwana othile.
I-Obstetrics Yendabuko
Udokotela wezidakamizwa odumile, ososayensi, umcwaningi, uphayona lokuzalwa ngokwemvelo uMichel Auden uthanda kakhulu ukucaphuna umfanekiso osempumalanga ukuthi ngisho nangomuthi ofanayo wonke ama-apole avuthiwe ngesikhathi sakhe. Ngendlela efanayo, wonke umntwana unesikhathi sakhe siqu lapho ekulungele ukuzalwa. Akufanele ugijimise izinto, kungcono nje ukubuka ukukhulelwa okuqondile ngosizo lwamadivayisi wezokwelapha atholakalayo nezindlela zendabuko zezinkinga.
Okokuqala, kufanelekile ukutadisha ngokuningiliziwe umlando womndeni, ngangokunokwenzeka. Ukwaziswa ukuthi uyise noma umama wengane wazalwa kamuva kunenkathi yokuvimbela, kufanele uqikelele.
Kubalulekile ukuqapha ngokucophelela ukunyakaza kwezimpumputhe. Uma behlala bengashintshi ngokuvama nokuqina - lokhu kuyisibonakaliso sokuthi konke kuhamba kahle.
Ukuskena kwe-Ultrasound. Inani lama-amniotic fluid livamile? Lesi yisiqinisekiso esingu-100% sokuthi akukho ukushintshwa kweqiniso.
I-Cardiotocography ihlola isimo sempilo yezimvuthwane "ezingenalutho" futhi ihlolisise isivumelwano sokubeletha kwesibeletho.
Ukuhlolwa kwe-Doppler kukuvumela ukuba uhlulele umsebenzi we-placenta, ukugeleza kwegazi emgqeni we-umbilical futhi uhlole isimo somntwana.
Ucwaningo lwama-Hormonal. Ukuze uthole ukuxilongwa, okuqukethwe egazini le-estriol, i-lactogen ye-placental ne-progesterone inqunywa. Ngokuphikelela kwangempela, okuqukethwe kulawa mahomoni akuvamile. Izinkomba ezinikezwayo ze-cortisol, i-hCG ne-alfa-fetoprotein. Omunye angakhuluma nge-amnioscopy (indlela ephephile yokuqapha isimo se-amniotic fluid: umbala wabo, ubungako, ukutholakala emanzini amafutha okuqala).
Vumela ingane ukuba ikhule
Udokotela kufanele asabele kanjani kolwazi olutholiwe? Uma kungekho uphawu lokukhubazeka, akufanele ugijimise izinto. Uma kukhona ukwesaba ukuthi ingane ihlupheka, kufanele kusetshenziswe isigaba sokudla, futhi singagqithisi ukucindezeleka, okuyinto ephakeme kakhulu lapho kuvuselela abasebenzi.
Ngenxa yokugqugquzelwa kwengxenye ebalulekile yokuzalwa emva kwesonto lama-41, kunzima kakhulu ukukhuluma ukuthi yiziphi amaphesenti okukhulelwa kwangempela okungenzeka kube khona uma kwakungekho ukungenelela kwezokwelapha. Odokotela, ngokuvuselela abasebenzi, bathole ukuthi ingane ihlelekile futhi ibhalele yona njengesikweletu sokuvimbela ukukhulelwa okubambezelekile. Empeleni, kunzima ukuhlola imiphumela yokungenela okunjalo. Singasho nje ukuthi ukuphazanyiswa kwindlela yokukhiqiza ngaphandle kwesidingo akufanele kubhekwe njengesibusiso. Ngakho-ke, uma usongela "ukubekezela", zama ukukhuluma ngokuthula nodokotela ngokuthi kungani kubheka ukuthi kuyadingeka ukukhuthaza ukubeletha .Uma lokhu kungengenxa yokuthi "yamukelwa" futhi udokotela unezizathu ezizwakalayo zokukholelwa ukuthi umntwana uhlupheka, okusho ukuvumelanisa. Kodwa-ke, ngaphandle kwesizathu, kungcono ukulinda nokunikeza ingane ithuba lokulungiselela ukuzalwa ngendlela acabanga ukuthi kufanelekile.