Izizathu ezingase ziphoqelele abasebenzi, ochwepheshe bahlukaniswe ukuqala kokukhulelwa, ngesikhathi, ngesikhathi nangemva kokubeletha. Izinkinga eziyinhloko zixoxwa kulesi sihloko esithi "Ukuphikisana kokubeletha, ukwehluka kwenhliziyo".
Akuyona imfihlo ukuthi iningi lobulili obuhle lihlushwa yilokhu noma leso sifo esingapheliyo. Okokuqala phakathi kwezifo ezinjalo izifo zezinso, khona-ke ukukhubazeka kwenhliziyo (isifo somfutho wegazi, i-vegetovascular dystonia, ukukhubazeka kwenhliziyo). Ukuphazamisa kabi ukukhulelwa nokubeletha, izifo ezingapheli ze-bronchial and lung. Kusobala ukuthi i-leukemia ekhukhulayo neyasiguli, i-lymphogranulomatosis, isifo sofuba, isifo sikashukela, isifo sofuba, ukutheleleka nge-HIV kanye ne-AIDS "kuyingozi" yokuzala inzalo. Ukuphathwa kahle kwezifo ezithile kungancishiswa. Abesifazane abanesimo se-asthenic futhi abanesifo sokuya esikhathini ngokuvamile bangabhekana nezinkinga ekubelethweni, kulandelwa iziguli eziphethwe yi-hormonal form of infertility kanye nokukhulelwa kwesisu okungapheli. Ukwelashwa esibelethweni se-cervix, ukuxoshwa okuningi kwegciwane lesibindi emlandweni, izibazi ezisezingeni eliphezulu ngenxa yezigaba ezidlule zisezimo ezimbi.
Odokotela bakholelwa ukuthi izinkinga ekubelethweni zingabangela ukukhulelwa kwamawele nokukhulelwa okuphindaphindiwe, ama-polyhydramnios, ubukhulu bezingane zobusana, okwandisa ukucindezelwa kwe-intrauterine futhi kungaholela ekukhuleni kwangaphambi kwesikhathi kwe-amniotic fluid. I-pelvis encane yesimiso noma emitholampilo emzimbeni wesifazane, ubude besikhathi eside bendawo ye-fetus noma isethulo se-placenta kubhekisela ezinkomba eziphelele zesigaba sokulahla. Lokhu kufaka phakathi ukungalingani phakathi kobukhulu bomntwana kanye nesifuba somama, isikhundla esiphambanayo se-fetus noma isethulo sesibhamu, intambo enezintambo. Ukuzalwa kwangaphambi kokuqala nokusebenza komntwana obusanda kuzalwa, ukuzalwa kwabesifazane emva kokukhulelwa okungekho emzimbeni kanye nokudluliselwa kombungu emgodini we-uterine (i-IVF ne-PE), odokotela banamuhla babhekisela ezinkingeni. Imithi yesimanje ine-arsenal yezinto ezicebile, futhi isilinganisa ingozi yalezi zici esikhathini eside ngaphambi nangesikhathi sokubeletha.
Ngaphambi kokuqala, ngaphambi kokuqala komsebenzi, ukuphuma kwe-amniotic fluid kuyinkimbinkimbi evame kakhulu yenkathi yokuqala yokusebenza. Ngokuvame ukwenzeka nge-pelvis encane, isethulo se-pelvic ye-fetus, ukukhulelwa okuningi, uma ingane inkulu noma kukhona ukungeniswa okungalungile kwekhanda. Ukuphuma kokuqala kungomunye wezibonakaliso zenkathi yokuqala ye-pathological. Babhekwa njengelungelo "lokuqala" lokubeletha, ngokulahlekelwa kwesifuba esingaphezu kwamahora angu-6-8. Ihambisane nazo ngezingqinamba ezingavamile, ezibuhlungu, eziphazamisa isigqi sokulala nokuvuka. Futhi ukukhathala kubangela ukusebenza. Awuholeli ekuvuleni komlomo wesibeletho futhi abangela i-intrauterine hypoxia ye-fetus. Le nkinga yokuletha kwezidingo iningi kakhulu kulabo asebekhulile nabancane abancane, abakhuluphele kakhulu, besifazane abangenakulinganiswa nabesabekayo, kanye nalabo abangenayo imithi mayelana nokukhulelwa kwabo. Isikhathi sokuqala sokulimala siyingozi ngoba singangena kunoma yiluphi uhlobo lwezinkinga zomsebenzi. Kodwa-ke, ngokuvamile emva kokuhamba kwamanzi, ithoni yebele isinciphisa, futhi inqubo yokubeletha iyathuthuka. Ngalokhu imigomo udokotela angasebenzisa i-amniotomy - ukukhishwa kwesibindi sesisu.
Olunye uhlobo lwezifo lomsebenzi lubuthakathaka balo. Kuyinto eyinhloko futhi eyesibili. Esikhathini sokuqala, owesifazane ungena ekubelethweni ngokunyuka okubuthakathaka. Okwesibili - ngemuva kwesikhathi sokusebenza komsebenzi okhulayo webelemba ngokungazelelwe kwehlisa amandla. Ukudalulwa komlomo wesibeletho kuyancipha, futhi umsebenzi ubambezelekile. Isizathu sivame ukutholakala okwanele kwezinto eziphilayo zokubeletha, izifo ezithathelwanayo, izifo ezivuvukalayo zezocansi kanye nokukhipha isisu ku-anamnesis, isisindo esiningi, inkambo eyinkimbinkimbi yokukhulelwa, ukukhathala ekubelethweni. Abesifazane asebekhulile nabancane, abesifazane besifo sikhukhukazi (ngenxa yokukhulelwa, isisu esikhulu, ukuzala okunengi, ukuchelela okuningi), i-mnogogorazhie, ehlukunyezwa kokuya esikhathini nokulinganisela kwe-hormone nayo isengozini.
Ukubeletha ngokuhlukana kwesisu esibelethweni (izinsuku eziningana ubude) kuholela ekukhatheni kowesifazane futhi kuvame ukucindezeleka ngobuthakathaka. Njengomthetho, ubuthakathaka bomsebenzi buhambisana nokuntuleka kokudalulwa komlomo wesibeletho. Ukulala - umuthi omuhle kakhulu, futhi ngesifo esifanayo, abesifazane banikezwa ukuphumula, basebenzisa ukuphumula nokuxhunywa. Njengomthetho, ngemuva kwalokhu inqubo isungulwa yedwa. Uma kungenjalo, iziphazamiso ze-uterine zithuthukiswa nge-oxytocin ne-prostaglandins ngaphansi kwesembozo se-epidural anesthesia. Uma yonke imizamo odokotela ingenalutho, lo wesifazane unikezwa isigaba se-cearean. Inkinga ephikisanayo - umsebenzi obhekene nokusebenza ngokweqile - uyabonwa ngokuba khona kwezimpi ezinamandla nezinde. Ukubeletha kungadlulela amahora angu-1-3. I-kid ishesha kakhulu ukungena emgodini wokuzalwa, ikhanda layo alinaso isikhathi sokumiswa, ingozi yokuhlukunyezwa kokubeletha ne-hypoxia iphezulu.
Ngomama, lezi zinhlobo zokubeletha nokuhlukana kwesibeletho ziyingozi ngokuhlukana komlomo wesibeletho, ubulili, i-perineum kanye nesisu. Inqola yangasese ye-placenta ingase ivele, okungabangela ukuphuma kwegazi. Njengama-preliminary eside, umama uphathwa ngokulala ngokugwinya, i-epidural anesthesia isetshenziswa. Ngokuvamile odokotela benza isinqumo mayelana nesigaba se-amniotomy nesesifo sokudla. Kwenzeka ku-1-3% amacala okubeletha. Kulesi simo, izilinganiso zokuqhaqha kwezibeletho zingavamile, zihlasele, izikhathi eziphakathi kwezingqinamba zihleliwe. I-Dangerous ingahle ibe ukuhlukana kwe-perineum nokungafani emhlangweni we-pubic. Ngokuvamile, ukuze ugweme imiphumela emibi kangaka, udokotela ngesikhathi sokubeletha wenza isinqumo sokusika i-perineum (i-episiotomy - i-cut from central perineum kuya ohlangothini, i-perineotomy - ukusika ngakwesokunxele kwe-anus). Manje siyazi ukuthi kunenkinga yokubeletha, ukuhlukana kwenhliziyo.