Zingaholela ekugezeni kwegazi okungenele ezinganeni futhi zingabungozi kokubili umama nengane. Kulesi sihloko esithi "Ukuphuma kwamanzi ngesikhathi sokukhulelwa" uzothola ulwazi oluningi oluthakazelisayo nolusizo.
Izimbangela
Kunezimbangela eziningana zokuphuma kwezingane ngaphambi kokubeletha. Ukuxilongwa okuyinhloko kwenziwa ngenxa yokuqina kwabo kanye nokuba khona kwamanye izimpawu, iningi lazo alivumi futhi liqale ngokuzumayo. Noma yikuphi ukuphuma kwegazi ngesikhathi ukhulelwe, kufanele uxoxe nodokotela ngokushesha. Umthombo wokuphuma kwegazi ngokuvamile uyisitsha se-placenta noma umlomo wesibeletho. Kubalulekile ukukhipha indawo ephansi ye-placenta emgodini we-uterine (praevia).
• Ukukhipha isisu kusuka esibelethweni
Ngesikhathi sokukhulelwa, kungaba khona i-ectropion ye-cervix (ukuguquka kwebhubhiso elimangcwabeni lomsele womlomo wesibeletho). I-membrane yamangcwaba yomsele womlomo wesibeletho inomthelela kakhulu futhi ingahamba. Lokhu kuphuma kwegazi ngokuvamile kuvamile futhi kuvame ukuvela ngemuva kocansi. Ukuthuthukiswa kwe-ectropion kungabangelwa ukutheleleka okuhambisana ne-pathological excretions kusukela kwesifazane.
• I-Placenta praevia
Isethulo se-placenta sibhekisela ekunamathiselwe kwayo engxenyeni ephansi ye-uterine ngesikhathi sokubeletha kwamasonto angaphezu kwangu-28. Ngaphambi kweviki lesishiyagalolunye lokukhulelwa, owesifazane wesithupha ngamunye unendawo ephansi yokungena. Kodwa-ke, njengoba umthetho, njengoba ubukhulu besisu bukhula, isikhundla se-placenta sishintsha, futhi ezimweni eziningi ngeviki lama-28 kunqunywa ngaphansi kwesibindi. Ukuphakama kwe-placenta kuvame kakhulu kulabo ababhemayo abaye bathola ukulethwa kwezidakamizwa nakwabesifazane abadala.
• Inqola yangaphambi kwesimiso se-placenta
Ngenqoqo yangaphambi kwesikhathi, i-placenta ihlukaniswe nodonga lwe-uterine. Lezi zifo zihlanganisa imiphumela embi kakhulu emntwaneni, ikakhulukazi uma kutholakala isayithi elibanzi. Ukweqa kungaba nzima ukuzalwa ngaphambi kwesikhathi. I-detachment yengxenye ebalulekile ye-placenta idinga isigaba esincane se-caesarean, ngoba kulokhu ukugeleza kwegazi ku-fetus kuphazanyiswa. Ngensiza yendawo encane, ukulethwa kwezimo eziphuthumayo akukwenziwa, kodwa isimo somama nesisu kufanele sihlolwe ngokucophelela.
• I-Edge ye-placenta
Ukukhipha igazi kungase kwenzeke lapho i-placenta isendaweni eseceleni. Ngokuvame ukuthi liphansi kakhulu futhi alilimazi umama nesisu. Ukuxilongwa kwenziwa ngemuva kokukhishwa kwesifo somlomo wesibeletho, previa kanye nokuthungatha isikhathi esingaphansi kwe-placenta. Njengomthetho, ukuphuma okunjalo kuyeka kalula. Ukunquma imbangela yokugaya ngesikhathi sokubeletha, ukuhlolwa okuphelele kowesifazane okhulelwe kuyadingeka. Ukuhlola isimo somama nesisu, kunezindlela eziningana ezisetshenziswayo. Noma yikuphi ukuphuma kwegazi ngesikhathi sokukhulelwa, owesifazane kufanele ahlolwe ngokushesha udokotela. Kungenzeka ukusola imbangela yayo kakade ekuhlolweni - isibonelo, ngokuphazamiseka kwamapayipi, isibeletho sinzima kakhulu futhi sibuhlungu, nge-placenta previa, isisu ngokuvamile sithatha isikhundla esingalungile (isethulo sokungena kwe-fetus) futhi ikhanda lakhe alifaki emgodini we-pelvic.
Ukuhlolwa kwama-vaginal
Ukuhlolwa kwama-vaginal kwenziwa kuphela ngemva kokukhishwa kwe-placenta isethulo ngosizo lwe-ultrasound, ngoba ngale ndlela yokukhubazeka ingabangela ukuphuma kwegazi okukhulu. Uma ukuhlolwa kwesisu kungabonisa ukuthi isifo sofuba somlomo, isibonelo ectronion. Ukuze unqume ukwakheka kwamaselula, igazi labesifazane abakhulelwe lihlaziywa. Kudingeka futhi ukhethe igazi lomnikeli ngokumpontshelwa igazi esimweni esiphuthumayo. Ngokuvamile, i-catheter enezinyosi ifakwe owesifazane okhulelwe.
Ukuhlolwa kwe-fetus
Ukuhlola isimo se-fetus, i-cardiotocography (CTG) eyenziwa, ebhalisa umsebenzi wayo wenhliziyo. Ukweqa okuvela e-placenta kungase kuhambisane nezinqamulelo ezingavunyelwe ukwelashwa. Ngosizo lwe-cardiotocograph, ukuphambana kokuqala kanye nezimpawu zokuzalwa ngaphambi kwesikhathi kungabhalwa. I-Ultrasound isetshenziselwa ukukhipha i-placenta previa nokugcina ukuthuthukiswa nomsebenzi we-fetus. Owesifazane okhulelwe ophuma ngegazi uvame ukuthunyelwa esibhedlela ukuze aqaphele. Ngokuvamile kukhona ukuphuma kwegazi okuphansi kakhulu, okuyinto eyekela ngokwabo (kuphela ukulawulwa kwesimo phakathi nosuku kuyadingeka). Kodwa-ke, nge-placenta previa, kunzima ukwenza noma yikuphi ukubikezela, futhi iziguli eziningi zidinga ukuhlala esibhedlela isikhathi eside. Ingozi enkulu yokukhula kwegazi enzeka kakhulu lapho i-placenta igqokisa umlomo wesibeletho. Lokhu kwenza kube nzima ukulethwa kwemvelo, ngakho-ke abasebenzi bezokwelapha kufanele balungiselele ingxenye yesimo esiphuthumayo.
Ukuzalwa kwangaphambi kwesikhathi
Ukuphuma kwamanzi kwanoma yiluphi uhlobo lwe-etiology landisa ingozi yokubeletha ngaphambi kwesikhathi - ngokuzenzekelayo noma okufakelwayo, ngesigaba sokudla. Inkinga ebaluleke kunazo zonke emitholampilo yengane engakafiki kusengaphambili ukungaqali kwamapayipi. Esengozini yokuzalwa ngaphambi kwesikhathi sokuzalwa kwe-steroids kunqunyelwe ukusheshisa ukuvuthwa kwamapayipi e-fetal. Kuphephile ingane engakazalwa.
Izinhlobo zegazi
Cishe owesifazane oyedwa kwabayishumi nanhlanu unomthelela omubi wegazi. Ukuvimbela ukungqubuzana kweRhesus ngesikhathi sokukhulelwa okulandelayo, lezi ziguli zinezijovo ezinqunyiwe zokulwa nama-anti-D immunoglobulin zingakapheli amahora angu-72 ngemva kokuphuma kwegazi.