Odokotela abaningi bokukhulelwa babhekwa njengesimo esidinga ukuqapha okusheshayo. Iqiniso lokuthi umzimba wesifazane uhloswe ngokwemvelo ukuthwala okuvamile kwengane eyodwa ukukhulelwa okulodwa, ukuze izingane ezimbili zingabi ne-oksijeni kanye nezakhi zomzimba okwanele, ziba ndawonye, futhi lokhu kwandisa ingozi yezinkinga ezihlukahlukene.
Ababili noma eyodwa?
Ukuhlolisisa ukuthuthukiswa kwe-intrauterine kokukhulelwa okuningi kungenzeka kakade ezinyathelweni zokuqala. I-Ultrasound ingathola ukuthi kuneqanda lesibili lesisu lesikhumba esikhathini esingamaviki ayisishiyagalombili kuya kwangu-12, kodwa umphumela wezinhlolo zokuqala awusakwazi ukubhekwa njengokugcina. Kunezimo lapho izithelo zihlelwe khona ukuze umuntu efihle okwesibili ngemuva kwabo, futhi ukutholakala kwamaqanda amabili e-fetal akusho ukuthuthukiswa okugcwele. Ku-1 trimester, cishe u-15-20% wokukhulelwa okuningi kuba umzali ongayedwa ngenxa yokufa kwesinye seqanda - liyeka ukukhula futhi lihlala esibelethweni kuze kube sekuzalweni.
Ngaphansi kokuqondisa
Uma lolu cwaningo lubonisa ukuthi akukho mntwana oyedwa oqale ukuthuthukisa, umama wesikhathi esizayo kuzodingeka avakashele ukubonisana kwabesifazane kaningi kunabanye. Ku-trimester yesibili - njalo ezinsukwini eziyishumi, naku-3 - njalo ngesonto. Ngaphezu kwalokho, lona wesifazane kufanele azinakekele impilo yakhe futhi alandele isimo sakhe, aqale ngesisindo (uma ekhulelwa kaningi, kufanele akhule ngaphezu kokuvamile - ukwanda okwenziwe izinyanga ezingu-9 kungafinyelela ku-18-20 kg) futhi kuphelile izimpawu ze-toxicosis, i-anemia, ukwephulwa kwezinso, inhliziyo.
I-anemia ingenye yezinkinga ezivame kakhulu lapho uphatha amawele. Nge-anemia, inani lamaseli abomvu abomvu (amangqamuzana egazi abomvu) ne-hemoglobin (i-oxygen transferring substance) egazini yehla njenge-anemia, ngenxa yalokho, owesifazane ngokushesha ukhathele, uhlale ezwa buthakathaka, ikhanda lakhe liphenduke lingcolile futhi isikhumba sakhe siphenduka, i-dyspnea, i-palpitations yezinhliziyo, ezimweni ezinzima, ibuye ilahlekelwe ukwazi ngemva kwemithwalo encane.I-anemia evame kakhulu eyenzeka ngokuntuleka kwensimbi, kanye ne-vitamin B 9 (folic acid), kokubili izinto zidinga ukuthuthukiswa nokukhula kodwa ikakhulukazi i-placenta.Uma ukukhulelwa okuvamile ingozi ye-anemia iyingcosana (ikakhulukazi uma uthatha imithi ekhethekile - ukudla okuvamile akukwazi ngaso sonke isikhathi ukukhokhela isidingo sensimbi esengeziwe), khona-ke lapho kukhona amawele kukhulisa ngokuphawulekayo, futhi ngokuphindwe kathathu ngaphandle kokuvimbela ukuphelelwa isikhathi kwegazi kuyinto engenakugwemeka. Yisiphi isengozi? Isikhathi esisodwa nesigamu esingaphezu kwamathuba amaningi okuvela ku-toxicosis, ingozi yokukhulelwa kwesisu ikhuphuka ibe ngu-40%, izinkinga zenzeka kaningi ngesikhathi sokubeletha, kungase kube nezinkinga zokuncelisa. Izingane ezibelethwe umama ohlushwa yi-anemia zingase zigule (zine-immunity encane), zijwayele izifo eziqeda ukugula.
Ungakugwema kanjani izinkinga?
- Gcina ithrekhi yesimo sakho, ngokuhamba kwesikhathi, xhumana nodokotela wakho.
- Thatha ukuhlolwa - i-anemia inqunywa ukuhlolwa kwegazi njalo.
- Thatha imithi enqunyiwe. Iqokwe ngokuqondile! Akuzona lezo umuntu owake wabhala, ozibonele ekukhangiseni ... Okokuqala, amalungiselelo ensimbi abesifazane abakhulelwe anemininingwane yabo siqu, futhi okwesibili, umthamo wesimame esizayo ukhethwe ngabanye, ngokusekelwe emiphumeleni yokuhlaziywa kanye nokujwayelekile isimo. Ungazitholi ukulinganisa umthamo: uma umuthi ubangela isicashu (ikakhulukazi okwenzekayo, ngempela, ne-toxicoses), udinga ukubona udokotela futhi ucele ukuthi uthathe omunye umuthi. Uma ungakwazi ukugwinya iphilisi nhlobo, kuzodingeka wenze izijovo. Futhi ngokuqinisekile umuntu akumele athembele ekudleni kwegazi kuphela "kokudla okunezinsimbi" .Izithelo nemifino, lapho kuleso simo "kunquma" abantu abahlukahlukene abahlakaniphile, ngokuvamile, bayasiza, nje ukuhlinzeka ngensimbi ne folic acid eziningana ezinjalo, okuyinto edingekayo yokukhulelwa okuningi, kudinga kudliwa ngaphezu komuntu onamandla kunabo bonke futhi onamandla kakhulu.
I-toxicosis ezayo
Ukukhulelwa kwabesifazane abane-intrauterine ukuthuthukiswa kokukhulelwa okuphindaphindiwe kwenzeka kaningi izikhathi eziphindwe izikhathi ezine kunamacala ajwayelekile. Kusukela evamile kuya ku-toxicosis amaningi ezinkathini zokuqala, kuyahluka, ngaphezu kwakho konke, ngoba kungabangela izinkinga eziningi ezinganeni kunomama. Nge-gestosis, i-nausea nokuhlanza akukwenzeka njalo, kodwa kukhona ukuvuvukala okufihliwe, amaprotheni avela emcimbini, ukuphakama kwengcindezi yegazi, futhi okubaluleke kakhulu - i-toxicosis ithinta i-placenta, iphazamise ukuhlinzekwa okuvamile kwengane (noma izingane) nge-oksijeni nezakhi. Yiqiniso, lena akuyona indlela engcono kakhulu yokuthinta ukuthuthukiswa, futhi ikakhulukazi (ngokufaka imigomo ye-akhawunti) - ohlelweni lwezinzwa. Futhi ukuzalwa kwabesifazane abane-gestosis ngokuvamile kuyinkimbinkimbi ...
Ukuqokwa kwesifo se-toxicosis sekwephuzile kungazuzwa njengefa, kodwa bonke abesifazane ababeletha kakhulu kakhulu (ngaphansi kweminyaka engama-18) noma kamuva (ngemva kweminyaka engama-35), ngokuvamile (phakathi kokuzalwa kwezingane ezingaphansi kweminyaka emibili ubudala), omama abanabantwana abaningi nge-multiple, futhi ngokukhulelwa okukodwa-ngokukhulelwa kwengane ngayinye ingozi iyanda). Ukucindezeleka okunamandla noma okuqhubekayo komama ozayo, impikiswano ye-Rh, ukucindezeleka komzimba kanye nezinye izifo nazo ziyizici ezingathandeki kakhulu.
Ibonakala kanjani? Esinye sezibonakaliso zokuqala ze-gestosis kungaba ukoma okunamandla, futhi isiguli siphuza amanzi amaningi (futhi ngokujwayelekile oketshezi - uma ubala, kufanele ucabange kokubili izitsha zesikhumba nazo zonke iziphuzo), kodwa umchamo ungaphansi kakhulu. Lokhu kubonisa ukwephulwa kwamanzi okusawoti emanzini: iningi lamanzi alisusiwe emzimbeni, kodwa lihlala emathisini kanye nezimbangela ze-edema esivamile. Uma ukuvinjelwa kokuphuza kanye nosawoti ekudleni akusizi, uma kunesihlungulu, ikhanda, isizungu, umfutho wegazi ophakeme, kufanele uthintane nodokotela ngokushesha bese ulandela yonke imiyalelo yakhe. Kuze kube sesikhungweni esingaba khona esibhedlela - ngokukhulelwa okuvamile ngokujwayelekile, kufanele ulungele ukuthi lesi sifo ngokushesha noma ngokuhamba kwesikhathi singadingeka ngenxa yezinkinga ezihlukahlukene, ngisho noma konke kujwayelekile, sekusele amasonto amabili ngaphambi kokuphela kwesikhathi sokubeletha, odokotela bangathatha owesifazane okhulelwe ngaphansi ukuqondisa kwakhe njalo futhi uqale amalungiselelo okubeletha.
Ukuvimbela igestosis
Sekuyi-trimester yesibili (futhi ngokuqinisekile ngokuphelele - engxenyeni yesibili yokukhulelwa), kuyadingeka ukuba wenqabe izitsha ezibandayo nezinobucayi, kusukela ezikhathini ezivundiwe, ezibhemayo kanye nosawoti. Isimo sokugcina ngezinye izikhathi kunzima kakhulu kunomama abalindele, kodwa, maye-nakanjani, kungenjalo kuyoba nzima ukugwema i-edema. I-chocolate kuzodingeka ishintshwe namanye amaswidi - ngenxa yethonya elinamandla ohlelweni lwe-cardiovascular. Yidla kahle, uhambe emoyeni omusha njalo futhi ugweme ukucindezeleka ngangokunokwenzeka - omama abalindele amawele, udinga ukuzibuka ngokwengeziwe kunabanye.
Kulungile
Kusukela nge-trimester yesibili, inkinga eyodwa ebaluleke kakhulu kumele ihlolwe: kungenzeka ukuthi ukukhulelwa kwesisu nokuqeda ukukhulelwa. Ngokwezibalo, abesifazane abangaba ngu-50% abanokukhulelwa okuningi babhekene nosongo lokulethwa kwesikhathi ngemuva kwesinye isikhathi noma esinye isigaba sokubeletha. Kukholelwa ukuthi lokhu kungenxa yokwelula ngokweqile kwezihlungwini ze-uterine ezibangelwa ivolumu eliningi kakhulu. Ngakho-ke, nganoma yiluphi ubuhlungu emhlane ongezansi nangaphansi kwesisu, umuzwa wokuhlukumeza esibelethweni, ukunganaki okungazelelwe, kufanele ufune usizo lwezokwelapha ngokushesha, futhi uma kudingeka, uye esibhedlela ukuze ulondolozwe: kungenzeka ukuthi odokotela kuzodingeka bathathe izinyathelo eziphuthumayo zokuyeka ukubeletha kwasekupheleni futhi banikele ithuba lokuba izingane zikhule ngendlela evamile. Ungakugwema kanjani izinkinga?
Kusukela emavikini angu-20, udinga ukuyeka ukudlala ezemidlalo (izinhlobo ezisebenzayo ikakhulukazi). Mhlawumbe udokotela uzakutusa ukunciphisa ukuphila kocansi (kuthinta kakhulu isimo sesisu), uma kunokwenzeka - ungasebenzi (futhi ikakhulukazi ungalishiyi isikhathi sekhefu lokubeletha, okuyinto uma ukukhulelwa okuningi kunikezwa kusukela ngesonto lama-28) ngaphandle kokulala ubusuku bonke amahora angaphansi kwama-4-6, futhi ekupheleni kwesikhathi - kuze kube amahora angu-8. Ungaphuthelwa ukuvakashelwa kokubonisana kwabesifazane. Okungenani kanye njalo ngemva kwamasonto amabili, umjozi wesifo somzimba kufanele anqume isimo sesisu, ikakhulukazi umlomo wesibeletho: uma uqala ukufinyeza ngaphambi kweviki lama-23, lokho okubizwa ngokuthi umgogodla wesibeletho somlomo wesibeletho kwenziwa - kusetshenziswe iziqu ezizokwehlisa ubungozi bokuzalwa ngaphambi kwesikhathi. Ngezinsuku ezedlule, ama-tocolytic agents asetshenziselwa injongo efanayo - amalungiselelo okwelapha akhethekile.
Sekuyisikhathi sokubeletha
Ukukhulelwa okuphindaphindiwe, imigomo embalwa yangaphambili yomsebenzi iyisici - lokhu kufanele kukhunjulwe futhi kungalingani ezinhlelweni zethu zokubala okuvamile. Ngempela, ekupheleni kokukhulelwa, izinsana esiswini sikamama zivele zingabi nesikhala, i-oksijeni, noma ukudla okunomsoco, futhi sezivele zithuthukile ngokwanele ukuze ziqhubeke zikhona ngaphandle komzimba womama. Imvelo iye yazinakekela izingane ezinjengoba kungenzeka: uma kwenzeka ukukhulelwa okuvamile ngokujwayelekile, abantwana abathuthuka ngesikhathi esifanayo - ekuqaleni kwe-placenta yabo "ubudala" futhi yonke inyama yesifazane ilungiselela ukulethwa.
Ngezintathu, i-term evamile yokuzalwa ngamaviki angu 34-36 okukhulelwa, amawele anexesha elincane - kuze kube amasonto angu-36-38. Amaphesenti angama-50% azalwe ngesisindo esanele (ngamanyathelo avamile) - kufika ku-2.5 kg, kanti phakathi kwezingane lapho kungase kube khona umehluko ngesilinganiso samagremu angu-200-300. Uma ngaphezulu (kufika ku-1 kg), lokhu kubonisa kakade izinkinga nentuthuko omunye wabo, kodwa ekhaya lwanamuhla lokubeletha futhi le nkinga ngokuvamile ixazululwe: umehluko usayizi uvame ukubonakala ngokucacile nge-ultrasound, futhi i-neonatologist izolungisa konke okudingekayo ukuze kusize ingane engakafiki. Ake siqaphele ukuthi izinkinga eziningi ziletha izingane ezinkulu nje - kunezimo lapho khona lapho ama-fetus amabili athola isisindo esingama-5-6 kg, ngakho-ke futhi i-вынашивание iyanzima kakhulu (ukuthi akumangalisi-esibelethweni kubalulekile ukulayisha okukhulu), nokubeletha ngaphandle kosizo lwabahlinzayo ngokuvamile akwenzeki.
Ngokuvamile, leyo nqubo yokulethwa akuyona eyodwa, kodwa izingane eziningana, yiqiniso, ziyinkimbinkimbi kunokuba zijwayelekile. Ngakho-ke, lapho silungiselela ukwamukelwa kwezintathu (ukungasho ukuthi ukwengezwa kokuningi komndeni) odokotela ngokuvamile batusa isigaba sokugcina. Amawele ngokuvamile abeletha ngendlela efanayo nayo wonke umuntu, nakuba kungenzeka kube nezinkinga. Kungcono ukungalahli ingane uma odokotela behlinzeka nge-anesthesia ye-epidural: uma kwenzeka izinkinga ezingalindelekile, lokhu kuzosindisa isikhathi.