Iningi labesifazane phakathi kwamasonto angu-14 no-20 lokukhulelwa bathunyelwa esibhedlela; lokhu kwenzeka lapho ukukhulelwa okuphindaphindiwe sekuqinisekisiwe kakade. Esihlokweni esithi "Ukuxilongwa kokukhulelwa okuningi kwe-uzi" uzothola ulwazi oluwusizo kakhulu kuwe.
Izinkinga ezingenzeka
Ngokucindezeleka okuningi kokukhulelwa kuvamile, ngakho-ke, ngokuvamile ukuxhaswa kokubeletha okuvamile kuyadingeka. Ezinye zezinkinga zihlotshaniswa nokucindezeleka okwenyuka kumzimba womama, okufaka:
• ukukhiqizwa kwegazi elengeziwe;
• ukushaya kwenhliziyo kaningi nokuqina;
• izidingo ezengeziwe zomsoco.
I-hypertension kwenzeka kule nkathi izikhathi ezingu-2-3 ngokuphindaphindiwe, futhi amathuba okubonakala kwawo okuqala aphezulu. Ukuthuthukiswa kwe-fetus kuze kube amasonto angama-32 ngokuvamile kwenzeka ngendlela efanayo, njengokukhulelwa okukodwa. Kamuva lesi sikhathi sandisa amathuba okuphazanyiswa kwentuthuko.
Ukuhlolwa okucacile
Ukuhlolwa kwegazi ukutholakala kwe-Down syndrome kunembile kakhulu uma kwenzeka ukukhulelwa kwamabili, kodwa ingozi ingabuyekezwa yi-ultrasound, evumela ukuthi kubonakale ukuqina kwenduku yentambo (collar space) yesithelo. Le mibuzo kufanele ixoxwe ngesikhathi sokuvakashela okokuqala kudokotela. Ngesikhathi samaviki angu-18-20, ukuhlolwa kabusha kuvame kwenziwa ukuze kuqinisekiswe imiphumela evamile. Lapho ingane isifubeni esisodwa esivamile kanye ne-placenta (ama-monochorionic twins), kukhona ingozi yesifo esingavamile lapho ukuhlanganiswa kwemithambo yegazi kungaholela ekomfuseni owodwa okukhula ngenye indlela (isifo sokumpontshelwa yi-perinatal syndrome). Izifundo zokuthola ukuthi lezo zifo zivame ukuqala ngamaviki angu-23-26.
Ukulethwa
Cishe i-1/3 yamawele izalwa ngaphambi kwamasonto angu-37 okukhulelwa, futhi ukuguqulwa komzimba kungenye yezingozi ezingenzeka kakhulu ekukhulelwe okuningi. Ubude besikhathi sokubeletha ngamawele ngamamaviki angu-37, kuyilapho izintathu zizalwa emavikini angu-35, futhi ukukhulelwa ngamathambo amane kuthatha cishe amasonto angama-28 emva kokukhulelwa. Ukulethwa kokukhulelwa okuphezulu kungenzeka ukuthi kuyenziwe ngesigaba sokudla. Ekupheleni kokukhulelwa, ama-10% amawele atholakale, ngakho-ke, isithelo sokuqala silele phansi, futhi ngaphezu kwengxenye yesithelo sesibili nayo ihlezi phansi. Kuphephile ngokwanele ukusebenzisa i-anesthesia ye-pidular ekuzalweni okuningi, futhi ababelethisi abaningi bayancoma ngenkuthalo, njengoba lokhu kuhlinzeka nge-anesthesia enhle kakhulu, uma kwenzeka usizo olwengeziwe luyadingeka. Ngokuvamile, isici esibaluleke kunazo zonke yisethulo se-fetus yokuqala. Ngisho noma kukhona isethulo se-breech ye-fetus yesibili, ukulethwa kwemvelo ngokwanele ngokwanele. Inhloko / isethulo se-breech cishe ama-25% wokuzalwa. Ngezinye izikhathi iwele lesibili lizodinga ukungenelela kokuvimbela ukubeletha noma, mhlawumbe, isigaba sokugcina. Ngezinye izikhathi kuphephile ukubeletha ngamawele amabili kusethulo sokubhubha ngendlela engokwemvelo, kodwa ngenhlanganisela ye-buttock / ikhanda, isigaba se-caesarean sivame ukuphakanyiswa. Amantombazane amathathu kanye namawele amaningi avame ukuzalwa ngesigaba sokudla. Ingozi yokumiswa kwesisu ngemuva kokubeletha ekukhuleni kwabaningi kuyanda.