Le nkathi ihlala cishe amahora angu-7. Ngokokuqala ngqa ukulwa okulungiswayo kungabambezeleka, okusho ukuthi bazovimbela umama ozayo ukuba aphumule futhi athole amandla "umsebenzi" ozayo. Khona-ke udokotela uzokwethula imithi yokwelapha ukuze ikwazi ukulala. Kuwo wonke umama, owokuqala, ukubeletha okwesibili nje kuphela, imininingwane - esihlokweni esihlokweni esithi "Ukuzalwa kokuqala kuhluke okwesibini."
- Isikhathi sokuqala - ukuvulwa komlomo wesibeletho
Lokhu kwenzeka uma isigaba sezinyathelo zokulungiselela sithatha isikhathi eside futhi sikhathele umama olindelekile noma amniotic fluid egijima ngaphambi kwesikhathi. Kulesi simo, udokotela uyomnika ikhambi lokudambisa ukuvumela ukuba aphumule futhi abuyisele isigqi. Kubuye kwenzeke ukuthi ngesikhathi sokubelethwa komlomo wesibeletho, umama we "debutante" akakulungeli, okungukuthi, awunambitheli futhi awufinyezi. Kulokhu kusizwa yiziphazamiso: zihlala njalo futhi zikhulu. Ngaphansi kwesenzo sabo, intamo ithambile, ifinyelelwe futhi ivuliwe kancane. Intamo ifana nethubhu enezinyathelo ezimbili: owokuqala "uvale" ukungena kwesibeletho (lapho, umntwana ugeleza emanzini amniotic), kanti enye - "ukuphuma" ngaphandle. Yile nqobe yokugcina ethwala umthwalo omkhulu ngesikhathi sokubeletha: kufanele ivule kaningi ukuze ingane idlule. Ukuze kucaciswe, cabanga ibhaluni yomoya (isibeletho), umlenze (umsele womlomo wesibeletho) ohlanganiswe nezintambo ezimbili (ukungena ngaphakathi nangaphandle komlomo wesibeletho). Isikhathi sokuqala sokuba "omama ongenalwazi" sithatha amahora angu-12-18 (lokhu kufaka ama-7 okulungiselela), ngesikhathi sokuzalwa okulandelayo kuthatha amahora angu-6-8. Ngesikhathi sokuqala isigqi sokulwa kulezi zigaba singaphambukela emvelweni, khona-ke siba mfushane, esingavamile, kanti umlomo wesibeletho njengesizathu asivuli. Khona-ke udokotela uzoqala ukulungisa umlomo wesibeletho ngosizo lwemithi, isibonelo i-gel, ehlanganisa izinto eziphilayo ezisebenzayo - i-prostaglandins, noma amakhandlela anezinto ezithobisa imisipha yakhe.
- Isikhathi sesibili - ukuzalwa kwengane
Iqala ngomzuzu wokuvulwa okugcwele komlomo wesibeletho futhi uphela ngokuzalwa kwengane. Ngalesi sikhathi, izibhamu ziyaqina kakhulu, futhi imizamo yenezelwa kubo. Inhloko yengane icindezela emisipha yecala lomzimba wesifazane, igxeka ukuphela kwesibindi, lapho isifiso esingenakubekezela khona sokunamathela. Isikhathi sesibili sithatha isikhathi eside "kubaqaphi", kusukela ku-1 ihora kuya ku-2. Lokhu kubangelwa ukuthi abesifazane aba ngumama okokuqala, imisipha ye-pelvic floor, izicubu zomzimba zingaphansi, okusho ukuthi abazimisele kakhulu ukwelula nokwenza okuningi ukumelana nokuzalwa kwengane. Ngenxa yalesi sizathu, ukuhlukumezeka komsele wokuzalwa ku-"debutant" kwenzeka izikhathi ezingu-2-3 kaningi. Ukuze uvimbele lokhu, udokotela uhlalisa izicubu ukuxuba. Isikhathi sesithathu ukuzalwa kokuzalwa. Iqala ngokubonakala komntwana bese iphela ngokuzalwa kokuzalwa (okungukuthi, i-placenta ene-fetal membranes). Isikhathi sesithathu siphezu kwemizuzu engu-5-10. Phakathi nalesi sikhathi, isibeletho sincishisiwe, siwela phansi kweveli, yingakho uxhumano lwawo ne-placenta luphukile, ludlulela futhi, ngosizo lwezimpi, luxoshwa ngaphandle kanye ne-membranes. Ayikho umehluko othize lapho "omama abangenalwazi" naba "abanolwazi" bahlangabezana nalesi sikhathi, cha. Ukubelethwa kwemvelo okuphindaphindiwe kunabo okukhethekile. Ngodonga lwangaphakathi lomzimba kanye nodonga lwangaphakathi lwesibindi emasimini anjalo abasawohloka kakhulu, ngakho-ke ikhanda lomntwana, elikude nokuphuma, kuze kube sekuqaleni kokulwa, lingase lihlale lihamba ngeselula ngaphezu kokungena kwesikhumba, kunokuba licindezelwe kulo, njengesikhathi sokulethwa kokuqala. Ngenxa yalokhu, owesifazane akazizwa sengathi uthanda "isisu sehlile" - ngokuvamile kwenzeka emavikini amabili ngaphambi kokuzalwa. I-cervix ngenkathi ibuyisela izivuthwane lula futhi ngokushesha. Okungaba yibo kuphela abomama abazobhekana nokulimala kanzima ngesikhathi sokubeletha kwangaphambilini. Ngenhlanhla, manje izimo ezinjalo azivamile. Uma ukuhlukana komlomo wesibeletho kungukuphela kwayo futhi akuzange kuphulukise noma isibazi sibonakala endaweni yaso, odokotela bangakwazi ukuqondisa lo wesifazane esigabeni esilungisiwe sokuqeda. Ukudalulwa komlomo wesibeletho ngesikhathi sokusebenza okuphindaphindiwe kuyashesha futhi kuthatha amahora angu-6-8. Kanye kanye nokulwa kokuqala, kokubili ukuvulwa nokunciphisa umlomo wesibeletho kuqala.
Ngenxa yokuthi ukubeletha okuphindaphindiwe kuyashesha futhi isiteji lapho izinkinga ziba buhlungu azihlali isikhathi eside, isidingo sokuba i-anesthesia engathà sina ivela kancane kakhulu. Uma ingane ezalwa ingadluli ngokweqile ubukhulu bokuqala futhi ilungile, isikhathi sesibili sokusebenza sibuyela ngokushesha . Ingane ihamba "eduze komkhondo oshaywayo", futhi uma okokuqala kusukela ngesikhathi sokudalulwa okuphelele kombelethisi ngaphambi kokuzalwa komntwana ngokuvamile kuthatha amahora angu-1-1.5, bese kuthi ngemva kwemizuzu engu-20-30. Ama-analgesics asetshenziselwa kaningi kakhulu i-analgesia, ajojelwe kanye nge-intramuscularly noma nge-intravenously. Ukulimala komlomo wesibeletho kanye ne-perineum ngesikhathi sokusebenza okuphindaphindiwe kungavamile ukudlula isikhathi sokuqala, uma nje izicubu ezithambile zingekho. Yiqiniso, konke ukukhulelwa nokubeletha kuyisivivinyo somuntu wesifazane. Futhi ukuzalwa kokuqala, uma nje bekhula ngokwemvelo, kusalokhu behlala njalo bekhumbuza umama osemncane njengomsebenzi onzima, kuyilapho lo mdlalo ushiya umuzwa wokungaboni kahle nokukhathala. Manje siyazi ukuthi ukuzalwa kokuqala kuhluke kanjani kwesibili. Futhi izinsana, ngenxa yokuthi ukunyakaza ngokusebenzisa i-canal yokuzalwa kuyashesha, ngokuvamile kusebenza kakhulu futhi kungcono ukuthatha isifuba ekudleni kokuqala. Njengoba konke ukuzalwa okulandelayo kukhulisa ingozi yokuphuma kumama osemncane, isimo sabazali abanolwazi olusesigaba sesithathu sokusebenza kanye namahora okuqala ngemva kokuphothula iziqu, udokotela nombelethisi baqaphe ngokukhethekile. Ezinsukwini zokuqala ngemva kokulethwa okuphindaphindiwe, abanye besifazane babona ukuhlukumeza okubuhlungu kwesibeletho, ngezinye izikhathi ngisho nokudinga i-analgesia emnene. Kodwa-ke, le mizwa idlula ngokushesha, futhi ukukhathala okuncane okuvela kule nqubo kanye nokuhlangenwe nakho okuzuzwe ekunakekeleni izibulo kusiza abesifazane ukuba baqinise ngokushesha.