Ingozi yokubambisana nge-pelvic presentation ye-fetus
Okokuqala, ukuphela komzimba (noma umpristi) wengane kuncane kakhulu ngokwevolumu kunhloko yayo. Ngakho-ke, icindezela kancane kancane engxenyeni engezansi yesibeletho. Isibeletho siphendula okubi kakhulu, futhi umlomo wesibeletho uba mbi kakhulu. Ieto konke kunciphisa ukuzalwa futhi kuholela ekubuthakathaka okuvamile.
Okwesibili, inhloko yengane ekukhulelweni kokubeletha inganakwa, futhi lokhu kuvame ukuholela ekulimaweni.
Ngokuvamile kukhona ukwephulwa kocingo oluphakathi komdonga womsele ongumuthi kanye nekhanda, ukuphonswa kwezinyane lembuzi kuya phezulu. Ukugeleza kwegazi ukuya embusweni kwenza kube nzima ukuthuthukisa intambo yomzimba, i-hypoxia iqala.
Ngokwezinga elikhulu, konke lokhu okungenhla kusebenza ezinganeni ezondlekile. Ubukhulu bomzimba wabo namanje buncane, ikhanda ngokuvamile likhulu, futhi lokhu kugwema kakhulu ukubeletha embukisweni wezintambo.
Kungenzeka futhi ukuthi i-profilical cord noma imilenze yesisu esisuka esibelethweni ngaphambi kokuqala komsebenzi omkhulu. Ngenxa yalokho, ukutheleleka kungakhuphuka esibelethweni bese kuhlukanisa umntwana, futhi umama wakhe (lokhu kuphethwe yi-endometritis yangemva kokubeletha).
Ngaphezu kwalokho, abafana bahluphekile kakhulu. Esikhathini sesethulo se-breech ekulethwa kunomcindezelo ophawulekayo kwi-scrotum, engabangela ukulimala kwakhe.
Indlela yokubeletha kwegazi
Umzuzwana wokuqala inguquko yangaphakathi yamadokodo. Iqala ngesikhathi sokuguqulwa kwamazinyo kusukela engxenyeni enkulu ye-pelvis kuya komncanyana. Lokhu kwenzeka ukuze usayizi oguquguqukayo wezinyawo emagqumeni angaphansi kwesigcawu uyingqayizivele eqondile yesikhumba salo uqobo, izinkinobho ziyeza ngaphansi kwe-arch bony, i-posterior ibekwe phezu kwe-coccyx. Kulesi simo, i-trunk ye-fetus yenza i-lateral kancane iguqulwe yi-convexity phansi, ngokufanayo nokugoba kwe-axis ye-pelvis.
Umzuzwana wesibili ukuhamba kwe-lateral kwe-spinal of the fetus (i-lumbar part). Ukunyakaza komntwana okuqhubekayo kuholela ekuguquleni komgogodla womgogodla wakhe. Ingxenyeni yangaphambili ye-butt isuke igoqwe phezu kwe-crotch futhi i-front buttock ivela ngaphansi kokushicilelwa kwe-pubic. Izinzwani zengane encane ngalesi sikhathi zifaka ububanzi obungenalutho kuya kobukhulu bokungena kwesikhumba, lapho i-prokealogs idlulile khona kakade. Kulesi simo, umzimba womntwana uphenduka kancane kancane.
Umzuzwana wesithathu ukuphenduka kwangaphakathi kwamahlombe, kanye nokuguqulwa okuhlobene kwesiqu. Lesi siphetho sigcina ngokusungulwa kwama-shoulder-hangers ngobukhulu bokuphuma okuqondile. Amaphethelo ephambili wengane ngesikhathi esifanayo afanele ngaphansi kwe-arch laminar, i-posterior ibekiwe ngaphezu kwe-perineum phambi kwe-coccyx.
Iphuzu lesine yi-crossxion ye-lateral cervicothoracic ingxenye yekholomu ye-vertebral. Ngaleso sikhathi, izibambo nezibhande zizalelwa.
Umzuzwana wesihlanu ukujikelezwa kwangaphakathi kwekhanda. Inhloko ingena ngobukhulu bayo obukhulu obungako oblique bokungena kwesikhumba, nokuphambene nalokho okushiwo amahlombe. Inhloko yenza ukuphenduka ngaphakathi ngaphakathi kwenqubo yokuguqula engxenyeni encane yesikhumba, ngenxa yalokho isiguli se-sagittal sitholakala esayizi elincane lokungenisa, futhi i-suboccipitary fossa iyinhlangano ehlangene kakhulu.
Umzuzwana wesithupha ukugoba kwekhanda, ukuqhuma kwalo: i-perineum yama-nasal isuke ilandelwa ngokulandelanayo: isikhumba, umlomo, ngemuva kwempumu, ebunzini lekhanda lomntwana.
Inhloko ikhiqizwa ngosayizi omncane oblique, njengokwethulwa kwangaphambi kwesikhathi. Ngokuvamile kakhulu ukuqhuma kwentloko ye-fetal ngaphansi kobukhulu be-palate-frontal, futhi lokhu kuholela ekusweleni nasekuqhekekeni kwe-perineum.
Izinto ezithandekayo ekubelethweni kwemvelo
Izimo zemvelo ziyakwazi ukulandela lezi zinto ezilandelayo. Lokhu ukukhulelwa kwesikhathi esigcwele (ngaphezulu kwamaviki angu-37); i-fetus yesifazane; ubukhulu obulinganiselwe bomntwana kusukela ku-2500 kuya ku-3600 amagremu, kanye nobukhulu obujwayelekile bomkhonto womama; i-clean-cut noma i-breech-foot prawn; ukutholakala kwabasebenzi abaqeqeshiwe kanye nemishini.
Uma zonke lezi zimo zifinyelelwa, ungazama ukwakha wena ngokwakho, kungenjalo kungcono ukuhlela isigaba sakho se-cearean kusengaphambili.
Izinto ezingathandeki ekubelethweni kwemvelo
Izimo ezimbi zokulethwa kwe-pelvic ziyingcosana ye-fetus encane kunama-2500, noma ngaphezulu kuka-3600 amagremu; ingane yokuqala, ukubeletha ngaphambi kwesikhathi, ukuhluka komlenze wesethulo se-pelvic; isisu sesilisa; ukuphakama okukhulu (ukuhambisa i-ultrasound) yekhanda le-fetal; ukuntuleka kochwepheshe oqeqeshiwe owazi ukukhiqiza ukuzalwa kwe-pelvic.
Uma okungenani elilodwa lalezi zici likhona, khona-ke ingozi yokucindezeleka inkulu. Kungcono ukuthi ungabungozi futhi ubelethe ingane enezinsizwa.
Ukuzalwa kuyenziwa kanjani ekubonisweni kwe-fetus ye-pelvic
Kunconywa kusukela esigabeni sokuqala sokusebenza ngenhliziyo ethandekayo ukuze ulale eceleni, lapho ingane ibheke khona.
Lapho izintwana zomntwana ziboniswa kusukela ekuqothulweni ngokobulili, owesifazane ovame kakhulu yi-perineum (lena i-episiotomy). Lokhu kuyadingeka ukuze kunciphise amathuba okulimala ekhanda le-fetus.
Abaziqhamuka izilwane balandela eduze kwenhliziyo yezingane ne-KTG. Lapho umntwana ezalwa ngaphambi kwenkaba, futhi ikhanda layo lifaka nje i-vtas bese licindezela intambo yomzimba, ngenxa yalokhu, i-hypoxia ivame ukukhula.
Uma ingane ingazalwa kungakapheli 7-10 emaminithi emva kwalokhu, kunengozi empilweni yakhe nasekuphileni kwayo. Ngakho-ke, ekubelethweni okunjalo, izidakamizwa ezikhuthaza umsebenzi zihlala zisetshenziswa.
Uma i-placenta izalwa, ukuvimbela ukuphuma kwe-postpartum hemorrhage, owesifazane unikezwa i-oxytocin ne-methylergometrine, okwenza ukwehla kwesibeletho.
Lapho kutholakala isigaba esiphuthumayo sokudla kwesimo esiphuthumayo
Ukuqala ukuzalwa kwe-pelvic ngendlela engokwemvelo, isazi singanquma ukuthi isigaba se-caesarean sisadingeka. Kulesi simo, kubizwa ngokuthi i-acute, ngoba yenziwa ngemuva kokuqala kokuphambana. Kungenzeka ezimweni ezilandelayo. Lokhu ukuwa kwezandla, imilenze noma intambo yomntwana wengane; ukuphazamiseka kwamapayipi; ubuthakathaka bokusebenza, ngokuvulwa kwesibeletho somlomo wesibeletho esingaphansi kuka-5 cm; hypoxia e-fetal ekhululekile; ukutholakala kwemisebenzi.