Ukuzalwa kunye nokuboniswa kwe-breech kunobungozi obuninzi. Ngenxa yoko, ukulungiswa kwabesetyhini abakhulelweyo kwinkqubo yokuhambisa kwenziwa kwangaphambili. Makhe siqwalasele le ngcaciso ngokubanzi, siza kuchaza izinto ezizodwa zokuqhuba ukunakekelwa kookhokho, iingxaki ezinokwenzeka kwenkqubo yokubonakala komntwana.
I-Biomechanism yezabasebenzi kunye neprovicvic
Ngaphambi kokulungiswa kokunikezelwa, oogqirha benza isifundo sokulawula iintsuku ezimbalwa ukujonga ukuba indawo ye-fetus ishintshile. Ngokuqala kwenkqubo yokuzalwa, lona wesifazane uya ekamelweni lokuhambisa. Yona ndlela yokwenziwa komsebenzi kwintetho ye-pelvic yile ndlela ilandelayo:
- Ukufakela umntanzana omncinci kwi-pelvis encinci yomama aze ahambe kunye nomsele wokuzalwa. Inkqubo iqala kunye nenyaniso yokuba umgca wokugcoba ukufakelwa kweso sifo somntwana. Emva koko isigxina sakhe sogxobhozo sidlulela emgodini we-pelvis encinci. Kwiinkqubo zokulwa, iinkuni ziyancipha ezantsi, kwaye zingene kwi-pelvis encinci. Elinye iqela liwela phantsi ngaphantsi kwesinye. Isebenza ngokuthe ngqo njengendawo yombambo, njengefowanel encinci kwi-preposition head.
- Ukujika kwangaphakathi. Kukho ukujikeleza kwamatye. Ngexesha elifanayo, enye yangaphambili isondela kwisigqibo esisodwa, isithuba esingaphambili sithunyelwa kwisikram.
- Ukusika kunye nokukhuphuka kwamatye. Kwenzeka emva kokulungiswa kwenkomo yangaphantsi yintsana ngommandla we-aliac. Ngoko ukuphela kweplvic kuzalwa. Kule meko, umgudu wenza ubopho olusisigxina. Ngendlela edibeneyo yokunikezwa kwefreech, enye imilenze emibili iphuma.
- Ukuzalwa kwebhande lehlombe. Ujikelezo lwangaphakathi lwenzeka phantse ngokukhawuleza kwentloko. Ibhinqa eliqhekezayo lizalwa kunye kunye nentloko ye-previa - umda ojikelezayo ufakwa kwi-pelvis yowesifazane ohamba phambili.
- Ukuzalwa kwentloko. Ivela kwindawo egobileyo. I-suboccipitary fossa ixhomekeke kwi-arc yesithambo esisezantsi. Emva koko, isangqa, ubuso bomntwana, ibunzi lakhe, isithsaba kunye nentloko yentloko iyazalwa ngokukhawuleza.
Ukuqaliswa kwe-breech kuqala njani?
Abaphambili bentsebenzo kwinkcazo ye-pelvic ayifani naleyo ehamba phambili kwinkqubo yobudala kwintloko. Kuloo mthinteli:
- ukuhamba kwenkomo ;
- qhe lekiso rhoqo;
- ukuphuma kwe-amniotic fluid.
Nangona kunjalo, kukho ezinye iinkalo zokuqalisa ngokukhawuleza kwenkqubo yokuzalwa. Ngoko inkqubo yokuthunjwa ingaqala xa kungekho nto evulekileyo yokuvula isisu. Oku kungenxa yobukhulu becala besiphelo seplavic, xa kuthelekiswa nentloko enye. Ngenxa yoko, kwithuba lokuqala lokubeleka ibhinqa linyanzeleka ukuba lihambisane nokuphumla kombhede. Oku kukuthintela uphuhliso lweengxaki zeenkqubo zokuhambisa.
Ukuzalwa njani kwintetho ye-pelvic?
Inkqubo yezabasebenzi kwinkcazo ye-pelvic ilawulwa ngokupheleleyo ngabagqithisi. Umgaqo oyintloko ekuqhubeni isibonelelo sokuzalwa kukugcina indawo efanelekileyo yengane. Imilenze kufuneka isetwe kwi-trunk. Iziqhamo zithatha iifomathi zifake kwi-esifubeni. Okokuqala umntwana uzalelwe kwinamba, aze aphephe umgca wezantsi we-scapula. Emva koko kuphela, izandla, ibhande lehlombe liphuma kwaye intloko izalwa.
Iingongoma eziphambili zabasebenzi kwinkcazo ye-pelvic yile:
- ukuthintela ukulahlekelwa kwemilenze;
- uncedo kunye nesidingo sokususa i-handles kunye nentloko (ukukhusela i-asphyxiation);
- ukuphunyezwa kwe-episiotomy (ukuzalwa ngokukhawuleza kwentloko).
Intshumayelo yepelvic - i-caesarean okanye ukuzalwa kwemvelo?
Ngalolu hlobo lwesilwanyana esiswini sikamama, njengentetho ye-pelvic ye-fetus, ukuzalwa okanye i-laarean imiselwe kuphela oogqirha. Kule meko, oogqirha bathetha ngokuzala umntwana. Kodwa akusoloko lolu hlobo lokuhambisa luvumelekile. Phakathi kwezibonakaliso zecandelo lesigxina kunye nenkcazo ye-pelvic, kuyafaneleka ukuphawula:
- ukuthwala umntwana wesisu;
- ukuqala kwangaphambili kwenkqubo yokuzalwa;
- ukunyuka kweenyawo;
- i-pelvis encinci yowesifazane ekubelekeni;
- umngcipheko wokongezwa okunamandla kwentloko ngethuba lobasebenzi;
- inkulu okanye ngokuchaseneyo - isityalo esincinane (ngaphantsi kwe-2.5 kg okanye ngaphezulu 4);
- ubunzima bokungena kwintambo;
- hypoxia engapheliyo;
- ubukho bezinye iingxaki.
Ngaba ukuzalwa ngokwemvelo kunokwenzeka nge-pelvic presentation?
Abaphengululi baphendula lo mbuzo kwi-affirmative. Ukuzalwa ngokwemvelo ngeentetho ze-pelvic zenziwa nge-glutealateral ne-gluteal ilungiselelo lomntwana. Kule meko, oogqirha banokuqwalasela ezinye iinkalo zobunzima bokubamba, okuvumela ukuba kuzalwe ngokutsha:
- ukungabikho komngcipheko weentambo ;
- iziqhamo ezincinci;
- ubungakanani obuqhelekileyo bentloko;
- ukuvula ngexesha lomlomo wesibeleko;
- ukukhulelwa kwexesha.
Ukuqhuba ukuzalwa kweNowvyanov ngeentetho ze-pelvic
Ukuqwalasela iimpawu ezibonakalayo zabasebenzi kwi-pelvic presentation, kubalulekile ukuba kuqaphele ukuba ngokuphindaphindiweyo ngabagqithisi bokuhambisa izibonelelo ezinjalo basebenzisa incwadi ye-Tsovyanov. Injongo yale nto kukugcina ilungiselelo eliqhelekileyo lamalungu omzimba kwinkqubo yokubeletha. Ngoko ngexesha lokuxoshwa komntwana kubalulekile ukuqinisekisa ukuba imilenze ihlale iqondiswe kwaye icinezelwe emzimbeni (thorax).
Ngexesha elifanayo, gcina iingalo zentsana ziwela xa ziphethe imilenze. Oku kuvimbela ukucima. Iinyawo zifakwa kwizinga lobuso, ezigcina isikhundla esifanelekileyo senhloko. Kule ndawo, umzimba wesisu ufumana umzobo. Umthamo ophezulu ufikelelwe kumgangatho wecala (42 cm ububanzi). Emva kokuzalwa kwamahlombe, ukubonakala kwentloko kwenzeka ngaphandle kobunzima. Yiyo ndlela ukuhanjiswa kweenkonzo kwenziwa ngeentetho ze-pelvic.
Iingxaki zokuhanjiswa kwefreech
Ukuchaneka kokuchaneka kwamaqhinga kunye nokugcinwa kokulandelelana kwesibonelelo sokunikezelwa kungabandakanyi uphuhliso lweengxaki. Nangona kunjalo, oku akusoloko kwenzeka. Phakathi kokuphulwa okusemandleni, oogqirha babiza imiphumo elandelayo yomsebenzi kwi-pelvic presentation:
- ukukhulelwa kwangaphambili kwe-amniotic fluid;
- ukulahlekelwa kwamalungu omzimba kunye nentambo yomlomo;
- Ubuthakathaka bokuqala bokusebenza kwabasebenzi;
- Ukufa komntwana (kunye noxinzelelo olude lwe-strings umlolical kwindonga ye-pelvic ngaphezu kwemizuzu engama-10);
- iinjongo nge-amniotic fluid;
- engapheliyo, engqongileyo.
Ukunikezelwa kwepelvic - ukuhanjiswa kwangethuba
Ukuzalwa ngokuveliswa kwe-pelvic yesisu kudla kuqala ngaphambi kwexesha elimiselweyo. Oku kubangelwa uxinzelelo olugqithisileyo kwinqanaba le-gluteal kwisiqu somlomo wesibeleko. Ukunikezelwa kweli qiniso, abafazi abaneentetho ezizinzileyo ze-pelvic babhedlele kwizibhedlele ezingama-38-39. Ukukhulelwa ngenyameko ukulungiselela inkqubo, landela ukuvulwa komlomo wesibeleko kunye nomntwana. Oku kunceda ukuphepha ukuphuhliswa kweengxaki kwinkqubo yokuhanjiswa.