Isithelo esinesisindo esingaphezu kwezingu-4000 g nokuphakama kwama-54 cm kubhekwa njengokukhulu.
Izibonakaliso zangaphandle, ezifana nesimo esikhulu somzimba kanye nokuphakama kwesimo se-uterine fundus, singaqinisekisa ngokuqondile ukuthi kuzoba nezithelo ezinkulu, ngoba ama-polyhydramnios nawo, ashintsha lezi zibonakaliso. Kodwa ukuskena kwe-ultrasound kusiza ukuxilonga i-fetus enkulu kakhulu ngokunembile. Okokuqala, lokhu kufanele kulindeleke uma, uma ingane ikhudlwana kunesikhathi sobukhulu besonto elilodwa noma ngaphezulu.
Kanti futhi, ngokugcwele ukukhulelwa nokulibaziseka, ikhanda elikhulu libalulekile emntwaneni - emva kwakho konke, kuyoba ngowokuqala ukudlula emgodini wokuzalwa, futhi uma ikhanda lidlula, bonke abanye bayodlula. Ubukhulu obukhulu bekhanda lamaviki angu-40 wokukhulelwa - i-BDP (ubukhulu biparietal ye-skull) - 94 mm, i-LTE (ubukhulu be-frontotemporal be-skull) - 120 mm, uma lezi zilinganiso zikhulu, lezi zibonakaliso zekhanda elikhulu ebusweni.
I-fetus enkulu nokubeletha
Uma kutholakala isisu esikhulu, khona-ke umbuzo walokho okufanele ukwenze: uhola ukubeletha ngokwemvelo noma usebenzise isigaba se-cearean, umi phambi komzimba wamazinyo. Kodwa ngokungajwayelekile, futhi lapho kungekho khona ukuvikelwa okuhambisanayo, udokotela unquma ukulethwa kwemvelo. Ukuphathwa kwemisebenzi ebhekene ne-fetus enkulu kunezici zayo ezibalulekile: kubalulekile ukuvimbela imithi ye-prophylaxis yobuthakathaka bomsebenzi kanye ne- hypoxia ye-fetus . Ngesikhathi sokubeletha kungase kube nesidingo se-perineotomy (ukuhlakaza i-perineum ukwandisa usayizi we-canal yokuzalwa nokuvimbela ukuqhuma kwayo). Esikhathini se-postpartum, ukugcinwa kokuvimbela kwe-hypotonic ukukhipha umama kwenziwa. Kodwa uma kutholakala i-pelvis esebenzayo ekuqaleni komsebenzi, owesifazane angenza isigaba sokugcina ingane ngesikhathi sokubeletha, ukuvimbela ukulimala kumama nengane.
Isigaba saseKesariya nge-fetus enkulu
I-fetus enkulu iyisibonakaliso esihambelana nesigaba se-cearean. Kodwa uma i-fetus enkulu ilindeleke ngesikhathi esifanayo, futhi owesifazane une-pelvis encane, noma intambo encane entanyeni ye-fetus, breech presentation , izinkinga ekuzalweni kwangaphambilini ne-fetus enkulu noma ingxenye ye-cearean esikhathini esidlule, isazi sokubeletha ngokuvamile asibeka engozini yokuzala ngokwemvelo. Ezinye izibonakaliso zesigaba sokudla kwezidakamizwa zezithelo ezinkulu -
Ukuvimbela ukuthuthukiswa kwe-fetus enkulu
Uma owesifazane esivele enezingane ezinkulu, kunezici eziyingozi zokuzalwa kwe-fetus enkulu kanye ne-ultrasound eqinisekisa ukuthi kungenzeka ukuzalwa kwengane enkulu, bese uyilungiselela kangcono kusengaphambili. Ukudla ezinyangeni zokugcina zokukhulelwa, ukulinganisela kuzo zonke izakhi, kepha ngokuvinjelwa ushukela kanye nama-carbohydrate kalula, kungavimbela ukuzuza kwesisindo esisheshayo emntwaneni.