Ngomkhuba wokuvimbela, izinkinga zokuphuma kwegazi zihambisana kakhulu. Phela, ukulahlekelwa kwegazi okukhulu kungabi nje imbangela yokufa kwe-fetus, kodwa futhi kuyisimo esongela impilo yowesifazane.
Ukuhlukaniswa kwegazi ku-obstetrics
Ukuphuma kwe-obstetric ngesikhathi sokukhulelwa kuhlukaniswa ngamaqembu alandelayo:
- ukuphuma egazini lokuqala lokukhulelwa;
- ukulimaza kwesigamu sesibili sokukhulelwa;
- ukuphuma kwegazi ngesikhathi sokubeletha;
- i-postpartum hemorrhage.
Ngenxa yalesi sigaba se-obstetric hemorrhages, kuyacaca ukuthi kungenzeka ngezigaba ezihlukahlukene zokukhulelwa. Kumele uqaphele ukuthi izimbangela zokugaya ziyohluka ngokuya esikhathini sokubeletha. Futhi ngokufanayo, ukulahleka kwegazi kuzokuhambisana nezimpawu ezithile zezimpawu zesifo somzimba.
Izimbangela zokuphuma kwe-obstetric
Izimbangela ze-obstetric hemorrhages engxenyeni yokuqala yokukhulelwa kungaba ukukhulelwa kwe-ectopic, isisu , ukukhulelwa kwesisu. Engxenyeni yesibili yokubeletha, ukuphuma kwegazi kuhambisana nenqola yangaphambi kwesikhathi ye-placenta noma isethulo sayo.
Ngokwehlukana, sizohlaziya izimbangela ze-obstetric hemorrhages ngqo ngesikhathi sokubeletha. Uma ukuphuma kwegazi kwenzeka ngesikhathi sokuqala sokusebenza, okungukuthi, ngesikhathi sokuvula umlomo wesibeletho, lokhu kungase kube umphumela:
- ukuchithwa kwe-placental ngaphambi kwesikhathi;
- ukuhlukunyezwa komlomo wesibeletho;
- ukuphuka kwesibeletho .
Izimo ezifanayo ziyimbangela yokulahlekelwa kwegazi esigabeni sesibili senqubo yokuzalwa. Isikhathi sesithathu sokusebenza, okungukuthi, ukuhlukaniswa kwe-placenta, kuhambisane nezinhlungu ezinkulu ze-obstetric kulezi zimo ezilandelayo:
- nge-dense, ukuhluma okujulile kwe-villi placenta emdongeni wesibeletho;
- kanye nokubambezeleka kwezingxenye zomuntu ngamunye wezicubu ezisekhaleni emgodini we-uterine;
- ukulimala kwezicubu ezithambile ze-canal yokuzalwa.
Esikhathini se-postpartum, ukuphuma kwamanzi kungabangelwa ithoni eyancipha yesibeletho. Kulesi simo, imicu ye-muscle ayinayo isivumelwano futhi imithwalo yegazi ayinqamuki, ngenxa yokulahleka kwegazi okuqhubekayo. Futhi ezimbangela zokugaya phakathi nalesi sikhathi zihlanganisa ukuphazamiseka kwegazi lokugaya futhi ukumbumbuluzwa yi-amniotic fluid.
Ekhuluma ngokuphuma kwegazi, kuyadingeka ukuthi uqaphele izimbangela ezivame kakhulu zokuphuma kwamagciwane ngaphandle kwesikhathi sokubeletha kwengane. Lezi zihlanganisa i-polyps nomdlavuza womlomo wesibeletho, i-uterine fibroids, i-endometriosis kanye nezifo ze-hormonal.
Ukuvimbela nokwelapha
Ukuvinjelwa kwamagciwane okuvimbela isisu kufanele kuqale isikhathi eside ngaphambi kokuqala kokukhulelwa. Phela, ukuthuthukiswa okuhambisanayo kohlelo lokubeletha kwabesifazane kakade kunciphisa ingozi yentuthuko yokugula ngesikhathi sokubeletha kwezingane. Okubalulekile ekuvimbeleni ukwelashwa kwezifo ze-extragenital.
Noma yikuphi ukuphuma kwegazi kudinga ukuthutha ngokushesha esibhedlela. Ukwelashwa kwezidakamizwa ze-obstetric kufanele kufane nezigaba ezilandelayo:
- yeka ukuphuma kwegazi;
- ukuqeda imbangela eyangele ukuphuma kwegazi;
- ukuvuselelwa kwe-hemodynamics ngokuqeda ukungabi khona kwemthamo wokujikeleza kwegazi.
Zonke izinyathelo ezihloswe ekuqedeni ukulahlekelwa kwegazi kufanele zenziwe ngokushesha kakhulu.
Ukunakekelwa kwezimo eziphuthumayo lapho kwenzeka khona isifo sokuvimbela isisu kuyisilwisana nokushaqeka kwe-hypovolemic. Ukwenza lokhu, sebenzisa ukwelapha ukumnika izixazululo ezihlukahlukene. Ukuze uzame ukuyeka ukuphuma ngegazi, i-Dicinone, i-aminocaproic ne-tranexamic acid, i-NovoSeven ilawulwa.