Ukuzalwa kwangaphambi kokuqala kuyinkimbinkimbi yokubeletha, lapho ukubukeka kwengane kwenzeka khona isikhathi eside ngaphambi kosuku lokugcina. Cabanga ngokuphulwa, ake sithi izimbangela zayo, izinhlobo, ubhale imiphumela kanye nesisekelo sezinyathelo zokuvimbela.
Yini engabangela ukuzalwa ngaphambi kwesikhathi?
Odokotela babona izinqwaba zezici, okukhona okubangela ukubonakala komntwana ekuqaleni. Phakathi kwazo zonke izindawo ezikhethekile zithathwe yizimbangela ezilandelayo zomsebenzi wokuqala:
- ukukhishwa kwesisu, ukukhipha isisu ngokuzenzakalelayo ku-anamnesis;
- ukukhubazeka kwe-anatomical kwesibeletho;
- Ukungakwazi ukusebenza kwe-istimico-komlomo;
- izifo ezivuthayo nezifo ezithathelwanayo zesistimu yokuzala;
- ukutheleleka kohlelo lwe-genitourinary (pyelonephritis);
- izifo ezithathelwanayo: ukucindezeleka komzimba, izifo zesimiso senhliziyo, ukuphazanyiswa kwegciwane le-thyroid;
- ukukhathazeka ngokweqile nokucindezeleka.
Usongo lokuzalwa ngaphambi kwesikhathi
Ngaphezu kwezizathu ezingenhla zokuzalwa kwangaphambi kwesikhathi kwengane, izidakamizwa zikhomba futhi zibeka phambili. Uma zivela, usongo lokubukeka komntwana ngaphambi kosuku olufanele lubekwe. Ingozi yokuzalwa ngaphambi kwesikhathi ingabangelwa yi:
- ukuhlukunyezwa kwemithi;
- ukuphuza utshwala;
- ukwanda ngokweqile esisiswini somama esizayo (inzuzo yesisindo sokukhulelwa kudlula 12 kg);
- ukungalingani kwe-hormonal;
- umsebenzi omningi ngokweqile, umsebenzi oqinile;
- i-placenta previa.
Ukulethwa kusengaphambili - isikhathi
Mayelana nokubeletha ngaphambi kwesikhathi, odokotela bathi lapho umntwana ezalwa esikhathini esingaphakathi kwamasonto angu-22-37. Kuye ngesikhathi esithile sokubukeka, umntwana unikezwa:
- ekuseni kakhulu (amasonto angu-22-27), isisindo somzimba semvuthuluka 500-1000 g;
- ekuqaleni (amasonto angama-28-33), isisindo somntwana singu-1000-2000, ukuchazwa kwezingane ezinjalo kuhle kakhulu;
- ukubeletha ngaphambi kwesikhathi, amasonto angama-34-37, isisindo somzimba sezingane sifinyelela ku-2500 g.
Ukuzalwa kwangaphambi kokubeletha - kusukela ngiliphi isonto ingane isinda?
Ukwethulwa kwangaphambi kwesonto 26 ngokuvamile kunomphumela omuhle. Masinyane ngalesi sikhathi, uhlelo lokuphefumula luvuthwa. Into ekhethekile iklanyelwe - isazi sezintambo. It kuvimbela ukwehla kwamathambo wamaphaphu, idlala indima ebalulekile ekuphefumulweni kokuqala. Ukubukeka kwezimbumbulu isikhathi esinqunyiwe ngaphambili kudinga uxhumano kudivayisi yokuphefumula okufakelwayo.
Ngokuqondene nokusebenza kwezinsana zangaphambi kwesikhathi, ukuthuthukiswa kobuchwepheshe bezokwelapha nemishini kusiza ukunakekela izingane ezinesisindo esingama-500 g. Kodwa lezo zimo azivamile. Ngenxa yokungaqali kahle kwezitho nezinhlelo, kunesilinganiso esiphakeme sokufa phakathi kokuqala. Odokotela ngokwabo bathi ithuba lokuphila lunezicucu ezinesisindo somzimba esingaphezu kuka-1000 g, futhi zivele ekukhanyeni amasonto angu-28 nangemva kwalokho.
Izimpawu zokubeletha ngaphambi kwesikhathi
Ukuqhathaniswa kokubhekiselwe odokotela ekuqaleni kokusebenza ngaphambi kokuba leli gama lidlala indima ebalulekile. Ngenxa yalokhu, owesifazane okhulelwe kufanele azi ukuthi ukuzalwa ngaphambi kwesikhathi kuqala, izimpawu zazo zilandelayo:
Izimpawu zokubeletha ngaphambi kwesikhathi emavikini angu-30 zifana nalokho okushiwo owesifazane okhulelwe ngesikhathi sokubeletha. Izinhlungu ezinzima emathunjini aphansi, njengasesikhathini sokuya esikhathini, okwandisa ngokuhamba kwesikhathi. Owesifazane okhulelwe uyaphawula ukuvuza kwe-amniotic fluid. Ivolumu yabo incane. Ukuvela kwezibonakaliso ezinjalo kufanele kube isizathu sokukhala isikhalazo esikhungweni sezokwelapha.
Ukulethwa kwangaphambi kwesikhathi - izinkinga
Uma ukuzalwa kusenesikhathi kuqala, owesifazane okhulelwe uyanconywa ukuba alale phansi, athathe isilwane futhi acele i-ambulensi. Ukuqeda ukuphahlazeka nokunciphisa ukulwa, kutuswa ukuthi akukho-Shpa. Lapho bebeka owesifazane esibhedlela, odokotela banquma imbangela eyabangela ukuzala ngaphambi kokuzalwa komzimba futhi ezama ukuyiqeda. Ngezinye izikhathi kunokwenzeka ukuyeka inqubo yokuqala yokubeletha. Ngesikhathi esifanayo, izidakamizwa ezenza ukunciphisa ukukhushulwa kanye nokwelashwa kwesibeletho kunqunywe.
Ngesikhathi esifanayo, izinyathelo zokwelapha ezihloswe ukwandisa ukusebenza kwe-fetus zenziwa. Odokotela bafeza ukuvimbela isifo sokucindezeleka ekusaneni - ukuphulwa kokuphefumula, ngenxa yokungasebenzi kwesistimu yokuphefumula. Uma ukukhulelwa angeke kugcinwe, odokotela basebenzela ukuphathwa kwemisebenzi yokuqala.
Kulesi simo, i-anesthesia iyadingeka. Uma leli liviki lingaphansi kwamasonto angama-34 kanti isisindo somntwana singaphansi kuka-2000 g, isigaba se-cearean senziwa. Ngokuphathelene nezinkinga, kubalulekile ukuthi kubonakale ukuthi ukubonakaliswa kwengane ngaphambi kwesikhathi kusuke kubonakala ngokushesha. Ngenxa yalokhu, ingozi yokuthuthukisa ukwephula okunjalo iyanda, njenge:
- ukuhlukunyezwa kokubeletha;
- ukuphuka kwe- perineum kanye nemisipha yesifazane
- umsebenzi ongeke uhlelwe umsebenzi - ukwephulwa komyalelo wezinhlangothi (ukunciphisa kuyabuhlungu kakhulu, akukho ukuphumula okuphelele kwamafayili emisipha kulezi zikhala).
- ukutheleleka kwesistimu yokuzala - kubonakaliswe ukuthuthukiswa kwe-endometritis, ukuxhaswa kwezicucu kusuka episiotomy.
Ukuzalwa kwangaphambili - imiphumela
Ngemva kokubeletha ngaphambi kwesikhathi, odokotela banakekelwa kakhulu ngesimo sensana. Ingane ifakwa kuvez, lapho izimo eziseduze nalazo ezisesibelethweni somama zidalwa. Phakathi kwemingcele elawulwayo ebonisa amandla enamandla, isikhundla esiphakathi sithathwa ngesisindo. Abahlengikazi besilinganisa nsuku zonke, bebheka ukushintsha kwamandla.
Ukuvimbela ukuzalwa ngaphambi kwesikhathi
Ukubiza izimpawu zokusongela kokuzalwa ngaphambi kokubeletha, kufanele kuqaphele ukuthi ukubukeka kwabo kuyisibonakaliso esiqondile sokubanjwa kowesifazane okhulelwe. Owesifazane uhlolwe, izidakamizwa zibekiwe. Izimpawu ezibonakalayo zokuqala komsebenzi ngesonto 28 zikhombisa ukubukeka komntwana okuzayo. Ukuthi lokhu akukenzekanga, yenza izinyathelo zokuvimbela:
- ukuqeda izifo zesigcawu somzimba esiteshini sokuhlela ukukhulelwa;
- ukubhaliswa kwangaphambili emtholampilo wokubeletha ekuqaleni kokubeletha;
- ukuhlaziya okufika ngesikhathi.