Ngā Painga me ngā Mōrearea o te Wāhanga Caesarean
Ko te pokanga whakawhānau (section caesarean) he tikanga pokanga e whānau ai te pēpi mā te tapahi i te pakitara puku me te kōpū. I roto i te maha o ngā whenua, kua piki haere te rongonui o tēnei tikanga mō te whānautanga, mō ngā take hauora me ngā take kore-hauora. Ahakoa ka taea e te pokanga whakawhānau te whakaora i te ora o te whaea me te pēpi i roto i ētahi āhuatanga, he pokanga nui tonu tēnei, ā, e rua ngā painga me ngā mōrearea. He mea nui te mārama ki ngā mea e rua kia taea ai e ngā whaea e hapu ana me ō rātou whānau te whakatau whai whakaaro me ā rātou kaiwhakarato hauora.
He aha te Wāhanga Caesarean?
Ka mahia te pokanga tākihi ina whakaarohia he mōrearea, he kore rānei e taea te whānau noa i te tara. I te nuinga o te wā ka mahia te tikanga i raro i te mate whakamoe tuaiwi, i te mate whakamoe epidural rānei (ka noho mataara tonu te whaea), ahakoa i ngā wā ohorere, ka whakamahia pea te mate whakamoe whānui. Whai muri i te tapahi i te puku me te kōpū, ka whānau te pēpi, ka tapahia te pito, ka tangohia te whenua, ā, ka kati te patunga. Ko te tikanga ka roa te pokanga i te 30–60 meneti, engari ka roa pea te whakaora mō ētahi wiki.
Ngā Hua o te Wāhanga Whakataata
1. Te Whakaora i te Oranga o ngā Whaea me ngā Pēpi i ngā Āhuatanga Ohotata
Ko te painga nui o te pokanga whakawhānau ko tōna kaha ki te ārai i ngā raruraru nui i roto i ētahi āhuatanga. Hei tauira, i roto i ngā take o te mamae o te kukune (he tohu o te korenga o te hāora), te pakaru o te whenua (te wehenga wawe o te whenua), te heke rānei o te pito o te kōpū (te pupū wawe rawa o te pito o te kōpū, ā, ka mau). I roto i ēnei āhuatanga, ko te pokanga whakawhānau te huarahi tere hei ārai i te kino o ngā whekau, te hauātanga, tae noa ki te mate.
2. Ngā otinga mō ngā tūranga pēpi kāore i te tino pai
Ka uaua pea te whānautanga ā-tarae mēnā he pēpi kei te tū whakarunga (upoko-ki-runga), kei te piko whakararo (whakapae), kei te āhua rerekē rānei. Ahakoa ka taea te whakahaere i ētahi wā mā roto i ngā tikanga motuhake, he maha ngā wā he kōwhiringa haumaru ake te pokanga tākihi, inā koa mēnā he āhuatanga tāpiri pērā i te pēpi nui, te hope whāiti rānei o te whaea.
3. Whakaiti i te tūponotanga o ētahi whara whānautanga
I ētahi wā, ka taea e te pokanga whakawhānau te whakaiti i te tūponotanga o te whara i te wā e whānau ana, pērā i ngā pēpi tino nui (macrosomia), e tūpono ana ki te pāngia e te dystocia pakihiwi i te wā e whānau ana te pēpi. Mō ngā whaea he mate hauora tō rātou, ka taea hoki e te pokanga whakawhānau te ārai i ngā raruraru mai i te pana roa, pērā i ētahi mate ngākau, i ngā mate pūnaha io tairongo rānei.
4. Ārai i te kino haere o te mate o te whaea
Ko ngā whaea e pāngia ana e te preeclampsia kino, te eclampsia, ngā raruraru rānei o te toto toto tiketike i te wā e hapu ana, me whānau wawe pea. Waihoki, ko ngā whaea e pāngia ana e ētahi mate hohe (pērā i te herpes taihemahema hohe) ka taea te tuku i te mate i te wā whānautanga. I roto i ēnei āhuatanga, ko te pokanga cesarean he wāhanga pea o tētahi rautaki whakahaere hauora hei whakaiti i te mōrearea ki te pēpi.
5. Kua whakaritea, ā, kua whakahaeretia ake i ētahi wā
Mā te pokanga whakawhānau kua whakaritea (whiriwhiri) ka tino mārama te wā whānau, ā, ka taea hoki te whakarite hauora tino pai ake, pērā i te wātea o tētahi tohunga, he rūma pokanga, me te wātea o tētahi pēpi hou mēnā e matapaetia ana ka hiahiatia he tiaki motuhake. Mō ngā whaea kua pāngia e ngā pokanga whakawhānau o mua, kua pokanga kōpū rānei, ka whiriwhiria he pokanga whakawhānau kua whakaritea hei whakaiti i te tūponotanga o te pakaru o te kōpū i te wā e whānau ana.
Ngā Mōrearea o te Wāhanga Caesarean
Ahakoa ōna painga, he mōrearea tonu te pokanga whakawhānau i te wā poto me te wā roa. Nā te mea he pokanga nui, he nui ake ngā mōrearea i ērā o te whānautanga tara i roto i te hāputanga ngāwari.
1. Te Mōrearea o te Mate Pāwera
Ka pā te mate ki te patunga pokanga, ki te arai o te kōpū (endometritis), ki te ara mimi rānei. Ko ngā tohu ko te kirika, te mamae o te puku, te whero, te pupuhi rānei i roto i te patunga, me te haunga kino o te wai o te tara. He maha ngā wā ka hoatu he paturopi hei ārai, engari ka taea tonu te mate, inā koa mēnā ka pakaru te wai i mua tata o te pokanga.
2. He nui ake te toto
He nui ake te toto e ngaro ana i ngā mahi whakawhānau pēpi i ngā mahi whānau tara. I ētahi wā, ka nui rawa te toto e hiahiatia ana kia whakawhitia he toto. Ka piki ake te mōrearea i roto i ngā āhuatanga pēnei i te placenta previa (te wāhi e aukatia ai te awa whānau e te placenta) te placenta accreta rānei (te wāhi e piri hohonu rawa ai te placenta ki te pakitara o te kōpū).
3. Mamae me te Whakaora Roa
I muri i te pokanga, ka pāngia ngā whaea e te mamae i te wāhi i tapahia, ā, ka iti te nekenekehanga mō ētahi rā, wiki rānei. Tērā pea ka uaua ake ngā mahi pēnei i te ara ake i te moenga, te whāngai ū i a koe e noho ana mō ngā wā roa, te hiki taonga rānei. He roa ake te wā whakaora katoa i te whānautanga tara, nō reira he mea nui te tautoko a te whānau.
4. Ngā Mōrearea o te Whakamamaetanga
Ka pā mai pea ngā pānga taha pēnei i te toto toto iti, te whakapairuaki, te makariri, te ānini rānei i muri i te werohanga o te repe. Ahakoa he onge te whakamahinga o te repe whānui, he mōrearea anō hoki pērā i te mimiti me te uaua o te manawa. Ko te whiriwhiri i te tikanga repe ka whakatauhia e te āhua o te whaea, te tere o te mahi, me te aromatawai a te tohunga whakamoe.
5. Te whara ki ngā whekau e karapoti ana
Nā te mea ka mahia te pokanga i te puku, ka tūpono pea te whara o ngā whekau e karapoti ana pērā i te pūkahukahu, i te puku rānei, inā koa mēnā he piri mai i ngā pokanga o mua. Ahakoa he onge, ka hiahiatia pea he tikanga tāpiri mō ēnei raruraru, ā, ka roa ake te noho ki te hōhipera.
6. Ngā mōrearea i ngā hāputanga o muri mai
Ka pā pea te pokanga whakawhānau ki ngā hāputanga o muri mai. Ko ētahi o ngā mōrearea e mōhiotia ana ko:
– Te placenta previa me te placenta accreta: ka piki ake te mōrearea mō ngā whaea kua whānau mai he whānautanga caesarean, inā koa mēnā he nui atu i te kotahi te maha o ngā whānautanga caesarean o mua.
– Te pakaru o te kōpū (te haehae o te kōpū): ka puta pea i te wā e whānau ana i muri i te pokanga tāne (VBAC), ahakoa he iti noa te mōrearea i ētahi kēhi me te aroturukitia tata.
– Ngā piri: ka taea e te kiko koha te whakararu i te mamae o te hope, te whakauaua rānei i te pokanga i muri mai.
7. Pānga ki ngā Pēpi
Ko ngā pēpi i whānau mai mā te pokanga tākihi, inā koa i mua i te wā, ka nui ake te mōrearea o te mamae manawa poto nā te mea kāore rātou e whai i te tukanga "pēhi" i roto i te awa whānau e āwhina ana ki te tango i te wai mai i ngā pukahukahu. Hei tāpiri, he iti noa te mōrearea o te pēpi ka tapahia ki te pokanga. Ko te tikanga ka taea te whakaiti i ēnei mōrearea mā te tikanga pokanga pai.
Te Wāhanga Whakawhānau i runga i te Tono (Kāore he Tohu Hauora)
I ētahi wā, ka whiriwhiria e ngā whaea te pokanga tākihi ahakoa kāore he tohu hauora mārama, hei tauira nā te wehi o te mamae o te whānautanga, te whara o te whānautanga o mua, te whakamarie rānei. Me āta whakaaroaro ki tēnei whakatau, nā te mea kāore ngā mōrearea o te pokanga e ngaro noa iho nā te mea kua whakaritea te tikanga. He mea nui te kōrero tuwhera ki tō tākuta, ki tō kaiwhakawhanau rānei, hei matapaki i ngā kōwhiringa whakahaere mamae mō te whānautanga tara, tō whakarite hinengaro, me ngā hua ka puta mō ngā hāputanga o muri mai.
Me pēhea te whakaiti i te mōrearea me te tere ake o te whakaora
Hei whakaiti i ngā raruraru, he maha ngā mahi ka taea te āwhina:
1. Whāia ngā tohutohu mō te nohopuku me te whakarite mō te pokanga e ai ki ngā tohutohu a te hōhipera.
2. Mā te nekeneke wawe (te neke āta i muri i te pokanga) ka taea te whakaiti i te mōrearea o te toto totoka me te tere ake te whakaora, e ai ki ngā tohutohu a te tohunga hauora.
3. Me rongoā tika te patunga, kia ma, me te tirotiro mō ngā tohu o te mate.
4. Whakahaerehia te mamae me te haumaru, nā te mea ka āwhina te whakahaere pai i te mamae i ngā whaea ki te neke me te whāngai ū kia māmā ake.
5. Kai i tētahi kai taurite me te nui o ngā wai hei tautoko i te whakaora me te whakaputa waiū ū.
6. Ngā tirotiro i muri i te whānautanga kia rite ki te wātaka hei whakarite kei te ora pai te kōpū, ngā patunga, me te āhua whānui.
Whakamutunga
He tino whai hua te pokanga whakawhānau, ā, he maha ngā wā ka ora ai te whaea me te pēpi i ētahi wā. Heoi, nā te mea he pokanga nui, he tūponotanga kei roto pērā i te mate pāwera, te toto, te mamae i muri i te pokanga, ngā raruraru moepuku, tae atu ki ngā pānga ki ngā hāputanga o muri mai. Ko te whakatau kia pokanga whakawhānau me ahu mai i tētahi tohu hauora kaha, i tētahi whakaaro āta rānei i muri i te kōrero ki tētahi tohunga hauora. Mā te māramatanga pai me te whakarite tika me te tiaki i muri i te pokanga, ka taea e ngā whaea te whānau whakawhānau i runga i te haumaru me te whakamarie.
