Inqubo Yokuhlukaniswa Kwesitho Sokuhlinzwa
Isigaba sokuhlinzwa (isigaba sokuhlinzwa) inqubo yokuhlinzwa yokubeletha umntwana ngokusikwa odongeni lwesisu sikamama kanye nesibeletho. Le nqubo ingahlelwa ekuqaleni kokukhulelwa noma yenziwe ezimweni eziphuthumayo lapho ukubeletha kwesitho sangasese sowesifazane kubeka engcupheni umama noma umntwana. Nakuba kuwukuhlinzwa okuvamile, isigaba sokuhlinzwa sisalokhu siyindlela enkulu yokuhlinzwa edinga ukulungiswa okuphelele, ukwenziwa okujwayelekile, kanye nokunakekelwa okufanele kokululama. Lesi sihloko sixoxa ngenqubo yokuhlinzwa ngokuphelele, kusukela ezinkomba, ukulungiselela, izigaba zokuhlinzwa, kuya ekunakekelweni kwangemva kokuhlinzwa.
Incazelo kanye nenhloso yokubeletha ngokuhlinzwa
Ukuhlinzwa kokubeletha kuhlose ukubeletha umntwana ngokuphephile lapho ukubeletha kwesitho sangasese sowesifazane kungenzeki noma kuyingozi. Ngaphezu kokuphepha, ukuhlinzwa kokubeletha kungenziwa futhi ukuvimbela izinkinga ezifana nokopha kakhulu, ukucindezeleka komntwana, noma ukulimala kukamama. Empeleni, isinqumo sokwenza ukuhlinzwa kokubeletha sisekelwe kakhulu ezicatshangelweni zezokwelapha, imiphumela yokuhlolwa, kanye nengxoxo phakathi kukadokotela nesiguli.
Izinkomba zokuhlinzwa kwesisu
Izinkomba zokubeletha ngokuhlinzwa zingahlukaniswa zibe ngumama, umbungu, noma inhlanganisela yazo zombili. Ezinye zezizathu ezivame kakhulu zifaka:
1. Ukucindezeleka kwengane esanda kuzalwa: Isilinganiso senhliziyo yengane esanda kuzalwa asizinzile noma kunezimpawu zokuntuleka komoya-mpilo.
2. Ukungalingani kwe-cephalopelvic: Ubukhulu bekhanda lomntwana abufani ne-pelvis kamama, okwenza kube nzima ukuthi umntwana aphume.
3. Isimo esingajwayelekile sengane: Isibonelo, ukuhlikihla isisu, ukujikijela ubuso, noma ukubonakaliswa kobuso okuthile.
4. I-placenta previa: I-placenta imboza umsele wokuzalwa ukuze ukubeletha okuvamile kube nengozi yokopha.
5. Ukuphazamiseka kwe-placenta: I-placenta iyahlukana ngaphambi kokuba umntwana azalwe, okungabangela ukopha kanye nokucindezeleka kombungu.
6. Umlando wokuhlinzwa kwesibeletho: Isibonelo, ukuhlinzwa kwangaphambilini (ikakhulukazi ngokuhlinzwa okuvamile), ama-myomectomies athile, noma ingozi yokuqhekeka kwesibeletho.
7. Ukukhulelwa kwamawele anezimo ezithile: Isibonelo, ingane yokuqala isesimweni sokukhwehlela.
8. Izifo ezithile: Njenge-herpes yobulili esebenzayo esengozini yokudluliselwa lapho ingane idlula emgudwini wokuzalwa.
9. Ukubeletha akuqhubeki: Ukukhula akuqhubeki yize ukufinyela kwanele, noma kukhona ukuvaleka phakathi nesigaba sesibili.
10. Izimo zezempilo zomama: Njenge-preeclampsia enzima, i-eclampsia, izifo ezithile zenhliziyo, noma izimo ezenza ukusunduza kube yingozi.
Lezi zinkomba azisho ukuthi kuzokwenziwa ukuhlinzwa kokubeletha kuzo zonke iziguli; udokotela uzohlola izimo zesimo ngasinye.
Ukulungiselela ngaphambi kokuhlinzwa
Ukulungiselela ukuhlinzwa ngokuvamile kuhlanganisa izici zokuphatha, zezokwelapha nezengqondo.
1. Ukubonisana kanye nemvume enolwazi
Udokotela uchaza isizathu sale nqubo, izinzuzo zayo, izingozi, kanye nanoma yiziphi ezinye izindlela. Isiguli noma umndeni ube ususayina ifomu lokuvuma.
2. Ukuhlolwa ngokomzimba nokusekelayo
Lokhu ngokuvamile kuhlanganisa ukuhlola umfutho wegazi, ukushaya kwenhliziyo, izinga lokushisa, ukuhlolwa kokubeletha, kanye nokuhlolwa kwelebhu njengokuhlolwa kwegazi okuphelele, uhlobo lwegazi, kanye nokuhlolwa kokutheleleka njengoba kudingeka.
3. Ukuzila ukudla kanye nokufakwa komugqa we-IV
Iziguli zivame ukucelwa ukuba zizile ukudla amahora amaningana ngaphambi kokuhlinzwa ukuze kuncishiswe ingozi yokufutha ngesikhathi sokuhlinzwa. Kubekwa umugqa we-IV ukuze kutholakale uketshezi, imithi kanye nokuvimbela ukuphuma kwegazi.
4. Ukufakwa kwe-catheter yomchamo
I-catheter isiza ukukhipha amanzi esinyeni ukuze ingaphazamisi indawo yokuhlinzwa futhi yenza kube lula ukuqapha ukukhiqizwa komchamo.
5. Ukunikezwa kwama-antibiotic okuvimbela
Ama-antibiotic avame ukunikezwa ngaphambi kokusikwa ukuze kuncishiswe ingozi yokutheleleka kwenxeba ngokuhlinzwa.
6. Ukulungiselela i-anesthesia
Udokotela wezinzwa uhlola isimo sesiguli futhi anqume uhlobo olufanele kakhulu lwezinzwa.
Izinhlobo ze-anesthesia zokuhlinzwa kwesisu
I-anesthesia yesifunda, ngokuvamile yomgogodla noma ye-epidural, isetshenziswa kakhulu ngoba umama uhlala ephapheme futhi angahlangana nomntwana ngokushesha ngemva kokuzalwa. I-anesthesia yesifunda nayo ngokuvamile inezingozi ezimbalwa kune-anesthesia ejwayelekile ezimweni eziningi. Kodwa-ke, i-anesthesia ejwayelekile ingakhethwa ezimweni eziphuthumayo, lapho i-anesthesia yesifunda ingavunyelwe, noma lapho izimo ezithile zidinga isinyathelo esisheshayo kakhulu.
Izigaba zenqubo yokuhlinzwa
Ngokuvamile, lezi yizinyathelo ezithathwayo enkambisweni yokuhlinzwa egumbini lokuhlinza:
1. Ukuhlanza nokufaka amakhethini okuhlinzwa
Indawo yesisu ihlanzwa ngesibulali-magciwane bese imbozwa ngendwangu engcolile. Kufakwa ama-drape ukuze kugcinwe ukungazali nokunciphisa ukubonakala kwamehlo kwesiguli.
2. Ukusikwa esikhumbeni
Ukusika okuvame kakhulu ukusikwa okuphansi okuphambeneyo (i-Pfannenstiel) ngaphezu komugqa wezinwele ze-pubic. Lokhu kusikwa kuvame ukujabulisa kakhulu ngobuhle futhi kubangela ubuhlungu obuncane ngemva kokuhlinzwa. Ezimweni ezithile, odokotela bangakhetha ukusikwa okuqondile.
3. Vula izendlalelo zodonga lwesisu
Ngemva kwesikhumba, udokotela ohlinzayo uvula izingqimba zamafutha kanye ne-fascia bese ehlukanisa imisipha yesisu ukuze afinyelele emgodini wesisu. Le nqubo yenziwa ngokucophelela ukuze kuncishiswe ukopha.
4. Ukuvula isibeletho (ukusikwa kwesibeletho)
Ukusikwa kwesibeletho ngokuvamile kwenziwa engxenyeni engezansi yesibeletho kusetshenziswa ukusikwa okuphambeneyo. Lolu hlobo lokusikwa ngokuvamile luphephile ekukhulelweni kwesikhathi esizayo kunokusika okungavamile okusetshenziswa kakhulu (ukusikwa okuqondile engxenyeni engenhla yesibeletho).
5. Ukukhipha umntwana
Ngemva kokuba isibeletho sesivuliwe, udokotela uyayisusa ingane ngobumnene. Uma kudingeka, kuyamuncwa ulwelwesi emlonyeni nasekhaleni lomntwana, bese intambo yesisu iqiniswa futhi inqunywe. Umntwana ube esehlolwa kusetshenziswa isilinganiso se-APGAR bese ehlolwa yithimba lezingane ezisanda kuzalwa.
6. Susa i-placenta bese uhlanza umgodi wesibeletho
I-placenta iyasuswa, bese isibeletho sihlanzwa igazi noma izicubu ezisele. Udokotela uqinisekisa ukuthi akukho ukuphuma kwegazi okusebenzayo nokuthi isibeletho sifinyeziwe kahle.
7. Ukuvalwa kwesibeletho kanye nolwelwesi lwesisu
Isibeletho sithungwa ndawonye, kulandele ukuvalwa kwengqimba ngengqimba kuze kufike esikhumbeni. Udokotela uzoqinisekisa ukuthi ukuphuma kwegazi kuyalawulwa futhi izicubu zisesimweni esihle ngaphambi kokuvala inxeba.
8. Ukuqapha okuqondile ngemva kokuhlinzwa
Ngemva kokuqedwa kokuhlinzwa, isiguli sidluliselwa ekamelweni lokululama ukuze kuqashwe umfutho wegazi, ukushaya kwenhliziyo, ukopha, ukufinyela kwesibeletho, kanye nemiphumela yokubulala izinzwa.
Isikhathi sokuhlinzwa siyahlukahluka, kodwa ukuhlinzwa okuhleliwe kuvame ukuhlala cishe imizuzu engama-30-60, kuye ngesimo sempilo kanye nezinga lobunzima.
Izingozi nezinkinga okudingeka uzazi
Nakuba ukuhlinzwa ngokuvamile kuphephile, kusenezingozi ezifana nalezi:
– Ukutheleleka (inxeba lokuhlinzwa noma ukutheleleka kwesibeletho)
– Ukopha kanye nesidingo sokumpontshelwa igazi
- Ukusabela kokubulala izinzwa
– Ukunamathela emgodini wesisu okungabangela ubuhlungu noma ukuphazamiseka kokuhlinzwa okulandelayo
– Ukulimala kwezitho zomzimba (isinyi noma amathumbu), nakuba kungavamile
– Amahlule egazi (i-thromboembolism), ikakhulukazi uma ukuhamba kwegazi sekwephuzile
Udokotela uzothatha izinyathelo zokuphepha ezijwayelekile, njengemithi yokulwa namagciwane yokuvimbela, ukulawula ukopha okuqinile, futhi ancome ukuthi kuqalwe kusenesikhathi.
Ukunakekelwa nokululama ngemva kokuhlinzwa
Ukululama ngemva kokuhlinzwa kuvame ukuthatha amasonto amaningana. Izinto ezibalulekile okufanele uzicabangele zifaka:
1. Ukulawula ubuhlungu
Isiguli sizonikezwa imithi yokunciphisa ubuhlungu. Ubuhlungu obulawulwayo buyasiza umama ukuba anyakaze ngokushesha futhi ancelise ngokukhululeka.
2. Ukushukunyiswa kusenesikhathi
Iziguli zivame ukwelulekwa ukuthi ziqale ukuhlala nokuhamba kancane phakathi kwamahora okuqala angu-12-24 kuye ngesimo, ukuze kuncishiswe ingozi yokuqhekeka kwegazi futhi kusheshiswe ukululama kwamathumbu.
3. Ukunakekelwa kwamanxeba
Inxeba kufanele ligcinwe lihlanzekile futhi lomile. Qaphela izimpawu zokutheleleka okufana nokubomvu okusabalele, ukuvuvukala, ubuhlungu obandayo, ukuphuma kwegazi okunuka kabi, noma umkhuhlane.
4. Ukudla okunempilo kanye nokumanzisa amanzi emzimbeni
Ukudla amaprotheni, uketshezi kanye ne-fiber kusiza ekwelapheni futhi kuvimbele ukuqunjelwa.
5. Ukuncelisa
Omama basengancelisa ngemva kokuhlinzwa. Izindawo zokuncelisa zingalungiswa ukuze kugwenywe ukucindezela inxeba, njengokulala eceleni noma ukubamba ibhola.
6. Qaphela izimpawu zengozi
Yiya esikhungweni sezempilo ngokushesha uma kukhona ukopha okukhulu, umkhuhlane omkhulu, ubuhlungu obukhulu besisu, ukuphelelwa umoya, ukuvuvukala emilenzeni, noma uketshezi oluphuma enxebeni.
I-Penutup
Ukuhlinzwa kokubeletha kuyinqubo eyenzelwe ukuqinisekisa ukuphepha kukamama nomntwana lapho ukubeletha kwemvelo kuyingozi noma kungenzeki. Le nqubo ihlanganisa ukulungiselela ngaphambi kokuhlinzwa, ukukhetha i-anesthesia, izinyathelo zokuhlinzwa ezihlelekile, kanye nokululama ngemva kokuhlinzwa. Ngokuqonda inqubo, izingozi, kanye nokunakekelwa kwangemva kokuhlinzwa, umama nomndeni bangalungela kangcono ngokomzimba nangokwengqondo. Uma udinga ukunquma ukuthi uzokwenzelwa yini ukuhlinzwa kokubeletha, xoxa ngakho ngokukhululekile nodokotela wakho wezifo zabesifazane ukuze uhlelo lwakho lokuzalwa luhambisane nesimo sakho sezokwelapha nezidingo zakho.
