Ubuthakathaka bomsebenzi: izimbangela, imiphumela, izibikezelo

Lesi sihloko sizokhuluma ngendaba yobuthakathaka emsebenzini. Sizokutshela ngokuningiliziwe ngezimbangela, izimpawu, imiphumela kanye nesinqumo sokubeletha.

Ukukhomba ukuthi kuyini. Ubuthakathaka bomsebenzi awusebenzi okwanele wesibeletho. Okusho ukuthi, ukusebenza kunzima futhi kudla isikhathi, ngoba lesi sibeletho singasebenzi kahle, isibeletho sinzima ukuvula futhi ingane ihamba kancane futhi inzima. Ukubeletha akuhambi kahle njalo, njengoba kufanele, kukhona ukuhlukunyezwa komsebenzi. Uzofunda ngomunye wabo ngokuningiliziwe okukhulu kusuka kulesi sihloko.

Ubuthakathaka bomsebenzi

Kodwa-ke kuyadabukisa kungase kuzwakale, ukungasebenzi kwezenzo zomsebenzi kuvamile. Izizathu zalesi simo ziningi kakhulu. Manje sizokhuluma ngobuthakathaka benqubo ejwayelekile.

Lokhu kungenye yezinhlupho zokusebenza zabasebenzi. Ngalolu cwaningo, umsebenzi wokusebenza wesibeletho, okudingekayo ekuxosheni i-fetus, ubuthakathaka. Lokhu kungenxa yokuthi:

• I-tonus ephansi ye-myometrium;
• Iziphazamiso ezivamile;
• Amandla amakhulu wezinhlangothi;
• Ukuqhathaniswa kwe-diastole;
• Isikhathi sokunciphisa sithatha kakhulu emva kwesikhathi sokuphumula;
• Ukuvulwa kwe-cervix okudlulile;
• Ukuqhubeka kancane kwe-fetus.

Imininingwane eminingi izonikezwa kwesinye isigaba. Manje unikeza ezinye izibalo. Lokhu kuhlolisiswa kwezidakamizwa kanye nomzimba wokubeletha kuyithandwa kakhulu, ngoba lokhu kuyinkimbinkimbi ephindaphindiwe yokubeletha kanye nombangela wezifo ezahlukene zomama nomntwana. Izibalo zithi amaphesenti angaphezu kwamaphesenti ayisikhombisa ekubelethweni ayinkimbinkimbi ngenxa yobuthakathaka bomsebenzi. Futhi iqiniso elilodwa: lokhu kuhlolisiswa kusungulwa kaningi ngabesifazane ababeletha ingane yokuqala. Njengomthetho, ukubelethwa okulandelayo kwenzeka ngaphandle kwezinkinga, kodwa kunezimo zokuthola ukuthi ubuthakathaka bomsebenzi kanye nokuzalwa okulandelayo.

Izimbangela

Sichaze ukuthi ubuthakathaka bomsebenzi buyini. Izinto eziningi zingaba yizizathu. Siphakamisa ukuwahlula. Izimbangela zobuthakathaka bomsebenzi kungaba:

• Ukungahleleki komzimba wesibeletho;
• Ukwanele kwemithethonqubo ye-hormonal yenqubo yokuzalwa;
• Ukusebenza okungenakusebenza kwezinhlaka zesisindo;
• Izifo zangaphandle;
• I-Hypoplasia;
• I-Myoma;
• I-endometritis engapheli;
• I-Adenomyosis;
• Isibeletho se-Bicornuate;
• Isibeletho sesisu;
• I-Medabort;
• Ukudweba;
• I-myomectomy ye-Conservative;
• Amakhanda emva kokwelashwa komkhuhlane wesibeletho (uma owesifazane engakazalwa).

Kukhona ezinye izizathu. Ubuthakathaka bamabutho okhokho bungaba khona ngenxa yokuphulwa kwezinto ezithinta umsebenzi ojwayelekile. Izici ezinhle zihlanganisa okulandelayo:

• I-Prostaglandins;
• Estrogens;
• Oxytocin;
• I-calcium;
• Abaxhumanisi njalonjalo.

Ukuthinta kabi:

• I-Progesterone;
• I-Magnesium;
• Ama-enzyme abhubhisa abalamuleli nabanye.

Kubalulekile ukuqaphela ukuthi abesifazane ababhekene nezifo ezithile (izitshalo-zemithi) bavame ukubhekana nale nkinga ngesikhathi sokubeletha. Ukuphulwa okunjalo kuhlanganisa:

• Ukukhuluphala;
• I-Hypothyroidism;
• Ukusebenza kwamakhemikhali adrenal;
• I-hypothalamic syndrome.

Ukuzalwa kwezibulo nakho kunethonya elikhulu. Uma le ntombazane isencane kakhulu noma yobudala ingaphezu kweminyaka engama-35, umsebenzi womsebenzi ungase ube nzima. Kubalulekile futhi negama lapho umsebenzi wokuzalwa waqala khona. Ubuthakathaka besibeletho singabangela ukukhulelwa okubambezelekile noma ngaphambi kwesikhathi.

Uma ukukhulelwa kukhulu, khona-ke lesi sifo singenzeka ngesikhathi sokubeletha. Ngokukhulelwa okuningi, lesi sibeletho sinyuka. Ukucindezeleka kungenzeka futhi nge-fetus enkulu noma ama-polyhydramnios.

Ngokuvamile, ngobunzima bokusebenza, amantombazane amancane ahlangana, ngoba isikhumba esincane senza ukuthi lesi sibeletho sisebenze kabi. Isizathu siwukungafani phakathi kobukhulu bomntwana kanye nesifuba sowesifazane.

Izizathu ziseningi kakhulu, ngeshwa, konke akunakululwa. Manje sizoqokomisa ezinye ezithandwa kakhulu:

• Ukusebenza ngokweqile;
• Ukucindezeleka kwengqondo;
• Umsebenzi womzimba;
• Ukudla okunomsoco;
• Ukungabi nokulala;
• Ukwesaba ukubeletha;
• Ukukhathazeka;
• Ukunakekelwa kokunakekelwa kokubeletha nokunye okunjalo.

Ngakho-ke, ungahlukanisa zonke izizathu kanje:

• Ezingxenyeni zomama;
• Izinkinga zokukhulelwa;
• Kusukela eceleni kwengane.

Izinhlobo

Ubuthakathaka bomsebenzi bungenzeka ngokuphelele kunoma yisiphi isigaba sokusebenza. Mayelana nalokhu, kuyisiko ukukhomba izinhlobo ezithile zobuthakathaka:

• Okuyinhloko;
• Secondary;
• Imizamo engalungile.

Siphakamisa ukucatshangelwa okuningiliziwe okunye kwezinhlobo ngokuhlukile.

Ubuthakathaka obukhulu bokusebenza bubhekene nokulwa okungasebenzi emkhakheni wokuqala wokusebenza. Banebuthakathaka kakhulu, bafushane futhi abavumelani nhlobo. Kubalulekile ukuthi uqaphele ukuthi ngobuthakathaka bokuqala, ithoni engaphansi kwesisu (ngaphansi kuka-100 mm Hg) ibonakala. Kulesi sigaba, owesifazane uyakwazi ukuxilonga le nkinga ngokwayo. Lokhu kungenziwa kanjani? Imizuzu eyishumi bese ubala inani lezimpi zalesi sikhathi. Uma inombolo engadluli kabili futhi cishe awuzizwa, ukuxilongwa kwaqinisekiswa. Ungakwazi ukulinganisa isikhathi sokuqedwa okulodwa, kufanele kube ngaphezu kwamasekhondi angu-20 ngokungabikho kobuthakathaka emsebenzini wokusebenza. I-diastole, noma isikhathi sokuphumula, ngenkathi ihlangene cishe kabili. Ama-tangible angayithinta kanjani inkinga? Kuyinto elula, uma ingenabuhlungu noma ingenabuhlungu, ingcindezi evela esibelethweni ayanele ukuvula intamo.

Ubuthakathaka obuncane bokusebenza bubhekene nokuncipha komzimba wesibeletho. Ngaphambi kwalokhu kulwa kungase kuvamile. Izimbangela zentuthuko zifana nalokho ekubhekene nobuthakathaka obuyinhloko yamandla okhokho. Esinye isibonakaliso ukuqhutshwa kokuvuthwa kwe-uterine emphinjeni. Uma intuthuko ingabonakali emva kwamamentimitha amahlanu kuya kwanguyisithupha ekuvezeni, khona-ke singakwazi ukukhuluma ngokuqiniseka ngesifo esibelethweni se-hypotonic yesibili.

Uma ubuthakathaka obuyisisekelo nobuncane bubekwe emaphesenti ayishumi amacala okubeletha okubi futhi luyisici se-primiparas, khona-ke ubuthakathaka besikhathi sokukhuphuka buyinto engavamile kakhulu (amaphesenti amabili azo zonke izimo zokubeletha okunzima), futhi kuyinto evamile kulabo besifazane abanomsoco noma ukukhuluphala.

Izimpawu

Izimpawu zobuthakathaka obuyinhloko bokusebenza yizi:

• Ukunciphisa ukunyakaza kwesibeletho;
• Ukunciphisa ithoni ye-uterine;
• Imvamisa yezinqamuzana ezincishisiwe (kuze kufinyelele emibili ngemizuzu eyishumi);
• Isikhathi esifushane sezinqamuzana (kuze kufinyelele kumasekhondi amabili);
• Amandla we-contraction awadluli ku-25 mm Hg. P.
• Isikhathi esifushane sokunciphisa;
• Isikhathi esengeziwe sokuphumula;
• Akukho ukunyuka kokuqina nokuvama;
• Izindlela ezingenabuhlungu noma ezingenabuhlungu;
• Ukuguqulwa kwesibindi esakhiweni somlomo wesibeletho (lokhu kufaka ukufinyeza, ukushelela nokuvula).

Konke lokhu kungandisa kakhulu isikhathi sokubeletha. Lokhu, futhi, kuthinta kabi umama nengane. Owesifazane obelethwe usebenza ngokweqile, mhlawumbe ukuxoshwa kwamanzi ngokushesha.

Izimpawu zobuthakathaka besibili:

• Ukwehlisa amandla okuphambana (mhlawumbe ngisho nokuphela okuphelele kwabo);
• Ukwehlisa ithoni;
• Ukunciphisa ukukhishwa;
• Akukho ukuqhubekela phambili kokuvula umlomo wesibeletho;
• Yeka ukuqhuma komfutho emgodini wokuzalwa.

Lokhu akuyingozi kakhulu kunobuthakathaka bokuqala. Ingane ingase ithuthukise i-asphyxia, noma ingase ife. Ngomama, lokhu kuyingozi ngamathuba okutheleleka kwesibeletho, ukuhlukunyezwa kokubeletha. Ukuma isikhathi eside kwekhanda lomntwana emgodini wokuzalwa kungaholela ekwakheni ukulimala noma i-fistula.

Izifo

Kulesi sigaba, sizoxoxa ngokuxilonga inkinga yobuthakathaka (abasebenzi basezingeni eliphansi nelesithupha). Ukuxilongwa kobuthakathaka obuyinhloko kusekelwe kulokhu okulandelayo:

• Ukunciphisa umsebenzi we-uterine;
• Ukunciphisa izinga lokunciphisa umlomo wesibeletho;
• Ukuvula isikhathi eside somlomo wesibeletho;
• Ukuma eside kwe-fetus;
• Isikhathi sokudiliva esanda.

Kubalulekile ukuphawula ukuthi i-partogram (noma incazelo ecacile yesigungu) inethonya elikhulu ekuxilongweni. Lo mdwebo ubonisa konke:

• Ukuvulwa komlomo;
• Ukukhuthazwa kwe-fetus;
• I-Pulse;
• Ukucindezela;
• I-palpitations yezingane;
• Ukuhlukaniswa nokunye okunjalo.

Uma kungekho nqubekela phambili ekuvezweni komlomo wesibeletho amahora amabili, okuvezwa ngokucacile eptogram, khona-ke lokhu kuhlolisiswa kwenziwa.

Ukuhlolisisa ubuthakathaka besibili kusekelwe kulezi zinkomba:

• I-partogram;
• I-CTG;
• Ukulalela ukushaya kwenhliziyo.

Lokhu kudingekile ukuze ingane ingatholi i-hypoxia. Kukhona ezinye izinkinga zenqubo yokukhiqiza, okufana nokufanekisa okufana nomsebenzi obuthakathaka. Lokhu kufaka:

• Ukukhubazeka kwezigaba zokuqala;
• Ukuhlukana kwemisebenzi;
• I-pelvis encane emitholampilo.

Ukwelapha

Kubalulekile ukuqaphela ukuthi ukwelashwa kukhethwe ngabanye besifazane abasebenza. Lapho ukwelashwa udokotela kufanele abheke yonke idatha anayo (isimo somfazi nengane).

Ikhambi elihle labasebenzi ababuthakathaka yindlela yokulala kwezidakamizwa. Ngenxa yalokhu, kutholakala imithi ekhethekile ukuze owesifazane aphumule, ngakho-ke umsebenzi womsebenzi ungase uthuthuke.

Uma lokhu kungazange kusize, basebenzisa isikhumba sesisu. Ngemuva kwalendlela, umsebenzi wezabasebenzi uba kakhulu kakhulu. Kumele uqaphele ukuthi ukukhishwa kwenziwa kuphela uma umlomo wesibeletho usulungile.

Ngezinye izikhathi odokotela basebenzisa izidakamizwa. Manje sizocubungula kafushane lesi sidakamizwa uMurouropriston ngokugqugquzela ukubeletha. Lesi sidakamizwa kufanele sithathwe ngokuqinile ngaphansi kokuqondiswa odokotela. Ivimbela i-progesterone, enomthelela omuhle emsebenzini wokusebenza wesibeletho.

Ukulethwa

Uma kungekho zindlela eziye zasiza, kuhlanganise noMuropriston ngenhloso yokugqugquzelwa komsebenzi, udokotela angenza isigaba esiphuthumayo sokudla kwezifo eziphuthumayo. Yiziphi izindlela ezenziwa ngaphambi kokusebenza:

• Imithi yokulala;
• Amniotomy;
• Ukuvuselelwa kwezidakamizwa.

Ngaphezu kwalokho, kungase kube khona izinkomba ezengeziwe zokusebenza. Kukhona uhlu oluthile lokuphikisana nokuvuselelwa kwemisebenzi (i-pelvis encane, izibazi ezibelethweni, isongo ekuphileni nokunye okunye).

Ukuvimbela

Sasihlolisisa ngokuningiliziwe ukuthi kunobuthakathaka bomsebenzi. Izincomo zezokwelapha zokuvimbela zinganikezwa isazi sezifo-mzimba esiholela ekukhulelwe kwakho. Kufanele akhulume ngezinkinga ezingenzeka ngesikhathi sokubeletha futhi aqeqeshe ngokomzimba nangokwengqondo owesifazane ekubelethweni. Ngaphandle kokuhlelwa kwe-rhodostimulation, ukuvimbela izinkinga ezingenzeka ku-fetus kuyimpoqo.

Imiphumela

Yiziphi izinkinga zobuthakathaka bokusebenza? Kumama, lokhu kungaba:

• Ukwenziwa kwama-hematomas;
• Ukwakheka kwe-Fistula;
• Ukutheleleka okungenzeka.

Izinkinga ezilandelayo zingenzeka ingane:

• I-Hypoxia;
• Acidosis;
• I-Edema yobuchopho;
• Ukufa.

Konke kuncike ekufundiseni udokotela. Ngokugqugquzela okufanele nokulawula okuqondile isimo somntwana nomama, akufanele kube nemiphumela.

Isibikezelo

Manje, ngokufushane mayelana nokubikezela ubuthakathaka bomsebenzi. Njengoba kushiwo ngaphambili, konke kuxhomeke ekusebenziseni udokotela kanye nesimo sengqondo sowesifazane. Ungesabi, kodwa ulalele izincomo zesazi. Izinkinga ngemuva kokusebenza nzima kunzima.

Ukulethwa okuqhubekayo

Ukungabi namandla okusebenza ekuzalweni kokuqala akusho ukuthi konke okulandelayo kuzoqhubeka ngendlela efanayo. Ubuthakathaka obuyisisekelo nabokuqala buvame ukutholakala kwabesifazane ababeletha izibulo. Iphesenti elincane le-mnogogorozhavshih lingase libhekwe ubuthakathaka besikhathi esibucayi.