Maererano nezvinorayirwa neWorld Health Organization (WHO), kuberekwa kubva pamasvondo makumi maviri nemasere kusvika ku37 ekuzvitakura (fetal weight 500 g kana kupfuura) zvasati yasvika. Kune mavambo mashoma ekuberekwa asati asvika (masvondo 22-27), kutanga (masvondo 28-33) uye kuberekwa kusati kwapera (vhiki 34-37). Munyika yedu, kubereka pamasvondo makumi maviri nemakumi maviri nemakumi maviri nemaviri hazvitarisidziki nguva isati yasvika, asi kurapwa kunowanikwa muchipatara chekuberekwa, uyewo kutora matanho ose anodiwa kuchengetedza fetus. Mwana akaberekwa panguva yakadaro (masvondo 22 kusvika ku23) anotorwa sean fetus mumazuva manomwe ekutanga ehupenyu. Kungoti mushure mevhiki, kana mwana achigona kuenderana nemamiriro ekuwedzera ehupenyu, anonzi ari mwana. Muchiedza chemazuva ano, kuwanda kwekutanga kwebasa kunoshanda kwete chete kunoderera, asi kunowedzera kuwedzera nekuda kwekuwedzera kwenhamba yekuzvitakura kakawanda, kushandiswa kwakapararira kwekubatsiridzirwa kwekuberekwa kwehutano. Ndezvipi zvinokonzera kuberekwa kusati kwaitika, dzidza munyaya iri pamusoro pehurukuro inoti "Ndeipi ngozi kune amai vanozvarwa vasati vasvika."
Zvinokonzera
Zvinokonzerwa nekuberekwa kwepakutanga zvakasiyana-siyana, zvinogona kugoverwa mumapoka maviri - socio-biological (kwete-kurapa) uye kurapa. Kune zvikonzero zvehupenyu hwevanhu nehupenyu hunovhiringidza (kushandisa doro, zvinodhaka, kusvuta panguva yekuzvitakura), hutsika hwehutano hwehupfumi hwehupenyu hwomunguva yemberi, zvinokonzera kushanda mamiriro ezvinhu (kuvapo kwemazuva ano, kudengenyeka, ruzha, rusina nguva, basa usiku), uye uyewo kushaikwa kwezvokudya zvinovaka muviri, mamiriro ekugadzikana kusingaperi.
Zvikonzero zvikuru zvekurapa zvinosanganisira:
• Kuwana (chimwe chezvikonzero zvinonyanya kukonzera kukanganisa kwokutanga kwekuita pamuviri). Kuti kuberekwa kusati kwasvika kunogona kutungamirira kune zvose zviri zviviri uye zvirwere zvisingaperi (bhakitiriya uye utachiona). Inogona kuva zvirwere zvinopararira zvinotapukira zvemuviri wenyama (pneumonia - pneumonia, pyelonephritis - kuvhiringidza kwetsvo, nezvimwewo), ipapo hutachiona hunopinda mumucheche kuburikidza neparcenta; kana utachiona hwemadzimai ejitini (chlamydia, trichomoniasis, gonorrhea, herpes, etc.), saka hutachiona kubva mumudzimai hunogona kupinda mumusana we fetal uchikwira.
• Kuyerwa mumatambudziko ekudzivirira kubvisa pamuviri (kubvisa pamuviri, kupera pamuviri - kukanganiswa kwepamuviri kusvika kumasvondo makumi maviri nemaviri uye kuberekwa nguva isati yasvika) uye / kana gynecological history (zvirwere zvinoputira zvekadzikadzi, chiremera chechibereko chemuviri, chirwere chemahomoni, chirwere chekudzivirira muviri - kusagadzikana kwechibereko).
• Isthmicocervical insufficiency - kusakwanira kwechibereki chibereko chekuberekwa nekuda kwekushungurudzika nekubvisa pamuviri, discontinuities mumarwadzo apfuura, nezvimwewo.
• Kuwedzera kwezvirwere zvezvirwere (zvirwere zvenhengo dzomukati) - endocrine pathology (kurema, chirwere cheshuga, zvirwere zvehutachiona), zvirwere zvakakomba zvemwoyo yemagetsi, itsvo nedzimwe nhengo. Kune boka iri rezvikonzero zvinosanganisira zvirwere zvehutachiona (zvirwere zvinobatanidza nekuwedzera kwebasa rekuisa ropa ropa), umo mukana wekutora nguva isati yasvika yepentecenta, thrombosis (kuvhara ropa remakumbo emidziyo yeropa yepentecenta), zvichiita kuti kuberekwa nguva isati yasvika kunoshamisa.
• Nzira yakaoma yekuzvitakura (gestosis - toxicosis yehafu yechipiri yepamuviri, maitiro akaoma e fetoplacental insufficiency, inokonzera kukwira kwechibereko - polyhydramnios, kutakura pamuviri).
Chiratidzo chekutanga kwekuberekwa kusati kwaitika
Chiratidzo chekutanga kwebasa chichava kuonekwa kwekugara uchipwanya marwadzo mudumbu rezasi, iyo inopfuura nguva yakasimba, inogara kwenguva refu uye ichiwanzoitika. Pakutanga, apo marwadzo ari mudumbu ane simba uye haawanzoitiki, kubuda mucous kana mucocutaneous kubuda kunogona kuonekwa kubva kumudzimai, izvo zvinoratidza kuchinja kwemuitiro (kupfupisa uye kunotsvedza) yemukirini. Kusiyana kwakasiyana-siyana kwekugadzirwa kwezviitiko kunogona kunge kusati kwapera kusununguka kweamniotic fluid, asi mvura yakajeka kana yakatsvuka inosunungurwa kubva mumudzimai, iyo yakawanda inogona kusiyaniswa kubva pagashupu kusvika kune girazi kana kupfuura. Kudururwa kweamniotic fluid kunogona kuendeswa nemarwadzo mudumbu rezasi, uye kunogona kuitika mukusakwana kwekuwedzera kwekutaura kwechibereko. Sezvo mutemo, kuputika kweamniotic fluid kunokonzerwa nehutachiona hwemuzasi wepeta ye fetal bladder nenzira inokwira (utachiona hunobva kumadzimai). Kuonekwa kwechimwe chezviratidzo pamusoro apa ndiyo nheyo yekudana "ambulensi" uye yekurumidzirwa kutarisirwa muchipatara chekuberekwa, sezvo nokukurumidza amai vari mberi vari mune imwe nzvimbo yezvechiremba, mikana yakawanda yekuchengetedza pamuviri. Kana pasina chikonzero chekuwedzera nguva yekuzvitakura, mamiriro ose ekunyatsochengetwa achagadzirwa muchipatara chekuberekwa, kuderedza dambudziko rematambudziko kune amai uye fetus, pamwe nekuyamwisa mwana asati aberekwa.
Nzira yekuberekwa kusati yasvika
Zvinetso zvinowanzoitika zvemaitiro ekuberekwa nguva isati yasvika ndezvakaipa zvebasa (kushaya simba, kuwanikwa kwebasa, kukurumidza kana kukurumidza kuendesa), kusununguka kusati kwatanga kwe amniotic fluid, kukura kwepinuterineine fetal hypoxia (kushaya oxygen).
Kurumidza kusununguka
Nokuda kwekuberekwa kusati kwasvika, kukurumidza nekukurumidza kuderera kunoratidza. Izvi zvinokonzerwa, kutanga, kune chokwadi chokuti pakuberekwa kwekuberekwa kusati kwasvika, kuzarurirwa kwemuviri wemukati (6-8 cm) kunokwana kudarika kubhadhara panguva yakakodzera (10-12 cm). Chechipiri, zvakawanikwa kuti chibvumirano chechibvumirano chechibereki mukutanga kwekutaura chinenge kakapetwa kaviri pane basa pakuberekwa nenguva. Chechitatu, mwana mudiki akareba anofamba nekukurumidza kuburikidza nezera rekuberekwa. Munyaya iyi, kazhinji, kurwadza, kurwisana kwenguva refu kunoonekwa. Kana muvhareji wehuwandu hwekuendesa panguva yakakodzera maawa 10-12, ipapo kuberekwa nguva isati yasvika kunopedza maawa manomwe kana masere. Nzira yekukurumidza yebasa inonyanya kukanganisa, iyo iyo kunyange nekuendesa nguva yakakodzera kunogona kutungamirira pakuvandudzika kwe hypoxia (oxygen nzara) ye fetus. Kushanda contract contractile basa yechibereko chinotungamirira ku kuderera kweutteroplacental blood flow, iyo inoguma ye hypocia ye fetus, uye inewo inonzi yakagadziriswa pamagariro asina simba emwana asati asvika. Mukuwedzera, nekufambisa nekukurumidza kuburikidza nemigero yekuberekwa, musoro weku fetal hauna nguva yekufananidza neyakakodzera, iyo inokonzera kushungurudzika kwechirwere chepervical, uyewo kuora ropa pasi pemakumbo europi ye fetal panguva yekuberekwa. Somugumisiro wekukuvara uku, mwana asati ava nenguva anogadzikana matambudziko mukugadzirisa mitsva (extrauterine) yemamiriro ezvinhu ehupenyu, ayo anonyanya kuratidzwa nehutano hwehutsinye uye inoda kunyatsochenjerera nekubika. Nokuda kwekufambira mberi kwakakurumidza kwemwana, pangave nekuputika kwechirwere chisina kunaka (ruptures yemukati, vagina, rabia) nekuda kwekuti mishonga haina nguva yokugadzirisa zvakanaka kusvika pakukura kwe fetus.
Kushaya simba kwebasa. Chimwe chinetso chisingawanzwisisiki chekusununguka nguva isati yasvika kushaya simba kwebasa, apo kuwandisa uye simba rezvipikiso zvakaderedzwa, izvo zvinonyanya kuwedzera nguva yebasa uye zvinowedzera kukanganisa chimiro chemucheche che fetus (hypoxia inokura). Basa rakaoma rebasa. Kuwedzera kune basa rakawandisa rakaoma kana risina simba, basa rinopesana rinowanzoitika rinowanikwa kazhinji pane kuberekwa nguva isati yakwana - rudzi rwekusateerera kwechiito chekuberekwa, umo chirongwa chekudzivirira kwemitsipa yebereki inoparadzaniswa (kazhinji kupindira kunotanga pakona yebereki uye kunopararira kubva kumusoro kumusoro). Mukati yebasa rinopesana, zvipembenene zvakanyanya zvinorwadza zvinoratidzirwa, mumakamukakati pakati pechibereko chisingazomboregi zvachose, chinotungamirira kukurudzirwa kwe intrauterine hypoxia ye fetus. Nzvimbo isina kukodzera yemucheche. Mumazuva ekuberekwa asati azvarwa, kutadza kwekuberekwa kunowanzoitika (somuenzaniso, mharidzo yepilvic) nemhaka yehukuru hwema fetus maererano nehukuru hwehutachi uterine.
Kutanga kusununguka kweamniotic fluid. Izvi zvinokonzerwa nekuberekwa nguva isati yasvika kakawanda uye kunokonzerwa ne isthmicocervical insufficiency kana utachiona. Chikamu chechivako, chakashandurwa kuva chikadzi, pasi pesimba rehutachiona chinotapurika kuchinja, chinowedzera kusviba, uye kuputika kwemakumbo kunowanikwa. Kudururwa kweamniotic fluid kunowanzoitika kusingatarisirwi, asi mvura yacho inosunungurwa kubva kumadzimai (kubva panzvimbo ine mvura panzvimbo yekuchenesa kusvika kumvura inoyerera muhuwandu hwakawanda). Muvara weamniotic fluid unogona kuva wakajeka uye wakajeka (izvo zvinoratidza uchapupu hunogutsa hwemucheche), pane dzimwe nguva, mvura inogona kuwana ruvara rwemavara, kuva nehutu, nekunhuhwirira kunofadza (izvo zvinoonekwa sechiratidzo chemukati weuteral fetal hypoxia kana utachiona).
Zvirwere
Zvinetso zvinotapukira pakuberekwa kana mu puerperium munguva yekuberekwa nguva isati yasvika zvinowanikwa kakawanda kupfuura panguva yekuberekwa nenguva. Izvi zvinogona kunge zvakakonzerwa nebasa rekushanda kwenguva refu (neutera hwebasa), nguva yakareba yenguva yakaoma - maawa anopfuura 12 (sekuda kazhinji mushure mekubuda kweamniotic fluid kusati kwatanga kubasa kunotora maawa mazhinji), pamwe nekuvapo kwekutanga mumuviri wehutachiona hwepamuviri, yakava chikonzero chekuberekwa kusati kwaitika. Dambudziko rinowanzopindirana nehutachiona ndeye postpartum endometritis (kuvhiringidza kwechibereko), kudyidzana kwe sutures mushure mekugadzirisa ruzi. Zvinetso zvisingawanzoitiki, asi zvakakomba zvinogona kuva peritonitis (kuputika kwe peritoneum) uye sepsis (kupararira kwose kwehutachiwana mumuviri wose).
Kutungamirirwa kwekutanga kwebasa
Kubva nokuda kwehupenyu hwemwana asati asununguka kushanda ndesimba rinomanikidzwa, kutungamirirwa kwekuberekwa nguva isati yasvika kune zvakasiyana-siyana zvakasiyana kubva kutungamiri yebasa mumubereki wepanguva yakazara. Izwi guru rokuti "motto" rinotungamira vacetricians ndiyo inonyanya kuchenjerera, kutarisira kutarisira muhutungamiri hwekutanga kwebasa, kusavapo kwekupindira kupi zvako pasina zvikonzero zvinokosha.
Kuchengetedza pamuviri
Panzvimbo yekutyisidzira kana kutanga kusununguka nguva isati yatarwa, kana pasina kupesana (zvakadai sekubuda kweamniotic fluid, zvinetso zvakakomba zvepamuviri, kuvhura kwechirwere chinopfuura 5 cm, kuvapo kwehutachiona, nezvimwewo), kurapwa kunotarisirwa kuchengetedza kubata pamuviri kunoitwa. Parizvino, vanogadzirisa zvipfeko vanogadzirwa nemishonga inogadzirisa iyo inodzvinyirira chibvumirano chechibvumirano chechibereko - tocolytic (inonyanya kushandiswa zvinodhaka zveboka iri HINIPRAL). Kuti kukurumidza kuderedze uterine tone, tocolytics inotanga kujowa mukati, shure kwekuderera kwekutaura kwavanoshandura kutora mishonga iyi nenzira yemapiritsi.
Kudzivirira kwezvinetso. Mune mhaka yekutyisidzirwa kwekuvhiringidzika kwepamuviri panguva yevhiki dzisingasviki 34, chirwere chekufema chirwere chechecheche (zvinokonzera kupora nekuda kwekukura zvakakwana kwemapapu emapapu) zvinodziviswa nekurondedzera mahomoni ane pamuviri we adrenal cortex-glucocorticoids (PREHNYOLOH, DEXAMETHANON, BETAMETAZON). Muyero wekudzivirira kwechirwere chekupemha kunetseka kwema fetus kunotora maawa makumi maviri nemasere pamusana (zvirongwa zvakasiyana-siyana zvekugadzwa kwe glucocorticoids zvakagadzirwa - kubva maawa 8 kusvika kumazuva maviri, kusarudzwa kunoitwa kunoenderana nemamiriro ezvinhu chaiwo). Mishonga iyi inobatsira pakukurumidza kwekutsvaga kwepermonary surfactant mu fetus, sezvo kusakosha kweiyo inogadzirisa iyo inowanikwa mualveoli - iyo mapurmonary "gas bubbles" iyo inoshandiswa gasi pakati peropa nemhepo - uye kudzivirira mapapu kuti asadonhedze kuputika kunokonzera kukura kwehutano hwekupemha premature neonate. Icho chasimbiswa kuti panguva yekubata kwemavhiki masere anopfuura 34, fetal lungumapfudze inenge iine yakakwana yekushanda. saka hapana chikonzero chekudzivirira kuporesa chirwere chinonzi syndrome. Muchikwata chezvipembenene uye neonatologists, maitiro ekugadzirisa mafashoni aripo panguva ino (KUROSURF, SURFANTANT BL), nekutumirwa kwevana vanozvarwa vasati vasvika kunogona kuderedza zvakanyanya kukanganisa uye kuoma kwepemiratory distress syndrome. Munguva yekuberekwa, kunyatsochenjerera kunoitwa pamwe chete nekuda kwechiitiko chemukadzi wechikadzi (kutonhorera, kuwedzera kweropa, kana zvichidikanwa, kuongororwa kwekliniki yeropa inoshandiswa), uye nokuda kwechimiro che fetus che fetus ne cardiotocography (ma sensor maviri anonyora izwi rechibereko chemuviri uye chimiro chemucheche , iyo inobvumira kuongororwa kunobudirira kwehutachiwana "hutano hwehutano" hwemucheche), pamwe nekugara uchinyatsoteerera mazwi emwoyo we fetal kuburikidza nemadziro emadziro emukati. Kudzivirira kwe intrauterine hypoxia ye fetus inoitwa, nokuda kweizvi vanorayirwa kuPIRACETAMES, ASKORBINE ACID, COCAROXYLASE, ACTO-VEGIN.
Anesthesia
Mamiriro akakwana ehutano hwakanaka hwepamberi pebasa inokwana anesthesia, sezvo kurwadziwa kunotungamirira kukurudzirwa kwepasmas spasm, iyo zvechokwadi inobata zvakaipa pamucheche usati wabva, nekuti basa ripi rinomanikidzira mamiriro ezvinhu. Nechinangwa chekuberekwa kweaneshetizing, spasmolytics uye analgesics, epidural anesthesia (nzira yeanesthesia, iyo iyo mishonga inorovedzwa mune epidural space) inoshandiswa. Iyo jekisi inowanikwa munzvimbo yakakomberedzwa, nzvimbo iri pakati pamadziro emusana uye ganda rakaoma rakavhara rwonzi rwomukona, catheter inowanikwa, uye anesthetic agent anoshandiswa. Tichifunga nezvekuti narcotic analgesics (somuenzaniso, PROMEDOL) inogona kuora mwoyo pamusana we fetal breathing center, kushandiswa kweboka iri remishonga hakubatsiri. Epidural anesthesia yakazviratidza pachedu mune kutungamirirwa kwekutanga kwekutanga kuberekwa, sezvo inobatsira pakuvandudzwa kwehutano hwehutachiona hwehutachiona, hunova nemigumisiro inobatsira pamuviri we fetus wekuberekwa uye nekuubatsira kuti ukunde kushungurudzika kwekuberekwa mumamiriro ezvinhu "akasununguka".
Rhythmostimulation
Izvozvo zvinotevera zvemazano ekushanda munyaya yekuzvitakura nguva isati yakwana inonyanya kutarisa pamusoro pekugadzirisa mafungiro apo utera hwebasa hunosimbiswa. Kana kutaurirana kwenguva yakakodzera kunotanga nehudhiostimulation, inofanira kuramba ichiguma kusvikira pakupera kwekuberekwa, zvino kana kana isati yaberekwa kubereka nzira yekudzivirira inoshandiswa: panguva yekusimudzira kwebasa, kukurudzira kunorega, sezvo kushandiswa kwechimiro chisina simba chemucheche asati asvika kunogona kukonzera intrauterine hypoxia.
Kuchengeta nguva yekuedza
Munguva yekudzingwa kwe fetus (nguva yekuedza) nokuda kwechinangwa chekunyatsorongedza kwe fetus, kuberekwa kunotorwa kusina kuchengetedza perineum kubva kumapapiro (iyo inonzi mavheti anonzi obstetric), uye kukanganiswa kwepineineal kunogadziriswa kuderedza kudzvinyirira kwomusoro wekufukidzira nematumbu emusana wekuberekwa-episiotomy. Pakuberekwa, neonatatologist nguva dzose aripo, akagadzirira kupa rubatsiro rwekukurumidzira kwechecheche uye kuitazve kudzosera kana zvichidiwa.
Chikamu cheKesariya chikamu chekushanda
Zvakanyanya kuoma kuziva zviratidzo zvechikamu chekuchengetedza mukati mekutanga kwebasa, kunyanya kana nguva yekuita nguva isati yasvika masvondo makumi matatu. Muzvinyorwa zvemazuva ano, kuendeswa nechikamu chekushaya chirwere chepamuviri nepamuviri pasi pevhiki kusvikira masvondo makumi matatu muhuwandu hwemhosva dzinoitwa maererano nezviratidzo zvachose - kureva, mumamiriro ezvinhu anotyisidzira upenyu hweamai. Zviratidzo zvisinganzwisisi zvinosanganisira nguva isati yakwana kuputika, placenta previa (iyo placenta inobata chibereko chechivharo, uye kuberekwa hazvibviri kuburikidza nemuviri wekuberekwa kwechizvarwa), chinzvimbo chepachiviri chemu fetus, nezvimwewo. Kudiwa kwekushandira kwepamusoro kune zvinodiwa nehumususipo kana kubata nguva isati yasvika kunobatanidzwa pamwe chete nyanzvi) vachifunga nezvekufananidzira kwehupenyu hwemwana uye nekukwanisa kupa vana vane unyanzvi hwekurera vana.
Nzira yekuzvibata sei?
Maitiro evanhukadzi panguva yekutangiswa kwekutanga kwekutanga haasi yakasiyana zvikuru kubva pamitemo nekutaura panguva yakakodzera. Kana chiremba achibvumira, iwe unogona kufamba-famba padivi, utore nzvimbo dzakasununguka dzemuviri dzinosunungura marwadzo ekugadzirisa, uchishandisa masheji (kuenderera mudumbu nenzira yakatarisa, kubvisa sacrum, nezvimwewo), kufema zvikuru panguva yekurwa. Mune zvimwe zviitiko (somuenzaniso, nekutaura kwepachesi ye fetus) zvinokurudzirwa kuva panhovo. Muchiitiko ichi, sarudzo yakanakisisa ichave iri parutivi rwaro, sezvo mamiriro ezvinhu aya asingabviri kudzvinyirira midziyo huru (iyo inogona kukonzera kukura kwe-intrauterine fetal kutambura), uye inodzivirirawo fetus kuti irege kufamba nekukurumidza kuburikidza nezera rekuzvarwa. Chinonyanya kukosha - ramba wakadzikama uye une mafungiro akanaka, nyatsoteerera uye tevera mazano avanyamukuta navanachiremba.
Premature baby
Mwana wacho, akaberekwa somugumisiro wekuberekwa nguva isati yasvika, ane zviratidzo zvekushanduka kwepakutanga, iyo yakasimba yakagadzirirwa muhuwandu hwekuberekwa - uremu huri pasi pe 2500 g, kukura pasi pemaminitsi makumi mashanu, kuwanda kwechizipa chechizi paganda, kunyorova kumeso uye nzeve yepamusoro, vasikana havafukidhi mazana madzimai , muvakomana mapepa haadonzwiki mukati memahombekombe, mahwendefa echipikiri haasviki pamuromo. Pakuberekwa, mwana anoongororwa neononatologist muimba yekutakura ndokuendeswa kuIntensive Care Unit kana Neonatal Resuscitation kuti arambe achiongorora uye kurapwa. Sezvo mutemo, vana vasati vasvika vanowanikwa mu'uzvez - inoputika inokosha uye masvingo akajeka, izvo zvinochengetedza kutonhora, humusi, okisijeni mune zvakakwanira kumucheche wemwana. Kuva mukuveze kunokurudzira kufamba kwakanyatsojeka kwenguva yekugadzirisa kwechechecheche kunze kwemuviri wamai. Iyo yakareba nguva yekuzvara uye kurema kwecheche paanenge aberekwa, zvinonyanya kufanirwa kupera. Kana zvichidiwa, mwana achangoberekwa anotamiswa kubva kuchipatara chekuberekwa kuenda kuchipatara chevana kune chikamu chechipiri cheukoti. Kune zvipatara zvekuberekwa zvakanyanyogadziriswa muhutungamiri hwekutangira kutangira uye kuyamwisa vana vatsva vasati vasvika, vane zvigadzirwa zvemazuva ano zvakaoma zvevana, vacetricians uye neonatologists vakawana ruzivo rwakakura mukurapa nekuendeswa kwezvipatara zvakadai, izvo zvinobvumira kuchinja zvakanyanya zvigumisiro zvevabereki vose uye nokuda komwana. Vakadzi vane ngozi yakawanda yekuberekwa vasati vasvika vanofanira kuberekerwa mumasangano iwayo ekuvhiringidzika, apo mamiriro ese ezvinhu aripo pakupa rubatsiro rwakakwana rwekudzorerazve kumwana asati azvarwa (Kuveza, ventilators, uye nyanzvi dzezinga rakakodzera).
Kugadziriswa kumamiriro ezvinhu matsva ehupenyu kunze kwechibereko chemucheche mwana asati asvika pane zvakanyanya uye zvakanyanya kupfuura kwenguva yakazara mwana. Izvi zvinokonzerwa nekusava nekuvandudza kwenhengo uye maitiro, kukwanisa kuderedzwa kwekutonga-kutonga, kusagadzikana kwekudzivirira kwezvirwere zvemuviri. Parizvino, kubudirira kwakakonzerwa nekuchengetwa kwevacheche vatsva vasati vasvika: maitiro ekugadzirisa mafungiro akaonekwa ari muchikwata chechiremba, icho, kana chichiendeswa kumwana, chinogona kuderedza zvakanyanya ngozi yekupemha chirwere chinonzi syndrome, zvipatara zvekuberekwa zvinowedzerwa nemichina yakasununguka kuti ipe rubatsiro rwepamusoro (kuvezes, ventilators, nezvimwewo), iyo inobvumira kuvandudza migumisiro uye kufanirwa kwekuwedzera kukura uye kukura kwemwana.
Kudzivirira kuberekwa kusati kwapera
Izvo zviyero zvakakosha zvakakonzerwa nekudzivirira kwekutanga kwekutanga kuberekwa kunoitwa pahuwandu hwekubvunzurudzwa kwevakadzi, sezvo ihwo hunhu hwekucherechedza kwedzidzo yekudzivirira inokubvumira kufanotaura uye kuongorora kutyisidzika kwekukanganisa kwayo munguva. Izvo zviyero zvekudzivirira kwekutanga kwebasa zvinosanganisira:
• Kubata pamuviri pamwe nekugoverwa kwekutanga kudzidzira, iyo inosanganisira kurapwa kwezvirwere zviripo zvemazuva ano, kurapwa kwechirwere chechirwere chepachirwere, kuitira kuti panguva yekudzivirira muviri weamai vanotarisira uri munharaunda yakakwana yekutakura kwomwana.
• Kuverengwa kunotanga nekubvunzurudzwa kwevakadzi uye kugara nekucherechedza kubata pamuviri. Izvi zvinonyanya kuitika kana munguva yakapfuura mukadzi ainge atova nematokari, kuberekwa nguva isati yasvika, kubvisa pamuviri.
• Kurapa kwechipi yehutachiona, kunyanya chirwere (kuvhiringidza zvirwere zvemukadzi), kunoonekwa panguva yekuzvitakura, sezvo nzira inowanzoitika iyo inokonzera kukura kwekutanga kwekuberekwa kuri kukwira (utachiona hunobva kumudzimai hunokwira uye hunokonzera chironda chepasi che fetal bladder).
• Nenguva yekudzivirira uye kurapwa kwezvinetso zvekudzivirira (zvakadai sokushaya kukwana, gestosis - toxicosis yehafu yechipiri yepamuviri, pyelonephritis - kuputika kwetsvo, nezvimwewo).
• Ultrasonic kutarisa kwemukati yeutrauterine fetal status uye kubata pamuviri (ultrasound inogona kushandiswa kuyera urefu uye chimiro chechirwere chechibereko chechirwere chekugadziriswa kwechirwere chechimiro chisina kukwana).
• Kana pane zviratidzo zvekutyisidzira kubvisa pamuviri, nguva yakakodzera yekurapa uye kurapwa nekudzivirira kuporesa dambudziko rekurwa mumwana. Iye zvino tinoziva kuti chii chakaipa kumamai ekuberekwa vasati vasvika.