Iyi nguva inosvika maawa manomwe. Kwenguva yokutanga hondo dzekugadzirira dzinogona kunonoka, zvinoreva kuti dzichadzivirira amai vari mberi kuti vazorore nekuwana simba re "basa" iri kuuya. Zvadaro chiremba achazivisa mishonga yekuita kuti aite kurara. Kune amai vose, vekutanga, vakaberekwa kwechipiri vari munhu oga, tsanangudzo - mune imwe nyaya pamusoro penyaya inoti "Kuberekwa kwekutanga kunopesana nechechipiri."
- Nguva yekutanga - cervical opening
Izvi zvinoitika kana chikamu chekugadzirisa zvinokonzerwa nekugadziriswa kwave kuchikurumidza kupera uye kuneta nemadzimai anotarisira kana amniotic fluid yakayerera mberi kwenguva. Muchiitiko ichi, chiremba achamupa remedy remedy kuti amurege kuzorora uye kudzorera rwiyo. Izvi zvinoitikawo panguva yekuberekwa kwechibereko chechibereko, amai ve "kukuvadza" havana kugadzirira, kureva kuti, hazviregi uye hazvipfupi.Pano izvi zvinobatsirwa nezvipikiso: zvinowanzogara uye zvakasimba. Pasi pechiito chavo, mutsi unonyoreswa, wapfupiswa uye zvishoma zvakasvinudzwa. Mutsipa unofanana nebhuruti ine mitsipa miviri: yekutanga "inovhara" mukova wechibereko (ipapo, mwana anoyambuka mumvura amniotic), uye imwe - "kubuda" kunze. Ndicho chishuvo chekupedzisira chinotakura mutoro mukuru pakuzvarwa: inofanira kuzarura nekuwedzera kuti mwana aende. Kuti ujekeswe, fungidzira bharuti yemhepo (chibereko), gumbo (cervical canal) iyo yakasungirwa nemaketani maviri (mukati nekunze kupenya kwechirwere). Nguva yekutanga ye "vasina ruzivo" amai vanopedza maawa 12-18 (izvi zvinosanganisira 7 kugadzirira), panguva yekuzvarwa kunotevera zvinotora maawa matanhatu nemaawa matanhatu. Kwenguva yokutanga rwiyo rwekurwa panguva iyi rutsva runogona kusiyanisa kubva pane zvakasikwa, zvino vanove vfupi, zvisina kukwana, uye chibereko chechivharo sechikonzero hachizaruri. Zvadaro chiremba achatanga kugadzirira chibereko chechibereko nemubhadharo, semuenzaniso gel, izvo zvinosanganisira biologically zvakagadzirwa nezvinhu - prostaglandin, kana makenduru nezvinhu zvinoderedza mishonga yake.
- Nguva yechipiri - kuberekwa kwechecheche
Inotanga nenguva yekuzarura kwakakwana kwechirwere uye inopera nekuzvarwa kwomwana. Panguva ino, maitiro anowedzera, uye kuedza kunowedzerwa kwavari. Musoro wemucheche unomanikidza pamusana wepachipfuva chemukadzi, unoshungurudza kuguma kwehutano, kubva kwaanova nechido chisingadikanwi chekuoma. Nguva yechipiri inotora nguva yakareba kune "vashandi", kubva paawa imwe kusvika ku 2. Izvi zvinokonzerwa nekuti muvakadzi vari kuva amai vekutanga, misungo yepachipfini, pasi rose zvinotapira zvishoma, izvo zvinoreva kuti havakwanisi kutambanudza uye kuwedzera zvimwe kudzivisa kuberekwa kwomwana. Nokuda kwechikonzero ichi, kushungurudzika kwekuberekwa kwechirwere mu "chivande" kunoitika katatu kakawanda kakawanda. Kuti zvidzivise izvi, chiremba anoendesa kunhengo dzemuviri. Nguva yechitatu ndiyo kuberekwa kwekuberekwa. Inotanga nechitarisiko checheche uye inopera nekuzvarwa kwekuberekwa (ndiko kuti, placenta ine fetal membranes). Nguva yechitatu inosvika anenge 5-10 maminitsi. Munguva ino, chibereko chinoderedzwa, chinowira pasi kusvika pamwero wejena, ndicho chikonzero kubatana kwayo neparcenta kwakaputsika, kunoputika uye, nerubatsiro rwekurwisana, kunobudiswa kunze pamwe ne membrane. Hapana misiyano yakasiyana mukuti "vasina ruzivo" uye "vakadzi vane ruzivo" vanoziva sei nguva iyi, kwete. Kudzokorora kuberekwa kwezvakaberekwa kune zvavanoda. Iro remadziro emadziro emadzimai uye ini wehuta hweuterine mumadzimai akadzo mune ramangwana haasi kutonhora, saka musoro wemwana, uri pedyo nekubuda, kusvika pakutanga kwekurwa, inogona kuramba ichifambisa pamusoro pemusuo wemapapiro, panzvimbo pokumanikidzira, sezvinenge panguva yokutanga. Nemhaka yeizvi, mukadzi haanzwi sokuda kwake "dumbu rakadonha" - kazhinji rinoitika mavhiki maviri asati aberekwa. Chirwere munguva yekudzoka kwechiri nyore nyore nekukurumidza. Izvo zvinenge zvichingova chete ivo vanaamai vari mberi vakagumburwa mutsipa wakakomba munguva yekuzvarwa kwekare. Nenzira yakanaka, iye zvino mamiriro ezvinhu akadaro haawanzoitiki. Kana chirwere chemuviri chemukati chakanga chakareba uye chisina kuporesa kana tsvuku yakaonekwa munzvimbo yavo, vanachiremba vanogona kutungamira mukadzi kumugadziro wakarongeka. Kuzarurirwa kwechibereko chemuviri panguva yekudzoka kwebasa kunokurumidza uye kunotora mavhareji emaawa matanhatu nemaawa matanhatu. Panguva imwe chete neyekutanga kurwisana, zvose kuvhura uye kupfupisa kwechibereko chechibereko chinotanga.
Nokuda kwekuti kuberekwa kwevana kunowedzera nekukurumidza uye danho kana zvipembenene zvichitambudza hazvirevi kwenguva refu, chido chekushaya anesthesia chinomuka kashoma.Kana mwana akaberekwa asingaiti zvakanyanya kukura kwekutanga uye akarurama, nguva yechipiri yebasa inopfuurawo nokukurumidza . Mwana anoenda "nechepamusoro-soro", uye kana kwenguva yekutanga kubva panguva yekuzarurirwa kwakakwana kwechirwere asati aberekwa mwana zvinotora nguva 1-1.5 maawa, uye maminitsi 20-30 gare gare. Analgesics inoshandiswa kakawanda kune analgesia, iyo inorayirwa kamwechete inopamuscularly kana intravenously. Kukuvadza kumuviri wemukati uye perineum munguva yebasa rinowanzopfuura hazviwanzopfuura nguva yekutanga, kunze kwekuti mhando dzakadzikama hadzina kupiswa. Ichokwadi kuti, pamuviri wese uye kuberekwa ndiko kuedza mukadzi. Uye kuberekwa kwekutanga, kunze kwekunge vakagadzirisa zvakasununguka, vachiri kuda kugara vari muchiyeuchidzo chaamai vaduku sebasa rakaoma, asi iyo yekupedzisira inobva ichinzwa kusanyanya kunetseka uye kuneta. Iye zvino tinoziva kuti kuberekwa kwekutanga kwakasiyana sei nechechipiri, uye macheche, nekuda kwekuti kufamba kuburikidza nezera rekuberekwa kunokurumidza, kazhinji kacho kunoshanda uye zviri nani kutora mazamu paanotanga kudya. Sezvo kuberekwa kunotevera kunowedzera mukana wekubuda muamai mune amai vaduku, mamiriro ezvinhu evabereki vane ruzivo muchetatu chebasa uye mumaawa ekutanga mushure mokunge vapedza kudzidza, chiremba uye mbuya vanove vakangwarira zvikuru. Mumazuva okutanga mushure mokudzorerwa zvakare, vamwe vakadzi vanoona kushungurudzika kunorwadza kwechibereko, dzimwe nguva kunyange kuchida analgesia. Zvisinei, manzwiro aya anokurumidza kupera, uye kuneta kuduku kubva pane zvakagadziriswa uye ruzivo rwakawanikwa nekuchengetwa kwekutanga dangwe kunobatsira vakadzi kukura zvakasimba nokukurumidza.