Breaks
Maererano nehuwandu, hukuvadza kwakasiyana-siyana kwekuberekwa kwechirwere kunowanikwa mumukadzi wese wechishanu uyo akazvara. Chimiro chakanyanya kufanana nokuparara kwepineum. Inowanikwa muna 7-15% yevakadzi vechidiki.
Risk Factors
Pasinei nokuti mishonga yepineineal inogona kumira mushure mekurwadziwa kwekusununguka panguva yekuberekwa uye kutambanudza zvakakwana kukanganisa musoro wecheche, zvinotaridzika kuti vanochinja sei. Deredza kuderedzwa kwezvinhu zvinotevera: kukwirira kwepamusoro nemafungiro akabudirira - kureba pakati peanus uye kupinda kwemukadzi kunopfuura masendimita 8-8; zera remukadzi zvinopfuura makore makumi matatu; anatomically narrow pelvis; chibereko chikuru; kuvhiringidza nzira mumukadzi panguva yekuberekwa; kumhanya nekukurumidza; kuzvimba kwe perineum (kusimba kwebasa uye kuedza kwenguva yakareba).
Chii chaunotarisira kubva pakuberekwa kwechipiri?
Zvimwe zvinowedzera dambudziko rekubuda kwe perineum zvinosanganisira zvipuka mushure mekukuvadzwa kunotsigirwa munguva yekuzvarwa kwepakutanga. Izvo zvinokonzera mavara kubva pane izvo zvinyorwa izvi zvinogadzirwa zvinenge zvisingakwanisi kutambanudza uye, nekuda kwekusava nehanya, misodzi pakuzvarwa kwechipiri, kazhinji mumutsara wekare. Asi iwe haugone kutaura pamusoro payo sekutonga kwesimbi. Vachizvidzivirira, avo vanoziva nezvezvinetso zvakadaro mumarwadzo apfuura, vachange vakachengetedza zvakanyanya kuchengetedza perineum. Kana zvikwangwani zviri panzvimbo yezviputi zvakapfuura zvishoma uye zvakaporeswa munguva, dzinogona kusavhiringidza nebasa rinowanzoshanda risina kupera, kunyanya kana fetus isiri yakakura. Kana pakanga pasina kuputika mumhando yekutanga, zvino mumudzimai anokwidzika mukana wekutora iwo muduku, sezvo mishonga yepineineal mushure mekutanga kwekubereka kunowedzera kuwedzera.
Kudzivirira
Sezvataurwa pamusoro apa, chimwe chezvikonzero zvinokonzera kuputika ishungu yakakura. Zvinokwanisika kuti kana mwana wako wekutanga akaberekerwa achiyera zvinopfuura 4000 g, ipapo yechipiri haingave yakakura, saka kuberekwa hakuzove kunetseka. Kuti urege kudzvinyirira mumwe mwana muchizvaro, nyora zvakanyanya kururamisa kwakakodzera. Kudya kwakanakisisa kune amai vane ramangwana kusanganiswa kweproteine uye mavitamini. Asi kushandiswa kwezvokudya zvakagadzirwa mumakrohydrates, glucose, zvinofanira kunge zvisingakwanisi. Panguva imwe chete mumwedzi yekupedzisira yehupamuviri, nyama yakanaka kuti isadye - inoita kuti mishonga isunge uye inodzivirira kusununguka. Tsiva iyo nehove kana chicken. Kuzvidzivirira kwakanaka kwekuputika panguva yebasa ndeye perineum massage pamwe nemafuta chaiwo. Inokurudzirwa kuti uite kubva pamakore makumi matatu nemaviri ekuberekwa. Dururira mafuta mashomanana emhuka kubva paminwe uye kutenderera kunofambisa kune ganda re perineum, sokunge kufananidza kutambanudza kwemukadzi: kakawanda, zviri nani. Gymnastics dzakanaka uye dzepedyo dzinobatsira - seti yezvidzidzo zvinosimbisa mitsipa ye perineum. Kana kusavapo kwekutyisidzirwa kwekuberekwa kusati kwaitika, hupenyu hunogara hwepedyo hwakakurudzirwa mumavhiki ekupedzisira ekudzivirira. Zvakakosha kuziva kuti iyi prophylaxis inonyanya kukodzera kugadzirira kuberekwa kwekutanga, asiwo yakakosha kuberekwa mumas.
Zvikamu
Mutsara we perineum munguva yebasa unogonawo kunzi kuparadza kwechisimba. Uku ndiko kushandiswa kwekuputika kwemasumbu akakomberedza chikamu chemukadzi. Iyo inobudiswa pachigamba apo musoro wecheche unenge uchiratidzwa muchikamu chekuberekwa kwetsamba. Izvo zvinowanikwa zvinowanzoitwa kakawanda, uye chikamu chikuru - pakuberekwa kwekutanga: kubva pa50 kusvika ku70%. Iyo perineum inoparadzaniswa nemuganhu wemukati kana kuti gareally kubva kwayo, zvichienderana nezvinoitwa zvinyorwa. Iko kusungirirwa nechepakati nepakati, kana mune imwe nzira-kuraira muviri, inorapa nokukurumidza uye isingaoneki mushure mekubereka mwana. Ndokusaka vananyamukuta vanowanzozvifarira.
Kana zvichidiwa?
Kana pane dambudziko rekuputsika kana kana kuputika kwave kwakatanga, mhiri dzakatetepa dzevanga rakatemwa, mukuenzanisa nemakona akacheka echiputsika, zviri nyore kugadzirisa nekuporesa nekukurumidza. Kana kutanga kwekushanda kwekushanda kwakakosha pa fetal hypoxia kana kusakosha kwekutsvaga kwayo (hydrocephalus). Aine nguva isati yazvarwa. Kuwedzera kumudzimai wemukadzi, kana mwana akaoma kukunda chirwere chekuberekwa (somuenzaniso, panguva yekuberekwa muzvinyorwa zvepilvic kana kuti nemukomana mukuru).
Chii chaunotarisira kubva pakuberekwa kwechipiri?
Mikana yokuti kubuda kutsva kuchaitika panzvimbo yeicheka, iyo yakaumbwa panguva yepineineotomy mukuzvarwa kwekutanga, yakakura. Asi kwete 100%. Zvichienderana nemamiriro ezvinhu, chiremba anofunga kana mukadzi angakwanisa kubereka kwenguva yechipiri asina kutemwa. Kana mukana wekuparara pa rumen yakakwirira, zvinofungidzirwa kuti zviri nani kutema kudarika pane kuwana nguva. Munguva iyi, vamwe vanachiremba vanoedza kudzivisa kusvika pakukwanisika kuparadzaniswa kwe perineum panguva yekuberekwa kwepamusoro, kunyange kana vachiwanzozviita pakutanga.
Kudzivirira
Sezvo izvo zvinongororwa, chaizvoizvo, zvinoparadzaniswa zvakafanana, zvinongoratidzwa nenzira yekuvhiya, zvose izvo amai vanguva yakazara vanoita kuitira kuti varege "kubvarura" zvakakodzera kudzivisa kupera. Yeuka kudya uye kudzidzira kwemasvikiro akakomba! Iwe unogona kuvadzidzisa chero kupi zvako: pane kufamba, pamberi peTV, uri panhovo.
Kegel Gymnastics
1. Kuderera kunononoka. Simbisa mishonga ye perineum, ibatire muhurumende iyi kwemasekondi masere, uye zorora. Iwe unogona kumanikidzika basa racho kana iwe ukanamatira misungo yako kwemasekondi 5-20.
2. Nhano-nhanho gymnastics. Bvisa mishonga kwema 3-5 masekondi, wozorora. Iye zvino simbisai misungo zvishomanana, mubatisise, uye-kusvika kumatanho 4-7. Sununguka zvishoma nezvishoma, uchimirira kwemaminitsi 2-3 pane imwe nhanho.
3. Kuderedza. Dzvinyirira uye usunungure mishonga yako nekukurumidzira. Dzokorora kakawanda.
4. Kubuda kunze. Tsika pasi sechigaro kana kubereka mwana. Ichi chiito, kunze kwemisungo ye perineum, inokonzera kushushikana uye imwe mimba. Kurovedza kunogona kutanga nemitemo 10 inononoka, kupwanya 10 uye 10 pops 5 pazuva pazuva. Dzokorora maitiro anosvika makumi maviri nemashanu kwezuva rimwe. Izvi zvakajeka zvikuru, nokuti mabasa akadaro haana kunyatsocherechedza kune vamwe.
Kuberekwa kwekutanga
Izvi zvinosanganisira zviitiko apo basa rebasa rinotanga pakati pemasvondo makumi maviri nemasere nemasere ekuberekwa uye kana chivharox ichivhurwa nguva isati yakwana. Kuwanda kwekutanga kwebasa ndiko 6-8% yevose vanozvarwa.
Zvinhu zvinokuvadza:
- nguva yemukadzi ane pamuviri ari muduku kudarika makore gumi nematanhatu uye anopfuura makore makumi matatu
- Kuvapo kwehutachiwana mumuviri wemai anouya
- kukanganisa kwechirwere, iyo inotanga pasina kupikisa kupfuura 3-4 cm
- yapfuura zvinyorwa zvisingabatsiri kana kubvisa pamuviri
- kuvhiya maitiro kune nhengo dzechipfuva nemimba iyi pamuviri
- zvimwe zvinokonzerwa ne fetus pamwe ne polyhydramnios
- multiple pregnancies
- basa rinoda basa remuviri kana kuperekedzeka mupfungwa mupfungwa
- Kusvuta, kushandisa zvinodhaka uye zvinodhaka
Vakadzi vane pamuviri avo vakatotanga kuberekwa vasati vasvika, iyo ingozi yekudzoka kwemamiriro acho ezvinhu - 3-4 nguva yakakwirira kudarika vamwe vose. Zvinonyatsozivikanwa kuti munyaya ino mikana yekuzivisa kubata pamuviri inenge 80%. Uye nechinangwa chekuberekwa kwekutanga kusati kwaitika, mukana wekudzokorora mamiriro acho akawedzerwa kanomwe. Mikana yekugara nguva dzose yevashandi inowedzerawo kana kupererwa kwepamuviri kuchikanganisa panguva yekuzvitakura. Kushaya simba kwebasa mumadzimai anopfuura makore makumi matatu nemakore makumi maviri anowanzoonekwa sevane makore 20-25. Inenge 60% mapatya, anopfuura 90% ezvitatu, uye inenge dzose 4-5 kana kupfuura mapatya anooneka mushure mezwi
Kudzivirira
1. Kuti urege kudzivirirwa nguva isati yakwana, zvakakosha kuziva chikonzero chakakonzera kusangana kwakadaro. Kusasimudzirwa kwekuita pamuviri kunowanzoitika nekuda kwehutachiona hwemukati. Muchiitiko ichi zvakakosha kupfuudza muedzo wekuvapo kwebhakitiriya musati watanga kubata pamuviri. Kana zvikaonekwa mumukadzi ane pamuviri atoita, chiremba acharapa kurapwa kunotangira kubva kumutatu wechipiri.
2. Vanachiremba vanoitawo kudzivirira kudzivirira kweimwe ngozi njodzi.
3. Amai vane ramangwana vaimbova nepamuviri vasati vasvika vangakurudzira kuramba kuita basa uye kurerutsa basa kusvikira kurara zororo panguva yechipiri uye yechitatu mitatu yekudzivirira.
4. Kutanga kusununguka nguva isati yasvika kunogona kukanganisa zvepabonde. Nokudaro, mumwedzi mitatu yekupedzisira yekuzvitakura, amai vakatarisira vanofanira kurega kurara pabonde, kuitira kuti vasakonzera kushanda kwechibereko chechibereko.
Kushaya simba kwebasa
Ichi chinetso pakuberekwa kunoratidzirwa nekusava, kupfupika kwezvipfeko, izvo zvinotadzisa kuzarura kwechibereko chechivharo uye kufamba kwe fetal muchengeti wekubereka.
Zvinhu zvinokuvadza:
- zvinokonzera endocrine uye zvinetso zvemagetsi mumama anouya (kurema, kushayikwa kwetachiona basa)
- kudarika kwechibereko, chimiro chema-fetus, fetus guru uye polyhydramnios
- kusagadzikana kwechibereko
Zera remukadzi rinopfuura makore makumi matatu
kufara kwakanyanya, kutya, kusava nemanzwiro asati aberekwa
Chii chaunotarisira kubva pakuberekwa kwechipiri?
Kushaya simba kwebasa kunowanzoonekwa kune vakadzi vepakutanga. Asi dambudziko rekudzoka rakakura kwazvo, kunyanya nezera. Chiremba anogadzirira kugadzirira kwekuzvarwa kwechirwere pavhiki 38-39 yekutakura. Kana zvichidikanwa, iyi nzira yekuisa inonzi yakanyorerwa, yakadai seamniotomy (kana kuti autopsy yechikanda). Iyi nzira inowanikwa muimba yekubereka uye haina kurwadziwa zvachose kune amai, sezvo pasina mishonga inopera mumakumbo. Mushure mokunge amniotomy, kubudiswa kwe prostaglandin - biological zvinhu zvinokonzera kushanda kwebasa rebasa - zvinofanira kuitwa. Uyezve, kutsamwiswa kwemasumbu emvura inoberekwa kunowedzera, izvo zvinotungamirira mukuderedzwa kwavo kwakanyanya, uye naizvozvo kuwedzera kwezvipikiso. Kana, maawa matatu mushure meAmniotomy, zvipembenene zvisingatangi, vanachiremba vanorayira kuvhara kweprogaglandin.
Obstetric forceps
Basa ravo rinoshanda basa rekushanda, umo mwana wenguva yakazara inotorwa kuburikidza nezera rekuberekwa nerubatsiro rwemakumbo asingagadziri. Chiremba anovafukidza nemusoro wemwana, achitora simba rokudzinga chibereko uye mudumbu remukadzi ari kubereka. Kushanda kwekushandisa forceps kunorongedzerwa nechigadzirwa chezvipfeko mune izvo zviitiko apo kuenderera kwepanyama kwebasa hakugoneki nekuda kwedambudziko rematambudziko makuru. Kazhinji inopindirana nekuvhiya kuti ucheke peineum kuti uwedzere chirwere chekuberekwa kunodzivirira kuumbwa kwemapapu akawandisa mumukadzi.
Kana sarudza?
Chiratidzo chekushanda kwemasimba anokanganisa zvinogona kugoverwa mumapoka maviri: zviratidzo zvekuberekwa uye zvekuberekwa zvinokonzerwa nekudzivirira uye kuberekwa, uye zviratidzo zvisinganzwisisiki zvinosangana nehosha dzevakadzi dzisingabvumi kuedza.
Kudzivirira
Pasinei nechokwadi chokuti kushaya simba kwebasa chinhu chakaoma, chinoratidzwa zvakananga mumatambudziko ekuberekwa, unogona kuedza kudzivirira kuitika kwaro panguva yekuzvitakura. Izvi zvinonyanya kuitika kune vakadzi vakatotarisana nechinetso ichi. Physiopsychic kugadzirira kubereka kunobata basa rinokosha pano. Izvo zvakanaka musati mava nemimba yekurapa kuporesa zvirwere zvemukondocrine, kana zviripo, kuedza kuisa uremu uye kusiya tsika dzakaipa. Kubva muvhiki yema 36 inokurudzirwa kutora mavitamini, izvo zvinowedzera simba remuviri wechibereko: zvinosanganisira vitamini B6, folic uye ascorbic acid. Kana pakutanga pakuberekwa chikonzero chekushaya simba kwebasa chaiva kutya kutya kubereka, zvinonzwisisika kuziva zvakaoma zvekudzidzira kwakakosha uye kudzidzira muviri kunoitwa nevadzidzisi vezvikoro zvevabereki vari mberi.
Uchapupu huripo:
- mhando dzakakura dze preeclampsia, dzinoda kubviswa uye kushungurudzika kwomukadzi wechikadzi
- kuramba kushaya simba mukuedza (kushayikwa kwemusoro wemwana kunotanga kupfuura maawa maviri)
- nguva isati yakwana kuparadzaniswa kupera pakuguma kwebasa
- acute fetal hypoxia ye fetus (oksijeni nenzara), apo kunonoka kunogona kutungamirira kurufu rwemucheche
Zviratidzo zveSomatic:
- chirwere chemwoyo, mwoyo kusakundikana
- kupfemara kunetseka nemhaka yemapapu zvirwere
- kutyisidzira kwemasvingo ye retina
- maitiro akaoma eetsuro neuropsychic
- kushanda kune nhengo dzechidziro chemuviri chakaitwa mushure mekushanda kwebasa
- kuwedzera kwehutachiona, kupisa kwakanyanya amai
Kana kwekutanga kokutanga kwaiva nekutaura pamusoro pekushandiswa kwemauto emagetsi pane zvinyorwa zvemaonero, ipapo kuburitswa kunowanzoitika kunogoneka chete nemvumo yechiremba. Semuenzaniso, zvichida kuti pakati pekuzvitakura mukadzi akashanda kugadzirisa maziso, uye ophthalmologist, uyo akamborambidza kubereka kwepanyama nekuda kwekugona kwemauto ekudzoka panguva yekuedza, zvino achapa mvumo. Asi uchapupu husina maturo hunopera uye hunogona kunge husingaoneki mukuzvarwa kwakatevera.