Oku kubangelwa kukuba abafazi ababelethayo sele beyazi ukuba zeziphi iimvakalelo, kunye nabasetyhini, abakhulelweyo okokuqala, bangakwazi ukuxuba ukunyanyiswa kwe-fetal ngelixa bengagxininisi, kunye ne-peristalsis yamathumbu, isakhiwo segesi kwisisu okanye isithintelo semisipha. Ukongezelela, xa sele ukhulelwe, udongeni lwangasemva lwangasese lube lukhulu kwaye lube lukhuni. Abafazi abaninzi abagqibeleleyo bavakalelwa ukuguqulwa komntwana ongaphantsi kwezilwanyana ezincinci. Iinkcukacha malunga nokuhamba komntwana kwisisu somama, fumana kwinqaku "Impawu zokuqala zokuhamba komntwana."
Ngoko, ngexesha lokukhulelwa kokuqala, abasetyhini baziva beqala ukunyakaza komntwana, ngokuqhelekileyo kwixesha eliphakathi kweeveki ezingama-18 neye-22 (ngokuqhelekileyo kwiiveki zoovuleni), kwaye iibhu iyakwazi ukunyuka kwengane ezayo kwiiveki ezili-16. Xa abafazi bexesha elizayo baqala ukuziva ukunyuka kweentsana zabo, banemibuzo emininzi kwaye bangathandabuzekiyo: kufuneka ahambe kangaphi umntwana? Ngaba ihamba ngokukhawuleza? Kufuneka kukhunjulwe ukuba nganye imbuzi iyodwa kwaye ikhula ngeyakhe, kwaye imigaqo malunga nokuhamba komntwana ihamba ngokubanzi.
Umlingani wezinto eziphazamisayo
I-trimester yokuqala. Kwi-trimester yokuqala yokukhulelwa, ukukhula okunamandla komntwana ongakazalwa kungenzeka. Okokuqala, iqela leeseli likhawuleza lihlula, likhula kwaye liba ngumbungu onamathele eludongeni lwe-uterine kwaye luqala ukukhula, lukhuselwe yi-amniotic fluid, i-membranes yesisu kunye nodonga lwe-muscular of the uterus. Ekuqaleni kweeveki ezi-7-8 ngexesha lokuhlolwa kwe-ultrasound, kunokwenzeka ukuba ulungise indlela ukugqitywa kwembungu ehamba ngayo. Oku kungenxa yokuba inkqubo yakhe yeentlanzi isele ivuthiwe ngokwaneleyo ukuba iqhube imiphumo yesibindi kwimisipha. Ngeli xesha, umbungu uhamba ngokukrakra, kwaye ukuhamba kwawo kubonakala kungenanto. Kwaye, kunjalo, kusencinane kakhulu, kwaye ukunyakaza kubuthakathaka ukungaziveleli. I sibini sithathu. Kwiiveki ezi-14 ukuya ku-15 zokukhulelwa, umntwana ukhule kwaye izitho zaso ziye zahluke ngokupheleleyo (ziye zaqhelana nathi kwifom nokubunjwa kweempawu kunye nemilenze), ukunyakaza kuye kwaba nzima kwaye kusebenza. Ngeli xesha, umntwana uhamba ngokukhululekile kwi-amniotic fluid aze aphephe kwiindonga zesisu. Ngokuqinisekileyo, usencinci kakhulu, ngoko ezi zinto zibuthathaka kwaye umama ozayo akasayi kubava.
Kwiiveki ezingama-18 ukuya kwe-20 umntwana ukhula, kwaye ukunyakaza kwawo kubonakala ngakumbi. Oku kuthinteka kokuqala kubesifazane abakhulelweyo bachaza ngokuthi "ukubetha iiblantshi", "ukuloba intlanzi." Njengoko umntwana ekhula, iimvakalelo ziba zihluke ngakumbi, kwaye ngeeveki ezingama-20 ukuya ku-22, njengomthetho, bonke abafazi abakhulelweyo baziva kakuhle ukunyakaza komntwana wabo. Kwimizi yesithathu yesibini, oomama abanokuva banokuva "intshukumo" yengane kwiindawo ezahlukileyo zesisu, ngenxa yokuba engazange ifinyelele kwindawo ethile kwisibeleko kwaye kukho indawo eyaneleyo yokujika kwaye ijikeleze kuzo zonke izikhokelo. Yintoni eyenziwa ngabantwana xa besesisu sikaMama? Ngokubhekiselele kwimibono eyenziwa ngexesha lokuhlolwa kwe-ultrasound, iintsana ezingakazalwa zinezinto ezininzi ezahlukeneyo: zisela i-amniotic fluid (nge-ultrasound ibonakala indlela umhlathi ophantsi uhamba ngayo), vula intloko, udibanise emilenzeni, izibambo zikwazi ukuqonda imilenze, umunwe uze uqonde intambo yomlomo. Njengoko ixesha lokunyuka kwamanyathelo likhula, umntwana usakhula kwaye uqina. Ukutshatyalaliswa kokukhanya sele kuthatyathelwe indawo "ngokukhaba" okuqinileyo, kwaye xa umntwana ejika ngaphakathi kwesibeleko, kubonakala kwangaphandle, njengoko isisu sitshintsha ukulungiswa kwayo. Ngelo xesha, umama unokujamelana neqiniso lokuba umntwana wakhe "uhlamba". Ngelo xesha, ibhinqa livakalelwa kukuba umntwana uyaqhaqhaza ngokukhawuleza. I-"icicle" ihambelana nenyaniso yokuba isiqhamo sinamandla ngokugubha i-amniotic fluid kwaye isalathisi sayo siqala ukuthenga isivumelwano. Ukunyakaza okunjalo kwesilathisi kuyilinga lokuzama ukukhupha umbane. Oku kuphephile kwaye kuyinto evamile. Ukungabikho kwe "hiccups" kukwahluke kwinto evamile.
Yesithathu kwekota
Ekuqaleni kwekota yesithathu, isiqhamo singakwazi ukujika kwaye sijikeleze kwaye ngeeveki ezingama-30 ukuya kweye -2 zihlala zihlala kwindawo ehlala kuyo. Kwiimeko ezininzi, zifumaneka phantsi. Oku kubizwa ngokuba yintloko yentetho yomntwana. Ukuba umntwana ubeka phantsi ngemilenze okanye i-glutes, oku kubizwa ngokuba yi-pelvic presentation of fetus. Ngentetho yentloko, ukunyakaza okusebenzayo kuyabonakala kwisigxina esiphezulu sesisu, nakwindawo yeplavic, ngokuchaseneyo, zivezwa kwiindawo eziphantsi. Kwi-trimester yesithathu, owesifazane okhulelweyo unokubona ukuba umntwana unemizila ethile yokulala nokuvuka. Umama ozayo uvele esayazi ukuba yeyiphi imeko yomzimba umntwana ukhululekile, kuba xa umama esesimweni esingenakunceda umntwana, ngokuqinisekileyo uya kumvumela umntu ukuba azi malunga nalo nobudlova, ukuphazamiseka okukhulu. Xa umfazi okhulelweyo elele emhlane, umbele uqhuba uxinzelelo kwimithanjeni yegazi, ngokukodwa ezo igazi elenziwe nge-oksijeni lingena kwisisu kunye nomntwana. Xa zicinywe, ukuhamba kwegazi kuyancipha, ngoko umntwana uqala ukufumana ukungabi nciphisa oksijini, apho aphendulela khona ngogonyamelo obundlobongelayo. Ngokusondele ekuzalweni, ukuphazamiseka kuvakalelwa kakhulu kwindawo apho iindawo eziphelileyo zentsana zihlala khona, ngokuqhelekileyo kwisigxina esiphambili (njengokuba ininzi yesisu ihlala ephantsi kwaye ibuyele ngakwesobunxele). Iinjongo ezinjalo zinokubangela ukuba ubuhlungu bube buzayo. Nangona kunjalo, ukuba uncike phambili phambili, umntwana uyayeka ukunyamezela. Oku kungachazwa ngento yokuba kule ndawo ukuphuma kwegazi kuphucula, i-oksijeni engena kwi-fetus kwaye "iyancipha."
Kungekudala ngaphambi kokuqala kobasebenzi, intloko yesana (okanye iintambo, ukuba umntwana lowo usetshulweni lwe-pelvic) ucinezelwe ekungeneni kwe-pelvis encinci. Ukususela kwicala libonakala ngathi isisu "sanyuka". Abafazi abakhulelweyo bayaqaphela ukuba ngaphambi kokuba kuzalwe imoto yomsebenzi we-fetus iyancipha, oku kuchazwa yinto yokuba ekupheleni kokukhulelwa komntwana sele sele inkulu kakhulu kangangokuthi ayinayo indawo eyaneleyo yokunyakaza okusebenzayo kwaye kubonakala sengathi "iphela". Olunye oomama bokamva, ngokuchaseneyo, phawula ukwandiswa kwemisebenzi yemoto yomntwana, ngenxa yokunciphisa umatshini wokusebenza kwemoto ezinye iintsana, ngokuchasene noko, uphendule ngongoma obundlobongela bokuphazamiseka.
Ngaphantsi kanani umntanakho ugxotha?
Ubume bomsebenzi we-motor fetus luhlobo "lwesinzwa" sekhosi yokukhulelwa. Ngokuqinisekileyo kwaye ngokukhawuleza ukuphazamiseka kukuva, unokugweba ngokuchanekileyo ukuba ukhulelwe nokuba ukhulelwa njani umntwana. Ngelixa leveki yesi-2, ngelixa umntwana esengumncinci, umama olindelekileyo angakhathalela ixesha elide (kuze kube semini) phakathi kweengqungquthela zokunyuka komntwana. Oku akuthethi ukuba umntwana akahambanga kakhulu. Kuphela nje ukuba umfazi akakwazi ukuphazamiseka, ngenxa yokuba umntwana engenalo ngokwaneleyo, kwaye umama ozayo akafundile ngokwaneleyo ukuqonda ukunyakaza komntwana wakhe. Kodwa ukususela kwiiveki ezingama-26-28 kukholelwa ukuba isiqhamo kufuneka sitshintshe amaxesha angama-10 kwiinyanga ezimbini ukuya kweyure.
Izilwanyana-izifo zogqirha ziye zavelisa "ikhalenda ehambelana nokunyakaza". Ebudeni bemini, loo nto ibhinqa amaxesha amaninzi umntwana wakhe ahambayo, kwaye ubhala ixesha apho kuqhuma yonke into yeshumi. Ukuba umntwana okhulelweyo ubonakala efile, kubalulekile ukuba uthathe indawo epholileyo, ukhulule, udle into (kukholelwa ukuba emva kokutya imoto yomsebenzi wefubus kwanda) kwaye kungakapheli iiyure ezimbini qaphela ukuba kaninzi kangakanani ngeli xesha umntwana ushukunywe. Ukuba kukho ukutshintsha kwama-5-10, akukho nto ingakhathazeki ngayo: umntwana usulungile. Ukuba unina akava ukuba umntwana uvuselela iiyure ezingama-2, kufuneka uhambe okanye ukhuphuke uze wehla ezitebhisini, uze ulale phantsi. Njengomthetho, le mi sebenzi inceda ekusebenzeni umntwana, kwaye ukuphazamiseka kuya kuqhubeka kwakhona. Ukuba oku kungenzeki, kufuneka ubone ugqirha kwiiyure ezingama-2-3 ezizayo. Umlinganiso wezinto eziphazamisayo zibonakalisa isimo se-fetus, ngoko kuyimfuneko ukuphulaphula. Ukuba umama olindelekileyo wabona ukuba kwiintsuku ezimbalwa zokugqibela umntwana waqala ukuhamba ngaphantsi, kufuneka udibane nogqirha ukujonga ukuba umntwana uvakalelwa njani.
Ngomlinganiso wesithathu wokukhulelwa, oomama abanomso, njengomgaqo, sele bebazi ubunjani bentshukumo yabantwana babo kwaye banokubona nayiphi na utshintsho "ekuziphatheni" kweintsana. Kwabaninzi abasetyhini, uphawu oluphazamisayo lunobundlobongela, olushukumisayo. Nangona kunjalo, ukwandiswa kwemisebenzi yeemoto akuyiyo imfuyo kwaye idla ngokuqhagamshelana nesimo esingenakunqwenelekayo somama ozayo, xa umntwana efumana i-oxygen encinci ngenxa yokuncipha kwegazi. Kuyaziwa ukuba xa umfazi okhulelweyo elele kumqolo okanye ehleli, elele kakhulu emva, umntwana uqala ukuhamba ngokuthe ngqo kunokuqhelekileyo. Oku kubangelwa ukuba i-uterus ekhulelwe ixubha imithana yegazi, leyo, ngokukodwa, ithwala igazi kwi-uterus ne-placenta. Xa zicinywe, igazi ligeleza kumntwana emva kwentambo encinci, ngenxa yoko, ivakalelwa ukungabikho kwe-oksijeni kwaye iqala ukuhamba ngokunyanisekileyo. Ukuba utshintshe isikhundla somzimba, umzekelo, hlala phantsi ngokuxhomekeka phambili okanye ulale ngecala layo, ngoko ukuphuma kwegazi kuya kubuyiselwa, kwaye umntwana uya kuhamba kunye nomsebenzi oqhelekileyo.
Ndifanele ndixhalabise nini?
Isalathisi esinoyikekayo nesesabekayo kukunciphisa umqhubi wemoto okanye ukusabalalisa kweminyango yomntwana. Oku kuphakamisa ukuba umntwana sele sele ehlanjululwa yi-hypoxia, oko kukuthi, ukusilela kwe-oxygen. Ukuba uqaphela ukuba umntwana wakho akanako ukuhamba, okanye awuveki ukunyuka kwakhe kwiiyure ezingama-6, ngoko kufuneka uqhagamshelane naye ngokukhawuleza. Ukuba akukho nangoko ukutyelela ugqirha kwi-patient-patient reception, kungenzeka ukuba wenze "uncedo lokuqala". Okokuqala, ugqirha uya kuphulaphula intliziyo yesisu ngokuncedisa i-stethoscope yesitrogram, ngokuqhelekileyo kufuneka ibe yi-120-160 ibhokhwe ngomzuzu (ngokuqhelekileyo - i-136-140 ibhokhwe ngomzuzu). Nangona xa kuqhelaniswe isithwathwa (ukuphulaphula) isisu senhliziyo yesisu esinqunywe kwimimiselo yesiqhelo, kubalulekile ukwenza enye inkqubo - i-cardiotocography (CTG). I-KTG - indlela evumela ukuba uhlolisise intliziyo yesisu kunye nomsebenzi wayo, ukuba ukhangele ukuba umntwana uyaphathwa yi-hypoxia (ukungabikho kwe-oksijeni). Ngethuba lokufunda, intsimbi ekhethekileyo eneenkcukacha ezihlanganiswe nodongeni lwangasemva lwangasemva komntwana kwindawo ecacileyo yentliziyo yakhe. Le senzwa inquma i-cural rate rate curve. Ngesikhathi sinye, umfazi okhulelweyo ubamba iqhosha elikhethekileyo esandleni sakhe, okufuneka ukuba ucinezele xa eziva ukuba umntwana uhamba. Kwitshathi, oku kuboniswa ngamabhile akhethekileyo. Kwimimiselo ekuphenduleni ukuphazamiseka, isisu senhliziyo esisanda kukhula: oku kuthiwa yi-reflex cardiac reflex. Le ngcamango ibonakala emva kweeveki ezingama-30-32, ngoko ke ukubambelela kwi-CTG ngaphambi kwesi sihlandlo akusizi ngokwaneleyo.
I-CTG yenziwa imizuzu engama-30. Ukuba ngeli xesha alikho ukwanda omnye kwintliziyo yenhliziyo ekuphenduleni ukuphazamiseka, ugqirha ubuza owesifazane okhulelweyo ukuba ahambe ixesha elide okanye amaxesha amaninzi ukuba akhuphuke kwizitepsi, aze enze enye irekhodi. Ukuba i-complexyo ye-myocardial ayibonakali, oko kungabonakali ngokucacileyo u-hypoxia we-fetus (ukungabi ne-oxygen). Kule meko, kwaye kwakhona, ukuba umntwana waqala ukuhamba kakubi kwixesha elide ukuya kwiiveki ezingama-30-32, ugqirha uya kumisela isifundo seDoppler. Ngethuba le sifundo, ugqirha ulinganisa isantya sokujikeleza kwegazi kwiinqanawa zentambo yomthi kunye nakwezinye iinqanawa zomntwana. Ngokusekelwe kwezi nkcukacha, kunokwenzeka ukuba kunokwazi ukuba ingaba umntwana ulwa ne-hypoxia.
Ukuba kukho iimpawu ze-hypoxia yobusana, i-tactics ye-obstetric igqitywe ngumlinganiselo we-hypoxia. Ukuba iimpawu ze-hypoxia zincinci kwaye zingabonakaliswa, ngoko umfazi okhulelweyo uboniswa ukubonwa, i-CTG kunye novavanyo lweDoppler kunye nokuvavanywa kweziphumo zabo kwi-dynamics, kwakunye nokuqeshwa kwamachiza anokuphucula ukujikelezwa kwegazi kunye nokufakelwa kwe-oxygen kunye nezondlo kumntwana. Ngokunyuka kweempawu ze-hypoxia, kunye nokubonakala kwezibonakaliso ze-hypoxia, ukuhanjiswa kwangoku kufuneka kwenziwe, njengoko kungekho nonyango elinobuchule elijoliswe ekupheliseni i-hypoxia yesisu. Kuza kubakho usebenziso lwecandelo le-shedding okanye ukuhanjiswa kwimizila yokuzalwa yendalo, kuxhomekeka kwizinto ezininzi. Phakathi kwabo - imeko yomama, ukuzimisela kwenzakaliso yokuzalwa, ixesha lokukhulelwa kunye nezinye izinto. Esi sigqibo senziwe ngumjobi wezilwanyana ngabanye kwimeko ethile. Ngaloo ndlela, ngamnye umfazi kufuneka aphulaphule ukuphazamiseka komntwana wakhe. Ukuba kukho nayiphi na into engathandabuzekiyo malunga nenhlalakahle yomntwana, musa ukulibazisa ukutyelela ugqirha, njengesibheno esikhatywayo ngexesha elifanelekileyo kwi-obstetrician-gynecologist inokuthintela iziphumo zokukhulelwa ezimbi. Ngoku uyazi ukuba zeziphi iimpawu zokuqala zentsana ezhukumisa kwisibeleko.