Izizathu ezinokubangela ukuba kube nzima ukuba abasebenzi, iingcali zidibene ngokwaqala ukukhulelwa, ngexesha, ngexesha nangemva kokunikezelwa. Iingxaki eziphambili zixutyushwa kwinqaku elithi "Inkxalabo yokubeletha, ukungafani kwentliziyo".
Ayikho imfihlelo yokuba ininzi yesini esilungileyo ihluphekile kule nto okanye esi sifo esingapheliyo. Eyokuqala phakathi kwezifo ezinjengeentlobo zesifo, isifo sengqondo esingaqhelekanga (i-hypertension, i-vegetovascular dystonia, i-heart defects). Ukungathinteli kakubi ukukhulelwa nokubeletha, izifo ezingapheliyo zesifo se-bronchial and lung. Kucacile indlela i-leukemia ekhukhulayo kunye engapheliyo, i-lymphogranulomatosis, isifo sofuba, isifo sikashukela, i-hepatitis, intsholongwane kaGawulayo kunye ne-AIDS "imbi" yokuvelisa inzala. Ngokulawulwa kakuhle kwezifo ezithile kunokunciphisa. Abasetyhini abane-asthenic physique kunye nabangamaxesha okuya esikhathini banokuba neengxaki zokubeleka, zilandelwa zizigulane eziphethwe yintsholongwane ye-hormonal yokungabikho komntwana kunye nokungahambi kakuhle komzimba. Ukuvuthwa kwi-cervix, ukuhluthwa okuninzi kwesigxina se-uterine emlandweni, izikrakra ebusweni balo ngenxa yezigqeba ezidlulileyo zizinto ezintle.
Oogqirha bakholelwa ukuba iingxaki ekubelekeni zingabangela ukukhulelwa kwamawele kunye nokukhulelwa okuphindaphindiweyo, i-polyhydramnios, ubukhulu bomntwana obushushu, obangela ukwanda kwengcinezelo ye-intrauterine kwaye kunokukhokelela ekukhutsheni kwangaphambili kwe-amniotic fluid. I-pelvis encinci okanye emfutshane yecala kumfazi, ubude bendawo yobusana okanye ukuveliswa kwe-placenta kubhekisela kwimpawu ezicacileyo zecandelo lesigxina. Oku kufaka phakathi ukungalingani phakathi kobukhulu bomntwana kunye nentloko yomama, isithuba esinqumlayo somntwana okanye intshumayelo yayo, intambo kunye nentambo yomlomo. Ukuzalwa kwangaphambi kokuqala kunye nokusebenza kunye nomntwana omdala, ukuzalwa kwabasetyhini emva kokutsalwa komzimba kunye nokudluliselwa kombindi kwi-uterine cavity (i-IVF ne-PE), oogqirha banamhlanje babhekisela kwizinto ezinzima. Iyeza zanamhlanje zineenqwelo eziphathekayo zeendlela, kwaye zikulinganisa ingozi yale miba emininzi ngaphambili nangesikhathi sokubeletha.
Ukuqala, ngaphambi kokuqala kobasebenzi, ukuphuma kwe-amniotic fluid yinkxalabo eqhelekileyo yexesha lokuqala lomsebenzi. Ngokuqhelekileyo kuyenzeka nge-pelvis encinci, intetho ye-pelvic ye-fetus, ukukhulelwa kaninzi, xa umntwana ekhulile okanye kukho ukungeniswa okungafanelekanga kwentloko. Ukuphuma kwephambi kokuqala kusengomnye weempawu zexesha eliphambili lokugula. Zithathwa ngokuba "yintetho yokuqala" yokubeleka, ngokulahlekelwa kwesifuba esingaphezu kweeyure ezingama-6-8. Kuhamba kunye neengxaki ezingaqhelekanga, ezibuhlungu, eziphazamisa isigqi sokulala nokuvuka. Nokukhathala kubangela abasebenzi. Abakhokeli ekuvuleleni umlomo wesibeleko kwaye babangela i-hypoxia ye-intrauterine yomntwana. Le nkcenkceshe yokunikezelwa ixhaphake kakhulu kubantu asebekhulile kunye nabancinci be-primiparas, baninzi kakhulu, besetyhini kunye nabangenabulungekileyo, kunye nakwabo abangenayo ingxaki ngokukhulelwa kwabo. Isikhathi sokuqala sentsholongwane siyingozi kuba sinokungena kuyo nayiphi na ingxaki yokusebenza. Nangona kunjalo, ngokuphindaphindiweyo emva kokuhamba kwamanzi, ithoni ye-uterus iyancipha, kwaye inkqubo yokubeleka iphucula. Ngale njongo ugqirha unokusebenzisa i-amniotomy - ukutshatyalaliswa kwesibindi sesisu.
Olunye utyando lomsebenzi lubuthathaka. Iyintloko kunye nesibini. Kwimeko yokuqala, ibhinqa lingena ekuzalweni ngokunyuka okunyanzelekileyo. Okwesibini - emva kwexesha lomsebenzi obanzi osebenzayo wesibeleko ngokukhawuleza buthathaka. Ukudalulwa komlomo wesibeleko kuyancipha, kwaye abasebenzi balibaziseka. Isizathu esisoloko saneleyo ukufumaneka kwendalo yokubeletha, izifo ezithintekayo, izifo ezithintekayo zesisu kunye nokukhipha isisu ku-anamnesis, ubunzima obunzima, inkambo eyinkimbinkimbi yokukhulelwa, ukukhathala ekuzalweni. Abasetyhini abakhulileyo nabancinci, abafazi bexinzeleleka kwi-uterus (ngenxa yokukhulelwa, umntwana omdala, ukuzala okuninzi, okuninzi-amanzi), i-mnogogorazhie, ukuxhatshazwa kwexesha lokuya esikhathini kunye nokulinganisela kwe-hormone kusengozini.
Ukuzalwa ngokubeleka kwesisu (iintsuku eziliqela ubude) kubangelwa ukukhathala komfazi kwaye kudla ngokubandezeleka ngokubuthathaka. Njengomthetho, ubuthathaka bezabasebenzi buhamba kunye nokungabikho kokwaziswa komlomo wesibeleko. Ukulala - iyeza elingcono, kunye ne-pathology efanayo, abafazi banikwa ukuphumla, basebenzisa ukuthunga kunye ne-hypnotics. Njengomthetho, emva kokuba le nkqubo isungulwe ngokwayo. Ngaphandle koko, izicatshulwa ze-uterine ziphuculwa nge-oxytocin kunye ne-prostaglandines phantsi kwe-cover of anesthesia. Ukuba yonke imizamo yoogqirha ayilutho, loo mfazi unikwe icandelo le-laarean. Ingxaki ephikisanayo - umsebenzi ogqithiseleyo wezabasebenzi - uyabonwa ngokuba nobukho bezinto ezinzima kunye nexesha elide. Ukubeleka kungapheli iiyure ezingama-1-3. Ingane injalo ngokukhawuleza ingena kumbhobho wokuzala, intloko yayo ayinaso ixesha lokuqwalaselwa, ingozi yokuxhatshazwa kokuzalwa kunye ne-hypoxia iphakamileyo.
Ngomama, ezi ntlobo zokuzalwa kunye nokuhlukana kwesibeleko ziyingozi ngenxa yokuphuka komlomo wesibeleko, isondo, i-perineum kunye nesisu. Ingxowankulu yexesha eliphambili le-placenta iyakwenzeka, oko kungakhokelela ekuphumeni kwegazi. Njengokuqala kwexesha elide, umama uphathwa ngokulala ngokucwiliswa, i-anesthesia ye-epidural isetyenziswa. Ngokuqhelekileyo oogqirha benza isigqibo malunga ne-amniotomy kunye necesarean section. Kwenzeka kwi-1-3% yamatyala okubeletha. Kule meko, iinqununu zokuqhawulwa kwesibeletho zingenangqamaniso, zixakeke, iindawo eziphakathi kweziphambano zikhethi. Ingozi inokuba yintlupheko ye-perineum kunye nokungahambelani kwi-jointic pub. Ngokuqhelekileyo, ukuze ugweme iziphumo ezimbi, ugqirha ngexesha lokunikezela wenza isigqibo sokunqumla i-perineum (i-episiotomy - ukusikwa kwinqanaba le-perineum ukuya kwicala, u-perineotomy - unqunywe kwicala le-anus). Ngoku siyazi ukuba kukho inkathazo yokuzala, ukungafani kwentliziyo.