Ngokuphindaphindiweyo, umama ozayo, obizwa ngokuba yi-obstetric term, oko kukuthi, umhla wokunikezelwa kubalwe ngugqirha, ubingelela esibhedlele ngala mazwi: "Ukuba asiyi kuzala ngeveki-41 - siya kuvuselela!" Hayi, ukuvuselelwa kwamathuba emisebenzi kumayeza ethu kubakho rhoqo Kubonakala ukuba ukuxilongwa kokukhulelwa okukhuselekileyo kusongela isiqingatha sezingane, kodwa makhe sibone ukuba kunokwenkqisa ukuba ngaba umsebenzi awuqali emva kweveki yesi-41, yintoni ingozi yokukhulelwa ngokunyanisekileyo? Inyaniso kukuba xa umntwana ephuma esibhedlele I-placenta, eyenza i-crumb yokutya, ikhula, oko kukuthi, ekugqibeleni iya kuba yimbi, ekubeni inkqubo yayo yokujikeleza ayilungiselelwe ubomi obude. ihluphekile ekuphuhlisweni kwayo: umzekelo, unengxaki kwinkqubo yeentlanzi, kwaye ibukeka ikhangeleka njengendoda endala endala: isikhumba ngaphandle kokugcoba, esomileyo, "ukuhlamba izandla" - ukususela ekuhlambeni okude. Yingakho kunengqiqo ukuqinisekisa ukuba umntwana akashukunyiswa.
Izibalo zibonisa ukuba phakathi kwezingane ezizalwe emva kweveki yama-41 yokukhulelwa, zikhona iimvumba ezithe zahlushwa kwisibeleko kunabanye abazalelwe kwiveki yama-38-41. Nangona kunjalo, amanani amaninzi, njengoko athethayo, "ubushushu obuninzi esibhedlele." Ngokuqhelekileyo, kwiveki yama-42 okanye kwimizuzu yama-43, abantwana abathandekayo nabanempilo babonakala bengenazo iimpawu ezincinane zokunyamezela, nangona kunjalo, ezininzi izibhedlele zijonge kumgaqo: emva kweveki yama-41, kuyimfuneko ukunyanzelisa ukuhanjiswa. "Ngokuqinisekileyo, umntwana" ovuthiwe "akayi kuba neengxaki zokubeletha, kwaye umngcipheko wokugqithisa kufuneka ugwenywe - uhlaziywe kwakhona.
Kutheni kungenjalo?
Konke oko kubonakala kunengqiqo ngokude nje sibone ukukhulelwa nokubeletha njengento yokuthumela umgangatho wohlobo olufanayo. Enyanisweni, yonke into iyinkimbinkimbi kakhulu ekukhuthazeni abasebenzi, inqununu yomsebenzi we-placenta. Ukukhula kwentsholongwane akukona nje ukukwazi ukuphefumula ngokuzimeleyo, kusana nokulawula ukushisa komzimba wayo (njengoko iingcali zidla ngokucinga). Kwakhona kukulungele ukubonakala, okubandakanya ukukhula kwenkqubo yeentlanzi kunye nezinye izikhombisi eziza kunceda umntwana ukuba alungiselele ubomi ngaphandle kwesisu somama. Kutheni enye umntwana ezalwa ngaphambili, kunye nomnye kamva? ISayensi, ngelanga, ayikwazi ukuphendula ngokupheleleyo le mbuzo. Kukho ngokuqinisekileyo into yokuzalwa kwimeko: inkwenkwe iphinda imbali yokuzalwa komnye okhokho.
Ngokomzekelo, abanye oomama abakhulu bathi, umzekelo, inkwenkwe "ihleli" ixesha elide kwaye ithola ikopi kayise, owaye wazalwa ngeveki 42. Umzimba womntwana ufuna ukuba uhlale ixesha esibelethweni ukuze uqinise into kwaye uyigcwalise Into yesibini yimeko yempilo kamama, imeko yakhe yengqondo, le nto inokutshintsha iindawo eziza kuzaliswa kwiindawo ezithile okanye enye into. Into yesithathu yinto ekhethekileyo yenkqubo yokukhulelwa, umzekelo, abanye oomama bayaqaphela ukuba bazalwa ngokukhawuleza xa bekhokela kunye nokuphila okusebenzayo kunye nokutya ngokufanelekileyo. Mhlawumbi utyhola okhokela impilo enempilo kunye nonina, ngokukhawuleza ukulungele ukuza kweli hlabathi kunomntakwabo, owaye "uvila" kwisisu. Ngaloo ndlela, akukho nto yokukhulelwa okugqithiseleyo ngaphezu kweeveki ezingama-41 engapheliyo ingozi kumntwana nonina. Abagqithisi abaneempumelelo bahlula ababelethi bexesha elide kwiiklasi ezi-2: ukukhulelwa ixesha elide (ukuhlukahluka komgangatho wesimo somzimba, umzekelo, kwabasetyhini abanexesha elide lokuhamba kwimihla yeentsuku ezingama-30-35) kunye nokukhulelwa okwenene (xa kuvela i-defect birth in the form of a generic). Kubalulekile ukufumanisa oko kwenzeka ngokwenene nomama kunye nosana.
Hayi, oku kusebenza
Nangona kunjalo, kwiinkqubo zonyango zanamhlanje, kwimeko edla ngokuphindaphindiweyo ukuvuselelwa kwabasebenzi kulawulwa ngokungakhethi. Kunokuba kuphelile?
Ukulenga "isongelo sokuvuselela" kuphazamisa umama kwaye kuyimvimbela ukuba aphile ubomi obuzeleyo. Uhlala ekhumbuza ngengqondo umntwana, ucinga ngamanyathelo angenelelo lwezokwelapha, oko kukuthi, kuluxinzelelo lwengqondo.
Ukukhuthazwa kokuzalwa kubakhokelela ekusebenziseni ngakumbi izibonelelo zonyango, oko kukuthi, ukuzalwa kuphelelwa ukuba kube yendalo, okuchaphazela imeko yomama nosana. Ngokuqhelekileyo izibonelelo azikho ekudaluleni ngexesha elifanelekileyo le-cervix, ngoko kufuneka uphendule kwinqanaba lexakeka.
Ukukhuthazwa kwezabasebenzi, i-detache ye-placenta ye-placenta ngokuqhelekileyo iqala nge-amniotomy (autopsy ye-fetal bladder), ephikisana ukuba ngale ndlela kukho ithuba lokubangela inqubo yokuzalwa ngaphandle kokusebenzisa i-droppers. Hayi, ukuba umntwana wayengeke azalwe, umzimba womama awuzange ulungele ukuzala. Ngenxa yoko, i-amniotomy ayiyikuvuselela inkqubo yokuzalwa, kodwa kwiimeko ezininzi iqinisekisa ukunyanzeliswa kwengcinezelo kumama (ngokwengqondo le nkqubo yinkqubo engathandekiyo - xa umgodi wenziwe kwisisu), ikhokelela kwiingxaki zentloko yomntwana (ekubeni isuswe "umlambo wamanzi").
Ukuzalwa okukhuthazayo kunxinzelelo ngakumbi koomama nakwiimvuthu, kuthatha ingozi enkulu kwimpilo yabo bobabini. Ukukhuthazwa kufuneka kwenziwe kuphela kulawo matyala xa zonke iziphumo zayo ezimbi zichanekile. Ingabonakali "emva kweveki yama-41 kufuneka ivuselelwe," kodwa ngoomama othile kunye nosana oluthile.
Iimpawu zeNdabuko
Udokotela wesigqirha esidumileyo, ososayensi, umphandi, uvulindlela wokuzalwa ophilayo uMichel Auden uthanda kakhulu ukucaphula umzekeliso osempuma othi nangomthi ofanayo yonke i-apula ivelisa ngexesha layo. Ngendlela efanayo, ngamnye umntwana unethuba lakhe xa uya kulungela ukuzalwa. Akufanele ugijime izinto, kungcono nje ukuba ubukele ukukhulelwa okuthe ngqo ngoncedo lwezixhobo zonyango ezifumanekayo kunye nezindlela zemveli zesigqirha.
Okokuqala, kukufanele ufunde ngokubanzi iinkcukacha zentsapho, ngokunokwenzeka. Ulwazi olusenziwa nguyise okanye umama wengane lwabazali emva kwexesha elithintekayo, kufuneka uqikelele.
Kubalulekile ukujonga ngokukhawuleza ukuhamba kweemvuthu. Ukuba abahlala bengatshintshi kwixesha kunye nobukhulu - oku kukuphawu lokuba konke kuhamba kakuhle.
Ukuskena kwe-ultrasound. Inani le-amniotic fluid liqhelekile? Esi siqinisekiso esingu-100% sokungabikho kokutshintshwa kweqiniso.
I-Cardiotocography ihlola imeko yempilo yeemvumba "ezingenayo" kwaye ihlolisise inkontileka yesisu.
Ukuhlolwa kweDoppler kukuvumela ukuba ugwebe umsebenzi we-placenta, ukuhamba kwegazi kwintambo yomlomo kunye nokuhlola imeko yomntwana.
Uphando lweHormonal. Ukuxilongwa, umxholo egazini le-estriol, i-lactogen eplastiki kunye neprogesterone. Ngokunyamezela kwangempela, umxholo wale hormone ungaphantsi kwesiqhelo. Kwakhona izikhombisi zokufundisa ze-cortisol, i-hCG kunye ne-alfa-fetoprotein. Omnye unokuthetha nge-amnioscopy (indlela ekhuselekileyo yokubeka esweni imeko ye-amniotic fluid: umbala wabo, ubungakanani, ubukho emanzini okuqala).
Vumela umntwana ukuba akhule
Ugqirha kufuneka uphendule njani ulwazi olufunyenweyo? Ukuba akukho mqondiso wokuphazamiseka, akufanele ugijime izinto. Ukuba kukho ukwesaba ukuba umntwana uhlupheke, kufuneka ukuba kwenziwe isigaba sokutya, kwaye ungagqithisi uxinzelelo, oluphezulu kakhulu xa abasebenzi bevuselela.
Ngenxa yokukhuthazwa kwendima ebalulekileyo yokuzalwa emva kweveki yama-41, kunzima kakhulu ukuthetha malunga nepesenteji yokukhulelwa ngokwenene kuyenokwenzeka ukuba kwakungekho ncedo lwonyango. Oogqirha, ngokunyusa abasebenzi, bafumanisa ukuba umntwana ulungele kwaye abhale yona njengetyala lokukhusela ukukhulelwa kokulibaziseka. Enyanisweni, kunzima ukuvavanya iziphumo zokungenelela okunjalo. Singathetha nje ukuba ukuphazamiseka kwinkqubo yesizukulwana ngaphandle kokuyimfuneko akunakuthathwa njengentsikelelo. Ngoko ke, ukuba unomngcipheko wokunyamezela ", xama ukuthetha ngokuzamile kunye nogqirha malunga nokuba kutheni kubalulekile ukuba uvuselele ukubeleka .Ukuba oku kungengenxa yokuba" yamukelwa "kwaye ugqirha unezizathu ezifanelekileyo zokukholelwa ukuba umntwana uyabandezeleka, intsingiselo yokuvuma. Nangona kunjalo, ngaphandle kwesizathu, kungcono ukulinda nokunika umntwana ithuba lokulungiselela ukuzalwa ngendlela ecinga ukuba ifanelekile.