Zingakhokelela ekuhambeni kwegazi okwaneleyo ukuya kumntwana kwaye zingabungozi kokubili umama nosana. Kwinqaku elithi "Ugalelo lokuphuma kwintsholongwane ngexesha lokukhulelwa" uya kufumana ulwazi olunomdla noluncedo.
Izizathu
Kukho izimbangela ezininzi zokuphuma kwegazi. I-diagnostic yokuqala yenziwe ngokujonga kwabo ngamandla kunye nobukho bezinye iimpawu, uninzi lwawo aluvuli kwaye luqala ngokukhawuleza. Kuba naluphi na ukuphuma kwegazi ngexesha lokukhulelwa, kufuneka uqhagamshelane nodokotela ngokukhawuleza. Umthombo wegazi udla ngokuba yiinqanawa ze-placenta okanye i-cervix. Kubalulekile ukuba ungabandakanyi indawo ephantsi ye-placenta kwisigxina se-uterine (praevia).
• Ukuhlamba umlomo wesibeleko
Ngethuba lokukhulelwa, kunokuthi kubekho i-cerctus ye-cervix (i-eversion ye-membrane ye-mucous canal). I-membrane ye-mucous ye-canal yomlomo wesibeleko inomthende kwaye ingazi. Ukuphuma kwegazi kudla ngokungaqhelekanga kwaye kwenzeka ngokuphindaphindiweyo emva kwesondo. Ukuphuhliswa kwe-ectropion kungabangela ukusuleleka okuhambisana ne-pathological excretions kwi-vagina.
• I-Placenta praevia
Inkcazo yepentecenta ibhekisela kwisinamathiselo sayo kwicandelo elincinane le-uterine kwisithuba sokunyuka kwamaxesha angaphezu kwama-28. Ngaphambi kweveki ye-18 yokukhulelwa, owesibini wesibini unendawo ephantsi yepaccental. Nangona kunjalo, njengomthetho, njengoko ubukhulu bombhobho bukhula, isikhundla se-placenta sitshintsha, kwaye kwiimeko ezininzi kwiiveki ezingama-28 zichazwe ngaphantsi kwesibeleko. Ubuninzi be-placenta bubonakala ngokuqhelekileyo kubantu abatshitshisiweyo abaye bafumana ukuhanjiswa kweenkonzo kunye nabasetyhini abadala.
• I-detachedature yamatente
Nge-detached clock, i-placenta ihlukaniswe ukusuka eludongeni lwe-uterine. Le ntsholongwane iquka imiphumo emibi kumntwana, ngakumbi xa ekhusela isayithi elibanzi. Ukuhlamba kunokuba nzima ukuzalwa ngaphambi kokuzalwa. I-Detachment yendima ebalulekileyo ye-placenta idinga i-caesarean section ngokukhawuleza, kuba kulo mzekelo ukuhamba kwegazi kumntwana kuphazamiseka. Ngentambo yendawo encinci, ukuhanjiswa kwexesha loxinzelelo akukwenziwa, kodwa imeko yomama kunye nomntwana kufuneka ihlolwe ngenyameko.
• Umda wepalacenta
Ukuhlamba kungenzeka xa i-placenta isesigxina. Ngokuqhelekileyo liphantsi kakhulu kwaye alilimazi umama kunye nomntwana. Ukuxilongwa kwenziwa emva kokukhutshwa kwe-pathology yomlomo wesibeleko, i-previa kunye ne-anti-premature ye-placenta. Njengomthetho, ukuphuma okunjalo kuyeka lula. Ukuqaphela isizathu sokuphaphaka ngexesha lokubeleka, ukuhlolwa ngokuthe ngileyo kwindoda ekhulelwe kuyimfuneko. Ukuvavanya imeko yomama kunye nomntwana, kukho iindlela ezininzi. Kukho nawaphi ukuphuma kwegazi ngexesha lokukhulelwa, umfazi kufuneka ahlolwe ngokukhawuleza ngugqirha. Kunokwenzeka ukukrokrela imbangela yayo sele isele kuviwo - umzekelo, kunye nokuphazamiseka kwamaplanga, isisu sisininzi kwaye sibuhlungu, kunye ne-placenta previa, umntwanama uhlala ehlala kwindawo engafanelekanga (ukuveliswa kwe-fetus) kunye nentloko yayo ayifaki kwi-pelvic cavity.
Uviwo lwevaginal
Uviwo lwe-vaginal luyenziwa kuphela emva kokungeniswa kwenkcazo ye-placenta ngoncedo lwe-ultrasound, ngenxa yokuba le ntsholongwane inokukhupha igazi elikhulu. Xa uvavanyo lwangaphantsi luyakubonisa intsholongwane yomlomo wesibeleko, umzekelo, i-ectronion. Ukucacisa ukubunjwa kwamaselula, igazi lelo mfazi okhulelweyo lihlalutyiweyo. Kufuneka kwakhona ukhethe igazi lomnikeli ngenxa yokumpontshelwa igazi kwimeko engxamisekileyo. Ngokuqhelekileyo, i-catheter enobungozi ifakwe kumfazi okhulelweyo.
Uvavanyo lomntwana
Ukuvavanya imeko ye-fetus, i-cardiotocography (CTG) eyenziwa, ebhalisa umsebenzi wayo wenhliziyo. Ukuhlamba okuvela kwi-placenta kuhamba kunye neengqamlezo ezingabonakaliyo ze-uterine. Ngokuncedwa kwe-cardiotocograph, ukuchasana kokuqala kunye neempawu zokuzalwa ngaphambi kokuzalwa kunokubhalwa. I-Ultrasound isetyenziselwa ukukhuphela i-placenta previa kwaye ukugcina uphuhliso kunye nomsebenzi we-fetus. Owesifazane okhulelwe ophuma ngegazi ngokuqhelekileyo uyathunyelwa kwisibhedlele ukuze aqaphele. Ngokuqhelekileyo kukho ukuphuma kwegazi ephantsi, okuyekezela ngokwabo (kuphela ukulawulwa kwimeko ngexesha lomhla liyadingeka). Nangona kunjalo, nge-placenta previa, kunzima ukwenza nayiphi na izibikezelo, kwaye izigulane ezininzi zidinga ukuhlala esibhedlele. Umngcipheko omkhulu wokuphuluka okukhulu kwegazi kwenzeka xa i-placenta igqithisa ngokupheleleyo umlomo wesibeleko. Oku kwenza kube nzima ukuhanjiswa kwezemvelo, ngoko ke abasebenzi bezonyango kufuneka balungiselelwe icandelo le-emergency breaker.
Ukuzalwa kwangaphambili
Ukuphuma kwamanzi kwanamaphi na i-etiology kwandisa ingozi yokubeleka kwangaphambi kwexesha - ngokuzenzekelayo okanye ngokufakelwa ngumzimba, ngokwamacandelo esondlo. Ingxaki ebaluleke kakhulu kwikliniki yengane engaphambi komntwana kukungakhangeli kwemiphunga. Kusemngciphekweni wokubeleka kwangaphambi kokuzalwa kwangaphambili kwe-steroid imiselwe ukuba kukhawuleze ukukhula komzimba wamaphapho. Kukhuselekile kumntwana ongakazalwa.
Iigazi zegazi
Phantse kwi-15 yabasetyhini bane-Rh echaphazelekayo yegazi. Ukuthintela ingxabano yeRhesus ngexesha lokukhulelwa okulandelayo, ezi zigulane zichongiwe i-immunoglobulin engama-72 emva kwegazi.