Ngokweziphakamiso ze-World Health Organisation (WHO), ukuzalwa okuvela kwiiveki ezingama-22 ukuya kwe-37 zokukhulelwa (ubunzima be-fetal 500 g okanye ngaphezulu) bungafiki. Kukho ukuzalwa kwangaphambi kokuzalwa kwangaphambili (iiveki ezingama-22-27), ekuqaleni (iiveki ezingama-28-33) kunye nokuzalwa kwangaphambi kwexesha (kwiiveki ezingama-34-37). Elizweni lethu, ukubeletha kwiiveki ezingama-22-27 akuthathwa njengengaphambi kwexesha, kodwa unyango lwezonyango lunikezelwa kwisibhedlele sokubeleka, kwaye uthathe onke amanyathelo afanelekileyo okunyamekela umntwana. Umntwana ozelwe ngexesha elide (kwiiveki ezingama-22 ukuya kuma-23) uthathwa njengengane ebusweni kwiintsuku zokuqala ezi-7 zobomi. Kuphela emva kweveki, ukuba umntwana unakho ukuzivumelanisa neemeko ezingaphezulu kwezilwanyana zokuhlala, uthathwa njengomntwana. Kwiimpawu zanamhlanje, ukuhamba kwexesha lokuqala komsebenzi kungagqithisi nje kuphela, kodwa kukhula ngenxa yokunyuka kwenani lokukhulelwa okuphindaphindiweyo, ukusetyenziswa ngokubanzi kwezobuchwepheshe bokuzala. Ziziphi izizathu zokuzalwa kwangaphambi kokuzalwa, funda kwinqaku ngesihloko esithi "Yintoni eyingozi kumama wokubeleka kwangaphambi kokuzalwa."
Izizathu
Izizathu zokuzalwa kwangaphambi kokuzalwa kokuqala zihlukeneyo, zinokuhlulwa zibe ngamaqela amabini - i-socio-biological (engeyonyango) kunye neyeza. Ngenxa yezizathu zentlalo-biological ziyingozi (ukusetyenziswa kotywala, iziyobisi, ukutshaya ngexesha lokukhulelwa), inqanaba elincinci lentlalo-qoqosho lobomi bomama ozayo, izimo zokusebenza zokusebenza ezinobungozi (ubukho bemisebe, ukuxubha, isandi, ishedyuli esingaqhelekanga, ukusebenza ebusuku), kwaye kwakhona ukungondleki, imeko yokuxinezeleka okungapheliyo.
Izizathu ezibalulekileyo zonyango ziquka:
• Ukukhulelwa (enye yezona zinto ezibalulekileyo ezibangela ukupheliswa kokuqala kokukhulelwa). Ukuzalwa kwangaphambi kwexesha kunokukhokelela kwizifo eziziimpawu ezinzima kunye nezifo ezingapheliyo (ibhaktheriya kunye ne-viral). Ingaba izifo ezixhaphakileyo zezifo zangaphakathi (isifo se-pneumonia - pneumonia, pyelonephritis - ukuvuvukala kweentso, njl.), Ngoko intsholongwane ifinyelela emntwaneni; okanye usulelo lwezitho zangasese (chlamydia, trichomoniasis, gonorrhea, herpes, njl.), ngoko isifo esivela kumfazi singangena kwiqanda lomntwana elinyukayo.
• Ukulinganisa i-anamnesis engathintekiyo (ukukhupha isisu, ukuphazamiseka komzimba - ukuphazamiseka kokukhulelwa ukuya kwiiveki ezingama-22 kunye nokuzalwa kwangaphambi kwexesha elidlulileyo) kunye / okanye imbali yomzimba (izifo ezivuthayo zesifo somzimba wesifazane, i-uterine myoma - tumor of the muscular layer of uterus, ukungasebenzi kwemveliso).
• Ukungakwazi ukusebenza kwe-i-hmicocervical - ukungakwazi ukukhutshwa kwesibeletho somlomo ngenxa yokuxhatshazwa ngokukhupha izisu, ukuyeka ukuhlaselwa kwangaphambili, njl njl.
• Izifo zesifo sangaphandle (izifo zenyama zangaphakathi) - i-endocrine pathology (ukukhuluphala, isifo sikashukela, izifo ze-thyroid), izifo ezinzima zesimo senhliziyo, iintso kunye nezinye izitho. Kule nqela yezizathu kubandakanya izimo zesifo sengxaki (izifo ezinxulumene nokwanda kwenkqubo yomsebenzi wegazi), apho umngcipheko wexesha elingaphambi kwe-placenta, i-thrombosis (ukugqithwa kwamacandelo egazi emithanjeni yegazi ye-placenta), okukhokelela ekuzalweni kwangaphambi kokuzalwa kwangaphambili kunyuke ngokuphawulekayo.
• Inkqubo ekhutheleyo yokukhulelwa (i-gestosis - toxicosis yesiqingatha sesibini sokukhulelwa, iifom ezinzima zokungakwazi ukuzalana, kubangele ukukhokelela ekugqibeleni kwe-uterus - polyhydramnios, ukukhulelwa okubanzi).
Isibonakaliso sokuqala kokuzalwa ngaphambi kokuzalwa
Isibonakaliso sokuqala kobasebenzi siya kuba yinto ebonakalayo yokutyumza intlungu kwisisu esisisiswini, esona ixesha elidlulileyo lihlala liqina, lihlala lininzi kwaye lihlala lihlala njalo. Ekuqaleni, xa iintlungu zesisu ziswelekile kwaye zingabalulekiyo, ukuphuma kwamanzi okanye ukucoca ngamanzi kungabonakala kwisisu, okubonakalisa utshintsho olusesikweni (ukufutshane nokunciphisa) lomlomo wesibeleko. Ukuhluka okuqhelekileyo kokuphuhliswa kweziganeko kunokususwa kwangaphambili kwe-amniotic fluid, ngelixa umbane ocacileyo okanye ophuzi ukhishwa kwisisu, isixa esingahluka kwi-isipuni ukuya kwiglasi okanye ngaphezulu. Ukukhupha i-amniotic fluid inokuhamba kunye nentlungu kwisisu esezantsi, kwaye iyakwenzeka ekungabikho kwenyuka kwithenda yesisu. Njengomgaqo, ukuphuma kwe-amniotic fluid kubangelwa ukusuleleka kwesigxina esingaphantsi kwesibhedlele se-fetal ngendlela ekhuphukayo (intsholongwane ivela kumfazi). Ukubonakala kwayo nayiphi na impawu ekhankanywe apha ngasentla kuyisiseko sokubiza "i-ambulensi" kunye nesibhedlele esiphuthumayo kwisibhedlele sokubeleka, njengoko kungekudala umama ozayo kwiziko lonyango, amathuba okugcina ukukhulelwa. Ukuba akukho ndlela yokunyusa ukukhulelwa, zonke izimo zokuhanjiswa ngokunyamekileyo ziya kwenziwa kwisibhedlele sokubeletha, ukunciphisa umngcipheko weengxaki zomama kunye nomntwana, kunye noonesi umntwana osanda kuzalwa.
Inkqubo yokuzalwa ngaphambi kokuzalwa
Iingxaki eziqhelekileyo zezifundo zokuzalwa kwangaphambi kokuzalwa kwangaphambi kokuzalwa zingabonakali zabasebenzi (ubuthathaka, ukuchithwa kwezabasebenzi, ukuhanjiswa okukhawulezayo okanye okukhawulezayo), ukukhulelwa kwangaphambili kwe-amniotic fluid, ukuphuhliswa kwe-hypoxia yobusana be-intrauterine (ukungabikho kwe-oxygen).
Ukuhanjiswa okukhawulezayo
Ukuzalwa kwangaphambi kokuzalwa, ukukhawuleza okukhawulezayo kunye nokukhawuleza kuyimpawu. Le meko ibangelwe, okokuqala, kwinto yokuba ukuzalwa komntwana ongaphantsi kwintsana, ukuvula encinci yomlomo wesibeleko (6-8 cm) kunelungelo kunokuba kunikezwe ngexesha elifanelekileyo (10-12 cm). Okwesibini, kwafunyaniswa ukuba umsebenzi onesivumelwano esibelethwayo ekuhanjisweni kwangaphambi kwexesha eliphambili ngowama-2 amaxesha angaphezu komsebenzi wokuzalwa ngexesha. Okwesithathu, umntwana omncinci omncinci uhamba ngokukhawuleza ngedaka lokuzalwa. Kule meko, iimbambano eziqhelekileyo, ezibuhlungu, zihlala zibala. Ukuba ubude bomyinge wexesha lokuhambisa ngexesha elifike ngexesha li-10-12 iiyure, ukuzalwa kwangaphambi kokugqibela kunokuthatha iiyure ezingama-7 ukuya kwe-8 okanye ngaphantsi. Inkqubo yokukhawuleza yomsebenzi yinto engathintekiyo, enokuba kunye nokuhambisa ngexesha elifanelekileyo kunokukhokelela ekuphuhliseni i-hypoxia (i-oxygen starvation) yomntwana. Umsebenzi onesivumelwano esisebenzayo we-uterus ukhokelela ekunciphiseni kwegazi le-uteroplacental flow, okubangelwa yi-hypoxia ye-fetus, kwaye nayo inefuthe elichanekileyo lokumelana nomzimba oswelekile wengane engekafiki. Ukongezelela, ngokuhamba ngokukhawuleza kwiimitha zokuzalwa, intloko ye-fetal ayinayo ixesha lokuzivumelanisa neqondo elifanelekileyo, elibangele ukukhathazeka komgudu womlomo wesibeleko, kunye nokubola kwegazi phantsi kweembombo zeengqondo zomntwana ngexesha lokubeletha. Ngenxa yeziphumo zokulimala, umntwana osengumntwana ufumana ubunzima ekuhambiseni izimo zobomi, obonakala ngokugqithiseleyo ngeengxaki zegazi kwaye kufuna ukubeka iliso ngokucophelela nokupheka. Ngenxa yenkqubela phambili ngokukhawuleza komntwana, kunokubakho ukuhlukana komsele ongaphantsi wokuzala (ubuhlungu bomlomo wesibeleko, isondo, i-labia) ngenxa yokuba izicubu zingenaso ixesha lokuzilungelelanisa ngokulinganayo nobukhulu bomntwana.
Ubuthathaka bomsebenzi. Ingxaki engabonakaliyo yokubeleka kwangaphambi kokuzalwa kungabuthathaka kwabasebenzi, xa ukuncipha kunye namandla okuphulwa kwemida kuncitshiswa, okwandisa kakhulu ubude bezabasebenzi kwaye kuphazamisa kakhulu isimo somntwana we-fetus (i-hypoxia iyaqhubeka). Umsebenzi wokungahambi kakuhle. Ukongezelela kwintsebenzo engqongqo okanye yobuthathaka, imisebenzi engavumelaniyo eyenziwa ngokuqhelekileyo ibonwa ngokuthe gqolo ekuzalweni kwangaphambi kokuzalwa - uhlobo lwesenzo sokuzalwa, apho umyalelo wokuqhekeka kwemisipha yomkhuhlane uphazamiseka (ngokuqhelekileyo ukuphambana kuyaqala kwinqanaba lombele kwaye lisasazeka ukusuka phezulu). Kwimeko yomsebenzi ongenakuxhatshazwayo, iingqamlezo ezibuhlungu ziphawulwa, kwixesha eliphakathi kweyiphi ibele engavumi ngokupheleleyo, ekhokelela ekuphuhlisweni kwe-hypoxia yangaphakathi kwe-fetus. Isikhundla esingalunganga somntwana. Ekuzalweni kwangaphambi kokuzalwa, ukungaqhelekanga komntwana kufumaneke kakhulu (umzekelo, iintetho ze-pelvic) ngenxa yobukhulu becala lomntwana ngokuphathelele ubungakanani bentambo ye-uterine.
Ukukhutshwa kwangaphambili kwe-amniotic fluid. Le nkxalabo iyenzeka ngokuzalwa kwangaphambili kwaye ibangelwa ukungasebenzi okanye usulelo lwe-ismicocervical. Ingxenye yesikhumba, iphendulelwe kuba ngumfazi, ngaphantsi kwefuthe losulelo oluchaphazelekayo luya kutshintsha, luba lukhuni, kwaye ukubola kweembrane kwenzeka. Ukutshala kwe-amniotic fluid ngokuqhelekileyo kwenzeka ngokungalindelekanga, ngelixa i-liquid ishicilelwa kwisisu (ukusuka kwindawo emanzi kwindawo yokuhlamba ukuya kumanzi amaninzi). Umbala we-amniotic fluid unokukhanya kwaye ungabonakali (obungqina bokuba imeko eyanelisayo yomntwana), kwezinye iimeko, amanzi angakwazi ukufumana umbala oluhlaza, ube ngongqungquthela, kunye nephunga elimnandi (elibhekwa njengophawu lwe-hypoxia okanye intsholongwane yobomi bentsholongwane).
Izifo
Iingxaki ezithintekayo ekuzalweni okanye kwi-puerperium ngexesha lokubeleka kwangaphambi kokuba zizalwe zijongwa ngokuphindaphindiweyo ngexesha lokubeleka ngexesha. Oku kungakho ngenxa yexesha elide labasebenzi (kunye nobuthathaka bentsebenzo), ixesha elide lexesha elimnandi - ixesha elingaphezu kwama-12 iiyure (njengoko rhoqo emva kokuphuma kwe-amniotic fluid ngaphambi kokuba kuqalwe iiyure ezininzi), kunye nobukho bokuqala emzimbeni wesifo esithathiweyo, yaba yimbangela yokuzalwa ngaphambi kokuzalwa. Iingxaki ezixhaphakileyo ezixhaphakileyo zihamba nge-postpartum endometritis (ukuvuvukala kwesibeletho), ukuxhaswa kwe-sutures emva kokugqithisa. Iingxaki ezinqabile kakhulu, kodwa ezinzima zingenziwa nge-peritonitis (ukuvuvukala kwe-peritoneum) kunye ne-sepsis (ukusasazeka jikelele kwintsholongwane kuwo wonke umzimba).
Ukulawulwa kwabasebenzi bokuqala
Ekubeni ngenxa yezinto ezisemthethweni zengqesho zabantwana zintsholongwane, ukulawulwa kokubeleka kwangaphambi kwexesha kunemibandela engundoqo ebusweni bezabasebenzi ekukhulelweni kwexesha elipheleleyo. I-"motto" ehamba phambili ekhokela abagqithisi ngumsebenzi oqapheleyo, obalaseleyo ekulawuleni umsebenzi wabasebenzi bokuqala, ukungabikho naluphi na ukungenelelo ngaphandle kwezizathu ezibalulekileyo.
Ukulondolozwa kokukhulelwa
Kwinqanaba lokusongela okanye ukuqala kokuzalwa kwangaphambi kokuzalwa, ukuba akukho zichaso (ezifana nokuphuma kwe-amniotic fluid, iingxaki ezinzima zokukhulelwa, ukuvulwa komlomo wesibeleko ngaphezu kwe-5 cm, ubukho bentsholongwane, njl.), Unyango olujoliswe ekugcineni ukukhulelwa lwenziwa. Njengamanje, izigqirha zixhotyiswe ngamachiza asebenzayo anqanda umsebenzi onesivumelwano sokuzalisa i-uterus - tocolytic (isicatshulwa esisetyenziswa kakhulu kweli qela yi-HINIPRAL). Ukunciphisa ngokukhawuleza ithoni ye-uterine, i-tocolytics iqala ukujova nge-intravenously, emva kokunciphisa ithoni abayitshintshelayo ekuthathele ezi zi yobisi ngendlela yamacwecwe.
Ukuthintela iingxaki. Kwimeko yeso sigxina sokuphazamiseka kokukhulelwa ngexesha elingaphantsi kweeveki ezingama-34, i-respiratory distress syndrome yengane esandula (iintsholongwane zokuphefumula ngenxa yokukhula ngokwaneleyo kwimizimba yamaphaphu) inqandwa ngokumisela amahomoni akhulelweyo e-adrenal cortex-glucocorticoids (PREHNYOLOH, DEXAMETHANON, BETAMETAZON). Isantya sokuthintela isifo sengxaki yokuphefumula komntwana osusayo kuthatha iiyure eziyi-24 ngokwemyinge (izicwangciso ezahlukeneyo zokutyunjwa kwe-glucocorticoids ziye zaphuhliswa - ukususela kwiiyure eziyi-8 ukuya kwiintsuku ezi-2, ukhetho olwenziwa ngokuxhomekeka kwimeko ethile yomqobo). Ezi zi yobisi zifaka isandla ekukhawulezeni ukukhula komfakeli we-pulmonary kwi-fetus, kuba kungabikho kwalolu hlobo lwama-alveoli e-alveoli-i-pulmary "bubbles bubbles" apho utshintshiselwano lwegesi phakathi kwegazi nomoya - nokuthintela umphunga ukuba ungadli ngokukhathala kwi-inhalation kubangela ukuphuhliswa kwezifo zokuphefumula i-neonate. Kucaciswe ukuba ngexesha lokunyuka kwamaviki angaphezu kwama-34, imiphunga ye-fetal sele iseneleyo. ngoko akukho mfuneko yokuthintela ukuphefumula kwesifo sengqondo. Kwi-arsenal of obstetricians kunye neonatologists, ukulungiselela amalungiselelo okwangoku okwenzekayo (UKUROSURF, SURFANTANT BL), ngokuqaliswa kwazo iintsana ezisanda kuzalwa zinganciphisa kakhulu iziganeko kunye nobunzima be-respiratory distress syndrome. Ngethuba lokubeletha, ukuhlolwa ngokunyameko kwenziwa kwimeko yesibini yomfazi (ukushisa, uxinzelelo lwegazi, ukuba kunyanzelekile, uvavanyo lwegazi lwekliniki lwenziwa), kunye nesimo sengqondo somntwana we-fetus nge-cardiotocography (abenzi beesibini abarekhoda ithoni yesisu kunye nomsebenzi wentliziyo womntwana , evumela ukuvavanya ngempumelelo kwe-intrauterine "imeko yezempilo" yomntwana), kunye nokuphulaphula rhoqo intliziyo yentliziyo kwisalathisi sangasemva kwesisu. Ukuthintela i-hypoxia ye-intrauterine ye-fetus yenziwa, ngenxa yale njongo zichazwe kwi-PIRACETAMES, ASKORBINE ACID, ICOCAROXYLASE, ACTO-VEGIN.
Anesthesia
Isimo esaneleyo sokulawulwa kweengqesho zangaphambili kweso-anesthesia eyaneleyo, kuba intlungu iholele ekuphuhliseni i-spasm ye-vascular, eyiyo imiphumo emibi ebusweni obusanda kuzalwa, apho umsebenzi onzima kakhulu. Ngenjongo yokuzalisa i-anesthetizing, i-spasmolytics kunye ne-analgesics, i-anesthesia ye-epidural (indlela ye-anesthesia, apho isicatshulwa ijojowe kwindawo ye-epidural). Injola eyenziwa kwingingqi ye-lumbar, isikhala phakathi kwodonga lwesigxina kunye negobolondo elukhuni enxibe umthambo womgudu, i-catheter ifakiwe, kwaye i-agent ye-anesthetic ilawulwa. Ukuqwalasela ukuba i-analcotic analgesics (umzekelo, i-PROMEDOL) ingaba nefuthe eliphazamisayo kwisikhungo sokuphefumula, ukusetyenziswa kweli qela leziyobisi akucebisi. I-anesthesia ye-epidural iye yazibonakalisa ekulawuleni ukuzalwa kwangaphambi kokuzalwa, njengoko igalelo ekuphuculeni ukuhamba kwegazi lokungena kwi-intereplacental, enomphumo onobuncedo kwiimeko zobumntwana bomntwana kunye nokukunceda ukuba unqobe uxinzelelo lokuzalwa kwiimeko "ezintle".
Rhythmostimulation
Ukuzikhethela okulandelayo kweendlela zokubambisa ekukhulelweni kwangaphambi kweso sijonga ngokubhekiselele kwi-rhodostimulation xa ubuthathaka bezabasebenzi buphuhliswa. Ukuba ukuhanjiswa okufike ngexesha kuqaliswe ngokugqithisa, kufuneka kuqhubeke ukuphela kokubeleka, ngoko ke xa kwenzeka ukuzalwa kwangaphambi kokuzalwa, isetyenziselwa ukunyusa: ngexesha lokuqhelaniswa kwabasebenzi, ukuvuselela kuphelile, kuba ukuvuselela isisu esincinci se-fetus ebusweni kungabangela i-hypoxia yangaphakathi.
Ukugcina ixesha lemizamo
Ngethuba lokuxoshwa kwe-fetus (ixesha lemizamo) ngenjongo yokucoca ngokugqithiseleyo kwe-fetus, ukuzalwa kuthathwa ngaphandle kokukhusela i-perineum ukusuka kumaphuphu (okubizwa ngokuba yi-manual ye-obstetric), kwaye ukuchithwa kwe-perineal kunqunywe ukunciphisa ukunyanzeliswa kwentloko ye-fetal ngamancuba e-canal birth-episiotomy. Ekuzalweni, i-neonatologist ihlala ikhona, ilungele ukubonelela ngononophelo ngononophelo olutsha kunye nokuvuselela xa kuyimfuneko.
Candelo laseKesariya
Kunzima ukufumanisa izibonakaliso zecandelo lexesha eliqhelekileyo ngexesha lomsebenzi wokuqala, ngokukodwa ukuba ixesha lokuthoba lingaphantsi kwamaviki angama-34. Kwizithintelo zanamhlanje, ukuhanjiswa kwinqanaba le-caesarean kunye nokukhulelwa kwangaphantsi kwexesha elide ukuya kwiiveki ezingama-34 kwininzi lamatyala lwenziwa ngokubhekiselele kwizibonakaliso ngokupheleleyo - oko kukuthi, kwiimeko ezongela ubomi bomama. Izibonakaliso ezingenasiphelo zibandakanya ukuphazamiseka kweplantshi kwangaphambi kwexesha, i-placenta previa (i-placenta ihlanganisa umlomo wesibeleko, kunye nokuzalwa akunakwenzeka ngohlobo lwezityalo zokuzalwa), isithuba esinqumlayo se-fetus, njl. iingcali) ngokuqwalasela ukunyanzeliswa kokuphila komntwana kunye nokuba kunokwenzeka ukubonelela ngononophelo olunezakhono zononophelo lwe-infantatal.
Indlela yokuziphatha?
Ukuziphatha komfazi ohamba phambili kwinkqubo yokuhanjiswa kwangaphambili akufani kakhulu nokuziphatha ngokuhambisa ngexesha. Ukuba ugqirha uyavuma, unokuhamba ngeenxa zonke zewadi, uthathe izikhundla zomzimba ezizinzileyo ezenza ukuba ubuhlungu bube bukhulu, usebenzise ubuchule bokusilalisa (ukujikeleza isisu ngendlela ejikelezayo, ukuxubha i-sacrum, njl njl.), Phefumla ngokukhawuleza ngexesha lokulwa. Kwezinye iimeko (umzekelo, nge-pelvic presentation of the fetus) kucetyiswa ukuba ulele embhedeni. Kule meko, ikhetho elifanelekileyo liza kuba kwicala layo, kuba le meko ingabandakanyi ukucinywa kweenqanawa ezinkulu (ezinokubangela ukuphuhliswa kweengxaki zentsholongwane yomntwana), kunye nokuthintela umntwana ukuba ahambe ngokukhawuleza kwi-canal yokuzalwa. Okona kubaluleke kakhulu - gcina umoya ozolile kwaye ulungile, phulaphulaphula ngokukhawuleza uze ulandele iziphakamiso zababelethisi kunye noogqirha.
Umntwana osengaphambili
Umntwana, ozalwe ngenxa yokuzalwa kwangaphambi kokuzalwa, unempawu zokungcoliswa kwangaphambili, ubunzima obunqunyanyiswayo ngokubanzi kwisisindo sokubeleka esingaphantsi kwe-2500 g, ukukhula okungaphantsi kwe-45 cm, ubuninzi beeshizi ezinqabileyo kwesikhumba, i-soft and ear ear cartilage, amantombazana akafihla i-labia encinci , kumakhwenkwe amathumbu awancishwanga kwi-scrotum, amacwecwe e-nail afikeleleki kwiinto. Ekuzalweni, umntwana uhlolwe yi-neonatologist eklasini lokuhambisa kwaye adluliselwe kwiNyunithi Yonyango Ejongene Nokukhathazeka okanye ukuvuselelwa kweNonatal for further monitoring and treatment. Njengomthetho, iintsana ezingaphambi kwexesha zifakwe kwi-kuvez-i-incubator ekhethekileyo eneendonga ezivulekileyo, ezigcina ukushisa, umswakama, umxholo we-oksijini ngokufanelekileyo kwimida yomntwana. Ukuba kwindlovu kukhuthaza ukuhamba okugqithiseleyo kwexesha lokutshintshela kwintsana ngaphandle komzimba kamama. Sekude ixesha lokugaya kunye nesisindo somntwana ekuzalweni, kulungele ukuhlaselwa. Ukuba kuyimfuneko, usana olususana luya kudluliselwa kwisibhedlele sokubeletha kwisibhedlele sabantwana kwinqanaba lesibini lokunesi. Kukho izibhedlele zokubeletha ezikhethekileyo ekulawuleni ukuhanjiswa kwangaphambi komntwana kunye noongikazi olutsha olusandul 'ukuzalwa, oluxhotyiswe kwizixhobo ezinokusetyenziswa kwezixhobo zenkwenkwezi, iintsholongwane kunye neonatologists ziye zafumana amava amaninzi kwiinkatho kunye nokuhanjiswa kwamaziko enyango, okuvumela ukuphucula kakhulu iziphumo zomama kunye ngomntwana. Abasetyhini abanomngcipheko omkhulu wokubeletha kwangaphambi kokuzalwa kufuneka banikezelwe kwiindawo ezinqamlekileyo, apho zonke iimeko zikhona ekuboneleleni ngoncedo olusisigxina ekuvuseleleni umntwana osanda kuzalwa (Kuveza, umoya, kunye neengcali ezifanelekileyo kwinqanaba elifanelekileyo).
Ukutshintshela kwiimeko ezintsha zobomi ngaphandle kwesibeleko umntwana osengumntwana kunzima kakhulu kwaye kuninzi kunomntwana opheleleyo. Oku kungenxa yokungagcini kwezitho kunye neenkqubo, ukunciphisa amandla okulawula, ukuphuhliswa okwaneleyo kwenkqubo yokuzivikela. Okwangoku, impumelelo ebalulekileyo iye yafunyanwa ekunakekeleni iintsana ezisandul 'ukuzalwa: izilungiselelo ezingabonakaliyo ziye zavela kwi-arsenal yoogqirha, okokuba, xa kuziswa umntwana, kunokunciphisa kakhulu umngcipheko we-respiratory distress syndrome, izibhedlele zokubeletha zixhaswa ngezixhobo ezixhasayo zokubonelela ngoncedo oluphezulu (kuvezes, ventilators, njl njl. njl), evumela ukuphucula iziphumo kunye nokuxela ukukhula okuqhubekayo nophuhliso lomntwana.
Ukuthintela ukuzalwa ngaphambi kokuzalwa
Amanyathelo angundoqo okujoliswe ekuthintekeni kokuzalwa kwangaphambi kokuzalwa kubanjelwa kwinqanaba lokubonisana kwabasetyhini, kuba kukubeka iliso kwendlela yokukhulelwa okukuvumela ukuba uqikelele kwaye uhlolisise ingozi yokuphazamiseka kwithuba. Amanyathelo okuthintela umsebenzi wokuqalwa komsebenzi kubandakanya:
Ukucwangciswa kokukhulelwa kunye nokubonelelwa koqeqesho lokuqala, oluqulethwe unyango lwezifo ze-somatic ezikhoyo, unyango lwezifo ezingapheliyo zentsholongwane, ukwenzela ukuba ngexesha lokukhulelwa, umama olindelekileyo useburhulumenteni obuhle ekuthwaleni komntwana.
• Ukubhalisa kwangethuba kunye nokubonisana kwamabhinqa kunye nokubeka esweni rhoqo ukukhula kokukhulelwa. Oku kuyinyani ngokukodwa ukuba ngaphambili kudlulelwe ngumfazi, ukuzalwa kwangaphambi kokuzalwa, ukukhipha isisu.
• Ukonyango lwe-foci yentsholongwane, ngokukodwa i-colpitis (iinkqubo zokuvuvukala kwesisini), zifunyanwe ngexesha lokukhulelwa, kuba indlela eqhelekileyo enokubangela ukuba uphuhliso lwe-premital birth lukhuphuke (usulelo oluvela kumfazi lukhuphuke kwaye luphazamise isigxina esincinane sesisu).
• Ukuthintela ngexesha kunye nokunyangwa kweengxaki zokukhulelwa (njengokungenakulungelelaniswa kwamapayipi, i-gestosis - toxicosis yesigamu sesibini sokukhulelwa, i-pyelonephritis - ukuvuvukala kwezintso, njl.).
Ukubeka iliso kwi-ultrasonic ye-intrauterine status fetal kunye nokukhula kokukhulelwa (i-ultrasound ingasetyenziselwa ukulinganisa ubude kunye nemeko yomsele wesibeleko ukuxilongwa ngokukhawuleza kokungaqiniseki komlomo).
• Ukuba kukho iziganeko zesongelo sokukhupha isisu, ukulaliswa kwezibhedlele kunye nonyango ngokukhusela ukuphefumula kwesifo sengqondo emntwaneni. Ngoku siyazi into eyingozi kumama wokuzalwa ngaphambi kokuzalwa.