Matšoao a Lemosang, Litlhapi le Tse ling
Mantsoe a lehetla dystocia a tšosa pelo ea ngaka e 'ngoe le e' ngoe. Sena se bolela hore, ka makhetlo a mabeli, mahetla kapa liphahla tsa lesea ha li kene pelvis nakong ea tsoalo ha li ntse li lokela. Dystocia ea mahetla e hlahella ka tlase ho 1% ea tsoalo eohle ho ea ka lithuto tse ling. Sena se ka baka mathata a mangata bakeng sa lesea le 'mè.
Litemoso Tse Lemosang bakeng sa Dystocia le Mahetla
Ho fapana le tumelo e tloaelehileng ha ho mokhoa o le mong o tobileng oa ho bolela esale pele hore na ke mang ea tla ba le dystocia ea mahetleng. Likhopolo tse fapaneng tse fapaneng li 'nile tsa lekoa, e' Re shebane le bana ba baholo, bakhachane ba monyenyane, bokhachane bo rarahaneng, haholo-holo mabapi le mathata a kang lefu la tsoekere la mokokotlo , menyetla, lilemo tsa botšehali , masea a fetileng le mahetla dystocia, le tse ling tse ngata. Ka mohlala, ho sebelisa boima ba ngoana feela e le ntho e itseng, hoo e batlang e le kotara ea dystocia ea mahetla e etsahala ho masea ka tlas'a "boima ba 'mele". Mokhoa o motle ka ho fetisisa o ka ba motsoako oa lintlha tse amehang.
U etsa'ng haeba uena le ngaka ea hau u ikutloa eka u kotsing ea dystocia ea lehetla? Karabo ha e hlake tsohle. Rea tseba hore maemo a itseng a ka 'na a lebisa dystocia lehetleng, mohlala, boemo ba lithotomy (bo otlolohileng ka morao) bo ka thibela sacrum hore e se ke ea falla nakong ea tsoalo' me kahoo e fokotsa boholo ba kamoreng ea hao ka mahetleng .
Episiotomy, ho buuoa ka lehlakoreng la letlalo pakeng tsa botšehali le phallo, hangata ho phehisana khang ka lehlakoreng le le leng ho re ho etsa episiotomy e fanang ka seatla se bulehileng ho lumella ngaka hore e tsamaise, lehlakoreng le leng le bolela hore perineum ha e sebetse 'mè oa morao' me o lokela ho sala a tiile.
Kapa ke karolo e tloaelehileng ea ho thibela kapa ho kenya letsoho karabo bakeng sa bohle.
Maneuvers ho Thusa ho Fokotsa Dystocia
Ho na le lintho tse 'maloa tse ka etsoang ho thusa ho rarolla bothata ba dystocia ea mahetla. Ho tloha ha tsoalo e 'ngoe le e' ngoe e fapane hase e 'ngoe le e' ngoe ea tsona e tla sebetsa nako le nako, kahoo ho tsamaisa mekhoa e mengata ho ka 'na ha etsoa liteko ka potlako e lekaneng ho thusa ho rarolla boemo ka tsela e ntle. Mona ke tse ling tsa mekhoa e fanoeng:
- Khatello ea Suprapubic : Khatello ena e phatong ea pubic , eseng ka holimo ea popelo. Sena se ka 'na sa lumella lehetla le lekaneng hore le tsamaee tlas'a li-pubis symphysis.
- Gaskin Maneuver : Fumana mosali letsohong le maotong . Sena se tla boela se fetole maramente a pelvis ea hae, le hoja ho ke ke ha khoneha kamehla ka li -epidural anesthesia .
- Maneuver ea McRobert : Flex maoto a 'm'ae mahetleng a hae ha a se a le mokokotlong, ka tsela eo a atolose phallo ea pelvic. Phuputso e 'ngoe e bontšitse hore sena se fokolitse 42% ea linyeoe tsohle tsa mahetla dystocia.
- Woods Maneuver : Sena se boetse se tsejoa e le mokotla oa sekoti, mohlokomeli o leka ho fetola lesapo la ngoana ka ho beha menoana ka mora lehetleng le ho phunya ka likhato tse 180.
- Rubin Maneuver : Joaloka molomo oa Woods, menoana e mabeli e behiloe ka mor'a lehetleng la lesea, 'me lekhetlong lena ba ntse ba phallela mahlo a lesea, ho hlahisa mahetleng.
- Zavanelli Maneuver : Ho qobella hlooho ea lesea ka hare ho botšehali le ho etsa lesarean. Ena ke eona e atisang ho botsoa ka mokhoa empa e boetse ke e 'ngoe ea kotsi ka ho fetisisa.
Ka mor'a tsoalo
Kamora 'tsoalo ea mahlaba-futa e kenyelletsang dystocia ea mahetla, ho na le lintho tse ling tseo ngaka ea hau kapa mohlokomeli a tlang ho li batla ho uena le lesea la hao, ho akarelletsa:
- Ngoana ea liehang ho qala 'me a ka hloka thuso ka phefumoloho.
- Ho robeha ha lesapo la lesea (clavicle) kapa humerus.
- Fetal Brachial Plexus e lematsa.
- Ho lokisoa ha episiotomy kapa ho senya ho etsoa nakong ea tsoalo.
- Ho khaola ha masea.
- Ho robeha ha lesapo.
Le ha dystocia e nang le mahetleng e se ntho e tloaelehileng ka ho fetisisa, ho tseba hore na maemo a mang a ka bang kotsi ho wena le lesea la hao a ka o thusa ho etsa liqeto tse bohlale bakeng sa mosebetsi le tsoalo ya hao.
Litlhahiso:
Cohen B, Penning S, Major C, Ansley D, Porto M, Garite T (1996). 'Ho Boleloa ha Sefahla sa Lehetla Dystocia ka Bana ba Masapo a Diabetes', Maqheku le Matšoao a Majoe, 88, 10-13.
Gaskin IM, Meenan AL, Hunt P le Ball CA (2001.) 'Maneuver e Ncha / ea khale bakeng sa Taolo ea Dystocia'
Gherman RB, Goodwin TM, Souter I, Neumann K, Ouzounian JG, Paul RH (1997). 'Mohato oa McRoberts' oa ho fokotsa mahetla dystocia: Ho atleha hakae? ', American Journal of Obstetrics le Gynecology, 176, 656-661.
Lee CY (1987). 'Shoulder dystocia', Lipetleleki tsa Obstetrics le Gynecology, 30, 77.
Mashburn J (1988). 'Ho khetholla le ho laola dystocia' mahlo, Journal of Nurse Midwifery, 33, 5.
Khutlisetsa R (1980). 'Management of shoulder beldle dystocia', Lipetleleki tsa Obstetrics le Gynecology, 23, 559.