Imposiso yomsebenzi yabasebenzi: oonobangela, iziphumo kunye noqikelelo

Eli nqaku liza kuxubusha yobulwelwe yabasebenzi. Siya kukuxelela ngokweenkcukacha ngoonobangela, iimpawu, ifuthe kunye nokusombulula yabasebenzi.

Ukubonisa ukuba. Imposiso zabasebenzi - kukunqongophala umsebenzi isibeleko. delivery okt nzima ixesha elide njengoko isibeleko kakubi zancitshiswa, wesibeleko dilates Nasenkonzweni kunye iziqhamo ehamba olucothayo kakhulu kwaye kunzima. LezeMisebenzi akasoloko hamba kakuhle, njengoko kufuneka, kukho mgaqweni yemisebenzi yabasebenzi. On omnye wabo uya kufunda ngokweenkcukacha enkulu kweli nqaku.

wesizalo inertia

Kangangoko ukuze kuvakala buhlungu, kodwa ukungaqheleki yabasebenzi eziqhelekileyo. Izizathu zale meko baninzi kakhulu. Ngoku siza kuthetha ubuthathaka kwinkqubo yabasebenzi.

Le yenye iintshukumo zokwaphulwa kwemithetho yabasebenzi kunokwenzeka. Nale isifo umsebenzi zesibeleko, apho kuyimfuneko ukugxothwa ndingekazalwa, kuba buthathaka. Oku kungenxa yokuba:

• ithoni sezantsi kwesikhundla myometrium;
• kwamathumbu ezinqabileyo;
• unciphiso awo amandla;
• ukwanda diastole;
• ixesha Ukwehla usemva kakhulu kwithuba lokuphumla;
• yalityaziswa kuvulwa wesibeleko;
• ukukhuthazwa lokuhlanganisa olungekazalwa.

Kabanzi symptomatology kuya kwenziwa esinye isithuba. Ngoku sinika manani. Esi sifo e kanye ne ethandwa, kuba ingxaki rhoqo kakhulu inenimba kunye unobangela ezimbi ezahlukeneyo umama kunye nomntwana. Amanani kuqinisekisa ukuba ngaphezulu kwe asixhenxe ekhulwini zizalwa nzima ngobuthakathaka umsebenzi yabasebenzi. Kwaye enye into: uxilongo isikakhulu abafazi abo ukuba umntwana wabo wokuqala. Njengoko umthetho, lihlaleni izizukulwana ngaphandle kobunzima, kodwa ke kukho iimeko zokufumanis yobulwelwe yabasebenzi kunye zokubeleka elandelayo.

izizathu

Siye wachaza ukuba lo ubuthathaka msebenzi yabasebenzi. Izizathu angaba ezininzi izinto. Sinikezela ukudwelisa kubo. Izizathu ngenxa yokuswela amandla yabasebenzi zezi:

• phansi morphological le esizalweni;
• ukungabikho ummiselo hormone inkqubo generic;
• inertia ye izakhiwo luvo;
• isifo ekstragenital'nye;
• hypoplasia;
• fibroids;
• endometritis ezingapheliyo;
• adenomyosis;
• wesibeleko lineempondo ezimbini;
• akhwela esizalweni;
• medabort;
• curettage;
• myomectomy elondoloza;
• yayenze emva konyango sokhukuliseko wesibeleko (ukuba umfazi zazingayiphanga ukuzalwa).

Unako kwakhona uqaphele ezinye zezizathu. Ubuthathaka imikhosi yezizwe lunokwenzeka ngenxa ukuba ukungalingani ezinokuphembelela babe negalelo zabasebenzi. Ukuze zibandakanya ezi zinto zilandelayo HIV:

• prostaglandins;
• estrogen;
• yioxytocin;
• calcium;
• ngabalamli njalo njalo.

Ichaphazele:

• hormone;
• wemagniziyam;
• thob enzyme kunye nezinye mediators.

Kubalulekile ukuqaphela ukuba abasetyhini abaphethwe izifo ezithile (kwezityalo-exchange), badla ngokujongana ingxaki ngexesha lokuzalwa komntwana. komgomo ezinjalo ziquka:

• ukutyeba;
• hypothyroidism;
• hypofunction le uthinte adrenal;
• syndrome hypothalamic.

Esona iphenjelelwa ubudala nulliparous. Ukuba intombazana eselula kakhulu, okanye ubudala bakhe lidlula engama-35, komxelengi kunokuba nzima. Kwakhona kubalulekile kwaye kwisithuba apho ukuqala umsebenzi. Ubuthathaka isibeleko isenokuba unobangela ukukhulelwa elide, okanye kwexesha.

Ukuba ukhulelwe ezininzi, ukuba kunokwenzeka oku ngezifo ngethuba lokubeleka. Xa kukho ezininzi ukukhulelwa zesibeleko hyperextension. Hyperextension kwakhona kwenzeka xa isiqhamo enkulu okanye polyhydramnios.

Amaxesha amaninzi asetyenziswe nzima bajongene intombazana encinane nje isinqe emxinwa ngayo kwakhona ngunobangela zesibeleko yomsebenzi ombi. Isizathu - ukungayelelani phakathi ubungakanani isinqe yomntwana kunye nabasetyhini.

Izizathu kusekho ezininzi kakhulu, ngelishwa, ayikwazi wazibala. Ngoku khetha nabanye abantu kakhulu ethandwa:

• nokudinwa;
• zeleka engqondweni;
• ukusebenza komzimba;
• abadli;
• ukungalali;
• ukoyika ukuzala;
• angaphatheki;
• ulondolozo abaziintsizana umama njalo njalo.

Ngaloo ndlela, kuyenzeka ukuba lihlele zonke izizathu ngolu hlobo lulandelayo:

• kwicala kanina;
• ukungaphili nokukhulelwa;
• kuloo mntwana.

iintlobo

Wesizalo inertia ingaba kwenzeka ngokupheleleyo kulo naliphi na inqanaba delivery. Kule nkalo, oko wagqiba ukuba zikhuphe ezinye iintlobo yobuthathaka:

• eziziiprayimari;
• zamabanga;
• iinzame buthathaka.

Sinikezela ngokutsha encinane iinkcukacha uhlobo ngalunye ngokwahlukeneyo.

Imposiso engundoqo yabasebenzi luphawulwa izishunqulelo ephantsi umsebenzi kwinqanaba lokuqala yabasebenzi. -Ethe kakhulu, elifutshane kwaye ezinesingqi. Okubalulekileyo, i waphawula ithoni understated le wesibeleko ngexesha buthathaka ephambili (ngaphantsi kwe-100 mm HG. V.). Kweli nqanaba, umfazi akakwazi ukufumanisa le ngxaki. Njani loo nto? Race ngokuchasene iwashi imizuzu elishumi uze ubale inani nokulwa ngeli xesha. Ukuba inani ayidluli ezimbini kwaye phantse musani va kubo, uxilongo siqinisekiswe. Ungakala ixesha elinye idabi, kufuneka ibe ngaphezu kwemizuzwana 20 yokungabikho zesibeleko inertia. Diastole, okanye ixesha ukuphumla, le phantse kabini landiswa. Njengoko izishunqulelo palpability ukuthetha ngale ngxaki? Kakhulu nje, ukuba yalula okanye maloboleznennye, uxinzelelo phezu inxalenye isibeleko akwanelanga ukuba ukuvula wesibeleko.

ubuthathaka Secondary yabasebenzi luphawulwa buthathaka ngobunzulu yomsebenzi zesibeleko. Ngaphambi kwelo ukulwa kungaba eqhelekileyo. Ubangelwa ngokufanayo, njengoko kwi buthathaka iphambili imikhosi yezizwe. Enye salathisi - ukuqhubela phambili ukubhengezwa zesibeleko umqala. Ukuba inkqubela kungabonwa emva ezintlanu okanye ezintandathu neesentimitha yokubhengeza, singakwazi ngokuzithemba sithethe secondary hypotonic zesibeleko kwekhono.

Ukuba buthathaka zaseprayimari nezasesekondari kuvandlakanywa ekhulwini ezilishumi kumatyala wokuzalwa ezingalunganga kwaye luphawu yokuzalwa yokuqala, imposiso ixesha lokuzala-phantsi kunqabile kakhulu (amabini ekhulwini kuzo zonke iimeko yabasebenzi zivalwe), kwaye ekuso abafazi multiparous okanye ukutyeba.

iimpawu

Iimpawu buthathaka iphambili zabasebenzi ziquka:

• kunciphise excitability le esizalweni;
• sehla ithoni isibeleko;
• kuncitshiswa rhoqo kwamathumbu (ukuya ku ezimbini ezilishumi imizuzu);
• ixesha elifutshane kwamathumbu (imizuzwana ukuya ku amabini);
• usika amandla ayidluli ixabiso 25 mm HG. Inqaku.;
• ixesha elifutshane nokuncipha;
• eyandisiweyo ixesha lokuphumula;
• akukho waphawula ukwanda ngamandla namatyeli;
• maloboleznennost elula okanye kwamathumbu;
• utshintsho Slow izakhiwo wesibeleko (ezi ziquka kunciphisa, smoothing kunye nokuchazwa).

Konke oku ngokubonakalayo ukwandisa ixesha iyonke yonikezelo. Oku, nto imbi kuba unina womntwana. Njengomfazi ozalayo okanye ukudinwa, mhlawumbi ukugxothwa yokuqala yamanzi.

Iimpawu buthathaka eziziisekondari:

• Abatyhafileyo amadabi ngamandla (mhlawumbi nokuba zokuyeka kwabo ngokuphelele);
• waphela tone;
• ukunciphisa excitability;
• akukho umqala progression sokuveza zesibeleko;
• ukuyeka nokukhuthaza olungekazalwa ngenxa emjelweni lokuzalwa.

Oko akukho akanangozi ngaphandle ubuthathaka zaseprayimari. Umntwana aphuhlise zizalwa, okanye afe. Lwezifo wesizalo umama linobungozi ukuba ukuzalwa trauma. intloko emi Long kosana emjelweni ekuzalweni kungakhokelela ukuyilwa haematomas okanye fistula.

ekuxilongweni

Kweli candelo uya siya kugxininisa zokufumanis iingxaki buthathaka yabasebenzi (ezaseprayimari nezeesekondari). Lokufunyaniswa ubuthathaka lokuqala obekwe kwi ngolu hlobo lulandelayo:

• ukuncipha umsebenzi isibeleko;
• Ukunciphisa izinga mpuluswa wesibeleko;
• ukuxelwa ilibasiza emqaleni wesizalo;
• Umgama iziqhamo elide;
• ukunyusa.

Kubalulekile ukuqaphela ukuba nefuthe elikhulu ngaphezu kokuba ukhubazwa yintoni na partogram (okanye inkcazo olubonakalayo lwe General). Le itshathi ikhankanya zonke:

• entanyeni lokuvula;
• ukukhuthazwa eneziqhamo zonke;
• ukubetha;
• wegazi;
• ukubetha kwentliziyo lomntwana;
• balwe njalo-njalo.

Ukuba akukho nkqubela kwi dilatation wesibeleko iiyure ezimbini, nto leyo kuboniswe ngokucacileyo kule partograph, wandula ke wayiphakamisa le isifo.

Uxilongo yobuthathaka zasesekondari isekelwe phezu kwezi zalathisi:

• partogram;
• CTG;
• ukuphulaphula nokubetha kwentliziyo.

Oku kuyimfuneko ukuqinisekisa ukuba umbungu zange ukuphuhlisa hypoxia. Kukho ubunzima obuthile inkqubo okuvelisa ukuba symptomatically efanayo kwezemisebenzi buthathaka. Ezi ziquka:

• emoyeni ixesha lokuqala;
• yabasebenzi diskoordinirovanie;
• isinqe ngokwezonyango elimxinwa.

unyango

Okubalulekileyo, unyango ikhethwe ngamnye ngenxa yomfazi okhulelweyo ngamnye. Xa ugqirha okunyangayo kufuneka ithathele ingqalelo yonke idatha anayo (imeko yomfazi kunye nosana).

A ngeyeza olungileyo ngemigudu buthathaka - njengobuchule amayeza ubuthongo. Ukulungiselela le njongo zezi ucwangciso olukhethekileyo, lo mfazi waphumla, ngoko nina ekubulalekeni nande.

Ukuba oku akusebenzi, ngoko babhenela kwenzakalani ngena kwiseli. Emva kwale nkqubo esaphuka iba kakhulu ngakumbi. Kufuneka kuqatshelwe ukuba okuhlatywa lwenziwa kuphela ukuba umlomo wesizalo ukulungele.

Ngamanye amaxesha oogqirha baye babhenela inkanuko iziyobisi. Ngoku siqwalasele ngokufutshane "Miropriston" iziyobisi eyenza umsebenzi. Olu nyango kufuneka athathwe ngokungqongqo phantsi kweliso logqirha. It abangaphangeliyo hormone, nto leyo iba nefuthe yingenelo kumsebenzi zesibeleko.

ukunikezelwa

Ukuba akukho iinketho imisebenzi, kuquka "Miropriston" zokuqhuba umsebenzi, ugqirha linokuyenza likaxakeka uqhaqho. Ziziphi iindlela yenziwa phambi kokuba ukusebenza:

• ubuthongo-eyabangelwa iziyobisi;
• amniotomy;
• yashukunyiswa iziyobisi.

Ukongeza, kusenokubakho ezibonisa eyongezelelweyo uqhaqho. Kukho uluhlu ezithile Izimo ukuba yoqheliso yabasebenzi (isinqe emxinwa, zesibeleko kukuqulungana, ubomi emngciphekweni, njalo njalo).

ukuvimbela

Siye sahlolisisa ngokweenkcukacha umbuzo yobulwelwe yabasebenzi. izikhokelo zonyango ukuze zothintelo unganikeza obstetrician-ugqirha ngubani na ukhulelwe. Kufuneka kukuxelela malunga iingxaki kunokwenzeka ngexesha lokuzalwa komntwana kwaye oomama ngokwasemzimbeni nangokwasengqondweni uqeqesho. Ngaphandle rodostimulyatsii isisinyanzelo kuwo kuthintelo iingxaki kunokwenzeka olungekazalwa.

imiphumela

Zeziphi iingxaki zesibeleko inertia? Kuba nomama kungaba:

• kwenyoka;
• fistulas;
• usuleleko kunokwenzeka.

Ukuze umntwana, iingxaki zilandelayo:

• hypoxia;
• asidi;
• nokudumba ubuchopho;
• ukufa.

Yonke into ixhomekeke ubuchule kagqirha. Nge uvuselelo ekunene, kunye nobume ulawulo ecacileyo umntwana nonina akukho iziphumo kufuneka kungabi.

Outlook

Ngoku ngokufutshane malunga yokuqikelela yobulwelwe yabasebenzi. Njengoko kuchaziwe ngaphambili, konke oko kuxhomekeke lobungcali kagqirha kunye nemeko ngokwasengqondweni yomfazi. Musa ukuphaphazela, uze umamele izindululo leengcali. Iingxaki emigudwini zivalwe zinqabile.

Le khosi ye-delivery elandelayo

Imposiso yomsebenzi yabasebenzi ekuzalweni lokuqala akuthethi ukuba bonke abanye baya kuqhubeka efanayo. ubuthathaka eziziiprayimari neziziisekondari kuxhaphakile phakathi abafazi kuzala umntwana wokuqala. Xa ipesenti encinane bangafumana multiparas ubuthathaka ethwele-phantsi xesha.