Udibaniso zangaphandle: OB ezizodwa

Wonke umfazi ufuna nivuyiswe ngumama. It is a mnqweno yendalo enxulumene ngoyena ndoqo yobuntu. Noko ke, abaninzi ubengayilungiselelanga yokuba kufuneka ubone ugqirha wakho rhoqo uze unyamezele nokwenza abanye mnandi kakhulu. Kodwa ukuze ukuba ukukhulelwa waqhubeka kakuhle kwaye cwaka, kuhle ukulandela imiyalelo leengcali, kunokuba sithembele luck.

Ukulungiselela iimviwo

Ngaphambi kokuba eze kwikliniki kokubeleka ukuze abhaliswe kwi ukukhulelwa okanye nje uhlolo izicwangciso, amanenekazi kufuneka iqalele. kufuneka Akukho umgudu okhethekileyo, kodwa kucetyiswa ukuba uthathe ishawa. Xa kungekho tyala kufuneka douche okanye into elolo hlobo, ngaba umfanekiso jikelele sifo (ukuba ikhona), ziya ifiphale, kwaye ugqirha ungakufumani nto. Uyacetyiswa ukuba ukucoca nelinen amatsha kunye itawuli yococeko (ukuba kuyimfuneko).

Jikelele kunye nembali ezizodwa

Njengaye nawuphi na ugqirha, i obstetrician-ugqirha kufuneka ifomu ukuba ngokutsha imbali yesigulane. Oku kuquka data yokundwendwela, izikhalazo, iirekhodi yokuhlala kunye nomsebenzi, wabonisa ubukho izifo yemfuza nosuleleko.

Imbali Special swi yokuba ugqirha wayeyiqonda kakuhle ingxaki kwazo inkazana leyo yabuza. Oku kuquka imibuzo malunga sexesheni, ngesondo, ukukhulelwa kunye isisu. Ukongeza, isishwankathelo efunekayo womlingane yomguli okanye iqabane, kwakunye nokuchuma wakhe.

Ke uqale uphando ukukhulelwa yangoku. Misela yobudala sokukhulelwa, kumiselwa ubungakanani zangasese kunye nendawo umntwana isibeleko.

Ukuzimisela ubudala sokukhulelwa

Kukho iindlela ezininzi ukubala engu sokukhulelwa kunye nomhla kwezi zibonelelo. Eyokuqala kuzo - ikhalenda. Nguye kakhulu elula. Kufuneka ukhumbule inani ngosuku lokuqala ixesha lakho lokugqibela uze uhlanganise kuyo iintsuku 280 +/- 7, okanye iinyanga ezili-10 month. Ngoko ke angasifumani imini elisondeleyo isiganeko bonwabile. Ukuba umfazi awukhumbuli umhla kwesisu, imfuneko ukuyidibanisa zonke iiveki efanayo 40, uze ufumane iimpendulo umbuzo wabo.

Enye indlela isekelwe ultrasound. Diagnostician ngu ubungqina Ungakwazi ukucacisa yobudala sokukhulelwa yosana olungekazalwa aze anike nosuku yonikezelo. Xa OB ukuphakama indawo zesibeleko fundus kwakhona ibalwa yobudala sokukhulelwa. Ukususela 12 ukuya 38 ngeveki wesibeleko ubude ngeesentimitha ekwafanekisa le kwiveki yokukhulelwa. Unako kwakhona bathembele kokugxojwagxojwa wokuqala olungekazalwa. In nulliparous kunjani kwiveki elinesibhozo kwaye multiparous - elinesithandathu.

Imilinganiselo isinqe ezinkulu

Kuba gqirha, ulwazi ubukhulu isinqe umfazi unalo ixabiso, kwaye idata kubalulekile zombini ngexesha Palsy kwaye inkqubo inenimba. Ukuze a imilinganiso elikhulu zangasese ezi udibaniso bangaphandle umgama ezintathu ulungelelene elibukhali iindawo amathambo zangasese kunye hip.

1. Distantia spinarum - kukho umsantsa phakathi manqaku ephakamileyo na ameva iliac. Oku iisentimitha malunga namashumi amabini anesithandathu.

2. Distantia cristarum - isithuba phakathi crests wethambo iliac, kwaye malunga iisentimitha mabini anesibhozo.

3. Distantia trochanterica - umgama ophakathi trochanter mkhulu elahliweyo kwi emathangeni, ngokulandelelana ngeesentimitha eziyi-31-32.

udibaniso engaphandle elahlukileyo lesisombululo. Ukuba emithathu edlulileyo eGibheyon ngelo moya ngokungqalileyo, ngoko lo sagittal. udibaniso yangaphandle - umgama phakathi oluvelayo umhlehlo yesihlanu vertebra empontshwa kunye umnqonqo eliphezulu symphysis zikawonke wonke. Ukubala, amanye amalungiselelo ayimfuneko. Ukuzimisela conjugates engaphandle iqala into yokuba isigulane elele ecaleni kwakhe. Foot, edulusele kwisingqengqelo, umfazi kukhokelela esiswini, kwaye overlying - notsalo. Emihlathini tazomera ihlanjululwa kwaye ibekwe ngaphezu unxibelelwano zikawonke wonke kunye emhadini suprasacral ukuze phantse ukuba zifana. Le - udibaniso engaphandle. Umlinganiselo kuxhomekeke siseko yenkazana Ebubanzini amathambo ayo. I ziyatyeba bona, kokukhona impazamo kubalo. Ubukhulu conjugates engaphandle - malunga namashumi amabini cm. yokubala waso ziyafuneka ukumisela udibaniso lokwenyaniso. Kwi-avareji, umahluko phakathi kwabo elihambelana iisentimitha 9. Umzekelo, ukuba udibaniso zangaphandle iisentimitha mabini, oyinyaniso yi-11 cm.

Imilinganiselo zangasese

Kukho ikho into sisitya tapered. Kokuba iingqameko ngokwezonyango okanye anatomically. Ukuze ukucacisa yokwakheka parameters umsebenzi osontiweyo ithambo, wenze imilinganiselo isinqe.

1. udibaniso oxwesileyo - ubude ukusuka ungqameko olungezantsi of pubis symphysis kwinxalenye kakhulu kwenqaba le sacrum. Kuyinto ulingana ngokweesentimitha-13. Oko kumiselwa kuphela xa uviwo lobufazi. Ukubalwa kwe conjugates bokwenyaniso yangaphandle kunye nemigca elinganayo sikuko yokuba evela engaphandle odlayo 9 cm, kwaye idiagonal -. 2 cm Ngokuqhelekileyo, udibaniso lokwenyaniso iisentimitha ubuncinane 11. Kuyinto ukuze kubalwe le parameter, kwaye kufuneka udibaniso lwangaphandle. UNorma ingahluka, kuxhomekeke Ebubanzini amathambo yabafazi, ukuze oogqirha reinsured nokuqhuba uphando lwangaphakathi. Kwi Ebubanzini ithambo udibaniso oxwesileyo ayiphazamiseki.

2. ubungakanani ngqo lo walivala ithende zangasese uchazwa lekhefu phakathi kummango esezantsi zikawonke ezikhankanyiweyo kwaye incam yaloo coccyx. Umlinganiselo lwenziwa tazomera kwaye ilingana no-11 cm.

3. Ubukhulu ezinqamlezayo of lokuphuma zangasese - umsantsa phakathi tuberosities ischial. Uyakwazi uchithe tazomera kunye tape yokulinganisa. Ngokuqhelekileyo, akukho ilingana iisentimitha ezisithoba, kodwa ukuba Ebubanzini ezongezelelekileyo ze inyama ithambile, ngoko ke sifumane 11 cm.

4. Imilinganiso zisecaleni isinqe ziyafuneka ukumisela ukuba wolingano welungiselelo emathanjeni. Kufuneka ubuncinane-14 cm, kungenjalo ukusiwa kwazo kuya kuba nzima okanye kungenzeki.

irhombus of Michaelis

udibaniso sangaphandle umlinganiselo othile ukuya irhombus kunye Michaelis, ekubeni ikwabonisa isinqe imilinganiselo. Eli liqonga akhiwa umphezulu elingasemva sacrum. imingcele yayo:
- inkqubo spinous le vertebra empontshwa yesihlanu;
- nesithandwa caudineural iliac umqolo;
- incam yaloo sacrum.

Ubukhulu ngokuqhelekileyo 11 ukuya ngokweesentimitha 11. udibaniso engaphandle unalo irhombus jikelele kunye ngongoma eliphezulu.

ubuchule Bhukwana nokubeleka

Emva kokuba wamashumi veki obstetrician uyakwazi ukubona intloko kwebala, emva, kunye namalungu omzimba womntwana esibelekweni. Ukulungiselela le njongo, iindlela zophando lwangaphandle yokubelekisa.

Indlela lokuqala: ugqirha uza kuqinisekisa ukuphakama fundus zesibeleko nomzimba ndingekazalwa, leyo ezikufutshane kuyo. Ukuze benze oku, ugqirha ubeka izandla zakhe phezu esisu ongentla ukubona.

Indlela yesibini imisela isikhundla kunye neembono umntwana. Ukuza kuthi ga ngoku, i-obstetrician kancinci lihlisa izandla zakhe encotsheni esiswini, bazaneka bangafani. Eliqhubela umphezulu ecaleni isibeleko, iminwe kunye entendeni gqirha uziva backrest okanye iinxalenye ezincinane umzimba ndingekazalwa, ngaloo ndlela ukuqinisekisa, umntwana chlenoraspolozhenie.

Indlela yesithathu kufuneka ugqibe ngokuzimisela ukuba ube yinxalenye yale oko kukuba yinxalenye yomzimba iqhele ngaphezu pubis symphysis. Kananjalo ukufumanisa nokushukumisa intloko.

Ukuqeshwa wesine likwancedisa wesithathu. It ikuvumela ukuba akuyi kuphela inxalenye zesifundo, kodwa ukuqonda oko lumiswe ngayo ngokunxulumene ekungeneni isitya esincinane. Ukuze benze oku, ugqirha ufumana emva kwisigulana kwaye ngesandla ngendlela yokuba iminwe idibane ngaphezu symphysis zikawonke wonke.

View kunye nesikhundla ezingekazalwa esibelekweni

Indawo - isikhundla umntwana umva kwicala wesizalo. Ukwahlula kwindawo yokuqala xa backrest ukwakweli kwicala lasekhohlo, kwaye eyesibini - xa umntwana babuyela ekunene. Kwindawo yokuqala kuxhaphake kakhulu kunokuba abantu yokugqibela.

View isikhundla - sengqondo umva ukuya udonga ngaphambili okanye emva isibeleko. Ngako oko, ukuba umntwana ayame eludongeni ngaphambili isibeleko, bathi indawo ngaphambili, kunye vice versa.

Xa i engaphandle OB ubuchule Leopold-Levitsky ukuvumela ugqirha ukujonga indawo olungekazalwa ngexesha yabasebenzi kunye ukuqikelela.

isifundo yangaphakathi

uphando Midwifery yangaphakathi nga kwenziwa iminwe emibini okanye emine okanye sonke isandla. Xa ugqirha yasemgceni uyakwazi ukubona ubungakanani dilatation wesibeleko, ukuchonga inxenye nokunikezela, ukuthembakala inwebu, imeko emjelweni wokuzalwa. Ukongeza, le ndlela Iqinisekile ukukhuthazwa olutshintshayo kolunye ukuzalwa komntwana lowo.

Nangona kunjalo, lo ngowona ungenelelo kakhulu, kwaye wenza inkqubo kufuneka ibe ngokungqongqo imithetho: on zokwamkelwa esibhedlele abese kaninzi ngaphezu qho kwiiyure ezimbini. I ngaphantsi, ngcono.

Uphononongo luqala uviwo lwe esini lwangaphandle kunye perineum. Ke iminwe baziswa kulo lobufazi kwaye nokuchaza bayo ubude, ububanzi, luthambe beendonga, iimpawu, zingaxhomekekanga okanye azikhuli onokuthintela ukuthungelana eqhelekileyo yonikezelo. Emva koko, ezihamba wesibeleko. Kuye avavanyelwe oqolileyo, imilo, ubukhulu kunye nemvakalo, kuphungulwe kunye athambileyo. Umfazi xa ingena yabasebenzi, ukubhengezwa wesibeleko alinganiswa ngomnwe-endleleni. Ukongeza, ugqirha uzama ukufumana inxalenye nokunikezela aqingqa nendawo intloko ukwenzela ukulungiselela kubunzima kunokwenzeka.

Ukuzimisela entloko indawo zosana

Kukho degrees ezintathu ukwandiswa entloko njengoko udlula emjelweni lokuzalwa.

I isidanga sokuqala (yokufaka perednegolovnoe) kuthetha ukuba intloko uya kucanda ubungakanani isinqe ngqo yayo. Kuyinto ilingana no-12 cm. Oku kuthetha ukuba wesibeleko kunye lobufazi kufuneka wandise phezu kweli xabiso.

bolwesibini udidi (yokufaka ngokungqalileyo) lihambisana yobukhulu enkulu ifayibha bundle (13-13.5 cm). Kuya kuba yinxalenye enkulu leyo ukuba adlule emjelweni lokuzalwa.

Degree lesithathu (yokufaka yobuso) uthi umbelekisi ukuba usana ehamba isinqe ubuso phambili, yaye emva koko, ubukhulu intloko inkulu iya ilingane 9.5 cm.