Biomechanism yobereka kutsogolo ngati previa occipital. Obstetric gawo pobereka

Pa kubadwa kwa mwana wosabadwayo angopita kunja kwa ngalande kubadwa, kuchita translational ndi kayendedwe rotational. Chotero mwaulesi zovuta akuimira biomechanism genera. yoopsa ulaliki kwakukulukulu Mzimuyo zovuta ya kubala lapansi. Pa 90% ya milandu occipital ulaliki yoopsa.

Biomechanism nulliparous

Malinga ndi maphunziro, mu nulliparous mutu amasuntha pang'ono ngakhale pa mimba. Mlingo wa patsogolo zimadalira chiŵerengero cha kukula kwa mutu yoopsa ndi mafupa a chiuno cha mayi. Wina wosabadwa mabasi kayendedwe ake pakhomo, ndi zina - mu gawo yaitali M'mimbamo wa beseni yaing'ono. Pamene amapita ku ntchito, mutu tikupitiriza pasadakhale ake pamene contractions choyamba. Ngati Kukwezeleza yoopsa kulepheretsa ngalande kubadwa, ndi biomechanism yobereka kutsogolo ngati previa occipital amapezeka m'dera m'chiuno, zomwe anakumana cholepheretsa. Ngati kubadwa kutenga malo bwinobwino, ndi biomechanism adamulowetsa pamene mutu apatsira malire pakati pa gawo lonse ndi yopapatiza wa M'mimbamo m'chiuno. Kuthana ndi zopinga, zina zazing'ono contractions uterine yekha. Pali zoyesayesa, kukankhira zipatso panjira kuchokera ngalande kubadwa.

Nthawi zambiri, pa yobereka biomechanism kutsogolo view wa previa occipital adamulowetsa mogwirizana athamangitsidwe pamene mutu akapitirira yopapatiza m'chiuno M'mimbamo wosiyana lonse ngakhale onse primiparous angayambe panthawi ya kutsegula, pamene mutu yoopsa ili pakhomo.

Pa athamangitsidwe ndondomeko wosabadwa mwana wosabadwayo ndi chiberekero nthawi zonse kucheza ndi mzake. Chipatso cha m'mimba kuyesera kutambasula malinga ndi mawonekedwe ake ndi kukula, chiberekero ndi mwamphamvu chimakwirira mwana wosabadwayo ndi madzimadzi amniotic, kusinthasintha kwa mawonekedwe awo. Chifukwa cha zimenezi ndi linagwira ndi lonse ngalande kubadwa kudzapeza machesi zonse. Choncho pali prerequisites kwa athamangitsidwe wa mwana wosabadwayo ku ngalande kubadwa.

Division ndi mfundo

Biomechanism yobereka kutsogolo ngati previa occipital lagawidwa mfundo zinayi:

• flexion mutu;
• lamkati kasinthasintha ake;
• kutambasuka kwa mutu;
• chamkati kasinthasintha thupi, pamodzi ndi akunja onsewo mutu.

Nthawi yoyamba

Kupinda mutu ndi mchikakamizo cha kuthamanga intrauterine msana khomo lachiberekero flexes, kubweretsa chibwano ndi chifuwa ndi kumbuyo kwa mutu kugwera pansi. Choncho fontanel yaing'ono ili pansipa lalikulu, pang'onopang'ono kufika pa mafupa a chiuno basi anatumizanso lamya mzere, ndi gawo ili amakhala ili pansipa mutu gawo lonse.

Ubwino kupinda izi limapereka mwayi kuthetsa mutu wa M'mimbamo m'chiuno ndi kukula zazing'ono. . Lolunjika mutu kukula kwa masentimita 12 ndi scythe yaing'ono, chifukwa kupinda - 9,5 masentimita Nzowona kuti zofunika yachibadwa Inde yobereka monga flexion amphamvu mutu Kodi osadzuka: izo akufunitsitsa monga mmene n'kofunika kupita ku lonse mafupa a chiuno yopapatiza kulekanitsidwa. Zolemba malire flexion mutu yoopsa kokha zofunika pa zochitika kumene ngalande kubadwa m'lifupi osakwanira kwa ndimeyi pa mutu. Izi zimachitika pamene mafupa a chiuno n'chochepa kwambiri, komanso nkhani ya kumbuyo-view occipital previa.

Kupinda si yekha yoopsa kuyenda pa ichi mfundo biomechanism yobereka. Pa nthawi yomweyo kumachitika translational gulu la m'mutu mwa ngalande kubadwa, ndipo pambuyo kupinda akuyamba nayenso ake mkati. Choncho koyamba biomechanism yobereka ndi osakaniza translational zoyenda ndi flexion ndi kupotoza. Komabe, chifukwa chakuti ambiri kutchulidwa kayendedwe ndi kupinda mutu, dzina la mphindi woyamba akuganizira mfundo imeneyi.

mphindi yachiwiri

Internal kasinthasintha mutu - osakaniza zoyenda ake translational ndi kasinthasintha mkati. Umayamba pamene mutu anali wopindidwa, ndi inakhazikitsidwa pa khomo beseni yaing'ono.

Yoopsa mutu, akusuntha pang'onopang'ono M'mimbamo m'chiuno ndi anakaniza kayendedwe zina ndipo akuyamba atembenuza padziko nguli kotenga. Zili ngati screwing mutu kwa mafupa a chiuno ndi. Izi zimachitika nthawi zambiri pamene chitadutsa kuchokera yotakata ndi yopapatiza m'chiuno dipatimenti patsekeke. Back mutu zithunzi pa khoma m'chiuno, mwatsala articulation obisika. Mfundo akhoza zokhoma kutsimikiza kuti kusintha kwa malo a suture sagittal. msoko Izi atembenuza mu mafupa a chiuno mu yopingasa kapena oblique kuchuluka, ndipo pambuyo kasinthasintha ndi kuchuluka patsogolo. mutu mapeto a kasinthasintha anaona pamene anakhazikitsa suture sagittal kuchuluka patsogolo, ndipo suboccipital fossa akutenga malo pansi pa Chipilala obisika.

nthawi yachitatu

Extension mutu. Mutu akupitiriza kusuntha pansi pa ngalande kubadwa, kuyambira pang'onopang'ono unbent. Pansi yobereka kutambasuka yachibadwa imagwiridwa mu linanena bungwe la mafupa a chiuno ndi. Back mutu achoka wa Chipilala obisika, ndi mphumi mutuluka kupitirira coccyx, mu mawonekedwe a mzikiti oumbidwa kutsogolo ndi gawo kumbuyo kwa crotch lapansi.

Suboccipital fossa apuma pa m'mphepete m'munsi mwa Chipilala obisika. Ngati kutambasuka loyamba mutu wakhala pang'onopang'ono, pa siteji iyi, izo kufulumiza: mutu unbent zoyesayesa chabe. Mutu likulowerera mwa vulvar mphete mu skew ang'onoang'ono kukula kwake.

Pa kutambasuka kwa ngalande kubadwa amasonyeza korona osiyana, m'dera mazunzo, nkhope ndi chibwano.

iyai chachinayi

Lakunja mutu kasinthasintha ndi mumtima onsewo thupi. Ngakhale mutu motere minofu zofewa wa kubwereketsa m'chiuno, mahang'ala ali tili m'mavuto mu ngalande m'chiuno. Mphamvu kasinthasintha izi kamakhala anabadwa mutu. Panthawi imeneyi, mutu wake atautembenuzira ku imodzi mwa ntchafu mayi. Front phewa choyamba, kenako yochepa kuchedwa chifukwa kupinda wa coccyx wabadwa ndi phewa kumbuyo.

Kubadwa kwa mutu ndi mapewa mokwanira amakonza ngalande kubadwa kwa maonekedwe wa thupi. Choncho, sitepe izi zimachitika mosavuta.

Akuti biomechanism yobereka kutsogolo ngati previa occipital kwa nulliparous zoona kwa multiparous. Kusiyana kokha kwagona kuti kubereka kachiwiri kuyamba biomechanism imagwera pa nthawi ya ukapolo, pamene madzi linathyoka.

zochita obstetricians

Komanso biomechanism, muyenera kugwiritsa ntchito gawo obstetric pobereka.

Sikuti onse ndi wodalirika chikhalidwe. Ngakhale amayi yobereka ndi wokhazikika mu ulaliki occipital, mungafunike thandizo azamba.

• Mfundo yoyamba. Kuteteza perineum, kuteteza kutambasuka patsogolo pa nthawi. Manja ayenera pilirani mutu, kuteteza gululi pamene akuyesetsa ndi kukula flexion. Tiyenera kuyesetsa kuonetsetsa kuti unakhota anali pazipita, chotero, ndi osiyana zofunika. Pokhapokha koyenera kutero safunika kusokoneza. Mwanayo zambiri amatha atengere lokha m'njira kubadwa. mavuto ambiri komanso zoopsa kubadwa Zoonadi obstetric gawo mu ntchito, osati yobereka. Nthawi zambiri mwana anavulala osati kwa amayi crotch ndi anamwino pa dzanja kuteteza perineum.
• Mfundo yachiwiri - chosowa ankafuna tikuona mutu wa kusiyana ndi jenda. Ngati inu wopita kwa pazipita zoyesayesa, ndi kulemedwa kwambiri kusiyana kugonana.

Ndondomeko ili. Ndi kumalizidwa kwa zoyesayesa za mphete vulvar mokoma kutambasula zala za dzanja lake lamanja pa mutu wa nascent lapansi. Anatambasula ndi linasokonekera ndi chiyambi cha anayesa latsopano.

Zimene Cholinga chake ndi gawo obstetric ayenera alternated mpaka tokhala moyandikana mutu parietal kwa kutsegulidwa maliseche, pamene mutu kumawonjezera psinjika ndi kwamakokedwe analimbitsa crotch. Chifukwa, izo kumaonjezera ngozi ya kupweteka mutu yoopsa ndi mkazi wobala.

Mfundo yachitatu - ngati kuli kotheka yochepetsera mavuto perineal kuonjezera kugwilizana kumenyera mutu. Azamba mokoma amayikanikiza mosavuta ake pa minofu ozungulira kutsegula maliseche, kuwatsogolera kwa crotch, kupanga izo kupatula mavuto.

Wachinayi mfundo - anayesa kusintha. Nthawi ya maonekedwe a parietal hillocks mutu mu kudula maliseche lingaliro chiopsezo perineal komanso zoopsa psinjika mutu chodziwa.

Ngozi mofanana kwambiri amanyamula zoyesayesa wathunthu kutha. Yofunika kwambiri mu izi ankaimba ndi mpweya wa. Latsopano mayi kunena kupuma kwambiri ndipo nthawi zambiri pakamwa kufooketsa zoyesayesa. Akapereka muyenera likutuluka, mkazi akabereka mwana molimbira pang'ono. Njira initialization ndi kuchotsa zoyesayesa mzamba oyang'anira yobereka mutu mu nthawi yovuta kwambiri.

The mfundo yachisanu - kuoneka manja chapamwamba ndipo torso. Pambuyo amasulidwe apakati mutu akhale molimbira. Mahang'ala amabadwa, zambiri popanda thandizo la mzamba wina. Ngati izo sizitero, mutu ndi kuti agwidwa manja. manja kanjedza kukhudza temporomandibular buccal dera la mwana wosabadwayo. mutu woyamba anagwetsa mpaka wina wa mapewa pansi pa Chipilala obisika.

Kenako, dzanja lamanzere amatenga mutu ndi wotukulidwa mmwamba, ndipo crotch bwino ankatembenukira kwa phewa kumbuyo, zomwe molondola amasonyeza. Kumasula mapewa gawo, thupi adakweza pa m'khwapa lapansi.

Nthawi zina, kuteteza intracranial choipa anapanga perineotomy ngati perineum anali ololera.

zosokonezeka

Ngakhale ntchito kutsogolo ngati previa occipital lokha kusonyeza biomechanism zingachitike ndi zosokonezeka. Wamphamvu chikoka pa n'zotheka yobereka otetezedwa, m'chiuno kukula. kubadwa zovuta zimachitika ngati amayi Ndikuchepetsa mafupa a chiuno. kudwala Izi kawirikawiri ndithu. Ali ngati chifukwa chisankho kuwalanga kusankidwa Kaisara gawo. Pali zinthu zina chokhwima kuti akhoza kusokoneza pobereka, lalikulu kapena pambuyo akuti mwana wosabadwayo. Nthawi zambiri osankhidwa milandu kusankidwa Kaisara gawo. Nthawi zina, kufunika akamaliza yobereka ndi gawo la Kaisara limapezeka tsopano m'njira yawo.