Pathological kuyambirira nthawi: chithandizo. Kuyambirira nyengo - ndi ...

Kuyambirira nyengo - nkhondo pamimba woyembekezera, limodzi ndi ululu pang'ono ndi mavuto minofu. Iwo ali osasamba. ndewu zimenezi ndi zofunika yobereka. M'mikhalidwe wabwinobwino, kuyambirira siteji ya ntchito ayenera kutenga nthawi za maola 6-8. Komabe, nthawi zina, nthawi imeneyi akhoza anachedwa. Izi angayambe zifukwa zosiyanasiyana. Pankhaniyi pali chosayenerera ntchito, napempha alowererepo mwamsanga madokotala. Popeza zotsatira za yaitali motero kuyambirira nthawi zikhoza kukhala zoopsa kwambiri kwa mayi ndi mwana: kwa mipata amphamvu mayi ndi kutsiriza ndi imfa ya mwana wosabadwayo.

Lingaliro la pathological kuyambirira nthawi

The Maphunziro Akakhalidwe Kazolengedwa wa mkazi aliyense payekha. Nthawi zina, nthawi imeneyi akhoza inachedwa, ndipo nthawi zina kwa masiku angapo. Zimenezi zimabweretsa zikutha m'mayiko akazi, imfa ya kugona, kudzikundikira pa nthawi ya kubadwa kwa wotopa kwambiri. Pankhaniyi, pali pathological kuyambirira siteji ya ntchito, ndiye nthawi akalandire chithandizo, umene unatha. Iwo amakhala ndi contractions osasamba chowawa, amene musataye pakhale kusintha khomo pachibelekeropo, ndi kokha kuchepetseratu m'thupi la mayi.

Mfundo yaikulu ya anomalous kuyambirira nthawi

tingathe kufotokoza akamanena yaikulu ya kudwala motere:

• Thupi kuyambirira nthawi anachedwa.
• Kumawonjezera kamvekedwe ka myometrium.
• Internal khomo pachibelekeropo adzafupikitsidwa.
• Pali kuchepetsedwa kwa m'munsi gawo uterine.
• Minofu ulusi anakonza bwalo, ndi mwauzimu transversely;

zifukwa

Monga ulamuliro, ndi pathological kuyambirira nthawi ndi pamaso pa zipolowe amayi thupi. The zifukwa zikhoza kugawidwa m'magulu atatu:

ob:

• Pamaso pa polyhydramnios kapena oligohydramnios.
• Angapo mimba.
• Chipatso cha m'mimba akutenga malo cholakwika (breech ulaliki).
• The nsengwa ndi otsika.

psychoemotional:

• Mkazi mantha pobereka.
• Wachisoni maganizo.
• Neuroses ndi aakulu maganizo nkhawa.
• Thupi kutopa odwala.
• Age akazi nulliparous (kuopa zotsatira za ntchito molawirira kwambiri kapena mimba mochedwa).

thupi:

• Kodi amayi Ndikuchepetsa mafupa a chiuno.
• Poyamba anachita opaleshoni utero (amamuyambitsa timabala pambuyo Kaisara neri Al.).
• Disruptions dongosolo endocrine (kunenepa, anorexia, etc.).
• Labile mantha dongosolo.
• Matenda a impso, mtima, chiwindi, ndi ena. Matupi.
• kutukusira kwa chiberekero.
• Preeclampsia.
• Angapo mimba.
• Padera cha mwana wosabadwayo.

zizindikiro

Kudwala prelimirnogo nthawi kuthandiza kuzindikira zizindikiro zotsatirazi:

• Chiberekero mu kukonzekera ndi kuyambirira nthawi momvetsa yafupika, pamene contractions si zonse. Iwo angayambe onse masana ndi usiku. Mu si kuyamba ntchito kwa nthawi yaitali.
• Kuchuluka kamvekedwe ka chiberekero ndi excitability ake.
• ndi khomo pachibelekeropo si anati, ikhala wandiweyani ndi yaitali.
• Kupereka gawo la mwana wosabadwayo si mbamuikha ndi mafupa a chiuno yaing'ono mkazi.
• Chifukwa uterine hypertonus zovuta kuzitsatira palpation mwana wosabadwayo.
• Chiberekero kwa nthawi yaitali amachepetsa monotonically. Mphamvu komanso pafupipafupi contractions sizimasintha. M'mene ndipo kuyambirira nthawi ndi nthawi yaitali mu chirengedwe.
• Mkazi pali kuwonongeka mu maganizo, anakhala akulira ndi kukwiya, iye ali ndi kusadalira bwinobwino yobereka lapansi.

mitundu kudwala

Pathological kuyambirira nthawi angakhale mitundu iwiri:

• Mbali yoyamba ya uterine minofu simuli omasuka, Ulusi minofu ya m'chiberekero zikufanana ndi "wokhwima" khosi, oligohydramnios, zikopa mosabisa.
• Ngati chachiwiri, khomo pachibelekeropo ndi "mwana", ali mawonekedwe chowulungika, kupereka gawo la mwana wosabadwayo si pafupi ndi khomo beseni yaing'ono. Nthawi zambiri, zikatero zimawonedwa mu wosabadwa perenashivanii.

Kutalika

Nthawi anomalous kuyambirira nthawi malingana ndi makhalidwe munthu wa mkazi aliyense akhoza zimasiyana maola 6 mpaka maola 24-48. Kwa ena akazi, zingatenge masiku angapo.

zotsatira zotheka

Pathological kuyambirira nthawi nthawi zambiri kumayambitsa mavuto pobereka. ntchito zambiri akuchikazi umayenda abnormally. Makamaka:

• NTCHITO ofooka. Mu chikhalidwe ichi, yodziwika ndi kupanda mphamvu ya contractions uterine, intervals yaitali pakati contractions, ndi khomo pachibelekeropo dilates pang'onopang'ono, kulimbikitsa yoopsa anachedwa.
• Diskoordinirovannaya amagwira ntchito mwakhama. Zikuoneka contractions zosathandiza m'madi- chiberekero. No kalunzanitsidwe mu chidule ndi zosangalatsa zigawo payekha. Chifukwa cha nkhondo ndi limodzi ndi ululu, kawirikawiri ndi osasamba, kuti exhausts mayi ndi wasandutsa kumasuka.
• Ntchito atuluka mofulumira. Pakuti anomaly imeneyi amakhala ndi contractions amphamvu kwambiri ndi akuthwa kuposa. Chifukwa, yobereka ndi kudya (mpaka 5:00). Zimenezi zingachititse kuti anawononga ya nyini ndi perineum mu amayi apakati, amataya magazi. Mu mwana wosabadwayo angathe hypoxia. yobereka mofulumira zikhoza choipa kubadwa kwa mwana wosabadwayo.
• uterine kafumbata - ochepa chabe anomaly. Pankhaniyi, chikhalidwe kumene chiberekero ndi omasuka kwathunthu. Izo zikuchitika mu mwambo pacemakers angapo mu madera osiyana a chiberekero. Zimadzetsa kuonongeka kwa kusokoneza contractions uterine ndipo amasiya yobereka. Mu mwana wosabadwayo angathe hypoxia, tingayambe matenda mtima.

Angathe kukumana ndi mavuto aakulu a nthenda yotaya ntchito:

• Mwadzidzidzi kuchotsa madzimadzi amniotic.
• Zikamera mu nkhondo oyambirira meconium, kutanthauza "nsautso" wa mwana wosabadwayo.
• Opaleshoni yobereka.
• Forceps.
• Aakulu nthenda magazi.
• Mu nthawi ya postpartum, kuyamba matenda purulent-opatsirana.
• Yoopsa hypoxia ndi kubadwa kwa mwana ndi kuwona mtima kapena inatsekeratu matenda mtsempha wamagazi.

diagnostics

Ngati mukukayikira kuti nthawi kuyambirira akuthamanga abnormally, inu nthawi yomweyo kuona azamba-gynecologist. Iye ayenera kuti achite kuunikidwa kunja. Palpation Zimathandizanso kudziwa mkulu kapena otsika udindo wa mwana wosabadwayo. Ngati zipatso si waponya, izo zikusonyeza kukhalapo kwa kudwala ntchito. Komanso pa kudwala akhoza adzaweruzidwa ndi pamaso pa mavuto amphamvu minofu ya nyini, chiberekero azikhala chosakhwima ndi spasms.

Mu nthawi kuyambirira zochokera matenda kudwala ndi matenda ndi zasayansi maphunziro kuganiza kuchepetsa erythrocyte acetylcholinesterase ntchito, kuwonjezera milingo mwazi wa mahomoni zikuwonjezereka masiku ano ndi noradrenaline.

Mwina kuphunzira chida. Kuti kuchita zimenezi, cardiotocography. Ndi inu mukhoza kulemba mphamvu ndi nthawi ya contractions.

Pathological kuyambirira nthawi: chithandizo

Pamene khomo pachibelekeropo mwana ndiponso kusapezeka kwa palokha chitukuko cha ntchito anaona chitsanzo perenashivanie mimba. Therapy ndiye kuikidwa pa maziko a pathogenesis matenda. Cholinga cha mankhwala imathandizira kucha ndondomeko ya m'chiberekero. Mwina ntchito njira zimenezi:

• Elektroanalgeziya.
• Elektrorelaksatsiya chiberekero.
• Mankhwalawa medikametov: MANKHWALA OLETSA VUTOLI, analgesics, prostaglatinov E2.

Ngati wodwala zimawonedwa kutopa kwambiri ndi kuchuluka mantha, iye kukhala mankhwala mankhwala anachititsa tulo. Komanso ndawalemba mankhwala.

A zabwino mankhwala zotsatira zimaonekera pa chiyambi zakuthwa contractions zonse. Kapena kucha thupi pobereka. Pamene chiberekero amakhala "wokhwima", ndi chikhodzodzo yoopsa lidzatsegulidwa ndipo patangotha maola awiri contractions zonse kuyamba. Ngati ntchito Sikuyaka, ndiye m'nsinga kutumikiridwa prostaglandins.

Pamene osamveka chithandizo pamodzi ndi mavuto ena (mbiri obstetrical, kukula lalikulu la mwana wosabadwayo, breech ulaliki, OPG-preeclampsia, yoopsa hypoxia pamwamba) anachita pangozi Kaisara gawo.

Njira pa kayendetsedwe ka amayi apakati amene ndasungira pathological kuyambirira nthawi

Pali njira ziwiri:

• Lopumula.
• Kupatsidwa ulemu ntchito ntchito oxytocin pamene.

njira onse ukunenedwa kuthetsa kuyan'anila za pobereka. Zotsatira anamuona pa 85% ya milandu. Posankha njira amaganizira zotsatirazi mbali ya kudwala:

• Mmene nkhawa wodwalayo ndi kutopa.
• Chifukwa chimene vuto.
• Kusankha njira, umene uli yabwino kwa wodwalayo komanso azamba.

Posankha njira ya nkhani lopumula pakati, chikuyendetsedwera intramuscularly 0,015 ga morphine. Ndiye secobarbital mu 0.2 ga Izi ndi zothandiza zokwanira. Childs, pambuyo utsogoleli wa morphine mtima amagona kwa ola limodzi. Patapita maola 4-5 kupuma, imene thupi wotopa Kukuthandiza Anthu Odwala, mkazi n'kudzuka popanda chilichonse zizindikiro kubadwa, kaya ntchito yogwira.

Posankha njira yachiwiri, i.e., kukondoweza wa oxytocin ayenera kupewa kutsegula nembanemba lapansi. Cesarean gawo yilungamitsidwa okha Zikavuta kwambiri.

kupewa

Major njira zoyezera pofuna kupewa kudwala kuyambirira nthawi ndi:

• Panthawi yake upo wa azamba a.
• Kutumiza nkhani zonse zofunika.
• Kuchita malangizo dokotala ponena mode ndi mphamvu.
• Psychological ndi thupi kukonzekera za amayi apakati pa pobereka.

Woyenera azamba muwasunge kulamulira akazi amene ali pa chiopsezo yatsoka za matenda. Ndicho nulliparous pansi ndi zaka 17 ndipo patapita zaka 30, komanso akazi amene ali ndi matenda a ziwalo zina (chiwindi, impso, mtima).

Choncho, pathological kuyambirira nthawi ndi imodzi mwa mitundu ya anomalies wa ntchito ntchito. Kumachitika nthawi zambiri. Koma chifukwa mankhwala amakono, 85% ya alowererepo yake madokotala yobereka mapeto bwinobwino. Choncho, pamene zizindikiro woyamba wa matenda ayenera yomweyo funsani munthu wodziwa bwino azamba-gynecologist. Zotsatira za nthenda kuyambirira nthawi zikhoza kukhala zoopsa kwambiri, mpaka hypoxia yoopsa zakulephera aliyense mu ziwalo zake mkati ndi imfa. Moyenera mankhwala pofuna kuteteza moyo wa mayi ndi mwana.