Delivery Biomechanism ngaphambili njengoko previa Occipital. Isibonelelo Obstetric ekukhulelweni

Ekuzalweni umbungu iphuma lomsele wokuzalwa, enza translational kunye nentshukumo ejikelezayo. zeziphakamiso ezintsonkothileyo imele biomechanism kwisizukulwana. intshumayelo Palsy kakhulu kugqiba ukuntsonkotha yonikezelo. Ngaphezu kwama-90% amatyala ntetho Occipital Palsy.

Biomechanism nulliparous

Ngokutsho izifundo, enkqayini nulliparous ihamba kancinci kude ngexesha lokukhulelwa. Ubungakanani phambili ixhomekeke lulwahlulo ubukhulu intloko ezingekazalwa kunye isinqe sikanina. Umntu umbungu eyeka intshukumo sayo ekungeneni, kwaye abanye - kwinxalenye ende lweHo- ye isitya encinane. Xa ingena yabasebenzi, intloko uyaqhubeka advance yayo xa kwamathumbu kuqala. Ukuba ukukhuthazwa foetal abayithintelayo emjelweni wokuzalwa, ukuziswa biomechanism ngaphambili njengoko previa Occipital kwenzeka kwindawo zangasese, nto leyo wadibana njengomqobo. Ukuba ukuzalwa zenzeke ngesiqhelo, lo biomechanism izingenele xa intloko udlula umda phakathi inxalenye ngokubanzi kwaye imxinwa kwisisu zangasese. Ukumelana nemiqobo, ezinye izishunqulelo zesibeleko encinane kuphela. Kukho amalinge, ihlaba isiqhamo kwi indlela yokuphuma lomsele wokuzalwa.

Kwiimeko ezininzi unikezelo biomechanism ngaphambili njengoko previa Occipital libandakanyeka kwinqanaba ekuthinjweni, xa intloko eshenxela kwisebe emxinwa kwisisu zangasese evela ebanzi, nangona nulliparous bonke ingaqala ngexesha elubala, xa intloko ezingekazalwa esisemnyango.

Ngexesha lenkqubo ukugxothwa olungekazalwa usana olungekazalwa kunye isibeleko rhoqo banxibelelane nabanye. Isiqhamo sesizalo ezama olule ngokwendlela emile ngayo kunye nobukhulu, isibeleko angenziwa iquka olungekazalwa kunye fluid, ngokuhlenga oko indlela yabo. Ngenxa yeso senzo iqanda iphela lomsele uzale nkulu emdlalweni ngokupheleleyo. Ngoko kukho zinto zifuneka kuqala ukuze ukugxothwa Umbungu ukusuka lomsele ekuzalweni.

Division ngamanqaku

delivery Biomechanism ngaphambili njengoko previa Occipital yohlulwe amanqaku amane:

• flexion intloko;
• ngaphakathi ukujikeleza yayo;
• ukwandiswa intloko;
• iqumrhu ujikelezo engaphakathi, kunye nentloko ejikelezayo engaphandle.

Lo mzuzu lowokuqala

Ayeguqa intloko kukuba phantsi kwempembelelo xi intrauterine yomqolo wesibeleko flexes, nto leyo isilevu esifubeni kwaye emva intloko ziyawa. Ngaloo fontanel amancinci ibekwe ngezantsi kwe elikhulu, ngokuthe ngcembe masisondele isinqe igxunyekwe umgca, yaye le nxalenye luthe ibekwe ngezantsi yonke inxalenye intloko.

Inzuzo kule ukugoba kukuba oko kunika ithuba lokuba boyise intloko kwisisu zangasese kunye ubukhulu omncinane. . Ubungakanani intloko Tye ye-12 cm kunye scythe encinane, onesiphumo uyigobayo - 9.5 cm Liyinyaniso ukuba iimfuno zonikezelo ikhosi yesiqhelo njenge flexion elinqatyisiweyo yintloko akuthethi kuvela: ukuba uzimisele kangangoko kuyimfuneko ukuya ukusuka ebanzi ku isinqe emxinwa ngokwahlukana. flexion iphezulu intloko ezingekazalwa iyafuneka kuphela kwiimeko apho lomsele ukuzalwa nobubanzi azonelanga ukuba sicatshulwa entloko. Oku kwenzeka xa isinqe sincinane, kwakunye kwimeko bakhulise-imbono Occipital previa.

Ukugoba ayikho intshukumo kuphela foetal kule ndawo unikezelo biomechanism. Okwangoku nye kwenzeka intshukumo translational yentloko ngokusebenzisa emjelweni ukuzalwa, yaye emva uyigobayo luqala ngethuba lawo yangaphakathi. Ngoko yonikezelo ixesha biomechanism lokuqala yindibaniselwano sesindululo translational kunye flexion kunye linegunya. Noko ke, ekubeni inkoliso intshukumo ngokukhawuleza i ukugoba entloko, igama mzuzu yokuqala ibonisa le nto.

mzuzu yesibini

ujikelezo yangaphakathi yentloko - indibaniselwano isindululo yayo translational kunye ukujikeleza lwangaphakathi. Iqala xa ikhanda kruthu, samiselwa ngasemnyango isitya esincinane.

intloko Fetal, ngokuthe ngcembe em- zangasese na omelana intshukumo enye kwaye iqalisa ukuba uphendule ngeenxa axis yayo longitudinal. Kuba ngathi kokujikeleza intloko isinqe. Oku kwenzeka kakhulu ngokufuthi xa edlula abanzi ukuya kwisebe elimxinwa kwisisu zangasese. Buyela intloko zemiboniso njengoko phezu kodonga zangasese, besondela ekwenziweni zikawonke wonke. Le ngongoma unako itshixiwe, qinisekisa ukuba cinci ku fana na indawo suture sagittal. Le umthungo ukuba ukujikeleza isinqe kwi ezinqamlezayo okanye elibhalwe ngokumileyo imali, kwaye emva kokuba ujikeleza kwi mali phambili. Ekupheleni intloko ukujikeleza waphawula xa ekumiseleni suture sagittal kwi mali phambili, kunye fossa suboccipital ithatha indawo phantsi Arch zikawonke wonke.

mzuzu leyesithathu

Ukwandiswa entloko. Intloko uqhubekela phantsi emjelweni wokuzalwa, iqala kancinci unbent. Phantsi ulwandiso unikezelo eqhelekileyo lwenziwa kwi imveliso ye isinqe. Emva intloko ufumana ngaphandle arch zikawonke wonke, kunye ebunzi kuphuma ngaphaya coccyx, ngokohlobo a ngaphambili udaka equmbile yaye inxalenye elingasemva uhanjiso.

fossa Suboccipital luphezu ungqameko olungezantsi Arch zikawonke wonke. Ukuba Ukongezwa okokuqala entloko kuye kwacotha, ngeli xesha, kuba ukukhawulezisa: intloko unbent iinzame nje ezimbalwa. Head ungena nge ring vulvar ngendlela ROOTN encinane kubungakanani bayo.

Ngexesha ukwandiswa emjelweni lokuzalwa ubonisa ezahlukeneyo isithsaba, indawo ngokungqalileyo, ubuso nasesilevini.

nomzuzu yesine

I engaphandle Intloko kujikelezo umzimba ejikelezayo embilwini. Nangona intloko ilandela nyama elithambileyo lo walivala ithende zangasese, zibe zona ziqinisiwe kungena lomsele zangasese. Amandla yale ujikelezo aze azalwe entloko. Ngalo mzuzu, intloko bakhe bayityekisela ukuya kwenye emathangeni unina. igxalaba Front ngaphandle kuqala, kulandele delay mfutshane ngenxa ukugoba le coccyx uzelwe kunye nomlenze umva.

Ukuzalwa intloko namagxa ngokwaneleyo ulungisa emjelweni sokuzalwa ukubonakala wonke umzimba. Ngoko ke, eli nyathelo lwenzeka kakhulu lula.

Izincomo unikezelo biomechanism ngaphambili njengoko previa Occipital ukuba nulliparous kwakuyinyaniso for multiparous. Umahluko kuphela kuxhomekeke yokuba uzalayo ukuphinda-ukuqala biomechanism iwela kwixesha ekuthinjweni, xa amanzi wayaphula.

obstetricians izenzo

Ukongeza biomechanism, kufuneka usebenzise isibonelelo yokubelekisa ekuzaleni.

Asingabo bonke angathenjwa kwindalo. Nokuba omama ukunikezelwa rhoqo noko kule ntetho Occipital, ungafuna uncedo obstetrician.

• Ingongoma yokuqala. Ukukhusela perineum, nokuthintela ulwandiso ngaphambi kwexesha. Izandla kufuneka ukubamba up intloko, ukuthintela intshukumo ngexesha uzama nokwandisa flexion. Kufuneka silwele ukuqinisekisa ukuba begoba waba eliphezulu, yaye ngaloo ndlela, i zemfuza kuyimfuneko. Ngaphandle kwalapho kuyimfuneko, akukho mfuneko ukuba ungayingeni indaba. Umntwana idla bakwazi ukuziqhelanisa ngokwayo emjelweni wokuzalwa. iingxaki ezininzi kakhulu kwaye ukuzalwa nomenzakalo kanye umxhesho yokubelekisa emigudwini, hayi ukunikezelwa. Kudla umntwana wonzakele nje oomama uhanjiso kunye ngababelekisi esandleni ukukhusela perineum.
• Ingongoma yesibini - ukungabi amalinge baphethe intloko Umsantsa ngokwesini. Ukuba intloko waphuma waya ubuninzi amalinge, kuba umthwalo omkhulu umsantsa ngesondo.

Inkqubo yile ilandelayo. Ngenxa ukugqitywa imizamo ring vulvar ngobunono olule iminwe isandla sakhe sokunene phezu kwentloko lutsha. Ukolula uphazamiseka kunye ekuqaleni amalinge ezintsha.

Ezi zenzo ijoliswe isibonelelo yokubelekisa, kufuneka ukuba mzuzu de kula maqhuqhuva intloko proximity Parietal emnyango angasese, xa intloko kwandisa ucinezelo kunye eqine uhanjiso lwesamente. Ngenxa yoko, oko konyusa ingozi yokwenzakala ku intloko ezingekazalwa kunye yomfazi onenimba.

Ingongoma yesithathu - kangangoko kunokwenzeka ukuze kuncitshiswe uxinzelelo isizalo ukwandisa uthotyelo Babesinqinda intloko. Obstetrician ngobunono uyayicinizela zeminwe yakhe inwebu ejikeleze ukuvulwa angasese, uyabaqondisa ukuya uhanjiso, iyenza nengxabano ngaphantsi.

Sesine ngongoma - imizamo yokulungisa. Ixesha legqwetha hillocks Parietal intloko kwi noqhoqhoqho angasese uthwala umngcipheko nangakumbi isizalo kunye nentloko ucinezelo esibuhlungu.

An ingozi enkulu ngokulinganayo ephethe epheleleyo iinzame kungayekwa. Indima ebalulekileyo kule idlalwa umoya. unina Elitsha ukuba aphefumle umlomo nzulu yaye ngokufuthi vula buthathaka imizamo. Xa amalinge imfuneko yoko, umfazi ukuzala kancinane ezingqongqo. Indlela Ukuqalisa kunye nokupheliswa iinzame umbelekisi iqwalasela kokunikezelwa intloko kweli xesha amanqam.

Ingongoma sesihlanu - imbonakalo iingalo kunye umntla eliphezulu. Emva kokukhutshwa maternity intloko kufuneka ibe ezingqongqo. Zibe bezalwa, ngokuqhelekileyo ngaphandle uncedo umbelekisi. Ukuba ayiwenzi, intloko ke izandla va. wesundu izandla touch temporomandibular ummandla buccal yosana olungekazalwa. Okokuqala intloko wazidiliza kude zamagxa phantsi zikawonke Arch.

Okulandelayo, uthatha isandla sasekhohlo intloko, ezinyusileyo, kwaye uhanjiso ekunene lwaye ukusuka emagxeni umva, elibonisa ngokuchanekileyo. Yokukhulula inxalenye umkhono, umzimba uphakanyiselwa phezulu phezu amakhwapha.

Kwezinye iimeko, ukuthintela ukwenzakala intracranial wenza perineotomy ukuba perineum yaba lukhuni.

ukungaphili

Nangona abasebenzi ngaphambili njengoko previa Occipital ngegama bonisa biomechanism kwenzeka kanye nobunzima. elinamandla phezu amathuba apho iincwadi zisiwa ekhuselekileyo, ubungakanani zangasese. okuzala enzima kwenzeka ukuba oomama ukuvala isinqe. Le ngezifo kakhulu inqabile. Sisebenza isizathu isigqibo sokubamba kwicandelo ekunokukhethwa ngoqhaqho. Kukho nezinye iimeko ezinzima ezinokuba nzima ukuzala, engekazalwa ezinkulu okanye post-term. Amaninzi onyuliweyo kwezi meko elective kwicandelo ngoqhaqho. Kwezinye iimeko, imfuno lokugqiba lonikezelo licandelo Uqhaqho ubonakala ngoku kuphela kwikhondo labo.