Yokopha yokubelekisa: Oonobangela kunye nezikhokelo zonyango

Ngelishwa, hemorrhages yokubelekisa ayesoloko ingqalelo omnye unobangela wokufa abafazi kokuba luzelwe. Yiyo loo nto kubalulekile ukuqwalasela amathuba iingxaki ukukhulelwa anokunika uncedo abanobuchule.

yokopha angama

Amaninzi ngexesha lokukhulelwa, ngexesha lokubeleka kunye nexesha Kukudandatheka, kusenokuba kukho iintlobo ezahlukeneyo iingxaki. Enye yazo Ukopha ebuchotsheni yokubelekisa. Xa izifo nococeko, lo gama ukuthini nokopha kakhulu ukusuka iphecana angasese ukusuka ekuzalweni ukuya kwixesha kokubeleka kade.

Ngokutsho manani, kaninzi zenzeka ukopha ezintathu lwesibini, lwesithathu emva kokubeleka. Ngenxa kwiimpawu yokwakheka kunye nokomzimba of nabasetyhini okukhawulezayo okanye omkhulu Ukopha ebuchotsheni yokubelekisa. Kule meko ifuna amalungiselelo kwangoko unyango, ngenxa yokuba urhulumente onjalo zibe usongo kakhulu kwabasetyhini kunye nabantwana.

Ukwahlukanisa yokopha yokubelekisa

Le ngxaki ubalwa ngokungqinelana nemigaqo ezahlukeneyo. Obstetrical ukopha yezizathu ezahlukeneyo, nto leyo eyavusa ngayo, kwakunye umthamo wegazi elahlekileyo. Phakathi iingxaki, zihlelwa ngokwimiselo yokuqala, sinako ukwahlula ukopha zenzeke:

• kwisiqingatha sokuqala yokukhulelwa;
• kwisiqingatha sesibini yokukhulelwa;
• xa beqala ukusikwa;
• phakathi kwenkqubo generic;
• kwinqanaba lokugqibela;
• emva kokubeleka;
• Kwiintsuku ezimbalwa emva kokubeleka.

Ngaphezu koko, kusenokwenzeka ukuba lokuhlela obstetrical ukopha umthamo wegazi elahlekileyo. Zahlula-hlulwe iintlobo ezifana:

• ukopha olunamandla;
• okukhulu syndrome ukulahleka igazi;
• sophele kukothuka.

Kuxhomekeka ukunyhashwa ezikhoyo yaye, ziziphi ixesha ukuba kwenzeka, umnyulwa indlela yonyango.

Ukopha ezintathu yokuqala yokukhulelwa

Iimbangi ezingundoqo ukopha kwiinyanga zokuqala ezimbalwa zokukhulelwa zezi:

• ukuphuphuma;
• ukukhulelwa izinyo;
• ukukhulelwa wesibeleko;
• ngezifo wesibeleko.

Ukuba isisu kwabasetyhini kuthathwa ukuba iimpawu eziphambili intlungu obukhulu kunye nelahleko enkulu negazi. Kunye nokoyikiswa ezingephi amabala kwesisu kunye neentlungu abekho okanye umlinganiswa ezibuhlungu buthuntu. Ukuqhomfa okuzenzekelayo inokuba epheleleyo okanye engaphelelanga. Kulo kuxhomekeke kakhulu imfuneko indlela yokunikezela unyango.

Ngaphezu koko, ukopha kunokwenzeka xa kukho ingxaki ezifana hydatidiform nolovane. Le ngezifo luphawulwa yokuba villi chorionic senziwa similise vesicles equlethe estrogen. Olusemngciphekweni amabhinqa ukudumba amalungu esini, kunye nezigulo hormone. Unyango kule meko kunokuba nzima kwaye kuxhomekeke kakhulu iqondo ukutshatyalaliswa lweHo- zesibeleko.

ukukhulelwa wesibeleko uphazamiseka ikakhulu kwiiveki ezili-12. Iqela umngcipheko kuquka abasetyhini kunye nezifo ukudumba, ukungaqheleki wesibeleko, ngokunjalo ukunyhashwa sexesheni. Kubaluleke kakhulu ukushukumiseka kakhulu asiyonto iqanda kwi wesibeleko kwaye emjelweni wesibeleko. Ukopha kulo mzekelo ngokwaneleyo luninzi ukususela isakhiwo Amathumbu amakhulu nemithambo kwaphulwa.

Iipolyps emseleni wesibeleko usenokuba unobangela ukopha, kodwa zingabalulekanga. Nge polyp enkulu ukuhluma ukopha wande, ngoko ke kubalulekile ukuba uncedo ngexesha elifanelekileyo legazi yokubelekisa.

yamathumba amabi, le isibeleko zenzeke ngexesha lokukhulelwa kunqabile, njengoko esi sifo sizibonakalisa ingakumbi abasetyhini abadala ngaphezu kweminyaka engama-40. Unyango lwenziwa emva kokubeleka. Ukuba ixesha elincinane, nto ibonisa nokususwa ngokupheleleyo isibeleko. Ngaphezu koko, ukopha esinxulunyaniswa ne pregnancy. Ngenxa yoko, indawo le umbungu ibe wesizalo lowanyathela.

Ukopha kwisiqingatha sesibini yokukhulelwa

Ukopha kwakhona lwenzeka kwi ezintathu yesibini neyesithathu yokukhulelwa. izizathu eziphambili zezi:

• previa ngumkhaya;
• abruption placental;
• wesizalo komsipha.

Iqela risk iquka abafazi abaye ngaphambili ukufumene sisifo yokukrala kunye malformations zesibeleko, kwakunye hypoplasia ye zangasese. Ukunyhashwa becala kwenzeka xa ngumkhaya kubekwe ngqo eludongeni phambi isibeleko. Kwisiqingatha sesibini ukukhulelwa unobangela ukopha sinokunyangwa iindonga zesibeleko kuyaphula ngenxa lobukho kukuqulungana emva kotyando, Uqhaqho okanye ubukho hydatidiform nolovane. Ukuba wesizalo uqhekeko, njengoko umthetho, le meko iphela lethally. Ngaphandle ukopha Kwakhona waphawula intlungu zazinzima kakhulu.

Kukudandatheka yokopha

Lidla kukho ukopha obstetrical ngexesha lokubeleka kunye nexesha lokuqala kokubeleka. nangoko abafazi abaninzi uqale yokothuka, ngenxa yokuba ndandingacingi uza kuqhubeka njani ukwimeko enjalo, kwaye igqalwa lo mmiselo, kwaye inxulumene ezimbi. Ukopha ngexesha lokubeleka zenzeka ngenxa ikakhulu:

• uqhekeko wesibeleko;
• wesizalo uqhekeko;
• PONRP (abruptio placentae).

Ngenxa uqhekeko wesibeleko kuba ukopha enzima kakhulu. Oku kwenzeka ngenxa yokuba umsantsa ungaba kuze kwigumbi kwilungu lobufazi, okanye kuchaphazela udonga emazantsi wesibeleko. Olusemngciphekweni amabhinqa eyayichasene yabasebenzi, iziqhamo elikhulu, kwakunye nokusetyenziswa kweziyobisi ezithile. uqhekeko wesibeleko inokwenzeka ngokohlobo ukopha kakhulu. Oku ikakhulu akunjalo amabhinqa ukunikezelwa ngokukhawuleza. Uxilongo lokugqibela ugqirha ekhoyo uhlolo lomsele wokuzalwa.

Inxaxheba kwinqanaba lokuqala yabasebenzi kunokwenzeka PONRP ukuba luphawulwa ziintlungu eziqatha wesibeleko ukuba musa ungqamane kwesibeleko. Kulo mzekelo, isibeleko buyasikhulula isingxobo okanye ngokwaneleyo sikhululekile, kwaye kukho amahlwili nokopha. Le meko olufunyanwa amabhinqa yabasebenzi discoordination, ukuqaliswa kwezinye imithi, ubukho lwegazi. Iiplastiki unikezelo ngokukhawuleza kakhulu.

ugqirha uqhekeko wesizalo nga nokuxilonga izishunqulelo ngokwaneleyo namandla, ngoxa abafazi banenkxalabo malunga intlungu obukhulu. Kulo mzekelo, kukho ukopha enkulu kakhulu lobufazi, kwakunye hypoxia kunokwenzeka Palsy. Xa kukhombisa lwenziwa icandelo ngoqhaqho.

Kusenokubakho ukopha Kukudandatheka yokubelekisa ezivela ngenxa yezizathu ezifana:

• sokuzalwa nzima;
• iziqhamo enkulu;
• ukukhulelwa multiple;
• polyhydramnios.

Ukopha kungenzeka kwixesha kade Kukudandatheka, apho kungenxa yokuba phambi kokuba ushiya ugqirha uqhuba uviwo ngokucokisekileyo oomama ukukhangela ukugqabhuka kunye nezinye iintshukumo zokwaphulwa kwemithetho, nokwenza iingcebiso ngokumalunga ixesha kunye neempawu kwexesha Kukudandatheka. Ngesiqhelo amabala ngokwanelisayo strong waphawula iintsuku eziliqela emva kokubeleka, ukuya mzuzu xa inyama yonakele kwiinwebu isibeleko lukusindisile. Ezimandundu post-partum Ukopha ebuchotsheni kukho iingxaki eziyingozi kakhulu ezinokukhokelela ekuswelekeni koomama. Ubuzaza ukopha kuxhomekeke kubungakanani wegazi elahlekileyo. Loo imeko ifuna yokurhaxwa ngoko nangoko.

Izinto ezibangela yokopha yokubelekisa

Phambi kokuba ukufeza unyango, kuyimfuneko ukuba amisele ukuba yintoni ebangela kwavusa solo lwaphulo. Lidla kukho legazi yokubelekisa. Uncedo kule meko isekelwe phezu imiba ayeke ukuba xesha ngalinye ukukhulelwa kunye zabasebenzi ezahlukileyo. ilahleko enkulu igazi kunokuba yingozi kakhulu ngenxa yomfazi kunye olungekazalwa. Kwisiqingatha sokuqala yokukhulelwa ukopha kuvela ngenxa kwezichumiso ethunjini okanye isisu. In ukopha ezintathu lesibini okanye lesithathu esinokubakho ngenxa ekubhobhozeni ngaphambi ngumkhaya.

ukopha wabalasela emva kokugqitywa yabasebenzi. Ngeli xesha, kusenokuba kukho iingxaki ezinxulumene yokuba:

• placental villi ikhule ibe isibeleko;
• kwezinye iindawo ngumkhaya ihleli isibeleko;
• imigodi sokuzalwa owenzakeleyo.

Ukopha okwenzeka kwixesha Kukudandatheka esinxulunyaniswa elincane ithoni zesibeleko. Nangona kunjalo, akukho lifinyele, ngoko ke, igazi akayeki. Kusenokwenzeka kuba yingxaki, yaye igazi ekunqandeni amahlwempu.

Iimpawu yokopha yokubelekisa

Ukopha inokuba ngaphakathi, ngaphandle, okanye zombini. ukopha engaphandle yabonakala abruption placental kunye dilatation wesibeleko. PONRP ukwakha hematoma ebonakala yophela ngaphakathi. ukopha Ludityanisiwe kungenzeka xa abruption osecaleni placental kunye ukuvulwa kancinane lomsele wesibeleko.

Emergency Care for ukopha yokubelekisa kufuneka uhlale unika kwimeko imiqondiso yokuqala, ezifana:

• ukopha evela kwilungu lobufazi, nokuba ubungakanani kunye nemvelo;
• ubuhlungu wesizalo;
• isiyezi, lisuke labuna ulusu, ubuthathaka, niphele;
• zokucutha;
• kutshintsha izinga intliziyo olungekazalwa.

Zokubonisa Kukudandatheka Ukopha ebuchotsheni kubangelwa inani nobushushu ukopha. Ukuba isibeleko akaziphenduli okubi enyangayo, ukopha kule meko womelele kakhulu kwaye esimfaneleko umlinganiswa zinganxitywa. Amaxesha kuyo kudambe phantsi amanyathelo kwamachiza eziliqela. Ukongeza, umfazi ngokugqithiseleyo ulusu pallor, tachycardia, hypotension.

Umthamo wegazi ilahleko efikelela kwi-0.5% ngokobunzima umfazi okhulelweyo luthathwa lwamkelekile physiologically, ngelixa sisenyusa umthamo le utshintsho eziyingozi kwenzeka emzimbeni, ngoko ke kubalulekile ukuba kupheliswe ingxaki ngexesha elifanelekileyo. Kweli xesha Kukudandatheka, lo mfazi kufuneka yaziswe ngamandla kakhulu wayolula lochia kunye izixa kakhulu, nentuthumbo enkulu ndawonenye esiswini.

isevisi ayikho

unyango obstetrical ukopha algorithm kwenziwa kuphela emva kokuba uyayazi ebanzi. Uxilongo luqala uphando isigulane ukuba ukujonga ixesha ukopha kunye nesimilo yayo. Ugqirha koko ukuqokelela imbali yezonyango ukufumanisa ukuba yintoni na isifo kungafezeki ekhulelwe naxa ezala.

Ngelo xesha lokuhlola abafazi, kulinganiswe izinga ukubetha, uxinzelelo lwegazi, wabancina isibeleko. Ngaxeshanye kufuneka sibe iimviwo zangasese ngoncedo yezibuko, zesibeleko Ngokucofa ukujonga ukuqina izihlunu. Ekuhloleni ezongezelelweyo olwenziwe ultrasound ukufumanisa ukuba placental abruption na, njengoko imfesane yosana kunye wesibeleko ukuba ingqibelelo yaphulwe. Kubalulekile ukwakha algorithm ecacileyo kakhulu. ukopha yokubelekisa kuyingozi kakhulu ngenxa yomfazi kunye nomntwana, ngoko ufuna uncedo ngoko nangoko.

uncedo lokuqala

Mfuneko yononophelo olungxamisekileyo ngenxa ukopha yokubelekisa, ekubeni imeko enjalo kuba kakhulu kwaye Uxhokonxwa iingxaki ezininzi ezahlukeneyo. Phambi yomfazi ukopha mfuneko ibekwe esibhedlele ukuze ahlolwe kunye nonyango. Zokuhamba kufuneka wenziwe kuphela kwindawo lisalele. Kwimeko isisu, kunye nelahleko igazi ebalulekileyo care etsolo ithetha sokususwa ukopha kukothuka. Iziyobisi zoshwankathelo zilawulwe yegazi phambi kokwamkelwa yesigulane. Xa kuqaliswa ngokupheleleyo isisu kuthetha ukuba kube lula kunciphiso isibeleko, yegazi.

Ukuba ukopha kukho yokubelekisa, ngexesha likaxakeka protocol kunye pregnancy iquka ukuqaliswa iziyobisi kunceda ekupheliseni iimpawu ukopha kukothuka. Noko ke, abafazi bachitha oksijini inhalation. Impatho nolawulo glucocorticoids lwenziwa kuphela xa kuboniswe. Isigulane ubonisa esibhedlele engxamisekileyo, ukuthuthwa lwenziwa kwindawo uvaleke. Ngexesha izithuthi, xi kugcinwa 80-100 mm HG. Art. Ekubeni esibhedlele kakhulu legazi yabamba iqela resuscitative- yotyando.

Ngaphezu koko, esibhedlele lwenziwa kwaye unyango koko yekhabhoni beendawo previa okanye kwecala. Qaphela ukuba ezinye iingxaki kunye nezifo ezibanga ukopha, ifuna kweliso kwagqirha, emithi ngokuyimfuneko ungeniswe esibhedlele.

Unyango lwe yokopha yokubelekisa

nokopha kakhulu loo zivuse iintlobo ukuphazamiseka ezahlukeneyo kunye nezigulo. Xa unyango lwe legazi yokubelekisa ekuqaleni kufuneka ukuba uyeke ukopha kunye nokuvala isoyikiso kwabasetyhini kunye nabantwana. Pregnant ukubonisa ukuba luphumlo olupheleleyo, ukuthintelwa umsebenzi ngokwasemzimbeni, kunye nokuhlala esibhedlele. Le entsokothileyo unyango ezikhethiweyo ingakumbi ngamnye kwaye kuxhomekeke ukopha yaqala oko kota. Uthintelo, unyango kunye algorithm of legazi yokubelekisa saphuhliswa yi-Ofisi yoMphathiswa wezeMpilo kwaye kufuneka ihlonitshwe ngoogqirha xa isigulane ifika esibhedlele.

Ukuba kukho ukopha prescribers ukukhulelwa kwangethuba, ukwandisa viscosity igazi, nadlamkisayo kwaye uqinise arhente. Kwimeko imeko kakhulu mfazi kunye olungekazalwa ubonisa labagula kakhulu. Phambi ukopha senyanga yesithathu ibonisa ukusebenza lonikezelo. Ukuba ufumana Kukudandatheka legazi yokubelekisa, a protocol unyango inokuba nomahluko - ukusuka ukusetyenziswa kweziyobisi ukususa isibeleko. konke kuxhomekeke kubunzima ingxaki, ngokuba le nto ibalulekileyo - ukusindisa ubomi mfazi.

prophylaxis

Uthintelo ukopha yokubelekisa ilinganiselwe ekuthobeleni imigaqo ethile ebalulekileyo. Okokuqala, kufuneka ukuba isicwangciso i ukukhulelwa ngendlela ngexesha ukubhalisa ukutyelela ugqirha rhoqo. Kufuneka kwakhona kufumaneka ngexesha ukunyanga izifo zangasese. Ukuba kukho imfuneko, kufuneka ukhethe i entsokothileyo ukuyifundisa. Kwinkqubo lokuzala ukuba baziphathe kakuhle, kuthathelwa ingqalelo zonke izindululo ugqirha, kwakunye ukuvavanya ukwalatha kunye Izimo.

Ukuthintela okuvela ukopha kwixesha Kukudandatheka, kufuneka ulandele le mithetho:

• ibele ngokufunwa;
• iliso isinye;
• elele esiswini sakhe;
• isicelo ebandayo ukuya osesiswini.

Onke la manyathelo othintelo kuya kukunceda ukuba uphephe kukuvela ukopha kunye nokuphucula impilo-ntle yabafazi.

Iingxaki kunye ezilwenza ukopha

Ingaba iingxaki anobungozi kunye neziphumo ukopha. To ezo ziquka:

• hypoxia Fetal;
• ukufa Palsy;
• yokopha odongeni embindini isibeleko;
• sophele kukothuka;
• ukufa unina wakhe.

Ukongeza, ezinobuzaza ziquka ukuphazamiseka okunzima coagulation igazi ukwenza nobuninzi thrombi kunye okuvela ukopha. Kusenokwenzeka ukuba ukungabikho igazi, ukuphazamiseka kwenkqubo yonyango kunye nokungabikho kwemveliso hormone.