Ukukhulelwa linqanaba lethemba kunye novuyo, kodwa kunye noloyiko kunye nokungaqiniseki kwimeko ethi, ngokwendalo, ibe yinto engaqhelekanga. Ukuzalwa komntwana kuhlala kunqweneleka njengoko kusoyikwa. Enye yezinto ezixhalabisa oomama bangomso, ngaphandle kwentlungu, yile ukuba umntwana uya kuhlala kakuhle esinqeni kwaye ukuba ukuma kwakho kuya kwanela ukuba kuphume ngokulula kunikezelo lobufazi.
Ngokubanzi, umntwana ubekwa kwindawo "yokuphuma", ngaphezulu okanye ngaphantsi kwinyanga yesibhozo yokumitha, kodwa oku kunokwenzeka emva kwexesha okanye nangaphambi nje kokubeleka ukuba umfazi sele enabantwana. Oku kwaziwa njengendlwane. Usana luyehla kwaye luzibeka kwisinqe sikanina, Ngokwesiqhelo intloko ibheke ezantsi, kodwa ngamanye amaxesha inokwamkela ezinye iindlela zokuma.
Indawo yokuma komntwana esibelekweni inokwaziwa ngokuskena kwi-ultrasound. Abazalisikazi abanamava banokwazi indawo yokuma komntwana ngokuziva esiswini sikanina. Nangona kunjalo, de Okwangoku ngexesha lokubeleka, akunakwenzeka ukuba sazi ngokuqinisekileyo isikhundla esiza kwamkelwa lusana ukuphuma ukusukela, nangona kwiiveki ezidlulileyo indawo incitshisiwe, i-amniotic fluid ivumela ukuhamba okuthile. Ukongeza, ngamanye amaxesha ukuxhathisa okufanayo kubangela ukuba abantwana abeza kwindawo enye batshintshe ngomzuzu wokugqibela.
Ukwazi umboniso apho umntwana akhoyo kwitrimester yokugqibela kubaluleke kakhulu kuba ikakhulu kumisela ukukhula kwezabasebenzi. Ngo-1996, umbelekisi waseNew Zealand uJean Sutton wapapasha incwadi yakhe, kunye notitshala ongaphambi kokubeleka uPauline Scott «Ukuqonda kunye nokufundisa ubume obulunge ngakumbi bomntwana» (ukuqonda nokufundisa ngesimo esifanelekileyo somntwana). Kuyo, baphuhlisa ithiyori yokuba intshukumo kunye notshintsho lwasemva komama kwiiveki zokugqibela zokukhulelwa zinokuba nefuthe kwindlela omiswe ngayo umntwana xa ezalwa. Oku kubaluleke kakhulu kuba, ngokwale ithiyori, uninzi lweengxaki ngexesha lokuhanjiswa zibangelwa yinto yokuba intetho yomntwana ayifanelekanga ukuba ikhule ngokwesiqhelo. Kodwa yintoni esona sikhundla siphezulu somntwana kwaye singenza ntoni ukusiphumeza?
Zintathu iintlobo zentetho zomntwana esibelekweni: icephalic (ngentloko ezantsi), breech (breech) kunye ezinqamlezayo (Intloko yosana ikwelinye icala lesibeleko sikanina kwaye umva wayo ukwelinye icala, yenza i-90º engile kunye ne-axis yesibeleko).
Inkcazo yeCephalic
Uninzi lweentsana zikwindawo ye-cephalic ngexesha lokuhanjiswa, oko kukuthi, nge intloko phantsi kunye neempundu phezulu. Ngaphakathi kule ntetho zimbini iintlobo: i-cephalic yangaphakathi kunye ne-cephalic yangemva.
Umboniso wangaphambili we-cephalic
Umntwana ujonge phantsi ngomqolo kufutshane nesisu sikanina. Le iya kuba yi-pIndawo efanelekileyo yokuzalwa. Intloko yomntwana iyaguquguquka, isilevu siphumla esifubeni kunye nesithsaba (indawo emxinwa entloko) ingowokuqala ukuwela umjelo wokuzalwa.
Inkcazo ye-cephalic yangemva
Kule ntetho, nosana luye lwajongiswa phantsi kodwa umqolo usondele kunina kwaye ubuso bakhe bujonge esiswini. Ngale ndlela, intloko yosana ayiguquki, kwaye i-chin yayo ayithambanga, kunjalo ukuma kwakho akubhetyebhetye xa uziqhelanisa nomsele wokuzalwa kukhokelela ekusebenzeni ixesha elide kunye nobuhlungu. Esi sikhundla asithethi ukuba kufuneka kwenziwe icandelo le-cearean, ukuhanjiswa kunokuba sisini kodwa kunokwenzeka ukuba kuthathe ixesha elide kuba inzala yomntwana inzima ngakumbi.
Breech okanye breech intetho
Kulentloko intloko yomntwana iphezulu kwaye iimpundu ziphantsi. Yiyo i isinqe somntwana sidibana nesinqe sikanina. Ngokwesiqhelo umntwana ubekwa kwindawo ye-cephalic phakathi kweeveki ezingama-28 ukuya kwezingama-32, kodwa abanye bajika amatyeli aliqela ngaphambi kokubeleka, ngakumbi ukuba kukho ulwelo oluninzi lwe-amniotic. Ezinye, malunga neepesenti ezi-3, azikaze zijike kwaye zihlale zikwimo yomoya okanye yempepho.
Inyani yokuba umntwana ukwimeko yokuphumla kwiiveki zokugqibela zokukhulelwa ihlala ivelisa uxinzelelo koomama abaza kubakho ukusukela oko umntwana ophethe i-breech uhlala enxulunyaniswa nokuhanjiswa kwe-cearean. Kodwa, ngaba icandelo lokuyeka liye laboniswa kwezi meko? Ngaba ukuhanjiswa kwelungu lobufazi kunokuzama?
Ngo-2000, iziphumo zophando olukhulu zabizwa "Uvavanyo lweXesha leBreech". Ngokwolu phononongo, kwimiboniso yomoya, Icandelo le-cesarean kufuneka libe yindlela yokuzikhethela kunikezelo lobufazi kuba kubonakala ngathi kunciphisa ukubeleka kwe-neonatal. Ezi ziphumo zamkelwe ngokukhawuleza luluntu lwamazwe aphesheya kwezonyango olukhethe ukucwangcisa amacandelo okuyeka kunokuzama ukubeleka kwilungu lobufazi xa abantwana bexesha elipheleleyo beziswa kwindawo yokubhabha.
Nangona isincomo seThemu Breech Trial samkelwa yimibutho ebalulekileyo yamanye amazwe kwicandelo lezempilo, phakathi kwabo i-SEGO (iSpanish Society of Gynecology and Obstetrics), bekukho ezinye, ezinje ngeCandelo loNcedo lwezeMpilo loMphathiswa. wezeMpilo kuRhulumente waseBasque, othathe isigqibo ukungalandeli ezi ngcebiso ngokusekwe kwinyani yokuba imeko yezempilo, iiprotocol kunye nezakhono zobungcali zahlukile kwezo zamazwe athe athatha inxaxheba kolu phando. Ngesi sizathu, ukuhanjiswa ngempumelelo kwelungu lobufazi kuyaqhubeka ukwenziwa kuseto apho kukho abasebenzi bezempilo abanamava.
Emva kokuba olu phando lupapashiwe, amanqaku amaninzi abuza ukusebenziseka kwawo okoko kuko konke ukuhanjiswa kohlalutyo izindululo zoncedo lokuhanjiswa kweebreech khange zilandelwe. Ngokwale ngcebiso, ungenelelo kuye kwafuneka lube lincinci kwaye konke ukuhanjiswa kwenzeke kwizicwangciso zonyango. Ngo-2006 kwaqhutywa olunye uphando, lwaphindaphindwe kane kuneSigwebo seXesha leBreech. Kolu phando, lubiziweyo IPREMODA, kwabonwa ukuba kwakungekho mahluko ubalulekileyo kwintsholongwane yokuzalwa kwangaphambi kokuzalwa komntwana kunye nokuhanjiswa kwecandelo lesisu. Okwangoku, I-SEGO ayisaphakamisi icandelo le-cesarean njengokhetho lokuqala xa usana lupholile Endaweni yoko, lishiya ucango luvulelekile kunikezelo lobufazi ukuba iimeko ezithile ziyafezekiswa: ukukhula okufanelekileyo komntwana kunye nobunzima obungaphantsi kweekhilo ezi-4, ukuba umntwana angajongi phezulu kwaye ubekwe ezinqeni okanye iinyawo ezifakwe emjelweni Yokuzalwa.
Ukunikezelwa okunqamlezileyo
Kule ndawo, i-axis ende yomntwana yenza i-angle ye-90º kunye ne-axis yesibeleko, oko kukuthi, intloko yayo ikwelinye icala lesisu sikamama kunye neempundu kwelinye icala.
Kule meko, ngokuchaseneyo nenkcazo-ntetho eyingozi, kuyingozi ukuzama ukuhanjiswa kwelungu lobufazi kuba kukho umngcipheko omkhulu wokonzakala kwanokufa kokubini kosana nakunina.
Yintoni ongayenza ukuze usana lwakho lube kwindawo efanelekileyo?
Njengoko sele sibonile, eyona nto ifanelekileyo yokuhanjiswa kukuba umntwana abekwe kwindawo yangaphakathi ye-cephalic. Nangona kunjalo, ukuba umntwana wakho uboniswe kwezinye iindawo, ungoyiki kuba kwiiveki zokugqibela okanye ngexesha lokuhanjiswa kunokwenzeka ukuba ajike. Abanye Amaqhinga kunye nobuchule bunokunceda umntwana wakho ukuba ahlale okanye angene kwindawo ye-cephalad.
Nika ingqalelo ekhethekileyo kwindlela omi ngayo
Imeko apho isisu sakho sisezantsi kunokubuyela umva ukuba umntwana abekwe kwi-cephalad yangaphakathi ukusukela, ngenxa yesiphumo somxhuzulane, umqolo womntwana uya kuhlala ubekwe emazantsi esisu sakho. Zama ukubuyisela umva wakho xa uhleli, uqinisekise ukuba amadolo akho asezantsi kunesinqe sakho kwaye uphephe ukuma kwakho apho uncike khona njengoko umqolo wakho uphantsi kunesisu sakho, uthande umntwana wakho ukuba azibeke kwi-cephalic yangemva.
Ziqhelise umthambo okhuthaza isikhundla esifanelekileyo somntwana
Ukubhukuda ngumsebenzi ofanelekileyo wokuba umntwana wakho angene kwindawo ye-cephalic. Eyona nto ilungileyo yile qubha ujonge ezantsi kwaye kuthintele ukuqubha emqolo ukuthanda indawo efanelekileyo yomntwana.
Ziqhelanise neyoga kangangemizuzu eli-10-15 ngemini, ngakumbi indawo yekati kunye ne-Mohammedan. Ukuma kwekati kwenziwa kuzo zone iinyawo izandla zihambelana namagxa kunye namadolo ahlukaniswe esinqeni. Umqolo uphakanyisiwe phezulu kunye nesilevu phantsi, kwaye emva koko wolule kancinci ide ithi nkqo njengoko intloko inyuka. Ukuma kukaMohammedan kuqhutywa ngokuma kuwo omane amanqwanqwa, ukubuyisa umboko kwaye ucofe isifuba emhlabeni kunye neengalo ezandisiweyo.
Sebenzisa enye Iibhola zepilates zokuzilolonga ngakumbi ezo uthembele kuzo.
Thatha ithuba ngelixa ubukele umabonwakude ukuya hlala esitulweni ujonge ngasemva kwaye engqiyame ngaye. Unako nokuguqa phantsi ungqiyame ngesitulo okanye kwimiqamelo.
Inguqulelo yangaphandle ye-cephalic
Inguqulelo yangaphandle ye-cephalic yi iseti yeendlela, ezenziwa esiswini sikanina, ukufumana i-breech okanye ukuhambisa abantwana kwi-cephalic position. Phambi kokuba uyiphumeze, kwenziwa i-ultrasound ukumisela indawo ekuyo kanye yomntwana, ukubekwa esweni kwentliziyo yomntwana okhulelweyo kubekwe esweni kwaye kunyangwa amayeza ukukhulula izihlunu zesibeleko kunye nokwenza inkqubo ibelula. Ugqirha ke uya kuthi gqolo ukuya Cinezela kumanqaku ahlukeneyo kwaye wenze umyalezo omnene ukuzama ukubeka umntwana we-cephalic.
Inguqulelo yangaphandle ye-cephalic yi ubuchule obukhuselekileyo kunye nenqanaba eliphezulu lempumelelo, kodwa inengxaki yokuba inokubangela ukuba abasebenzi basebenze, ke kufanelekile ukuba kwenziwe kwimeko yezonyango kunye neentsana ezizeleyo.
Ukufuduka
Obu buchule bucetyiswa yiWHO ngenkqubo yokubonisa usana kwaye inokwenziwa kwiveki yama-32 ukuya phambili.Yindlela yamayeza esiTshayina aqulathe khuthaza amanqaku ahlukeneyo omzimba ngobushushu bokutsha kwemagwort (Moxa), imifuno ebonakala ngathi ivuselela i-pelvic kunye ne-uterine ukujikeleza kwegazi, kunye nokukhuthaza i-adrenocortical okuphelisa ukuvuselela umsebenzi womntwana. Kwimeko yokubonakaliswa komoya wosana, yalatha a vuselela indawo engaphandle yesikhonkwane senzwane encinci. Inqanaba lokuphumelela liphezulu kakhulu njengoko kubonisiwe kwizifundo ezahlukeneyo, kwaye ngokungafaniyo nenguqulelo yangaphandle ye-cephalic, ayinangxaki yokuba nako ukunyanzelisa abasebenzi.
Njengoko ubona, kude kube ngumzuzu wokugqibela kunokwenzeka ukuba umntwana wakho ajike kwaye unezinto ezahlukeneyo kwizandla zakho zokumnceda. Kumthetho akukho sidingo sokucwangcisa icandelo le-cearean. Ukongeza, oku kukwabonisa umngcipheko njengoko inguqhaqho, ke umyinge womngcipheko wenzuzo kufuneka uvavanywe. Ngayiphi na imeko, ukuba kubalulekile ukuyenza, kuya kufuneka uyazi ukuba akuyomfuneko ukuyicwangcisa kuba inokwenziwa nje ukuba unikezelo luqalise. Ngale ndlela umntwana wakho uyaxhamla kwimisebenzi yangaphambili eya kumnceda ukuba aqhelane nemeko engaphandle. Ukuba umntwana wakho upholile okanye unqamleza, okokuqala hlala uzolile njengoko konke kungalahlekanga. Ngaphezu kwako konke, nokuba sithini na isikhundla sakho, zama ukonwabela amaxesha awodwa angenakuphindwa awakunika ukukhulelwa.