Ukukhulelwa kuyisigaba sethemba nenjabulo, kepha futhi nokwesaba nokungaqiniseki esimweni okuthi, ngokwemvelo, kukhulu ngokweqile. Ukubeletha kuvame ukufiswa njengoba kwesatshwa. Enye yezinto ekhathaza kakhulu omama besikhathi esizayo, ngaphandle kobuhlungu, ngukuthi uma ingane izofakwa kahle esinqeni futhi uma ukuma kwakho kuzokwanela ukuphuma kalula lapho ubeletha isitho sangasese sowesifazane.
Ngokuvamile, ingane ibekwa "endaweni yokuphuma", cishe kusukela ngenyanga yesishiyagalombili yokukhulelwa, kodwa lokhu kungenzeka ngemuva kwesikhathi noma ngaphambi nje kokubeletha uma owesifazane esevele enezingane. Lokhu kwaziwa ngokuthi yisidleke. Ingane iyehla futhi izibeka esifubeni sikanina, imvamisa ikhanda libheke phansi, kepha kwesinye isikhathi lingamukela okunye ukuma.
Ukuma kwengane esibelethweni kungaziwa ngokuskena kwe-ultrasound. Ababelethisi abanolwazi nabo bangakwazi ukuma kwengane ngokuzwa isisu sikanina. Kodwa-ke, kuze kube Ngesikhathi esifanayo sokubeletha, akunakwenzeka ukwazi ngokuqiniseka isikhundla ingane ezosamukela ukuphuma kusukela, yize emasontweni edlule isikhala sinciphile, i-amniotic fluid ivumela ukuhamba okuthile. Futhi, kwesinye isikhathi ukuphambana okufanayo kubangela ukuthi abantwana abeza endaweni eyodwa bashintshe ngomzuzu wokugcina.
Ukwazi isethulo lapho ingane ikwi-trimester yokugcina kubaluleke kakhulu ngoba kunquma kakhulu ukuthuthukiswa komsebenzi. Ngo-1996, umbelethisi waseNew Zealand uJean Sutton washicilela incwadi yakhe, kanye nothisha osanda kuzalwa uPauline Scott "Ukuqonda nokufundisa ukubekwa kahle kombungu" (ukuqonda nokufundisa isikhundla se-fetus esifanele). Kuyo, bathuthukisa umbono wokuthi ukunyakaza nokushintsha kwesimo sikamama emasontweni adlule okukhulelwa kungaba nomthelela esimweni ingane esikuthathayo lapho izalwa. Lokhu kubaluleke kakhulu ngoba, ngokusho kwale mbono, ubunzima obuningi ngesikhathi sokubeletha kungenxa yokuthi ukwethulwa kwengane akuyona into efanelekile ukuze ikhule kahle. Kepha siyini isikhundla esifanelekile sombungu futhi yini esingayenza ukuze sikufinyelele?
Kunezinhlobo ezintathu zezethulo zengane esibelethweni: cephalic (ngekhanda phansi), ukuphefumula (breech) kanye iyanqamula (Ikhanda lengane lisohlangothini olulodwa lwesibeletho sikamama futhi ingemuva layo lingakolunye uhlangothi, kwakheka i-engeli engu-90º ne-eksisi yesibeletho).
Isethulo seCephalic
Iningi lezingane zisesimweni se-cephalic ngesikhathi sokubeletha, okungukuthi, nge ikhanda phansi nezinqe phezulu. Ngaphakathi kwalesi sethulo kunezinhlobo ezimbili: i-anterior cephalic ne-posterior cephalic.
Isethulo sangaphambili se-cephalic
Ingane ibheke phansi ngomhlane isondele esiswini sikanina. Lokhu kuzoba yi-pisikhundla ekahle sokuzalwa. Ikhanda lengane liyashintshashintsha, nesilevu lihlala esifubeni nomqhele (indawo emincane ekhanda) kube ngeyokuqala ukuwela umsele wokuzalwa.
Isethulo se-cephalic esingemuva
Kulokhu kwethulwa, nengane nayo ibhekise ikhanda phansi kepha umqolo usondele kunina nobuso bayo bubheke esiswini. Ngale ndlela, ikhanda lengane aliguquki, futhi nesilevu salo asitshekile, ngakho-ke ukuma kwakho kuguquguquka kancane ekuzivumelaniseni nomsele wokuzalwa okuholela ekusebenzeni isikhathi eside futhi okubuhlungu kakhulu. Lesi sikhundla asisho ukuthi kufanele kwenziwe ingxenye yokuhlinzwa, ukulethwa kungaba ngesitho sangasese sowesifazane kepha kungenzeka kuthathe isikhathi eside ngoba ukwehla kwengane kunzima kakhulu.
Isethulo se-breech noma se-breech
Kulesi sikhundla ikhanda lengane liphakeme nezinqe ziphansi. Leyo isifuba sengane sithintana nesitho sikamama. Imvamisa ingane ibekwa endaweni ye-cephalic phakathi kwamasonto angama-28 kanye no-32, kepha amanye aginqika kaningi ngaphambi kokubeletha, ikakhulukazi uma kune-amniotic fluid ngokweqile. Abanye, cishe u-3%, abaze bajike futhi bahlale endaweni enesiphepho noma yomoya.
Iqiniso lokuthi ingane isesimweni esibucayi emavikini adlule okukhulelwa livame ukudala ukukhathazeka komama besikhathi esizayo selokhu i-breech baby ivame ukuhlotshaniswa nokulethwa kwe-cearean. Kepha ingabe isigaba sokuhlinzwa sibonisiwe ngempela kulezi zimo? Ngabe ukulethwa kwesitho sangasese sowesifazane kungazama?
Ngo-2000, imiphumela yocwaningo olukhulu yabizwa "Isivivinyo seThemu Breech". Ngokwalolu cwaningo, ezethulweni ze-breech, isigaba se-cearean kufanele sibe yindlela yokuzikhethela ngaphezu kokulethwa kwesitho sangasese sowesifazane ngoba bekubonakala kunciphisa izifo ezisanda kuzalwa. Le miphumela yamukelwa masinyane ngumphakathi wezokwelapha wamazwe omhlaba okhethe ukuhlela izigaba zokuhlinzwa esikhundleni sokuzama ukulethwa kwesitho sangasese sowesifazane lapho izingane zesikhathi esigcwele zilethwa endaweni ebusayo.
Yize izincomo zeThemu Breech Trial zamukelwa yizinhlangano eziningi ezibalulekile zamazwe omhlaba emkhakheni wezempilo, kufaka phakathi i-SEGO (iSpanish Society of Gynecology and Obstetrics), bekukhona, njengeDirectorate of Health Assistance of the Ministry of Impilo kaHulumeni waseBasque, othathe isinqumo ukungalandeli lezi zincomo ngokususelwa ekutheni isimo sabo sezempilo, izivumelwano kanye namakhono obuchwepheshe ayehlukile kulawo amazwe abebambe iqhaza ocwaningweni. Ngalesi sizathu, ukuhanjiswa okuphumelelayo kwesitho sangasese sowesifazane kuyaqhubeka ukwenziwa ezindaweni lapho kunabasebenzi bezempilo abanolwazi.
Ngemuva kokuthi lolu cwaningo lushicilelwe, izindatshana eziningi ezingabaze ukusebenza kwaso ngoba kukho konke ukulethwa okuhlaziyiweyo izincomo zosizo ekulethweni okushisiwe bezingalandelwa. Ngokuya ngalezi zincomo, ukungenelela bekumele kube kuncane futhi konke ukulethwa kwenzeke ezindaweni ezinelashwa kakhulu. Ngo-2006 kwenziwa olunye ucwaningo, lwalulukhulu kane kuneThemu Breech Trial. Kulolu cwaningo, olubizwa I-PREMODA, kubonakale ukuthi bekungekho mehluko ophawulekayo ekuguleni kwe-neonatal kanye nasekubeletheni kokubeletha phakathi kokulethwa kwe-breech yesitho sangasese sowesifazane kanye nezingxenye ze-caesarean. Okwamanje, i-SEGO, ayisasincomi isigaba se-caesarean njengenketho yokuqala lapho ingane ipholile Esikhundleni salokho, kushiya umnyango uvulekele ekulethweni kwesitho sangasese sowesifazane uma nje kuhlangatshezwana nemibandela ethile: ukukhula okufanelekile kwesisu kanye nesisindo esingaphansi kwamakhilo ama-4, ukuthi ingane ayibuki phezulu nokuthi ibekwe nezinqe noma izinyawo ezifakwe emseleni Lokuzalwa.
Isethulo Esinqamulelayo
Kulesi sikhundla, i-eksisi ende yombungu lakha i-engeli engu-90º ne-eksisi yesibeletho, okungukuthi, ikhanda laso lisohlangothini olulodwa lwesisu sikamama nezinqe ngakolunye uhlangothi.
Kulokhu, ngokungafani nokwethulwa kwe-breech, kuyingozi ukuzama ukulethwa kwesitho sangasese sowesifazane njengoba kunengozi enkulu yokulimala nokufa kwengane nomama.
Yini ongayenza ukuze ubeke ingane yakho endaweni efanelekile?
Njengoba sesibonile, inhloso yokubeletha ukuthi umntwana abekwe endaweni yangaphakathi ye-cephalic. Kodwa-ke, uma ingane yakho ivela kwezinye izikhundla, ungakhungatheki ngoba emasontweni edlule noma ngesikhathi sokubeletha kungenzeka ukuthi ijike. Abanye Amaqhinga namasu kungasiza ingane yakho ukuthi ihlale noma ingene endaweni ye-cephalic.
Naka kakhulu ukuma kwakho
Isimo lapho isisu sakho siphansi kunomhlane wakho sithanda ukuthi ingane ibekwe ku-cephalad yangaphakathi kusukela, ngenxa yomphumela wamandla adonsela phansi, umqolo wengane uzojwayela ukubekwa engxenyeni engezansi yesisu sakho. Zama ukubuyisela emuva okhalweni lwakho lapho uhleli, uqinisekise ukuthi amadolo akho aphansi kunezinqe zakho futhi uvikele izikhundla lapho ulele khona emuva ngoba umhlane wakho uphansi kunesisu sakho esithanda ukuthi ingane yakho ibekwe kwi-cephalic yangemuva.
Zijwayeze izivivinyo ezithuthukisa isikhundla esifanelekile sombungu
Ukubhukuda kungukuzivocavoca okuhle kwengane yakho ukuze ingene esimweni se-cephalic. Okuhle kakhulu yilokho ukubhukuda ubheke phansi futhi ugweme ukubhukuda emhlane wakho ukuze ubeke ukuma okulungile kwengane.
Zijwayeze i-yoga imizuzu eyi-10-15 ngosuku, ikakhulukazi ukuma kwekati nalokho kwama-Mohammedan. Iposi lekati lenziwa kuzona zozine izandla ziqondaniswe namahlombe namadolo ahlukaniswe okhalweni. Umhlane ugoqelwe phezulu ngesilevu phansi, bese unwebeka kancane uze uqonde njengoba ikhanda liphakanyisiwe. Ukuma kukaMohammedan kwenziwa ngokuma kuzo zonke izinyawo ezine, kubuyiswe isiqu emuva bese kucindezelwa isifuba phansi izingalo zeluliwe ziye phambili.
Sebenzisa eyodwa Ibhola le-pilates lokuzivocavoca ukuzamazama ikakhulukazi lapho uncika phambili.
Sebenzisa ngokunenzuzo ngenkathi ubukele i-TV ukuze ahlale esihlalweni ebheke emuva futhi uncike kuye astride. Ungaguqa futhi phansi uncike esihlalweni noma kumakhushini.
Uhlobo lwangaphandle lwe-cephalic
Uhlobo lwangaphandle lwe-cephalic yi- iqoqo lezinto ezenziwa esiswini sikamama, ukuthola umoya opholile noma oguqukayo wezingane ungene endaweni ye-cephalic. Ngaphambi kokukwenza, kwenziwa i-ultrasound ukuthola ukuthi ingane ithini, ukushaya kwenhliziyo kwengane kuyabhekwa futhi kusetshenziswa umuthi wokuphumuza imisipha yesibeletho nokwenza inqubo ibe lula. Ngemuva kwalokho udokotela wezifo zabesifazane uzoqhubeka cindezela amaphuzu ahlukene bese wenza ukubhucungwa okuhle ukuzama ukubeka i-cephalad yengane.
Uhlobo lwangaphandle lwe-cephalic yi- inqubo ephephe impela futhi enezinga eliphezulu lokuphumelela, kepha kunenkinga yokuthi kungabangela ukubeletha, ngakho-ke kufanele kwenziwe kuphela endaweni yezokwelapha nangabantwana abanesikhathi esigcwele.
Moxibustion
Le ndlela inconywa yi-WHO ngokwethulwa kwengane komoya futhi ingenziwa kusukela ngesonto lama-32 kuye phambili. Kuyindlela yemithi yendabuko yamaShayina equkethe khuthaza amaphuzu ahlukene omzimba ngokushisa komlilo we-mugwort (Moxa), imbiza ebonakala ivusa ukujikeleza kwegazi okhalweni nasesibelethweni, kanye nokukhuthaza i-adrenocortical okugcina kukhuthaza umsebenzi wombungu. Endabeni yokwethulwa komoya kwengane, khomba a ukuvuselela indawo engaphandle yesipikili kuzwane oluncane. Izinga lempumelelo liphakeme impela njengoba kukhonjisiwe ezifundweni ezahlukahlukene, futhi ngokungafani nohlobo lwangaphandle lwe-cephalic, alunankinga yokukwazi ukufaka abasebenzi.
Njengoba ukwazi ukubona, kuze kube umzuzu wokugcina lapho kungenzeka khona ukuthi ingane yakho iphenduke futhi unezinsizakusebenza ezahlukene ezandleni zakho ukuze uzisize. Ngokomthetho asikho isidingo sokuhlela isigaba se-cearean. Ngaphezu kwalokho, lokhu kubuye kuveze nezingozi njengoba kungukuhlinzwa, ngakho-ke isilinganiso senzuzo yenzuzo kumele sihlolwe. Kunoma ikuphi, uma kubalulekile ukukwenza, kufanele wazi ukuthi akudingekile ukuyihlela ngoba ingenziwa uma ukulethwa sekuqalile. Ngale ndlela ingane yakho ihlomula ngomsebenzi owedlule ozomsiza ukuthi ajwayele imvelo engaphandle. Uma ingane yakho ishaywa umoya noma inqamula, okokuqala hlala uzolile njengoba konke kungalahleki. Ngaphezu kwakho konke, noma ngabe sikuphi isikhundla sakho, zama ukujabulela izikhathi ezihlukile nezingaphindeki lapho ukukhulelwa kukunikeza khona.