Ukuqhekeka ngesandla kwamanzi, okanye ukuqhekeka kweembumba zomntwana (i-AROM), kuyinto eqhelekileyo, inkqubo yesiqhelo xa kubelekiswa. Ezona njongo ziphambili kukuukukhuthaza ukuqala komsebenziokanye ukwandaizishunqulelokunye nokukhawulezisa ukusebenza ngokukhawuleza. I-AROM inezibonelelo ezimbalwa kodwa inobungozi. Fumana iinyani malunga nokwaphula amanzi ukukhuthaza abasebenzi.
I-toast yomtshato kumyeni nomyeni
Ukuqhawuka okungafunekiyo kweMembranes
Ikwabizwa ngokuba yi-amniotomy okanye ukwaphuka ibhegi yamanzi, iinyani malunga nokuqhekeka kweembumba kubandakanya:
- Yinkqubo ekhawulezayo nelula kwizandla ezinamava.
- Unonina omncinci kunina, ngenxa yoko akukho tyhefu isetyenziswayo.
- Ihlala yenziwa xa umlomo wesibeleko ucociwe kwaye uye waqhubela phambili ubuncinci kwiisentimitha ezintathu.
- Kwiindawo ezininzi kwihlabathi liphela, kwenziwa ngesiqhelo kubo bonke abantu basetyhini ngaxa lithile ngexesha lomsebenzi osebenzayo okanye ukuba ukubeleka kuyacotha.
- Izinto zokwenza xa unenyanga ezili-9 ukhulelwe
- Ukudala isicwangciso sokuzalwa ekhaya (kunye netemplate)
- Kuthatha ixesha elingakanani emva kokuqhekeka kwamanzi ngaphambi kokuba kuzalwe usana?
Izizathu zeNkqubo yoLwaphulo lwaManzi
Izizathu zokwenza utyando olwenziwe ngenwebu lubandakanya oku kulandelayo:
- Ukwenza ukuba kuqale ukusebenza: Oogqirha nabazalisikazi bahlala bephula ingxowa yamanzi njengenye yeendlela ezisetyenziswayo ukuqhelaniswa nomsebenzi . Kucingelwa ukuba i-AROM ikhupha ii-prostaglandins kunye nezinye iikhemikhali kwiimbumba zomntwana, ezibangela ukuqala komsebenzi.
- Ukongezwa kwabasebenzi: I-AROM ihlala isenziwa xa umsebenzi okhawulezileyo ungaqhubeki ngokukhawuleza njengoko kulindelwe. Ukukhutshwa kweekhemikhali zeembumba zomntwana kunokuqinisa ukuxhoma kunye nokukhawulezisa abasebenzi.
- Ukuncamathisela i-electrode yokhokho oluseluswini: I-electrode iqhotyoshelwe entlokweni yomntwana ukubeka esweni kwangaphakathi yenqanaba lentliziyo lomntwana olungekazalwa. Oku kwenziwa xa ukujonga ngokusondeleyo umntwana kufuneka, okanye ulwazi lwangaphandle lwesisu se-electrode aluthembekanga.
- Ukubekwa koxinzelelo lwe-catheter yangaphakathi: Ngamanye amaxesha oku kuye kufuneke ukuze kulinganiswe ngokukuko uxinzelelo kwisisu se-uterine ngexesha lokuchasana. An ipayipi yoxinzelelo lwangaphakathi (IUPC) idla ngokubekwa xa iidosi eziphezulu zePitocinzisetyenziselwa ukukhuthaza ukuphambana.
Ngexesha elithile ngexesha lokubeleka ukuba i-amniotic sac isasebenza, kufuneka yaphulwe ukuze kuqhubekeke kwinqanaba lesibini (lokutyhala) labasebenzi ukukhupha umntwana kwilungu lobufazi.
Ukwenza iAmniotomy
Ukunciphisa umngcipheko wokuqhekeka kwentambo ngexesha lenkqubo, intloko yesisu kufuneka ibandakanyeke kwi-pelvis kwaye ifakwe kwisibeleko. I-amniotomy yenziwa phantsi kweemeko ezingenazintsholongwane ukunciphisa ithuba lokungenisa usulelo esibelekweni.
Izixhobo zeAmniotomy
Ukophula ingxowa yamanzi, oogqirha abaninzi basebenzisa i-amniohook engenazintsholongwane - isixhobo esikhethekileyo esifana nekhonkco elide le-crotchet. Ezinye izixhobo zibandakanya:
- I-amnioglove-ihhuku elincinci ekupheleni komnwe weglavu engenazintsholongwane
- I-amniocot - 'isikhuseli' somnwe omnye esisilayida ngaphezulu komnwe weglavu engenazintsholongwane.
- Umnwe-Ngamanye amaxesha kulula nje ukubamba umnwe kwisangxobo se-amniotic ukuba amanzi ayagqabhuka ngokuvulwa komlomo wesibeleko.
Inkqubo yoGqirha waKho waManzi
Ngexesha lenkqubo, umfazi okhulelweyo ulele ngomqolo ebhedini yakhe yokubeleka enamadolo agobileyo kunye nemilenze enemilenze yesele emacaleni. Xa usebenzisa i-amniohook, ugqirha uthatha la manyathelo alandelayo emva kokulungiselela isigulana:
- Ngeeglavu ezingenazintsholongwane, ufaka iminwe emibini kwilungu lobufazi efana novavanyo oluqhelekileyo lobufazi.
- Nje ukuba ugqirha awufumane umlomo wesibeleko, ubeka iingcebiso zomnwe wakhe emnyango ukuze achukumise ingxowa yamanzi.
- Ugqithisa i-amniohook kwilungu lobufazi, eyikhokele ecaleni kweminwe yakhe kwingxowa yamanzi ye-amniotic.
- Ngesinye isandla sakhe, ugqirha ulawula umlobothi wakhe ukuze abambe umngxuma engxoweni yamanzi, ejonge ukuba angalimazi umntwana.
- Ugqirha ujonga ujonge umlomo wesibeleko ukuqinisekisa ukuba umbilical cord awudluli kuwo.
- Abasebenzi bezonyango babek 'esweni ukubetha kwentliziyo yosana olungekazalwa kwimizuzu engama-20 ukuya kwengama-30 elandelayo.
Njengomphumo we-amniotomy, i-amniotic fluid (amanzi) iyaphalala, kwaye intloko yosana inokuhla iye phambili. Inkqubo ilula ukuba ibhegi yamanzi igqobhozaumlomo wesibeleko.
Izibonelelo zeAmniotomy
Izibonelelo zokwaphula amanzi zibandakanya:
- Ivumela ukubek'esweni ngokusondeleyo kosana kunye nokucutha amandla ngokubeka i-elektrode yomntwana oseluswini okanye i-catheter yoxinzelelo lwangaphakathi, ukuba iyafuneka.
- Ugqirha uyakwazi ukubona ukuba i-amniotic fluid ine-meconium (isitulo sokuqala somntwana) kuyo kwaye ithathe inyathelo. Ukudlula kwe-meconium kunokuba luphawu loxinzelelo lomntwana. Ukuba umntwana uphefumla i-meconium, umbeka emngciphekweni wokufa kwi-utero okanye ubunzima bokuphefumla xa ezalwa.
- Ugqirha unokuphinda abone ukuba ngaba kukho iimpawu zosulelo, ezinje nge-amniotic fluid emnyama okanye enukayo.
Iingozi zeAmniotomy
Kukho iingozi ezimbalwa kwi-amniotomy, kubandakanya:
- Ukuba intloko yomntwana ayihambelani kakuhle kwi-pelvis ngaphambi kwe-AROM, njengoko amanzi ephuma, intambo ye-umbilical ingahla kwaye icinezelwe yinxalenye yomntwana. Intambo inokuphinda ingene kwilungu lobufazi. Zombini ezi meko zinokunqumamisa unikezelo lweoksijini yosana.
- Kwangokunjalo, xa intloko ingakhange ibandakanyeke ngaphambi kokuqhekeka kweembrane, kunokwenzeka ukuba umntwana ajike aye kwindawo enesiporho emva, okuyindawo enobungozi ngakumbi yokuzalwa.
- Inqanaba lentliziyo elingekazalwa linokwehla ngenxa yenkqubo.
- Kukho umngcipheko omncinci wokukhululwa kwesikhumba sokhanda olungekazalwa olubangela ukopha.
- Yonyusa ukubakho kokunye ukungenelela okuya kulandela, kubandakanya ukonyuka kwamathuba okuzalwa kwe-cesarean.
- Kukho umngcipheko omncinci wokungenisa usulelo esibelekweni ukuba ubuchule obungenabungozi abusetyenziswanga.
Nje ukuba ingxowa ye-amniotic yaphulwe, kukho umngcipheko owandayo wosulelo koomama kunye nolusana olusuka kwiibhakteria zangasese ukuba ukuhanjiswa kukude ngaphezulu kweeyure ezingama-24.
Uphando nge-Amniotomy ukukhawulezisa abasebenzi
Kukho impikiswano malunga nokuba i-AROM ikhawulezisa ukusebenza ngokuzenzekelayo. Kwingxelo ka-2013 ye Uvavanyo lweNkqubo yeCchrane yezifundo zophando, esekwe kwiziphumo zokukhulelwa okungama-5,583 abaphandi abakufumanisileyo:
- Rhoqo amniotomy khange ikhawulezise inkqubela yenqanaba lokuqala labasebenzi abazenzekelayo.
- Kwakungekho phuculo kwimeko yeentsana ezisandul 'ukuzalwa okanye kulwaneliseko lwabasetyhini ngamava abo okuzalwa xa kuthelekiswa nabasetyhini ngaphandle kwama-amniotomies.
- Ubungqina abuxhasanga ukusetyenziswa kwesiqhelo kwe-amniotomy kulawulo lwabasebenzi.
Uluvo lweKomiti ye-ACOG
Ngokusekwe kuphononongo lweCochrane kunye nolunye ulwazi, iAmerican College of Obstetricians kunye neGynecologists (ACOG) ikhuphe Uluvo lweKomiti ngoFebruwari 2017. I-ACOG yacebisa ngokuchasene nokusetyenziswa kwesiqhelo kwe-amniotomy ekukhulelweni okusemngciphekweni apho umsebenzi uqhubeka ngaphandle kwengxaki. Olu luvo malunga nokwaphula amanzi ngokuyinxalenye yinxalenye yeengcebiso ezingaphantsi zongenelelo ngoncedo lwe-ACOG.
Ukuziqhelanisa ne-AROM ukuzama ukukhawulezisa abasebenzi kuyacotha ukutshintsha ikakhulu ngenxa yesiko lalo elide lokusetyenziswa ngokulula nangokukhuselekileyo kokubeleka. Okwangoku, yinkqubo exabisekileyo xa izinga lokubetha kwentliziyo yosana olungekazalwa okanye uxinzelelo lwe-intrauterine luyafuneka okanye ukujonga ukuhamba kwe-meconium ngumntwana osengxakini.
Thetha noMboneleli wakho we-OB
Xa uthetha ngesicwangciso sakho sokuzalwa kunye nogqirha wakho we-OB okanye umbelethisi, faka ingxoxo malunga nokusetyenziswa kwe-amniotomy ngexesha lokubeletha kwakho. Uya kukulungela ngakumbi ukujongana neenzuzo kunye neengozi ukuba ngaba ucebisa ukuba aqhekeze amanzi akho ngelixa ubelekile.
