Zizindikiro zakubadwa msanga, zoyambitsa komanso zovuta zina

Zamkati

• Zoyambitsa zazikulu
• Zizindikiro za kubadwa msanga
• Zovuta zotheka
• Momwe mungapewere kubadwa msanga

Kubadwa msanga kumafanana ndi kubadwa kwa mwanayo asanakwane milungu 37, yomwe imatha kuchitika chifukwa cha matenda a chiberekero, kuphulika msanga kwa amniotic sac, gulu la nsengwa kapena matenda okhudzana ndi mayiyo, monga kuchepa kwa magazi m'thupi kapena pre-eclampsia, chifukwa Mwachitsanzo.

Izi zitha kuzindikirika kudzera kuzizindikiro zina monga kutsekeka kwa chiberekero pafupipafupi, kuwonjezeka kwa nyini komanso kupsinjika kapena kupweteka m'chiuno, mwachitsanzo. Ndikofunika kuti mayi akapite kuchipatala akangomva zizindikirozi, popeza kuti kubala masiku asanakwane kumatha kukhala pachiwopsezo kwa mwanayo, popeza kutengera zaka zakubadwa ziwalozo zimatha kukhala zisanakhwime, ndipo pakhoza kukhala mavuto mtima ndi kuvutika kupuma, mwachitsanzo.

Chifukwa chake, pankhani yakugwira ntchito isanakwane, adokotala atha kuyesa kuchedwetsa kubadwa pogwiritsa ntchito mankhwala ndi njira zopewera kutsekeka kwa chiberekero ndikutambasula, komabe, ndizovuta kuti athe kubweza nthawi yopitilira maola opitilira 48 mpaka 72. Pankhani ya kubadwa kwa mwana wakhanda asanakwane, zimakhala zachilendo kukhala mu ICU yoyamwitsa kuti chitukuko chake chiziwunikidwa ndikulephera zovuta.

Zoyambitsa zazikulu

Kubadwa msanga kumachitika kwa azimayi opitilira 35 kapena kupitilira zaka 16, ali ndi pakati ndi mapasa, adaberekanso msanga kapena akataya magazi kudzera kumaliseche m'chigawo chachitatu cha mimba. Kuphatikiza apo, zina zomwe zingayambitse ntchito isanakwane ndi:

• Kutuluka msanga kwa thumba la amniotic;
• Kufooka kwa khomo pachibelekeropo;
• Matenda a bakiteriya Streptococcus agalactiae (gulu B streptococcus);
• Gulu lankhondo;
• Pre eclampsia;
• Kusowa magazi;
• Matenda monga chifuwa chachikulu, chindoko, matenda a impso;
• Mimba yapasa;
• In vitro umuna;
• Kusokonezeka kwa fetal;
• Kulimbikira thupi;
• Kugwiritsa ntchito mankhwala osokoneza bongo ndi zakumwa zoledzeretsa;
• Kukhalapo kwa fibroids m'chiberekero.

Kuphatikiza apo, azimayi omwe ali ndi mbiri ya vaginosis amakhalanso pachiwopsezo chobadwa msanga, chifukwa mabakiteriya ena amatha kutulutsa poizoni ndikulimbikitsa kutulutsa ma cytokines ndi prostaglandins omwe amakonda ntchito. Zakudya zina ndi zitsamba zimathandizanso kuti chiberekero chichepe komanso kuti azigwira ntchito asanakwane, motero, amatsutsana panthawi yapakati. Onani mndandanda wa ma tiyi omwe mayi wapakati sayenera kumwa.

Zizindikiro za kubadwa msanga

Mayiyo atha kukayikira kuti ayamba kubala masiku asanakwane ngati ali ndi zizindikilo monga:

• Mitsempha ya chiberekero;
• Kupanikizika pansi pamimba;
• Kuchulukitsa kukodza;
• Kuchulukanso kumaliseche kumaliseche, komwe kumakhala gelatinous ndipo kumatha kukhala kapena kuchepa kwamagazi;
• Ululu pansi pamsana;
• Kutsekula m'mimba nthawi zina;
• Colic yamphamvu.

Chifukwa chake, ngati mayi awonetsa zodabwitsazi asanakwane milungu 37, ndikofunikira kuti ayimbire azamba ndikupita kuchipatala kuti akamuyese ndipo angatengepo mbali.

Kuti atsimikizire kuti pali chiopsezo chobadwa msanga komanso kusankha zoyenera kuchita pankhaniyi, adotolo athe kuyesa kuyeza kwa chiberekero kudzera mu transvaginal ultrasound komanso kupezeka kwa fetal fibronectin mkatikati mwa chikazi.

Muyeso wopitilira 30 mm mu khomo pachibelekeropo umawonetsa chiopsezo chachikulu chobereka m'masiku asanu ndi awiri ndipo amayi omwe ali ndi mtengowu ayenera kuwunikidwa ngati ali ndi fibronectin. Ngati mayiyo ali ndi miyezo pakati pa 16 ndi 30 mm koma fetal fibronectin yoyipa imakhala pachiwopsezo chobereka, komabe, fetal fibronectin ikakhala yabwino, pamakhala chiopsezo chobereka pasanathe maola 48.

Zovuta zotheka

Zovuta zakubadwa msanga zimakhudzana ndi msinkhu wa khanda lobadwa, ndipo pakhoza kukhala:

• Kuperekera msanga pamasabata 23 mpaka 25:milandu yambiri imatha kukhala ndi zilema zazikulu, monga ziwalo za ubongo, khungu kapena kugontha;
• Kuperekera msanga pamasabata 26 ndi 27: milandu ina imatha kukhala ndi zolemala pang'ono, monga kulephera kuwona, kusayendetsa magalimoto, mphumu yayitali komanso kuvutika kuphunzira;
• Kuperekera msanga pamasabata 29 mpaka 31: ana ambiri amakula popanda mavuto, koma ena amakhala ndi mitsempha yofewa ya ziwalo zaubongo komanso zovuta kuwona;
• Kubadwa msanga pamasabata 34 mpaka 36: Makanda akhanda msanga amakula chimodzimodzi ndi omwe amabadwa pa nthawi yake, koma amakhala ndi zovuta zakukula komanso kuphunzira.

Nthawi zambiri, makanda obadwa masiku asanakwane amaikidwa mu chofungatira, chifukwa samatha kutentha thupi. Chifukwa chake, chipangizochi chimasunga kutentha ndi chinyezi chofanana ndi chiberekero, kulola kuti chikule.

Makanda ochepera milungu 34 ya bere amatha kulumikizidwa ndi zida zopumira, monga asanakwane milungu 34 ya bere samatha kugwira ntchito, chinthu chomwe chimathandizira kulowa kwa mpweya m'mapapu ndipo, pachifukwa ichi, ziwonetsero monga mtundu wabuluu zitha kuwoneka. ndi zala, milomo ndi mphuno.

Kuphatikiza apo, ana obadwa masiku asanakwane amakhala pachiwopsezo chodwala matendawa, zomwe zimachepetsa kuwoneka bwino, chifukwa chake ana onse asanakwane amafunika kuvala chigamba cha diso ali mu ICU yoyamwitsa. Mwanayo amangotulutsidwa kunyumba akafika makilogalamu awiri komanso ziwalo zake zitakula kale, kuti athe kumeza opanda chubu ndikupuma popanda thandizo lazida.

Momwe mungapewere kubadwa msanga

Pofuna kupewa kubala masiku asanakwane, zomwe mayi wapakati angachite panthawi yonse yoyembekezera ndikuti apewe kuchita masewera olimbitsa thupi kwambiri ndikutsatira malangizo onse a azamba pakapita nthawi yobereka.

Komabe, ngati kubereka kumayamba nthawi isanakwane, woperekayo angalimbikitse kugwiritsa ntchito mankhwala monga ma corticosteroids kapena otsutsana ndi oxytocin, omwe atha kugwiritsidwa ntchito pakati pa masabata 25 mpaka 37 a bere. Njira izi zopewera kubadwa msanga ziyenera kuchitika mukakhala kuchipatala ndikugwiritsa ntchito malingana ndiubwino wa mayi ndi mwana.