ʻO ka ʻāpana Caesarean i kēlā me kēia pae

Me Polofesa Gilles Kayem, obstetrician-gynecologist ma Louis-Mourier haukapila (92)

E kuhikuhi i ka pōhaku

Inā hoʻonohonoho ʻia ka cesarean a wikiwiki paha, hoʻokomo ʻia ka wahine hāpai i loko o kahi lumi hana. ʻO kekahi poʻe makuahine e ʻae, inā kūpono nā kūlana, aia ka makuakāne ma kona ʻaoʻao. ʻO ka mua, hoʻomaʻemaʻe mākou i ka ʻili o ka ʻōpū me kahi huahana antiseptic mai ka lalo o ka ʻūhā a hiki i ka pae o ka umauma, me ka hoʻoikaika ʻana i ka piko. Hoʻokomo ʻia kahi catheter mimi i mea e hoʻopau mau ai i ka ʻōpū. Inā aia ka makuahine i kahi epidural, hoʻohui ka mea hoʻomaʻamaʻa i ka nui o nā huahana anesthetic e hoʻopau i ka analgesia.

ʻoki ʻili

Hiki i ka obstetrician ke hana i ka pauku cesarean. I ka wā ma mua, ua hana ʻia ka ʻoki ʻana i ka ʻili a me ka ʻōpū. ʻO kēia ka mea i nui ai ke koko a ʻoi aku ka palupalu o ka ʻili o ka ʻōpū i ka wā hāpai e hiki mai ana. I kēia mau lā, ʻokiʻoki ʻia ka ʻili a me ka ʻōpū.. ʻO kēia ka mea i kapa ʻia ʻo Pfannenstiel incision. Mālama kēia ʻenehana i ka paʻa. Nui nā makuahine e hopohopo no ka nui o ka ʻili. Hoʻomaopopo kēia. Akā inā haiki loa ka ʻoki ʻana, ʻoi aku ka paʻakikī o ka unuhi ʻana i ke keiki. ʻO ka mea nui ke ʻoki i ka ʻili ma kahi kūpono. ʻO ka laulā maʻamau i ʻōlelo ʻia he 12 a 14 cm. Hana ʻia ka ʻoki ma 2-3 cm ma luna o ka pubis. ʻO ka pōmaikaʻi? Ma kēia wahi, ʻaneʻane ʻike ʻole ʻia ka ʻili no ka mea aia i loko o ka ʻili ʻili.

Ka wehe ʻana o ka paia ʻōpū

Ma hope o ka ʻoki ʻana i ka ʻili, ʻoki ka obstetrician i ka momona a laila ʻo ka fascia (ka ʻiʻo e hoʻopuni ana i nā ʻiʻo). Ua ulu ka ʻenehana o ka ʻāpana cesarean i nā makahiki i hala iho nei ma lalo o ka mana o nā polopeka Joël-Cohen lāua ʻo Michael Stark. ʻO ka momona a laila hoʻolaha nā ʻiʻo i nā manamana lima. Wehe ʻia ka peritoneum ma ke ala like e hiki ai ke komo i ka ʻōpū o ka ʻōpū a me ka ʻōpū. Aia nā ʻano ʻano like ʻole o ka ʻōpū o ka ʻōpū e like me ka ʻōpū, kolone a i ʻole ka ʻōpū. ʻOi aku ka wikiwiki o kēia ʻano. Pono e helu ma waena o 1 a me 3 mau minuke a hiki i ka peritoneal cavity i ka manawa o ka pauku cesarean mua. ʻO ka hoʻopōkole ʻana i ka manawa hana e hōʻemi i ke koko a hoʻohaʻahaʻa paha i ka pilikia o ka maʻi, e hiki ai i ka makuahine ke ola wikiwiki ma hope o ka hana.

ʻO ka wehe ʻana o ka ʻōpū: hysterotomy

A laila komo ke kauka i ka ʻōpū. Hana ʻia ka hysterotomy ma ka ʻāpana haʻahaʻa kahi i ʻoi aku ka lahilahi o ka ʻiʻo. He wahi ia e kahe liʻiliʻi ke koko me ka loaʻa ʻole o nā pathology hou. Eia kekahi, ua ʻoi aku ka ikaika o ka ʻili o ka ʻōpū ma mua o ke kuʻi ʻana o ke kino o ka ʻōpū i ka wā hāpai e hiki mai ana. No laila hiki ke hānau ʻia ma ke ʻano kūlohelohe. I ka wā e ʻoki ʻia ai ka ʻōpū, hoʻomāhuahua ke kauka maʻi i ka ʻoki ʻana i nā manamana lima a wāwahi i ka ʻeke wai. ʻO ka hope, unuhi ʻo ia i ke keiki ma ke poʻo a i ʻole nā ​​wāwae ma muli o ka hōʻike. Hoʻokomo ʻia ka pēpē me ka makuahine no kekahi mau minuke. E hoʻomaopopo: inā ua loaʻa mua i ka makuahine ka ʻāpana cesarean, hiki ke lōʻihi ka lōʻihi o ka hana ʻana no ka mea aia paha ka male, ʻoi aku ma waena o ka ʻōpū a me ka ʻōpū. 

Delivery

Ma hope o ka hānau ʻana, wehe ke kahu hānai i ka placenta. ʻO kēia ka hoʻopakele. A laila, nānā ʻo ia i ka hakahaka o ka ʻōpū. Paʻa ka ʻōpū. Hiki i ke kauka lapaʻau ke hoʻoholo e hoʻokuʻu iā ia i mea maʻalahi a waiho paha i loko o ka ʻōpū o ka ʻōpū. ʻO ka maʻamau, ʻaʻole i pani ʻia ka peritoneum visceral e uhi ana i ka ʻōpū a me ka ʻōpū. Paʻa ka fascia. ʻO ka ʻili o kou ʻōpū ʻo ia, no kāna ʻaoʻao, ua humuhumu ʻia e like me ka poʻe loea. omo omo ʻaʻole a i ʻole me nā kīʻaha. ʻAʻohe ʻenehana pani ʻili i hōʻike i kahi hopena maikaʻi aʻe i ʻeono mahina ma hope o ka hana