Hānau hānau: hoʻokau pinepine ʻia…

ʻO nā hōʻike - ʻike ʻole ʻia - he mea hōʻino. « I koʻu hoʻolālā hānau ʻana, ua hōʻike wau makemake wau e kali i 2 a i ʻole 3 mau lā ma hope o ka lā i kau ʻia ma mua hoʻoulu i ka hānau keiki. ʻAʻole i noʻonoʻo ʻia. Ua kiʻi ʻia au i ka lā o ke kau i ka haukapila a ua hoʻomaka wau, me ka hāʻawi ʻole ʻana iaʻu i kahi ʻano ʻē aʻe. ʻO kēia hana a me ka hou ʻana o ka ʻeke wai i kau ʻia ma luna oʻu. Ua loaʻa iaʻu he hana ʻino nui », Hōʻike i kekahi o ka poʻe i komo i ka noiʻi nui o ka Collective interassociative a puni ka hānau ʻana (Ciane *) e pili ana i ka "Hanau keiki i hoʻomaka i loko o kahi haukapila". ʻO nā pane 18 mai nā maʻi i hānau ma waena o 648 a me 2008, ʻo 2014% o nā wahine i nīnau ʻia i ʻōlelo ʻia ua loaʻa iā lākou kahi "trigger". ʻO kahi helu i paʻa mau i ko mākou ʻāina, ʻoiai ʻo 23% ia ma 23 (National Perinatal Survey) a me 2010% i ka wā o ka noiʻi hope loa ma 22,6. 

I ka manawa hea e hōʻike ʻia ai ke kumu?

Ua wehewehe ʻo Dr Charles Garabedian, ka obstetrician-gynecologist a me ke poʻo o ke keʻena ma ka hale hānai makuahine ʻo Jeanne de Flandres ma Lille, ʻo ia kekahi o nā mea nui loa ma Farani me 5 mau hoʻopuka i kēlā me kēia makahiki. ʻO ka hoʻokomo ʻana he ala hana no ka hoʻoulu ʻana i ka hānau ʻana i ka wā e pono ai ka pōʻaiapili olakino a me ka obstetrical.. » Hoʻoholo mākou e hoʻomaka no kekahi mau hōʻailona: i ka wā i hala ai ka lā kūpono, e pili ana i nā maternities ma waena o D + 1 lā a me D + 6 mau lā (a hiki i ka palena o 42 pule o ka amenorrhea (SA) + 6 mau lā kiʻekiʻe **). Akā inā loaʻa ka makuahine i ka wā e hiki mai ana nahae o ka eke wai me ka hana ʻole ʻana i loko o 48 mau hola (no ka pilikia o ka maʻi no ka pēpē), a i ʻole ina ua keakea ka ulu ana o ka fetus, ka puuwai kupilikii, a me ka hapai mahoe (i kēia hihia, hoʻomaka mākou ma 39 WA, ma muli o ka like ʻana o nā māhoe i ka placenta hoʻokahi a ʻaʻole paha). Ma ka ʻaoʻao o ka makuahine hāpai, hiki ke hiki i ka wā preeclampsia, a i ʻole i ka hihia o ka maʻi maʻi ma mua o ka hāpai ʻana a i ʻole ka maʻi diabetes gestational kaulike ʻole (mālama ʻia me ka insulin). No kēia mau hōʻailona olakino, makemake nā kauka hoʻoulu i ka hānau keiki. No ka mea, i kēia mau kūlana, ʻoi aku ka maikaʻi o ke kaulike a me ka pilikia i ka hoʻomaka ʻana o ka hānau ʻana, no ka makuahine a no ka pēpē.

Triggering, he hana lapaʻau koʻikoʻi ʻole

« I Farani, hoʻomaka pinepine ʻia ka hānau ʻana, hōʻike mai ʻo Bénédicte Coulm, ka pale keiki a me ka mea noiʻi ma Inserm. I ka makahiki 1981, aia mākou ma 10%, a ua pāpālua ʻia kēlā pākēneka i 23% i kēia lā. Ke piʻi nei ia ma nā ʻāina Komohana a pau, a ua hoʻohālikelike ʻia ʻo Farani me kona mau hoalauna ʻEulopa. Akā ʻaʻole mākou ka ʻāina i hoʻopilikia nui ʻia. Ma Sepania, kokoke hoʻokahi o ʻekolu hānau ʻia i hoʻomaka. » A i ʻole, ke kākoʻo nei ka World Health Organization (WHO) "ʻaʻole pono e hoʻopaʻa inoa kahi ʻāina i ka helu o ka hoʻokomo ʻana o ka hana ma mua o 10%". No ka mea, ʻaʻole ia he hana koʻikoʻi ka hoʻoulu ʻana, ʻaʻole no ka mea maʻi, ʻaʻole no ka pēpē.

ʻO ke kumu: ʻeha a me ka pilikia o ke koko

ʻO nā lāʻau lapaʻau i kuhikuhi ʻia e hoʻoulu i ka ʻōpū o ka ʻōpū. Hiki ke ʻeha kēia mau mea (kakaikahi nā wahine i ʻike i kēia). ʻOi loa inā hoʻokomo ʻia ka hana me ke kōkua o kahi infusion o ka oxytocin synthetic, ʻoi aku ka kiʻekiʻe o ka hyperactivity uterine. I kēia hihia, ikaika loa nā hoʻopaʻa ʻana, kokoke loa a ʻaʻole hoʻomaha ʻoluʻolu (ka manaʻo o kahi hoʻokahi, lōʻihi ka lōʻihi). I ka pēpē, hiki i kēia ke alakaʻi i ka pilikia fetal. I ka makuahine, uterine rupture (kakaikahi), akā ma luna o nā mea a pau, ka pilikia o ka hemorrhage postpartum hoonuiia e elua. Ma kēia wahi, ua hāʻawi ka National College of Midwives, i hui pū me nā anesthesiologists, obstetrician-gynecologists a me nā pediatricians, i nā manaʻo e pili ana i ka hoʻohana ʻana i ka oxytocin (a i ʻole synthetic oxytocin) i ka wā o ka hana. Ma Farani, ʻelua hapakolu o nā wāhine i loaʻa iā lākou i ka wā hānau keiki, inā i hoʻomaka ʻia a ʻaʻole paha. “ ʻO mākou ka ʻāina ʻEulopa e hoʻohana nui nei i ka oxytocin a kāhāhā ko mākou mau hoalauna i kā mākou mau hana. Eia nō naʻe, inā ʻaʻohe manaʻo e pili ana i nā pilikia e pili ana i ka induction, hōʻike nā haʻawina i ka loulou ma waena o ka hoʻohana ʻana i ka oxytocin synthetic a me ka nui o ke kahe koko no ka makuahine. “

Hoʻokomo ʻia ka hoʻomaka ʻana: ʻaʻole maopopo

ʻO kekahi hopena: ʻoi aku ka lōʻihi o ka hana, ʻoiai inā hana ʻia ma ka ʻāʻī i kapa ʻia ʻo "unfavorable". (he pūpū paʻa a lōʻihi paha ma ka hopena o ka hāpai ʻana). “ Pīhoihoi kekahi mau wahine i ko lākou noho ʻana i ka haukapila no XNUMX mau hola ma mua o ka hoʻomaka ʻana o ka hana maoli », Wehewehe ia Bénédicte Coulm. I ka hoʻokolokolo Ciane, ua ʻōlelo kekahi mea maʻi: " Makemake au e ʻike i ka ʻoiaʻiʻo ʻaʻole hoʻomaka ka hana no ka manawa lōʻihi… 24 mau hola noʻu! 'Ōlelo kekahi makuahine iā ia iho: " Ua loaʻa iaʻu kahi ʻike maikaʻi ʻole me kēia hoʻoiho, a ua lōʻihi ka manawa. ʻO ka tamponade i ukali ʻia e ka infusion he 48 mau hola. I ka manawa o ka kipaku ʻia, ua luhi au. "Hoʻopau ka hapakolu:" ʻO nā ʻokiʻoki ma hope o ka hoʻoulu ʻana he ʻeha loa. Ua ʻike wau he mea ʻino loa, ma ke kino a me ka noʻonoʻo. Eia nō naʻe, ma mua o ka puka ʻana mai, pono e hoʻomaopopo ʻia nā wahine e pili ana i kēia hana a me kona hopena. Pono mākou e hōʻike iā lākou me ke koena pilikia / pōmaikaʻi o ia hoʻoholo, a ma luna o nā mea āpau e loaʻa i kā lākou ʻae. ʻOiaʻiʻo, hōʻike ka Public Health Code "ʻaʻole hiki ke hana ʻia kahi hana lapaʻau a lapaʻau ʻole me ka ʻole o ka ʻae manuahi a ʻike ʻia o ke kanaka, a hiki ke hoʻihoʻi ʻia kēia ʻae i kēlā me kēia manawa".

Hānau hānau: he hoʻoholo i kau ʻia

Ma ka noiʻi Ciane, ʻoiai ua hoʻonui ʻia nā noi no ka ʻae ʻana ma waena o ka manawa 2008-2011 a me ka manawa 2012-2014 (nā ʻāpana ʻelua o ka noiʻi), he hapa nui o nā wahine, ʻO 35,7% o nā makuahine mua (ʻo ia ke keiki mua) a me 21,3% o multiparas (ʻo ia ka mea ma ka liʻiliʻi o ke keiki ʻelua) ʻaʻole lākou i manaʻo e hāʻawi. ʻOi aku ka liʻiliʻi ma mua o 6 i 10 mau wahine i ʻōlelo ua hoʻomaopopo ʻia lākou a ua noi ʻia lākou no kā lākou ʻae. ʻO kēia ka hihia no kēia makuahine nāna e hōʻike: "I ka wā i hala aku ai au i koʻu manawa, i ka lā ma mua o ka hoʻomaka ʻana o ka papahana, ua hana kahi pale keiki i kahi wehe o nā membrane, kahi hana ʻeha loa, me ka hoʻomākaukau ʻole a ʻōlelo ʻole iaʻu! Ua ʻōlelo kekahi: " Ua loaʻa iaʻu ʻekolu mau mea hoʻoheheʻe i nā lā ʻekolu no kahi ʻeke i manaʻo ʻia he māhā, inā ʻaʻohe o mākou maopopo. ʻAʻole i nīnau ʻia mai koʻu manaʻo, me he mea lā ʻaʻohe koho. Ua haʻi ʻia iaʻu e pili ana i ka cesarean inā ʻaʻole kūleʻa nā mea hoʻoulu. I ka pau ʻana o nā lā ʻekolu, ua luhi wau a ua huikau. He mau manaʻo kānalua koʻu no ka hemo ʻana o ka membrane, no ka mea, ʻo ka ʻeha a me ka hōʻeha maoli kaʻu hoʻokolokolo ʻana. ʻAʻole wau i noi ʻia no koʻu ʻae ʻana. »

ʻAʻole i loaʻa i kekahi o nā wahine i nīnauele ʻia i ka noiʻi ʻana i kekahi ʻike, akā naʻe ua nīnau ʻia lākou no ko lākou manaʻo ... Me ka ʻole o ka ʻike, e kaupalena ʻia ke ʻano "mālamalama" o kēia hoʻoholo. ʻO ka hope loa, ua manaʻo kekahi o nā maʻi i nīnauele ʻia ua noi ʻia lākou no kā lākou ʻae ʻana, me ka hoʻoikaika ʻana i nā pilikia no ka pēpē a me ka hōʻike ʻana i ke kūlana. ʻAʻole hiki i kēia mau wahine ke manaʻo ua koi ʻia ko lākou lima, a i ʻole ua hoʻopunipuni maoli ʻia lākou. Ka pilikia: e like me ka noiʻi ʻana ʻo Ciane, ʻo ka nele o ka ʻike a me ka ʻoiaʻiʻo ʻaʻole i nīnau ʻia nā makuahine i ka wā e hiki mai ana no ko lākou manaʻo e like me nā mea hoʻonāukiuki o ka hoʻomanaʻo paʻakikī o ka hānau ʻana.

Hoʻokomo ʻia: kahi hānau keiki liʻiliʻi

No nā wahine i loaʻa ʻole ka ʻike, 44% ka ʻike "ʻino a maikaʻi ʻole paha" i kā lākou hānau ʻana, kūʻē i ka 21% no ka poʻe i ʻike ʻia.

Ma ke Kula Nui o nā Midwives, kūpaʻa ʻo Bénédicte Coulm: " Akaka loa ke kulana o ke Koleke, ke manao nei makou he pono ke hoike ia na wahine. I nā hihia inā ʻaʻohe pilikia, e hoʻokaʻawale i ka manawa e wehewehe i nā makuahine hāpai i nā mea e hana nei, nā kumu o ka hoʻoholo ʻana, a me nā pilikia kūpono, me ka hoʻāʻo ʻole e hoʻoweliweli iā lākou. . I hoʻomaopopo lākou i ka hoihoi olakino. He mea kakaikahi ka wikiwiki o ka hiki ʻole ke lawe i ka manawa, ʻelua mau minuke, e noho a hoʻomaopopo i ka mea maʻi. "ʻO ka moʻolelo like mai ka ʻaoʻao o Dr Garabedian:" ʻO kā mākou kuleana ma ke ʻano he poʻe mālama e wehewehe i nā pilikia, akā ʻo nā pōmaikaʻi no ka makuahine a me ke keiki. ʻOi aku koʻu makemake e noho ka makua kāne a mālama ʻia ʻo ia. ʻAʻole hiki iā ʻoe ke mālama i ke kanaka me ka ʻole o kā lākou ʻae. ʻOi aku ka maikaʻi e hele mai e kamaʻilio me ka mea maʻi me kahi hoahana loea e pili ana i ka pathology, i kahi pilikia a inā ʻaʻole makemake ka mea maʻi e hoʻomaka. Lilo ka ʻike i ka multidisciplinary a ʻoi aku ka ʻike o kāna koho. Ma ko mākou ʻaoʻao, wehewehe mākou iā ia i ka mea hiki iā mākou ke hana. He mea kakaikahi ka hiki ole ke kuikahi. Kāhea ʻo Madeleine Akrich i ke kuleana o nā makuahine e hiki mai ana: “Makemake au e ʻōlelo aku i nā mākua, 'E lilo i poʻe keaka! E nīnau! Pono ʻoe e nīnau, nīnau, ʻaʻole ʻae, no kou makaʻu wale nō. E pili ana i kou kino a me kou hānau ʻana! “

* Nīnau e pili ana i nā pane 18 i ka nīnau nīnau o nā wahine i hānau ʻia ma kahi haukapila ma waena o 648 a me 2008.

** Nā Manaʻo a ka National Council of Obstetrician Gynecologists (CNGOF) o 2011

I ka hoʻomaʻamaʻa: pehea e hele ai ke kumu?

Nui nā ala e hoʻoulu ai i ka hoʻokomo ʻana o ka hana. ʻO ka mea mua he manual: "Ua loaʻa i kahi detachment o nā membranes, pinepine i ka wā o ka hoʻokolokolo vaginal.

Ma kēia ʻano hana, hiki iā mākou ke hana i nā ʻokiʻoki e hana i ka cervix, "wahi a Dr Garabedian. ʻO kekahi ʻenehana i kapa ʻia ʻo mechanical: "ka baluna pālua" a i ʻole ka Foley catheter, kahi baluna liʻiliʻi i hoʻonui ʻia ma ke kiʻekiʻe o ka pūpū e hoʻokau i ke kaomi a hoʻoulu i ka hana. 

ʻO nā ala ʻē aʻe he hormonal. Hoʻokomo ʻia kahi tampon a i ʻole gel e pili ana i ka prostaglandin i loko o ka ʻōpū. ʻO ka hope, hiki ke hoʻohana ʻia ʻelua ʻano hana ʻē aʻe, inā wale nō e ʻōlelo ʻia he "maikaʻi" ka cervix (inā ua hoʻomaka e pōkole, wehe a palupalu, pinepine ma hope o 39 mau pule). O ia ka haki ʻana o ka ʻeke wai a me ka infusion oxytocin synthetic. Hāʻawi kekahi mau makuahine i nā ʻano hana maʻalahi, e like me ke kau ʻana i nā nila acupuncture.

Ua hōʻike ʻia ka noiʻi ʻo Ciane ʻo nā mea maʻi i nīnau ʻia he 1,7% wale nō i hāʻawi ʻia i ka baluna a me 4,2% acupuncture. I ka hoʻokaʻawale ʻana, hāʻawi ʻia ka infusion oxytocin i ka 57,3% o nā makuahine e manaʻo nei, i ukali pū ʻia me ka hoʻokomo ʻana o kahi tampon prostaglandin i loko o ka vagina (41,2%) a i ʻole he gel (19,3, XNUMX%). Ke mākaukau nei nā haʻawina ʻelua e loiloi i ka laha ma Farani. ʻO kekahi o lākou, ʻo ka MEDIP study, e hoʻomaka i ka hopena o 2015 ma 94 maternities a pili i nā wahine 3. Inā nīnau ʻia ʻoe, mai kānalua e pane!

Makemake ʻoe e kamaʻilio ma waena o nā mākua? E hāʻawi i kou manaʻo, e lawe mai i kāu hōʻike? Hui mākou ma https://forum.parents.fr.