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ʻO ka huaʻōlelo "dystocia"No ka Helene kahiko"maʻi", 'o ia ho'i ka pilikia, a me"nā hōʻailona”, ʻO ke ʻano o ka hānau ʻana. ʻO ka hānau ʻana i kapa ʻia ʻo ia ka hānau keiki paʻakikī, e kūʻē i ka hānau ʻana eutocic, kahi hana maʻamau, me ka ʻole o ke keakea. No laila, hui pū mākou ma lalo o ka huaʻōlelo obstructed birth nā hāʻawi a pau i kū mai nā pilikia, e pili ana i ka ʻoki ʻana o ka ʻōpū, ka dilation o ka pūpū, ka iho ʻana a me ke komo ʻana o ka pēpē i loko o ke pelvis, ke kūlana o ka pēpē i ka wā o ka hānau ʻana (ma ka breech in particular), etc. Aia ʻelua ʻano nui o ka dystocia:
- -dynamic dystocia, pili i ka dysfunction o ka uterine "motor" a i ole dilation o ka cervix;
- -a me mechanical dystocia, ke ālai 'ia, no ka fetal origin (ka nui a / a i'ole ka hoike ana o ka bebe...) a 'ole (tumor, placenta praevia, cyst...).
E hoʻomaopopo i ka hoʻokaʻawale ʻia ʻana o ka hana keakea i kekahi manawa ma muli o ke kumu o ka makuahine (dilation of cervix, uterine contractions, placenta previa, pelvis too haiki, etc.) a i ʻole no ka hānau keiki.
ʻO ka hana keakea: inā ikaika ka hana keakea
Wahi a nā manaʻo o ka obstetrician-gynecologists, ʻoi aku ka nui o ka hana obstructed dynamic ma mua o 50% o nā kumu o ka hana keakea. Hiki ke pili me lawa ʻole ka hana o ka ʻōpū, i ka wā ʻaʻole i lawa ka maikaʻi o ka hoʻopaʻa ʻana o ka ʻōpū e hiki ai ke kipaku ʻia ke pēpē. ʻO ka ʻokoʻa, hoʻopaʻapaʻa ikaika loa hiki ke hana keakea. Hiki nō hoʻi nā ʻokiʻoki "ʻano maʻamau", nāwaliwali a ʻoi aku ka ikaika pale i ka hoʻomāhuahua pono ʻana o ka pūpū, a no laila paʻakikī ka hānau keiki. Loaʻa paha i ka pūpū ponoʻī nā mea ʻokoʻa e pale aku ai i ka hoʻolala maikaʻi a lawa.
ʻO ka hana keakea: inā he mechanical ka hana keakea
ʻEkolu ʻano nui o ka mechanical dystocia ma ʻaneʻi, ke loaʻa kahi pilikia mechanical e hoʻopili ana i ka hānau ʻana.
- -Ke kamaʻilio nei mākou iwi dystocia i ka wā e hōʻike mai ai ka pelvis o ka makuahine i kahi anomaly o ka nui, ʻano a i ʻole ke ʻano, e paʻakikī ana i ka hele ʻana o ka pēpē ma nā ʻāpana like ʻole o ke kīʻaha;
- -Ke kamaʻilio nei mākou dystocia mechanicalo ke kumu o ka fetal i ka wā ʻo ka fetus ka mea paʻakikī i ka hānau ʻana ma muli o kona kūlana (i loko o ka breech i hoʻopau ʻia a i ʻole piha ʻole), kona nui a me kona kaumaha nui (ke kamaʻilio nei mākou no ka macrosomia fetal, inā ʻoi aku ke kaumaha o ke keiki ma mua o 4 kg) a i ʻole. i ka malformation (hydrocephalus, spina bifida, etc.);
- ke kamaʻilio hope nei mākou ʻiʻo palupalu mechanical dystocia i ka wā o ka hana ālai ʻia ma muli o kahi placenta previa i uhi ʻia ma ka liʻiliʻi loa i ka ʻōpū, nā ʻōpū ovarian, nā pilikia uterine (fibroids, malformations, scars, etc.) etc.
ʻO kahi hihia kūikawā o ka hana mechanical obstructed of fetal origin poʻohiwi dystocia, i ka wā i kipaku ʻia ai ke poʻo o ka pēpē akā paʻakikī nā poʻohiwi e komo i ka pelvis ma hope. Kūkākūkā nui mākou e pili ana dystocie d'engagement i ka wā e paʻakikī ai ka pēpē e komo pono i loko o ke pelvis, ʻoiai ka hoʻomāhuahua ʻana o ka ʻōpū.
ʻO ka hana keakea: pono mau anei ka ʻāpana cesarean?
Ma muli o ke ʻano a me ke kiʻekiʻe o ka hana keakea i ka wā hānau, hiki ke hōʻike ʻia ka ʻāpana cesarean.
E hoʻomaopopo i ka holomua ʻana o ka ultrasound i kēia lā e hiki ai ke pale i kekahi mau hānau ʻana, ma ke koho ʻana i kahi ʻāpana cesarean i hoʻonohonoho ʻia, ke loaʻa kahi placenta previa e uhi ana i ka pūpū, no ka laʻana, a i ʻole nui loa ka pepe no ka laula o ke pelvis o ka makuahine. Eia nō naʻe, hiki i ka hānau ʻana ke hōʻoia i ka holomua ʻoiai nā pilikia i ʻōlelo ʻia ma luna.
I ke alo o ka dystocia ikaika, hiki i ka haki ʻana o nā membrane a me ka hoʻokomo ʻana o ka oxytocin ke hiki ke hana ʻoi aku ka maikaʻi o ka hoʻopaʻa ʻana a me ka hoʻomāhuahua ʻana o ka pūpū.
Pono paha ka hoʻohana ʻana i nā mea hana e like me ka forceps a i ʻole nā kīʻaha hoʻoheheʻe i kekahi mau dystocia mechanical.
Akā inā ʻaʻole lawa kēia mau hana no ka hoʻopuka ʻana i ka pēpē, a / a i ʻole nā hōʻailona o ka pilikia fetal, ua hana ʻia kahi ʻāpana cesarean pilikia.