Zamkatimu
The push reflex: chikhumbo chosatsutsika
Pakubadwa kwachilengedwe, pali a kukankha reflex zimapangitsa kuti mwanayo achotsedwe. Amatchedwanso kuthamangitsidwa reflex. “Pankhani ya kubadwa kwa thupi (kutanthauza kuti popanda epidural kapena chithandizo china chilichonse), mkaziyo amakankhira mphamvu yomwe imachititsa zidzachitika mwachibadwa pamene mwana alowa m'chiuno, pamene ikupita kukanikiza minofu ya perineum ndi pa rectum ", mwatsatanetsatane Catherine Mitton, mzamba mu Taluyers ndi luso nsanja Givors (69). Reflex iyi, yomwe zimachitika panthawi yapakati (imodzi yokha ndiyokwanira), Dr Bernadette de Gasquet, katswiri wodziwa za amayi, akulongosola kuti ndi "chilakolako chosaletseka", pang'ono ngati chilakolako chofuna kutuluka m'matumbo, kapena ngati kusanza, zovuta kwambiri kuziletsa. “Chigawo chotsika kwambiri cha m’mimba chimakankhira chiberekero m’mwamba ndi kukankhira mwanayo pansi, chifukwa chafika pamene sichikhoza kutuluka,” akufotokoza motero. Kenako chitsekocho chimakwera, mofanana ndi pamene mayi akusanza, mayi amapuma mwadzidzidzi ndipo chiberekero chimakanika mosadziletsa.
Monga ngati chikhumbo chokhala ndi matumbo koma champhamvu kwambiri, kuthamangitsidwa kwa kubadwa kwa mwana kungakhale kokhudzana ndi thupi. Mwa amayi omwe amasankha kubereka popanda epidural, zimachitika mwamphamvu ndi njira yokha, ndipo amalola kuthamangitsidwa kwa mwanayo, kawirikawiri popanda kulowererapo kwa kunja. Episiotomy kapena kutulutsa mwana mwamakina (zokakamiza, kapu yoyamwa) zitha kukhazikitsidwa ndi gulu lachipatala.
Pamene epidural imakukakamizani kuti muyesere reflex iyi
Tsoka ilo, opaleshoni iyi ya reflex sichitika nthawi zonse, kapena nthawi zina imakhala yopanda mphamvu mokwanira. ” Ngati pali epidural, sipadzakhalanso reflex flare », Akutsimikizira Catherine Mitton. "Ziwonetsero zidzasokonezedwa, ndipo izi zidzatengera mlingo wa epidural. Ena amamwa bwino, ena pang'ono. Choncho nthawi zina muyenera kutero khazikitsani kukankha mwaufulu, akumaganiza kuti tikukankha ngati kuti tili ndi matumbo. "Epidural anesthesia imabweretsadi kumasuka kwa minofu, makamaka mu perineum. Komanso, ngati epidural ndi dosed kwambiri, m`munsi pamimba lonse ndi ululu, kugona pansi mphamvu ya mankhwala ochititsa. "Malinga ndi mlingo wake, pangakhale odwala omwe sakuwona kuti mwanayo ali pachibwenzi komanso kuti ali ndi mwayi wotuluka", akupitiriza mzambayo. Izi zidzasamaliraauzeni wodwala nthawi yoti akankhire, pamene mikhalidwe ili yoyenera. Pazifukwa izi, kuyezetsa kumachitika pafupifupi ola lililonse kuti muwone kukula kwa khomo pachibelekeropo komanso momwe thanzi la mwanayo likuyendera. Pa dilation zonse, mwachitsanzo pafupifupi 10 centimita, wodwalayo kukonzekera kukankha molingana ndi malangizo azamba. Nthawi zina, kuti amuthandize kumva komwe angakankhire, mzamba amalowetsa chala m'nyini kukanikizira khoma lakumbuyo, lomwe limakankhira pa rectum. Koma Catherine Mitton akufuna kukhala wolimbikitsa : “Nthaŵi zina zimachitika kuti epidural ndi mlingo wochepa kwambiri, umene umachititsa kuti mayiyo amve ngati mwana wake akukankha ndi kusunga nyonga. Koma izi sizili choncho kwa ma epidurals onse. “
Onani kuti Dr Bernadette de Gasquet sagawana malingaliro awa konse. Amawonetsetsa kuti kuthamangitsidwa kwa reflex kumachitika ngakhale mutakhala pa epidural kapena mukomoka, koma gulu lachipatala silikufuna kudikirira kuti izi zitheke. Pankhani ya mwana woyamba makamaka, kutsika kwa khanda kungakhale kwautali. Kwa Dr de Gasquet, kukankhira molawirira kwambiri ngakhale khomo pachibelekerocho chitatambasuka mokwanira sikoyenera, ndipo kumayambitsa kuwonongeka kwakukulu kwa ziwalo. Udokotala ukhoza kuyika zambiri kumbuyo kwa epidural, pomwe sizimakhudzidwa kwenikweni.
Malo a gynecological omwe samapangitsa zinthu kukhala zosavuta
Pansi pa epidural, popeza kuti kukankhira mphamvu kulibe kapena kumveka mokwanira, gulu lachipatala nthawi zambiri limapempha wodwalayo kuti akhazikike. gynecological udindo : kumbuyo, theka-kukhala, mapazi mu stirrups ndi miyendo motalikirana. Tsoka ilo, malo awa, ngakhale omasuka kuchita mayeso a pelvic, siwothandiza kukankhira koyenera. "Pambuyo pake, sacrum (fupa lomwe limatsogolera coccyx ndikubweretsa pamodzi mafupa a m'chiuno, zolemba za mkonzi) akhoza kutsekedwa. Pali kuyenda kochepa ndipo timataya mwayi wa mphamvu yokoka kutithandiza ", adavomereza Catherine Mitton.
Dr Bernadette de Gasquet amanong'oneza bondo kuti udindo uwu nthawi zambiri zoperekedwa ndi zinthu, pakalibe mpando wodziyimira kuti ulole malo ena. Kwa iye, chikhalidwe cha amayi chimakankhira pansi, chimabweretsa pansi ziwalo ndipo zingayambitse zotsatira za nthawi yaitali (kusadziletsa, etc.). Osanenapo kuti pamafunika khama lalikulu kuchokera kwa wodwalayo, yemwe amatopa kwambiri. Bwino kubereka kuyimitsidwa ndi lamba, pambali, pamiyendo inayi kapena ngakhale squatting. Kaŵirikaŵirinso ndiwo maudindo amene amatchuka kwambiri ndi akazi amene kubereka kwawo sikunachiritsidwe ndi mankhwala, akutero Catherine Mitton. “M’malo mosuntha mayi woyembekezerayo kuti mwanayo atsike, mumamukankhira pansi. Komabe, monga pamene timatuluka m'matumbo, a udindo wabwino Nthawi zambiri zokwanira kuti kuthamangitsidwa kuchitike, palibe chifukwa chokankhira ", akutsimikizira mbali yake Bernadette de Gasquet.
Dziwani muvidiyo: Kodi kukula bwino pa nthawi yobereka?
Muvidiyo: Momwe mungakulire bwino panthawi yobereka?
Kodi tingaphunzitse kukankha?
Panthawi ya push reflex, kutha kwa ntchito kumachepetsedwa mu glottis ndipo modzidzimutsa. Zonsezi, Catherine Mitton ndi Bernadette de Gasquet amavomereza zimenezo kuphunzira kupuma n’kopanda ntchito. "Zidzagwira ntchito nthawi yoyenera ikakwana," akutero Dr de Gasquet. "Tikhoza kuyesa kuphunzira panthawi yokonzekera ndi mzamba, koma palibe chomwe chimasonyeza kuti njira yopuma yomwe taphunzira idzakhala yomwe mzamba angakonde pa D-day", akufotokoza Catherine. Mitton. ” Sikuti nthawi zonse timasankha. Koma tingathebe kumuuza mzamba zimene taphunzira komanso zimene tikufuna kuchita, makamaka pankhani ya udindo. “
Mulimonsemo, ” nthawi zambiri zimakhala zovuta kuzindikira momwe ndi komwe mungakankhire mpaka mutakhala ndi kumverera komwe kumayenderana nazo », Kutsindika Catherine Mitton. Pofuna kutsimikizira odwala ake, amaumirira kufunika kowaphunzitsa malo omwe angatheke komanso njira zopumira zomwe zidzachitike. kutsegula glottis. Choyamba chidzakhala kupuma, kutsekereza mpweya, ndi kukankha. Izi ziyenera kupewedwa, komabe, chifukwa glottis pamalo otsekedwa amatseka minofu, pomwe glottis yotseguka ikatha ntchito imakonda perineum yosinthika kwambiri. Kwa Bernadette de Gasquet, wolemba mabuku Ubwino ndi umayi et Kubereka, njira ya Gasquet, ili pamwamba pa malo onse omwe ayenera kukonzekera. Choncho amakonda kaimidwe komwe mungathe kukankhira manja anu kumbuyo pamene akupuma.