Obstetric ropa: Zvinokukonzera uye kurapwa nhungamiro

Zvinosuruvarisa obstetric hemorrhages vakanga ndichingoti mumwe chikuru zvinokonzera rufu vakadzi pashure yokusununguka. Ndokusaka zvichikosha kuti funga mukana pamuviri yematambudziko kuti aigona kupa rubatsiro gona.

obstetric ropa

Kazhinji panguva pamuviri, mwana uye postpartum nguva, pangava nekuve yematambudziko. Mumwe wavo ari obstetric chokubuda. In Gynecology, ichi izwi chinorehwa chero kwazvo ropa kubva dzokubereka turakiti kubva pakurongwa mukupera postnatal kumwedzi.

Maererano nenhamba, kazhinji kuitika ropa iri, trimester wechitatu rechipiri uye pashure pakusununguka. Nokuda anatomical uye vasiri maitiro vakadzi vanogona kuva nokukurumidza kana akakura obstetric chokubuda. Muchiitiko ichi zvinoda pakarepo urongwa okurapwa, nekuti ezvinhu akadaro kunogona kuva nengozi vakadzi nevana.

Kupatsanura pakati obstetric ropa

dambudziko iri muboka maererano nenheyo siyana. Obstetrical ropa zvikonzero zvakasiyana, izvo akaparirwa izvozvo, uyewo bhuku ropa akarasika. Pakati matambudziko, izvo Classified maererano wokutanga pfungwa, tinogona kusiyanisa ropa yokuvamba:

• rokutanga hafu pamuviri;
• yechipiri yezana pamuviri;
• pa kutanga basa;
• pakati munhu Generic kwacho;
• wokupedzisira Danho;
• pashure kusununguka;
• mazuva mashomanana pashure pakukurukura.

Uyezve, zvinoita here patsanura obstetrical ropa bhuku ropa akarasika. Vari rakakamurwa mhuka yakadai:

• chenjera ropa kurasikirwa;
• wandisa ropa kurasikirwa chirwere;
• Hemorrhagic kuvhunduka.

Zvichienderana raivapo kutyorwa uye kuti, nguva ipi zvaitika, akasarudzwa nzira kurapwa.

Ropa ari trimester akazvitakura rokutanga

The kukonzera ropa yokutanga mishomanana pamuviri vari:

• kupfupfudzika;
• matadza pamuviri;
• remuromo pamuviri;
• remuromo zvokurwara.

Kana kupfupfudzika vakadzi kuonekwa chikuru zviratidzo kurwadziwa uye yakanyanya ropa kurasikirwa. With nokutyisidzirwa nokupfupfudzika kusvibisa muduku uye marwadzo hatisi kana vane mikukutu dzava hunhu. Vaingoerekana pamuviri uzadziswe kana kukwana. Kubva izvi zvinoenderana kudiwa uye nzira wokupa kurapwa.

Uyezve, ropa kunogona kuitika kana dambudziko akadai hydatidiform nhuta. zvokurwara ichi kunoratidzwa pakuti chorionic villi tinoshandurirwa vesicles ane inonzi estrogen. Pangozi vakadzi vane kuzvimba sikarudzi, uye hormone zvirwere. Treatment hazvisi nani kwakatooma uye hunoenderana ukuru kuparadzwa uterine mhango.

Remuromo pamuviri iri kuvhiringidzwa kuchitendero vhiki 12. Boka pangozi zvinosanganisira vakadzi vane anogumbura zvirwere, abnormalities ari cervix, uyewo kutyorwa kumwedzi. Kwakakosha kunyanya mufambo haisi nembeu zai iri dumbu uye remuromo mugero. Ropa kana ichi zvakakwana zhinji kubva yakaputsika guru uterine vascular marongerwo.

Polyps remuromo Canal kunogona kuva chikonzero ropa, asi ivo haakoshi. With huru dzakabuda polyps ropa zvowedzera, saka zvakakosha kundibatsira mune obstetric ropa.

Nyanyisa mapundu ose dumbu munguva pamuviri hariwanikwi, sezvo chirwere ichi kunoratidzwa zvikurukuru vakadzi vakura kupfuura makore 40. Treatment rinoitwa mushure pakukurukura. Kana nguva iri diki, zvinoratidza wakakwana kubviswa dumbu. Uyezve, ropa anogona vawadzane ectopic pamuviri. Somugumisiro, nzvimbo embryo kupinda uterine sepombi anogona kuputsa.

Ropa yechipiri yezana pamuviri

Ropa zvingaitikawo ari trimester pamuviri rechipiri uye rechitatu. Zvikonzero zvavo chikuru vari:

• placenta previa;
• placental abruption;
• uterine atsamwira.

Boka pangozi zvinosanganisira vakadzi vakambotadza vakanga ndavhiyiwa imwe anogumbura chirwere pamwe uterine malformations, uyewo hypoplasia pamusoro sikarudzi. Kutyorwa kunyanya kuitika kana placenta iri zvakananga pamadziro pamberi dumbu. In yechipiri yezana nepamuviri zvinokonzera ropa kungasanganisira atsamwira kwemasvingo muchibereko chemusikana somugumisiro kuvapo scarring pashure pokuvhiyiwa, cesarean chikamu, kana kuvapo hydatidiform nhuta. Kana uterine atsamwira, sezvo mutemo, zvinhu inoguma lethally. Kunze ropa kuchengetwa zvakare zvikuru kurwadziwa.

postpartum ropa

Kazhinji pane obstetrical ropa pakusununguka uye vokutanga postnatal nguva. Vakadzi vazhinji pakarepo vatanga kutya, nekuti haana fungidzira sei mumamiriro ezvinhu akadaro kuchapfuurira, uye kuti vaiona ndozvakajairwa, uye kuti inobatana pathologies. Ropa pakusununguka kuitika kunyanya nokuda:

• remuromo atsamwira;
• uterine atsamwira;
• PONRP (abruptio placentae).

Pamusana remuromo atsamwira kunogona nekutambudzika ropa. Izvi zvinoitika nokuti kuti pakakoromoka zvinogona kusvika kusangana nekutsi kwemukadzi rakatenderera, kana kunyange kukanganisa pasi parusvingo dumbu. Pangozi vakadzi vane zvaipesana basa, michero guru, uyewo nokushandisa zvimwe zvinodhaka. remuromo atsamwira munogona muchimiro ndichibvunza kubuda ropa. Izvi vainyanya nyaya yevakadzi vane nokukurumidza pakusununguka. The yokupedzisira chirwere ari chiremba zvinoita vakaongorora nokuberekwa Canal.

In padariro wokutanga basa zvingaitika PONRP kuti kunoratidzwa kurwadziwa mukati dumbu kuti murege uwirirane sunga. Panyaya iyi, muchibereko chemusikana relaxes kana insufficiently vagadzikana, uye pane zvikuru ropa clots. Izvi mamiriro ezvinhu akawanda chirwere vakadzi vane discoordination basa, kutanga zvimwe zvinodhaka somushonga, kuvapo neBP. Vanogona kuva nokukurumidza chaizvo pakusununguka.

Uterine atsamwira chiremba anogona rokuongorora sunga insufficiently simba, apo vakadzi vane hanya nokurwadziwa zvikuru. Muchiitiko chino, pane kwazvo ropa kubva nyinyo, uyewo zvichibvira fetus hypoxia. Kana chiratidzo hwakadaro kuitiswa caesarean chikamu.

Pangave ropa mu obstetric postpartum yomuka nezvikonzero akadai:

• kuberekwa zvakaoma;
• muchero guru;
• pamuviri pevana vakawanda;
• polyhydramnios.

Ropa kunogona kuitika mukunopera postpartum nguva, ndokusaka usati wabva chiremba achiitisa kumbonyatsoongorora kuongorora vanaamai kuti hwatsvuka uye mamwe nekukasika, uye vanorumbidza noruremekedzo kuti nguva uye zvechadenga postpartum nguva. Kazhinji zvakanaka simba kusvibisa aona kwemazuva anoverengeka pashure pokuberekwa, kusvikira nguva apo ukama mucous zvinyama pamusoro dumbu kwakuporesa. Zvakakomba post-partum chokubuda vari yematambudziko ngozi chaizvo zvingakonzera rwaamai nzufu. Kwokuomerwa ropa kunoenderana uwandu ropa akarasika. ezvinhu akadaro zvinoda pakarepo nokumutswa.

The zvinokonzera obstetric ropa

Usati kuita kurapwa, zvakakodzera atange chinokonzera atsamwiswa yakadaro rusvingo. Kazhinji pane obstetric ropa. Help iyi nyaya iri inobva precipitating zvinhu kuti neimwe nguva pamuviri uye basa zvakasiyana. Large ropa kurasikirwa kunogona chaizvo ngozi mukadzi azvarwa. In yokutanga yezana pamuviri ropa simuka nokuda ectopic muchangosangana kana pamuviri. In yechipiri kana yechitatu trimester ropa kunogona kuitika nokuda vakurumidze kubuda ari placenta.

Zvikurukuru chaikoshawo ropa pashure pokupedza basa. Panguva ino, pangava nematambudziko chokuita chokwadi kuti:

• placental villi kukura kupinda dumbu;
• zvimwe zvikamu placenta anoramba ari dumbu;
• akuvara pakuberekwa mugero.

Ropa kuti rikaitika postpartum nguva vangava chokuita ungaderedza uterine matauriro. Zvisinei, hazvina ipfupi, uye naizvozvo, ropa hakugumiri. Zvinogona kuva dambudziko, uye murombo kweropa.

Zviratidzo obstetric ropa

Ropa angava nechomukati, zvokunze, kana mubatanidzwa. External ropa iri akaona placental abruption uye remuromo dilatation. PONRP kuumba hematoma inozivikanwa zvemukati kubuda ropa. Combined ropa kunogona kuitika kana lateral placental abruption pamwe zvishomanana yokutanga remuromo mugero.

Emergency hanya obstetric ropa vanofanira nguva dzose kupiwa kana zviratidzo zvokutanga, akadai:

• ropa kubva nyinyo, zvisinei nokukura kwavo uye hunhu;
• uterine kurwadziwa;
• dzungu, hapana ganda, simba, kufenda;
• kumanikidzwa rutapudzo;
• kushandura mwoyo yevanhu azvarwa.

Kuratidza postpartum chokubuda anokonzerwa nhamba uye kusimba kurasikirwa neropa. Kana dumbu haateereri kuchirapa kumonyanisa kubuda kweropa iri nyaya yakasimba chaizvo uye zvinogona zvasakara Wavy hunhu. Nguva nayo aserera pasi zvinoitwa zvinodhaka zvakawanda. Uyezve, mumwe mukadzi ane kunyanya ganda pallor, tachycardia, hypotension.

Vhoriyamu kurasikirwa neropa anosvika 0.5% kurema womukadzi pamuviri anonzi kuti physiologically zvinogamuchirika, apo kuwedzera bhuku iyi anokuvadza kuchinja kuitika mumuviri, saka zvakakosha kuti kubvisa dambudziko iri nenguva nenzira. Muna postpartum nguva, mukadzi anofanira yazivisa simba rinokunda uye mazhinji lochia pamwe Masvinga makuru uye kudhonza marwadzo mudumbu.

SERVICING iri

Mabatirwo obstetrical ropa algorithm anoitwa chete pashure misoro kuongorora chirwere. Chirwere chinotanga murwere kuongorora kuona ya ropa uye tsika dzaro. Chiremba akabva anoenderera kuunganidza nhoroondo vezvokurapa kuziva chii vaiva chirwere rwuchibuda nepamuviri uye pakusununguka.

Panguva iyoyowo kuti aongorore vakadzi, kuyerwa kupomba zvazvingava, BP, akaongorora dumbu. Panguva iyoyo tinoda pelvic bvunzo achibatsirwa nezvionioni, uterine palpation kuona kukakavadzana tsandanyama. In chokuwedzera ongororo Ultrasound kuziva kana placental abruption iri, sezvo ari achiine rukuvhute tambo uye dumbu kana kuperera raputsika. Zvakakosha kuvaka algorithm zvakajeka. Obstetric ropa iri ngozi chaizvo nokuti mukadzi nemwana, saka unoda kubatsirwa nokukurumidza.

rubatsiro First

Hako zvaida chimbichimbi kutarisira obstetric ropa, sezvo zvakadaro kungava dzinonetsa uye chinokurwadzai matambudziko akasiyana siyana. In paine mukadzi ropa hazvo akaiswa muchipatara kuti pakuongorora uye kurapwa. Transportation kunofanira kuitwa chete supine chinzvimbo. Kana pamuviri, uye chinokosha ropa kurasikirwa rikwanise kutarisirwa kunoreva kubviswa Hemorrhagic nehana. Zvinodhaka zviri raitongwa nomutsinga asati murwere rubvumo. Kana akasuma zvakazara pamuviri zvinoreva kuti zviite kuti rutapudzo ari dumbu, nomutsinga.

Kana paine obstetric ropa, nechimbichimbi dzakati pamwe ectopic pamuviri kunosanganisira kutanga zvinodhaka kuti abatsire kubvisa zviratidzo Hemorrhagic nehana. Zvisinei, vakadzi vanopedza okisijeni inhalation. Treatment nokuda kwokubatsira glucocorticoids chiri kuitwa chete kana akaratidza. Murwere inoratidza zvokukurumidzira muchipatara, kutakurwa rinoitwa munyika asingatani chinzvimbo. Panguva zvekufambisa, kumanikidza anodzokororwa pana 80-100 mm HG. Art. Ane simba chaizvo ropa muchipatara wakaitwa kuvhiya chikwata resuscitative-.

Uyezve, muchipatara rinoitwa uye nekutambira kunzwisisa kurapwa pamwe placenta previa kana yokuzviparadzanisa. Ona kuti zvimwe matambudziko uye zvirwere kuti rukungiso ropa, zvinoda chiremba cherechedzo, saka nhumbu hazvo vakabvuma kuti kuchipatara.

Mabatirwo obstetric ropa

Ropa rakawanda kungamutsawo akasiyana-siyana zvinetso zvakasiyana uye matambudziko. In pakurapa obstetric ropa pakutanga vanofanira kumisa kurasikirwa neropa uye kubvisa ngozi vakadzi nevana. Pregnant hako anoratidza zororo rakakwana, akavarambidza kurovedza muviri, uye chipatara mutsigiri. The kunzwisisa yokurapa akasarudzwa kunyanya nomumwe uye zvichienderana ropa rakatanga chii izwi. Prevention, kurapwa uye algorithm pamusoro obstetric ropa yakatanga neShumiro Health uye kunofanira kuremekedzwa navanachiremba kana murwere paanosvika pachipatara.

Kana ari ropa in early pregnancy prescribers uchiwedzera viscosity ropa, sedatives uye kusimbisa nevamiririri. Kana rakakura nemamiriro mukadzi mudumbu rinoratidza yevanorwara zvikuru. In pamberi wechitatu trimester ropa inoratidza kushanda pakukurukura. Kana uri kusangana postpartum obstetric ropa, kurapa dzakati angava akasiyana - nokushandisa zvinodhaka uye kubvisa dumbu. Zvose zvinoenderana kunzwisisa dambudziko, nokuti chinonyanya kukosha - kuponesa upenyu hwemukadzi.

prophylaxis

Kudzivirira obstetric ropa ndeyevanyori pokuita dzemitemo dzinokosha dzakawanda. Chokutanga, unofanira kuronga pamuviri nenzira yakakodzera nenzira vanyorese uye kushanyira chiremba nguva dzose. Zvinofanira kuva iripo nguva kubata zvirwere sikarudzi. Kana zvakakodzera, unofanira atore kunzwisisa kuti physiotherapy. In muitiro achisununguka kufamba nemazvo, kufungisisa zvose kunenge ose chiremba, uyewo kuongorora zviratidzo uye contraindications.

Kudzivisa panowanikwa ropa ari postpartum nguva, unofanira kutevera mitemo iyi:

• breastfeed pamusoro chinodikanwa;
• kuongorora dundira;
• avete dumbu rake;
• kushandisa inotonhorera rezasi dumbu.

nezviyero zvose izvi chokudzivirira kuchabatsira kudzivisa panowanikwa ropa uye vanatsiridze zvakanaka vakadzi.

Matambudziko uye sequelae kuti ropa

Anogona kuva zvakaoma kunzwisisa zvikuru ngozi uye zvakaipira ropa. To avo vanosanganisira:

• Fetal hypoxia;
• fetus rufu;
• ropa racho kumadziro mukati menyika dumbu;
• Hemorrhagic kugwinha;
• ramai vake rufu.

Uyezve, nemamwe matambudziko anosanganisira kwazvo kusagadzikana ropa coagulation chokuumba muzvizhinji kuti thrombi uye panowanikwa ropa. Kungavawo kusava ropa rakawanda, nokuvhiringidzirwa ari kwemakemikari anobudiswa ino uye kushaya kemikari kugadzirwa.