Pathological rokutanga munguva: kurapwa. Rokutanga nguva - zviri ...

Rokutanga munguva - hondo mudumbu panguva pamuviri, achiperekedzwa zvishomanana kurwadziwa uye makakatanwa tsandanyama. Vane kwemashifiti. kurwa kwakadaro Precursors makurukuriro. Under kwomuzvarirwo ezvinhu, rokutanga padanho basa anofanira kutora nguva pamusoro maawa 6-8. Zvisinei, mune zvimwe zviitiko, izvi nguva anogona kunonoka. Izvi zvinogona kuitika nezvikonzero zvakasiyana-siyana. Muchiitiko ichi kune abnormality webasa, rinoda pakarepo vanachiremba. Sezvo migumisiro kuramba tichishanda rokutanga nguva kunogona kuva dzakakomba zvikuru pana amai mwana kubva simba discontinuities muna amai uye anopera norufu azvarwa.

Pfungwa yacho pathological rokutanga nguva

The physiology mukadzi mumwe nomumwe. Mune zvimwe zviitiko, izvi nguva anogona seranonoka kwemaawa anoverengeka, uye dzimwe nguva kwemazuva mashomanana. Izvi zvinotungamirira kuti Kuparadzwa vakadzi, kurasikirwa hope, kuunganidza panguva yokuberekwa yokunyanyisa kuneta. Muchiitiko chino, pane pathological rokutanga padanho basa, kureva pamuviri nguva, urwo rwakatora. It kunoratidzwa kwemashifiti zvinorwadza sunga, izvo regai kukonzera kuchinja cervix, uye chete deplete muviri mumwe mukadzi.

Musimboti wacho anomalous rokutanga nguva

tinogona kutaura inokosha musimboti zvokurwara sezvinotevera:

• Vasiri rokutanga nguva iri kunonoka.
• Anowedzera mataurire myometrium.
• Internal cervix mupfupi.
• Kune reductions repasi uterine chidimbu.
• Muscle fibers akaronga mudenderedzwa, uye zononoka transversely;

zvikonzero

Sezvo kutonga, pathological rokutanga nguva ndiyo pamberi nenyonganiso mumuviri vanamai. The zvikonzero inogona kupatsanurwa muzvikwata zvitatu:

Ob:

• Kuvapo polyhydramnios kana oligohydramnios.
• Multiple pamuviri.
• Chibereko chechizvaro anotora isiri nzvimbo (breech mharidzo).
• The placenta yakaderera.

psychoemotional:

• Mukadzi afraid yokusununguka.
• Negative kumunetsawo.
• Netsinga uye zvakakomba mupfungwa.
• Kuneta varwere.
• Age nulliparous vakadzi (kutya mugumisiro basa zvakare mangwanani kana kunonoka pamuviri).

vasiri:

• Ko vanamai rakatetepa chiuno.
• Kare anoitwa utero Kuvhiya (scarring pashure caesarean and said.).
• Disruptions kuti kwemakemikari anobudiswa hurongwa (kufutisa, kudya etc.).
• Labile tsinga.
• Zvirwere itsvo, mwoyo, chiropa, uye vamwe. Matare.
• kuzvimba dumbu.
• Preeclampsia.
• Multiple pamuviri.
• Kupfupfudzika ari mudumbu.

zviratidzo

Zvokurwara prelimirnogo kumwedzi kubatsira kuziva zvinotevera zviratidzo:

• Dumbu iri regadziriro uye rokutanga nguva inorwadza akaderedzwa, apo sunga havasi dzose. Vanogona kuitika vaviri masikati uye usiku. In haadi kutanga mabasa kwenguva refu.
• Inosimudzira mataurire dumbu yayo excitability.
• kuti cervix isina kuchengetwa, inoramba gobvu uye refu.
• Kupa chikamu mudumbu haina waitsimbirira vaduku chiuno mukadzi.
• Nekuti uterine hypertonus zvakaoma dzika palpation mudumbu.
• The dumbu kwenguva refu nguva shoma monotonically. Simba uye kakawanda sunga handishanduki. Kwezvapupu uye rokutanga nguva tiri refu zvakasikwa.
• Mukadzi pane kuderera mune epfungwa, akava nemisodzi uye kutsamwa, ane chivimbo mune anobudirira kuvakwa pakukurukura.

zvokurwara mhando

Pathological rokutanga nguva kunogona kuva marudzi maviri:

• Muchiitiko chokutanga kuti uterine tsandanyama havasi vasununguke, kuti tsandanyama fibers ari dumbu akafanana "vakakura mumudzimu" mutsipa, oligohydramnios, flat membranes.
• Kana yechipiri, cervix ndiye "saibva", ane denderedzwa chimiro, kupa chikamu mudumbu haasi pedyo nesuo kuti wokushambidzira duku. Kakawanda, zvinhu zvakadaro kuchengetwa perenashivanii mudumbu.

chinguva

Duration anomalous rokutanga nguva kuchitsamira pamunhu unhu mukadzi mumwe nomumwe anogona anosiyana kubva maawa 6 maawa 24-48. Vamwe vakadzi, zvingatora mazuva akawanda.

pezvingazoitika

Pathological rokutanga nguva kakawanda kunotungamirira matambudziko pakusununguka. rwaamai mabasa mazhinji runoyerera zvisinganzwisisiki. In zvikuru:

• Akatambura simba. Mumamiriro ezvinhu ichi, dzinoratidzwa kushaya simba uterine sunga, zvikamu refu pakati sunga, kuti cervix dilates zvishoma nezvishoma, kukurudzira fetus kunonoka.
• Diskoordinirovannaya akatambura. Rinooneka sechisina musoro sunga yacho dumbu madhipatimendi. No yaunonyanya kushandisa ari marwadzo uye kutandara netumedu zvikamu. Somugumisiro kurwa vari pamwe irwadziwe kwazvo, vari kakawanda uye kutadza, kuti exhausts amai uye inoita vake kuzorora.
• Pamabasa anoenderera nokukurumidza. Nokuti anomaly ichi kunoratidzwa sunga simba chaizvo uye unopinza uye kungoita. Somugumisiro, kukurukura zvakasimba chaizvo (kusvika 5:00). Izvi zvingaita kuti atsamwira pamusoro nepanhengo uye perineum vakadzi vane pamuviri, yakanyanya ropa. Ari mudumbu anogona kutanga hypoxia. Rapid wakurukura zvingakonzera kuberekwa zvakuvadza azvarwa.
• uterine tetenasi - isingawanzowanikwi anomaly. Muchiitiko chino, mamiriro apo dumbu chose vagadzikana. Zvinotora nzvimbo iri chiitiko vakawanda pacemakers munzvimbo dzakasiyana-siyana dumbu. It inotungamirira nokuvhiringidzirwa uterine sunga uye vanorega pakusununguka. Ari mudumbu anogona kuva hypoxia, izvo zvingaita kuti cardiac zvirwere.

Zvingamuka nemigumisiro yakaipisisa zvemamiriro chokubuda basa:

• Kukurumidza Kubviswa Líquido amniótico.
• The chidzoke pakutanga hondo meconium, izvo zvinoreva kuti "kutambudzika" ari mudumbu.
• Kuvhiya pakusununguka.
• Forceps.
• Zvakakomba mwero kubuda ropa.
• Muna postpartum nguva, dzichiri zvirwere purulent-rwarisa.
• Fetus hypoxia uye kuberekwa mwana vasingadzoreki cardiac kana coronary tsinga chirwere.

Diagnostics

Kana uchifungidzira kuti rokutanga nguva anomhanya zvisinganzwisisiki, iwe pakarepo kuona obstetrician-gayinakorojisiti. Anofanira kuita kuongorora kwokunze. Palpation kunobatsira kuziva yakakwirira kana nzvimbo yakaderera azvarwa. Kana muchero isina rakadonha, inoratidza kuvapo zvokurwara zvebasa. Uyewo ari zvokurwara anogona vachatongwa pamberi simba nemakakatanwa pakati tsandanyama ari nyinyo, muchibereko chemusikana chokusunungukira umbishi uye kurwadza kwacho.

In rokutanga nguva yakavakirwa chirwere zvokurwara ndiko kurapwa uye rabhoritari zvidzidzo kugumisa achidzikisa erythrocyte acetylcholinesterase basa, kuwedzera ropa kwevari hormone adrenaline uye noradrenaline.

Zvichida kudzidza chokushandisa. Kuti aite izvi, kuti cardiotocography. Narwo unogona kunyora simba uye paanowedzera sunga.

Pathological rokutanga kumwedzi: kurapwa

Apo saibva cervix uye kusavapo kuzvimirira kukura basa vakachengeta muenzaniso perenashivanie pamuviri. Zvipatara vachabva vakagadzwa maererano pamusoro pathogenesis zvirwere. Vavariro mishonga kuwedzera ichiibvira muitiro yacho dumbu. Dai kushandisa kurapa kwakadaro:

• Elektroanalgeziya.
• Elektrorelaksatsiya dumbu.
• Treatment pamwe medikametov: antispasmodics, analgesics, prostaglatinov E2.

Kana murwere akacherechedza zvikuru kuneta uye kwakawedzera kutya, iye akagadzwa kuva pakurapa hope zvinodhaka Kutemeswa. Also akanyorwa kubva sedatives.

A akanaka kurapwa Mugumisiro zvinoratidzwa unopinza pakutanga dzose sunga. Kana ichiibvira muviri yokusununguka. Kana dumbu anova "vakakura mumudzimu", fetus dundira kuzarurwa uye mumaawa maviri dzose sunga kutanga. Kana pamabasa musingadi kutanga, zvino nomutsinga dzakabatwa prostaglandins.

Kana basa kurapwa pamwe nemamwe matambudziko (obstetrical nhoroondo, yakakura kukura ari mudumbu, breech mharidzo, OPG-preeclampsia, fetus hypoxia pamusoro) akaita njodzi Caesarean chikamu.

Anouya basa vakadzi nepamuviri vakanga ndachengeta pathological rokutanga nguva

Pane Nzira mbiri:

• Complete zororo.
• Induction kuti basa vachishandisa oxytocin.

Nzira Dzose inoitirwa kubvisa kutyorwa basa. Zvakanaka Mugumisiro kuchengetwa 85% nyaya. Pakusarudza nzira inorangarira zvinotevera zviri zvokurwara:

• Kwakaita murwere kufunganya uye kuneta.
• Chikonzero icho munhu kuomesa.
• Pakusarudza nzira, iyo yamunenge murwere uye obstetrician.

Pakusarudza nzira zvakakwana zororo pamuviri nyaya, izvozvo chinotarisirwa intramuscularly 0,015 g morphine. Zvadaro secobarbital kupinda 0.2 d pfungwa uyu inoshanda zvakakwana. Kazhinji, pashure kwokubatsira morphine murwere kanorara awa rimwe. Mushure memaawa 4-5 rokuzorora, umo aneta muviri bumbunuka, mumwe mukadzi anomuka pasina chipi pakuzvarwa zviratidzo, zvichida basa rokumanikidzirwa.

Pakusarudza wechipiri njanji, i.e., kweiyi oxytocin havafaniri kuvhura membranes. Cesarean chikamu anoruramiswa chete wakakura zvikuru kacho.

dziviriro

Major matanho yokudzivisa zvokurwara rokutanga kumwedzi vari:

• Panguva Chaiyo kubvunza pamusoro obstetrician.
• Delivery ose anodiwa Analyses.
• Achiita chiremba mirayiridzo chokuita chimiro uye simba.
• Psychological uye mumuviri kugadzirira vakadzi pamuviri chokusunungukira.

Nomazvo obstetrician kuramba kudzora vakadzi vari panjodzi panowanikwa chirwere ichi. Zvinoti nulliparous pasi makore 17 uye pashure pemakore 30, uyewo vakadzi vane chirwere nedzimwe nhengo (chitaka, itsvo, mwoyo).

Saka pathological rokutanga nguva mumwe mhando anomalies okushanda basa. It kunoitika kakawanda. Zvisinei, nemhaka kwemazuva ano, 85% of nenguva vanachiremba Delivery magumo zvakanaka. Naizvozvo, kana zviratidzo chirwere wokutanga hwobva zivisai nomazvo obstetrician-gayinakorojisiti. Migumisiro kanganisika rokutanga nguva kunogona kuva dzakakomba zvikuru, kusvikira fetus hypoxia upi kukundikana kwayo nhengo dzomukati uye rufu. Zvakarurama ushandiswe kurapwa kubatsira kuponesa upenyu mai nomwana.