Ithuba lokukhulelwa elifanelekileyo: Isikhokelo esipheleleyo sokukhetha elona xesha lilungileyo

Ukukhupha izithuba zokukhulelwa Ukuncancisa ngokufanelekileyo kunokuphucula amathuba okuba neentsana ezisempilweni kwaye kukhusele impilo kamama. Ubungqina bubonisa ukuba njengesikhokelo esiqhelekileyo, kungcono ukulinda ixesha eliphakathi kokuzalwa komntwana omnye kunye nokukhawulwa kolandelayo. ubuncinane iinyanga ezili-18 ukuya kwezingama-24 nangaphantsi kweminyaka emi-5. Xa isithuba si imfutshane kakhulu o ixesha elide kakhulu, iingozi ze ukuhanjiswa kwangaphambi kwexesha, ubunzima bokuzalwa obuphantsi kunye nezinye iingxaki.

Uhlalutyo olucatshulwe ngokubanzi lufumanise ukuba, nge isithuba esingaphantsi kweenyanga ezili-18, kwaphawulwa ukwanda 40% kumathuba okuzalwa kwangaphambi kwexesha, a 61% ubunzima bokuzala obuphantsi kwaye a 26% abantwana abasanda kuzalwa abancinci-for-gestational-age. Ngexesha elifanayo, kunye nezithuba ngaphezulu kweenyanga ezingama-59, iintsana zabonisa phakathi kwe-a 20% kunye ne-43% iziphumo ezibi ngakumbi. Le mibutho iye yaphindwa ngokuphindaphindiweyo kubantu abahlukeneyo kwaye ixhasa isincomo sokuphepha ukugqithiswa kwezinto zombini kunye nezithuba ezikufutshane.

Ukucwangcisa ukukhulelwa Ukubonisana kwangaphambili kunceda ukuqinisekisa isiqalo esinempilo kumama nosana. Kuyacetyiswa ukuba wenze ishedyuli yokubonisana kwangaphambili ukusombulula nayiphi na imibuzo, ukuphonononga izifo ezidlulileyo, vavanya amayeza kunye neendlela ezinokuthi zikhuseleke, hlaziya ugonyo (umzekelo, ngokuchasene nemasisi-mumps-rubella okanye chickenpox ukuba kufanelekile), kwaye wenze ukuhlolwa kosulelo izifo ezosulela ngokwabelana ngesondo. Kukwacetyiswa ukuba ucele uvavanyo lwegazi kunye intsimbi, ferritin y folate, kwaye uqale folic acid ngaphambi kokukhulelwa.

Imikhwa emihle -ukutya okunempilo, ukwenza umthambo rhoqo, ukongeza nge folic acid, ziphephe Inetyhefu kwaye, kwimeko yokutshaya, yeka ukutshaya- zingundoqo kukukhulelwa okunempilo. Ukongeza umsebenzi Umgangatho we-pelvic (ezifana ne-Kegel exercises) ikhuthaza ukubuyiswa kwasemva kokubeleka.

Kubalulekile ukukhumbula ukuba ukuba ibhinqa likhulelwa ngaphandle kwawona mathuba acetyiswayo, akufanelanga ukuba wothuke: nge uphononongo lwezonyango kunye nemikhwa efanelekileyo, kunokwenzeka ukunciphisa imingcipheko kunye nokukhokela ukukhulelwa kwisiphumo esiyimpumelelo.

Zilinganiswa njani izithuba eziphakathi kokukhulelwa?

Kuncwadi ziyasetyenziswa iindlela ezahlukeneyo zokulinganisa izithuba kwaye la magama asetyenziswa rhoqo:

• Ukususela kumhla wokuzalwa ukuya kumhla wokuzalwaKulula ukubala, kodwa ayicingi ngokuqhomfa kwangaphambili; yiyo loo nto ithande ukuba njalo uqikelelo olugqithisileyo elona xesha lokuphumla. Le yayiyimetric kwizifundo ezininzi zakudala.

• Ukususela ngomhla wokuzalwa ukuya umhla wokukhulelwa. Ilinganisa ukusuka ekuzalweni komntwana ozelwe ephilayo de ukuqonda yokukhulelwa okulandelayo. Ibonisa ngcono ixesha lokubuyisela phakathi kokukhulelwa, nangona ukubala kwayo kungabi ngaphantsi.

• Ixesha phakathi kokukhulelwa (ekwabizwa ngokuba yi-IPI, ukusuka kwixesha lokukhulelwa). Isuka kwi ukuqonda ukusuka kumntwana wokuqala ukuya kwi ukuqonda eyesibini. Le ndlela inxulumene kakhulu ne impilo kamama kuba ibandakanya ukukhulelwa okuphela ngokuqhomfa, nto leyo echaphazela oovimba bomzimba.

Omnye umlinganiselo oluncedo yi-IDI (ikhefu lokuhanjiswa kweenkonzo ezahlukeneyo), ebala ixesha phakathi ukuzalwa kabiniNangona i-IPI igxininise ekubuyiseleni umzimba ngaphambi kokukhulelwa, i-IDI inceda ukuvavanya i-intrapartum phenomena (umzekelo, ukuhanjiswa kwe-vaginal okucwangcisiweyo emva kwecandelo lokubeleka).

Imingcipheko xa ixesha lokuphumla lilifutshane kakhulu okanye lilide kakhulu

Xa ukukhulelwa okulandelayo kuqala kwi iinyanga zokuqala 6-12 Emva kokubeleka, umama nosana banokujamelana nezinye iingxaki. Izifundo zibonisa ukwanda kwi ukuhanjiswa kwangaphambi kwexesha, ubunzima obuphantsi y incinci kwiminyaka yokumithaKumama, kuchazwa ngakumbi i-anemia y ukunqongophala kwe-micronutrient (ingakumbi ye folate y intsimbi), kuba umzimba awukawafumani ngokupheleleyo oovimba bawo, ngakumbi ukuba kukho ukuncelisa.

Ukongeza, amathuba amafutshane kakhulu angadityaniswa ukukhulelwa okungacetywanga kwaye, ke, ixesha elincinci lokulungelelanisa imikhwa, ukongeza y lawulo. Amathuba aphezulu okuba iziphene zokuzalwa kunye nemibutho ichazwe kunye ukugqabhuka kwangaphambi kwexesha kweembrane kunye neengxaki ze-intrapartum. Inxalenye yesiphumo inokuchazwa ngu ukudumba okuqhubekayo emva kokukhulelwa kwangaphambili, ukuphiliswa okungaphelelanga (umzekelo, ukusuka kwicandelo lotyando) okanye ukuchacha ngokwaneleyo komgangatho we-pelvic.

Kubafazi be ubudala obudala bokuzala, amaxesha angaphantsi konyaka omnye emva kokuzalwa aye adityaniswa nangaphezulu ukugula komama. Ngokuchasene noko, linda i Iinyanga ze18 ithande ukunciphisa loo mngcipheko. Eli linqaku elifanelekileyo kwabo bafuna ukugqiba usapho lwabo ngaphandle kokulibaziseka okungafanelekanga ngenxa ukwehla kokuchuma.

Xa isithuba si ixesha elide kakhulu (ngaphezulu kweminyaka emi-5), imingcipheko ethile iyanda, njenge preeclampsia kunye umsebenzi onzima ngakumbi (dystocia). Kucetywayo ukuba ukukhulelwa kunemiphumo emihle kwi-uterus ethotywayo ngokuhamba kwexesha.

Uluhlu lweziphumo ezichazwe kuncwadi ngokunciphisa kakhulu isithuba kwaye, kancinci, ngokulenza kakhulu:

• Usana olusandul' ukuzalwa: ubunzima bokuzalwa obuphantsi, ukukhula komntwana, ukukhula kwangaphambi kwexesha kunye nokugqabhuka kwangaphambi kwe-membrane; ukwanda komthwalo wengane iziphene zokuzalwa kwaye, kwezinye izifundo, ukuphazamiseka okuninzi kwe uphuhliso.
• UmamaI-anemia: preeclampsia, iingxaki ekuzalweni kwelungu lobufazi emva kwecandelo lotyando (kubandakanywa ukugqabhuka kwesibeleko ngamaxesha amafutshane), kunye nokwanda kokugula ukuba ukukhulelwa okutsha kuqalwe kwangoko kakhulu.

Kwimeko a icandelo lotyando lwangaphambili, ukuchacha kwesiva sesibeleko kubalulekile. Ikhefu elifutshane linyusa umngcipheko we ukugqabhuka kwesibeleko ngexesha lokuzama ukubeleka kwilungu lobufazi emva kwecandelo lotyando, ngakumbi ukuba ukukhulelwa okutsha kwenzeka ngaphambi kweenyanga ezili-18. Umngcipheko uyancitshiswa njengoko ixesha elininzi lihamba kwaye isiva sifikelela a ukukhula kakuhle.

Leliphi ixesha elifanelekileyo phakathi kokukhulelwa?

Sisigqibo esinzulu esenziwe sisibini. Umlinganiselo ophambili kukuba bobabini abazali bazilungiselele ngokwasemzimbeni nangokweemvakalelo. Nangona kunjalo, ngokwembono yezonyango, kukho izintlu ezicetyiswayo ngakumbi: uninzi lwezikhokelo zibonisa ukuba eyona ilungileyo kubemi ngokubanzi linda phakathi kwe-18 kunye ne-24 yeenyanga emva kokuzalwa okuphilayo phambi kokuba ukhawule kwakhona, kwaye ungadluli kwiminyaka emi-5. Umgaqo-nkqubo sele ucetyiwe kumsebenzi wangaphambili Iinyanga ezi-20 ukuya kwezi-48. Ngokuphathelele ubuncinci, amanani akhankanywe Iinyanga ezi-9-12, kodwa imeko yangoku iyathandeka Iinyanga ezili-12 njengendawo yokuhlala y Iinyanga ezili-18 njengenjongo ukunciphisa iingozi.

Lo mda uvumela umama azalise izondlo emva kokukhulelwa kunye nokuncelisa kwaye, ngokwembono yengqondo, inika ixesha lokuba ukuziqhelanisa nobuzali yomntwana omkhulu. Ngonyaka wokuqala wobomi, umntwana ufuna ubukho obuninzi; emva kwelo xesha, kudla ngokubakho ngaphezulu ukufumaneka ngokweemvakalelo kumntwana omtsha. Ukuba ukuzalwa kwangaphambili kwakubangelwa Icandelo leKesareya, ixesha lokubuyisela izicubu libaluleke kakhulu: umngcipheko wokuqhekeka kwesibeleko ekuzalweni okulandelayo iphindwe kabini xa ikhefu lingaphantsi kwe 2 iminyaka.

Ngokwembono yomntwana omdala, iminyaka emibini yokuqala zibalulekile kwibhondi, ingakumbi kumama. Ukunikezela ngeli xesha ngokukhethwayo kunokwenza kube lula ukuziqhelanisa nosapho. Ukongezelela, xa umntwana ehamba yaye eqeqeshelwe ukuya kwindlu yangasese, ukufika komntakwenu kudla ngokungena lula ngakumbi kucwangciso lwentsapho.

Ezinye izinto ezinokuguqula elona xesha lifanelekileyo

Ukongeza kwizikhokelo eziqhelekileyo, zikhona iimeko ezithethelela ukulungiswa kwesithuba. Ngezantsi kukho iingqwalasela eziqhelekileyo:

• Emva kokuphuphuma kwesisu (ngaphambi kweeveki ezingama-20)Ukuba umfazi usempilweni kwaye uziva ekulungele, akusoloko kuyimfuneko ukulinda ixesha elide. Ezinye iingcebiso zakudala zicebisa ukuya kwiinyanga ezi-6, kodwa olunye uphando alufumani ncedo lucacileyo lokulibazisa. Eyona nto ibalulekileyo yile ukuchacha ngokwasemzimbeni nangokweemvakalelo, kwaye ulandele iingcebiso zengcali. Ukuba bekukho ukuphunyelwa zizisu okuphindaphindiweyo, uvandlakanyo lwangaphambili lungundoqo.
• Emva kokuzala umntwana ongasekhoyo (ukususela kwiiveki ezingama-20-22). Kuyafaneleka funda unobangela ukuba kuyenzeka kwaye wandise imiba eguquguqukayo (ulawulo lwe ifuthe legazi, iswekile yegazi, ukupheliswa kwe icuba, ubunzima obunempilo) phambi kophando olutsha. Ikhefu elithile lixhomekeke kwingxelo yeklinikhi.
• Icandelo langaphambili le-CaesareanKunconywa ukuba ulinde ubuncinane Iinyanga ze18 -kwaye rhoqo Iinyanga ezi-18-24- ukunciphisa umngcipheko ukugqabhuka kwesibeleko kwiinzame zokubeleka kwilungu lobufazi emva kotyando.
• Ukuzalwa kwangaphambili kwangaphambili okanye i-preeclampsiaNgokubanzi, ukulinda ubuncinane 1 ngonyaka, uphononongo lwe umngcipheko kunye namanyathelo okukhusela (umzekelo, i-aspirin prophylaxis kwiimeko ezikhethiweyo).
• iminyaka kamama. Isuka e 35 iminyaka, amanye amabhinqa akhetha ukwenza njalo amathuba amafutshane noko (malunga neenyanga ezili-12-18) ukunqanda ukulibazisa ukukhulelwa okulandelayo, ekubeni i inzalo iyancipha ngokuthe ngcembe kwaye imingcipheko iyanda njenge uxinzelelo lwegazi o isifo seswekileOlu hlengahlengiso kufuneka lulinganiswe kwimbali yeklinikhi.
• Ukuncedisa ekuveliseniEmva kokunikezelwa kwelungu lobufazi kunye nokuchacha kakuhle, kukho iiklinikhi ezicinga ukuba zinokwenzeka ukudluliselwa kwe-embryo isuka kwi Iinyanga ze6; emva kokuhlinzwa, ngokuqhelekileyo kuyakhethwa ubuncinci iinyanga ezingama-12. Ukulungiswa kwe-Endometrial kunye ii-estrogens y iprogesterone inokuchaphazela i ukuncelisa, ngoko kuyacetyiswa ukuba uyicwangcise kunye neqela lezonyango.
• Ukuncancisa kunye nokuthintelaUkuncancisa ibele kuphela kunokuba nefuthe inxenye yocwangciso (indlela ye-LAM) kwiinyanga ezimbalwa zokuqala, kodwa akusiyo isidenge; kucetyiswa ukuba isetyenziswe iindlela zokucwangcisa ezihambelanayo ngokuncancisa ngelixa besenza isigqibo sexesha lokukhulelwa okulandelayo.
• Umgangatho we-pelvic kunye nokubuyisela emva kokubelekaIkhefu elaneleyo liququzelela ukuhlaziya yomgangatho we-pelvic kunye nodonga lwesisu, ukunciphisa ukungakwazi ukuzibamba kunye nokungakhululeki. Bandakanya unyango lomzimba okanye imithambo yeKegel iluncedo phambi kokuba uzame ukukhulelwa kwakhona.
• Umxholo wobuqu kunye nomsebenzi. Iimeko zokusebenza, ukufumaneka kwe inkxaso Ukhathalelo lwabantwana kunye nemeko yentlalo-ntle yezoqoqosho inefuthe kwixesha elikhethiweyo. Ukunciphisa ixesha kunokusabela kwimfuno xolelana, rhoqo ngemvume yezonyango.

Kwisigama sobugcisa, IPI ye ngaphantsi kweenyanga ezimbini iyaqwalaselwa ayonelanga, kunye ngaphezulu kweenyanga ezi-60, ngokugqithiseleyo. Uninzi lweziganeko ezimbi zigxile kwi ixesha elifutshane, nangona amaxesha amade kakhulu nawo aphethe imingcipheko ephakathi.

Isondlo kunye nezongezelelo xa ukukhulelwa kusondelelene

Ukuba ukukhulelwa okutsha kwenzeka kwangoko, kubaluleke kakhulu kwandisa isondlo ukuhlawula unciphiso olunokwenzeka. Iingcebiso eziqhelekileyo:

• Qaphela Izidlo ezi-5 okunempilo yonke imihla, ukubeka phambili ukutya okutsha kunye neentlobo ngeentlobo.
• Ukhuselekile vitamin D ngokugqatswa kwelanga okulumkileyo kunye nokutya okutyebileyo kule vitamin, okanye ukongezwa xa kuboniswa yingcali.
• Yandisa ukuthathwa kwe folic acid (iimbotyi, imifuno enamagqabi aluhlaza) kwaye uthathe i isongezelelo emiselweyo.
• Ukubeka iliso kwigalelo le intsimbi y calcio; Amandongomane kunye noncedo lobisi luhlangabezana neemfuno, kwaye i-iron inokufuna ukongezwa ukuba ikhona ukunqongophala.
• Lungisa iikhalori ngokweemfuno, ngeecarbohydrates ezintsonkothileyo (irayisi, ipasta, iitapile) kunye nokubeka iliso ekuzuzeni ubunzima kunye neqela lezempilo.

Umahluko weminyaka phakathi kwabantakwenu: usapho kunye nemiba ephathekayo

Ukongeza kwimbono yeklinikhi, iintsapho zihlala zicinga ukuba umahluko weminyaka uya kuchaphazela njani Amandla endlu:

Umahluko omncinci weminyaka

• Abazalwana banokuba abalingane bokudlala kunye nezigaba zokwabelana.
• Iimfuno ezifanayo ziququzelela iindlela eziqhelekileyo kunye nolungiselelo lwemihla ngemihla.
• Umzamo wokuqala unzima, kodwa kunjalo igxile kwiminyaka embalwa yokukhuliswa.

Kwelinye icala, kusenokuba njalo ukudinwa ukunyamekela abantwana ababini abancinane ngaxeshanye. Ukuba ukukhulelwa okutsha kufikile kwangoko, kucetyiswa ukuba kuthathelwe ingqalelo kakhulu cwangciso kwaye uthembele kusapho okanye kwinethiwekhi yobuchwephesha.

Umahluko omkhulu weminyaka

• Umkhuluwa udla ngokuba ngaphezulu ezimelayo, okukuvumela ukuba uchithe ixesha elingakumbi nosana lwakho.
• Ingaba Sebenzisa kwakhona ibhedi, istroller, iimpahla kunye nezinto zokudlala.

Kusenokubakho ngaphezulu nomona Ekuqaleni kunye nezigaba zophuhliso ziya kuhluka, ezifuna ukuguquguquka ukuphendula kwiimfuno ezahlukeneyo.

Iingcebiso ezisebenzayo zokugqiba ixesha

Ngelixa usenza isigqibo ngelona xesha lilungileyo lokwandisa intsapho, sebenzisa i indlela yocwangciso esebenzayo kwaye iyahambelana nemeko yakho. Ukuba uceba ukukhulelwa okutsha:

1. Ishedyuli a ukubonisana kwangaphambili ukuphonononga imbali, ugonyo kunye namayeza, kwaye ucele uhlalutyo ukuba kufanelekile.
2. Qala okanye ugcine folic acid kwaye, ukuba kuyimfuneko, ukongezwa kwe intsimbi; yomeleza i ukutya kunye ukusetyenziswa isiseko.
3. Vavanya kunye nengcali yakho ixesha elililo kwimeko yakho (iminyaka yobudala, uhlobo lokunikezelwa kwangaphambili, iingxaki ezifana ne-preeclampsia okanye ukuhanjiswa kwangaphambili, kunye nendlela yokukhulelwa, yendalo okanye encediswayo).

Ithuba lexesha phakathi kokuzalwa kunye nokukhulelwa okulandelayo libizwa ngokuba yi-IPI kuncwadi oluntetho isisiNgesi; ixesha phakathi kokuzalwa kabini yi-IDI. Nangona kungekho mvumelwano ipheleleyo, ii-IPIs ngokugqithisileyo (> Iinyanga ezingama-60) kunye ne ayonelanga (Iinyanga ezi-<6) zinxulunyaniswa nokusebenza kakubi kokubelekisa, ngakumbi ezimfutshane kakhulu. Nokuba ikhefu elinqwenelekayo alifikelelwanga, a ukhathalelo lwaphambi kokubeleka, ulawulo lwe ifuthe legazi, ukulandelwa kwe Peso, umthambo ofanelekileyo, ukulahlwa kwe Inetyhefu kunye nemfundo malunga imiqondiso yesilumkiso (ukuqhawuka kwamanzi, rhoqo, ukufinyela kwangoko, ukopha) kunceda ukunciphisa umngcipheko.

Olunye ulwazi Gen. Ulwazi.

Ukukhetha ixesha lokufumana omnye umntwana akusoloko kungqamene, kwaye akukho xesha ligqibeleleyo. Ukuqonda i imingcipheko yokunciphisa okanye yokwandisa isithuba, yomeleza i impilo yesondlo kunye Umgangatho we-pelvic, kunye nokulungelelanisa kunye neqela lezonyango livumela ukuthatha i isigqibo esinolwazi ukukhusela umama, usana kunye nosapho.

Inqaku elidibeneyo:

Ukucwangcisa ukukhulelwa: isikhokelo sangaphambili, imikhwa kunye nexesha