Hana me ka lawe ʻana

Anter

• Nā hōʻailona o ka hana
• Pākuʻi ʻo Braxton Hicks
• ʻO ka pae mua o ka hana
• Ka hana mua
• Hana hana
• Hana kuapo
• Mahele ʻelua o ka hana
• Lawe lawe
• ʻO ke kahua ʻekolu o ka hana
• Ka lawe ʻana i ka placenta
• Hoʻomaha ʻeha
• Nā Narcotics
• Lāhuawewe nitrous
• Epidural
• Nā koho kōkua ʻeha kūlohelohe
• Hoʻokomo i ka hana
• Kūlana Fetal
• ʻĀpana Cesarean
• ʻO ka hānau hānau ʻana ma hope o ka ʻāpana C (VBAC)
• Hāʻawi ʻia i kōkua ʻia
• Episiotomy

Hōʻike Overview

ʻOiai ʻeiwa mau mahina e ulu ai i kahi pēpē holoʻokoʻa piha, hana a hānau i kekahi mau lā a i mau hola paha. Eia nō naʻe, ʻo ke kaʻina hana a me ka lawe ʻana i mea e noho nui i ka manaʻo o nā mākua e kali nui ana.

Heluhelu inā he mau nīnau a hopohopo kāu e pili ana i nā hōʻailona a me ka lōʻihi o ka hana, a pehea e mālama ai i ka ʻeha.

Nā hōʻailona o ka hana

Ua hoʻomaka a hele mai paha ka hana inā ʻike ʻoe i nā ʻōuli e like me:

• hoʻonui kaomi i ka kōpū
• kahi hoʻololi o nā pae ikehu
• kahi hoʻokuʻu mucus koko

Ua hōʻea paha ka hana maoli ke lilo i mea maʻamau a ʻehaʻeha nā kuʻikahi.

Pākuʻi ʻo Braxton Hicks

He nui nā wahine ʻike i nā kuʻikahi kūpono ʻole ma hope o 20 mau pule o ka hāpai ʻana. ʻIke ʻia e like me ka ʻaelike ʻo Braxton Hicks, ʻaʻohe lākou ʻeha. ʻO ka hapa nui, ʻoluʻolu ʻole lākou a kūlike ʻole.

Hiki i nā kontraction Braxton Hicks ke hoʻoulu ʻia i kekahi manawa e ka hoʻonui ʻana o ka hana a ka makuahine a pēpē paha, a i ʻole kahi kīʻaha piha. ʻAʻohe mea i maopopo leʻa i ka hana a Braxton Hicks contraction i ka hāpai ʻana.

Hāpai paha lākou i ke kahe o ke koko, kōkua i ka mālama ʻana i ke olakino uterine i ka wā o ka hāpai ʻana, a hoʻomākaukau paha i ka uterus no ka hānau keiki.

ʻAʻole nā ​​hoʻokūkū ʻo Braxton Hicks e hoʻoulu i ka cervix. ʻAʻole paha ʻo Braxton Hicks nā kuʻikuʻi ʻeha a maʻamau paha. Akā, ʻo lākou ke ʻano o nā ʻelike e alakaʻi iā ʻoe e kāhea i kāu kauka.

ʻO ka pae mua o ka hana

Māhele ʻia ka hana a me ka lawe ʻana i ʻekolu mau hanana. Hoʻokomo ka pae mua o ka hana i ka hoʻomaka o ka hana ma o ka dilation piha o ka cervix. Mahele hou ʻia kēia pae i ʻekolu mau ʻanuʻu.

Ka hana mua

ʻO kēia ka maʻa mau ʻoi loa a ikaika loa o ka hana. Kapa ʻia ka hana mua i ka pae latent o ka hana. Hoʻopili kēia manawa i ka lahilahi o ka cervix a me ka dilation o ka cervix i 3-4 cm. Hiki iā ia ke hana i kekahi mau lā, mau pule, a i ʻole kekahi mau hola pōkole.

Hoʻololi nā kuʻikahi i kēia wā a hiki ke kaʻina mai ka haʻahaʻa a ka ikaika, e hana ʻia i nā wā maʻamau a i ʻole kūlike ʻole. Hiki i nā ʻōuli ʻē aʻe i kēia wā ke hoʻopili i ka ʻeha o ke kua, ka ʻūhū, a me ka hoʻokuʻu mucus koko.

E mākaukau ka hapa nui o nā wahine e hele i ka haukapila ma ka hopena o ka hana mua. Eia nō naʻe, nui nā wahine e hōʻea i ka haukapila a i ʻole ke kikowaena hānau ke hiki lākou i ka hana mua.

Hana hana

ʻO ka pae aʻe o ka pae mua o ka hana ke hana ʻia ka cervix mai ka 3-4 cm a i ka 7 cm. E ikaika aʻe nā kuʻikahi a me nā ʻōuli ʻē aʻe e pili pū me ka ʻehaʻeha a me ke koko.

Hana kuapo

ʻO kēia ka mahele ikaika loa o ka hana me ka hoʻonui nui ʻana o nā contraction. Lilo lākou i ikaika a kū ma kahi o ʻelua a ʻekolu mau minuke ke kaʻawale, a me ka awelika 60 a 90 kekona. ʻO ka 3 cm hope loa o ka dilation i hana mau ʻia i kahi manawa pōkole loa o ka manawa.

Mahele ʻelua o ka hana

Lawe lawe

I ka wā o ka lua o ka pae, ua kīloi piha ʻia ka cervix. Manaʻo paha kekahi mau wahine i ka makemake e pahu koke a i ʻole ma hope koke o ka hoʻoliʻiliʻi piha ʻana. Piʻi kiʻekiʻe paha ka pēpē i ka pelvis no nā wahine ʻē aʻe.

Lōʻihi paha ka manawa no ka iho ʻana o ka pēpē me nā mea hōʻemi no laila he mea liʻiliʻi ia no ka hoʻomaka ʻana o ka pēpē ʻana e ka makuahine.

ʻO nā wahine i loaʻa ʻole i kahi epidural ka mea nui me ka ikaika e koi aku, a i ʻole he koʻikoʻi koʻikoʻi koʻikoʻi ke ke haʻahaʻa ka pēpē i ka pelvis.

Hiki paha i nā wahine me ka epidural ke koi e kāomi a manaʻo paha lākou i ke kaomi pololei, ʻoiai ʻaʻole maʻamau ka ikaika. ʻO ke kuni ʻana a i ʻole ke kuʻi ʻana i ka wao ma ke ʻano he mea mau nā pāpale poʻo o ke pēpē.

He mea nui e hoʻāʻo e noho hoʻomaha a hoʻomaha i waena o nā kuʻikahi. ʻO kēia ka manawa e kōkua nui ai kāu kaʻi hana a doula paha.

ʻO ke kahua ʻekolu o ka hana

Ka lawe ʻana i ka placenta

E hānau ʻia ka placenta ma hope o ka hānau ʻana o ka pēpē. E kōkua ka hoʻohaʻahaʻa haʻahaʻa i ka placenta mai ka paia uterine a neʻe i lalo i ka ʻōpū. ʻO ke kuʻi ʻana e hoʻopaʻa i kahi waimaka a i ʻole ʻoki ʻoki (episiotomy) e hana ma hope o ka hānau ʻia ʻana o ka placenta.

Hoʻomaha ʻeha

Hiki i nā lāʻau lapaʻau i kēia manawa ke hāʻawi i nā ʻano koho like ʻole e mālama i ka ʻeha a me nā pilikia i hiki ke hana ʻia i ka wā o ka hana a me ka lawe ʻana. Loaʻa kekahi o nā lāʻau i loaʻa i kēia.

Nā Narcotics

Hoʻohana pinepine ʻia nā lāʻau Narcotic no ka hōʻeha ʻeha i ka wā o ka hana. Hoʻohana palena ʻia ka hoʻohana i nā pae mua no ka mea makemake lākou e hoʻonui i ka makuahine, ka fetal, a me ka sedation neonatal.

Hāʻawi nui ʻia nā Narcotics i nā wahine i ka hana e ka injection intramuscular a i ʻole ma o ka laina intravenous. Hāʻawi kekahi mau kikowaena i ka hoʻoponopono hoʻomalu hoʻomanawanui. ʻO ia ka mea hiki iā ʻoe ke koho i ka wā e loaʻa ai ka lāʻau.

ʻO kekahi o nā narcotics maʻamau ʻo:

• morphine
• meperidine
• fentanyl
• butorphanol
• nalbuphine

Lāhuawewe nitrous

Hoʻohana ʻia nā lāʻau analgesic i loko o kekahi manawa i ka wā o ka hana. Hoʻohana pinepine ʻia ʻo Nitrous oxide, i kapa pinepine ʻia he gas hoʻomākeʻaka. Hiki iā ia ke hāʻawi i kahi hōʻoluʻolu ʻeha kūpono no kekahi mau wahine ke hoʻohana ʻia intermittently, keu hoʻi i nā wā mua o ka hana.

Epidural

ʻO ke ala maʻamau o ka hōʻoluʻolu ʻeha i ka wā o ka hana a me ka lawe ʻana ʻo ka pale pale epidural. Hoʻohana ʻia ia e hoʻolako i ka anesthesia i ka wā o ka hana a me ka lawe ʻana a i ka wā o kahi cesarean delivery (C-section).

ʻO nā hopena ʻehaʻeha mai ka hoʻopili ʻana i kahi lāʻau anesthetic i loko o kahi ākea, aia ma waho pono o ka uhi o ka uhi o ka iwi kuamoʻo. Pākuʻi ka lāʻau i ka lawe ʻia ʻana o nā ʻehaʻeha ma o nā ʻalolo e hele ma waena o kēlā ʻāpana o ke ākea ma mua o ka hoʻopili ʻana me ka iwi kuamoʻo.

ʻO ka hoʻohana ʻana o nā spinal-epidurals i hui pū ʻia a i ʻole epidural hele wāwae i loaʻa i kaulana i nā makahiki i hala iho nei. Hoʻopili kēia i ka hele ʻana i kahi nila kuʻikuʻi penikala liʻiliʻi loa ma o ka nila epidural ma mua o ke kau ʻana o ka anesthetic epidural.

Hoʻokomo ʻia ka nila kuʻikuʻi i kahi ākea e pili ana i ka iwi kuamoʻo a hoʻokomo ʻia kahi lāʻau liʻiliʻi o ka narcotic a i ʻole ka anesthetic kūloko i ka hakahaka.

Hoʻopili kēia i nā hana sensory wale nō, e hiki ai iā ʻoe ke hele a neʻe i ka wā o ka hana. Hoʻohana maʻamau kēia hana i nā wā mua o ka hana.

Nā koho kōkua ʻeha kūlohelohe

Nui nā koho no nā wahine e ʻimi nei i kahi ʻeha ʻeha nonmedical no ka hana a me ka lawe ʻana. Kūleʻa lākou i ka hōʻemi ʻana i ka ʻike o ka ʻeha me ka hoʻohana ʻole o ka lāʻau. ʻO kekahi o kēia mau mea:

• hanu lauana
• Lamaze
• hydrotherapy
• hoʻoulu uila uila transcutaneous (TENS)
• hypnosis
• ʻākehu
• lomilomi

Hoʻokomo i ka hana

Hiki ke hoʻopili ʻia i ka hana ma nā ʻano like ʻole. Pili ke ʻano i koho ʻia i nā kumu he nui, e like me:

• pehea ka mākaukau o kou cervix no ka hana
• ʻo kāu pēpē mua paha kēia
• pehea kou lōʻihi i ka hāpai ʻana
• inā ua haki kou mau membrane
• ke kumu o ka hoʻokomo

ʻO kekahi mau kumu e koi ai kāu kauka i ka hoʻokomo ʻana:

• ke hele a hāpai i ka hebedoma 42
• inā haki ka wai o ka makuahine a ʻaʻole hoʻomaka ka hana ma hope koke iho
• inā he pilikia me ka makuahine a pēpē paha.

ʻAʻole koi ʻia ka hoʻokomo ʻana i ka hana i ka wā i loaʻa i ka wahine i kahi ʻāpana C mua a i ʻole inā he breech ka pēpē (lalo lalo).

ʻO kahi lāʻau lāʻau hormone i kapa ʻia ʻo prostaglandin, kahi lāʻau i kapa ʻia misoprostol, a i ʻole he hāmeʻa e hoʻohana ʻia e palupalu a wehe i ka pūpū inā lōʻihi a ʻaʻole i palupalu a hoʻomaka paha e pālahalaha.

ʻO ka hemo ʻana i nā membrane e hoʻoulu ai ka hana no kekahi mau wahine. He hana kēia e nānā ai kāu kauka i kou cervix. E hoʻokomo lākou i ka manamana lima ma waena o nā membrane o ka ʻeke amniotic a me ka paia o ka kōpū.

Hoʻokuʻu ʻia nā prostaglandins kūlohelohe ma o ka hoʻokaʻawale ʻana a holehole ʻana paha i ka ʻaoʻao haʻahaʻa o nā membrane mai ka paia uterine. Mālama paha kēia i ka cervix a hana i nā pāʻina.

Hiki ke hoʻokō ʻia ka hemo ʻana i nā membrane inā ua nui ka cervix e ʻae i kāu kauka e hoʻokomo i ko lākou manamana lima a hana i ke kaʻina hana.

Hiki ke hoʻohana i nā lāʻau e like me ka oxytocin a i ʻole misoprostol e hoʻohuli ai i ka hana. Hāʻawi ʻia ka Oxytocin me ka intravenously. ʻO Misoprostol kahi papa i hoʻonoho ʻia i loko o ka lua.

Kūlana Fetal

Mālama mau kāu kauka i ke kūlana o kāu pēpē i ka wā o ke kipa prenatal. ʻO ka hapa nui o nā pēpē e huli i kahi kūlana poʻo i lalo ma waena o ka pule 32 a me ka pule 36. ʻAʻole huli iki kekahi, a ʻo kekahi e huli i kahi wāwae a i ʻole ke kūlana lalo-mua.

ʻO ka hapa nui o nā kauka e hoʻāʻo e hoʻohuli i kahi fetus breech i kahi kūlana poʻo i lalo me ka hoʻohana ʻana i ka mana cephalic waho (ECV).

I ka wā o kahi ECV, e hoʻāʻo kahi kauka e hoʻoliʻiliʻi mālie i ka fetus ma ka hoʻopili ʻana i ko lākou mau lima i ka ʻōpū o ka makuahine, e hoʻohana ana i kahi ultrasound i alakaʻi. E kiaʻi ʻia ka pēpē i ke kaʻina hana. Kūleʻa pinepine ʻo ECV a hiki ke hōʻemi i ka likelihood no kahi hāʻawi C-ʻāpana.

ʻĀpana Cesarean

ʻO ka awelika hānau hānau ma o ka ʻāpana cesarean i piʻi nui i nā makahiki he hala i hala. Wahi a, ma kahi o 32 pākēneka o nā makuahine ma ʻAmelika Hui Pū ʻIa e hānau ai ma kēia ʻano hana, i ʻike ʻia he hānau cesarean.

ʻO kahi mahele C ka manawa ʻoi aku ka palekana a me ka wikiwiki o ka hāʻawi ʻana i nā hāʻawi pilikia a i ʻole ke kū ʻana o nā pilikia.

Kuhi ʻia kahi ʻāpana C he ʻoki nui. Hāʻawi ʻia ka pēpē ma o kahi incision i ka paia o ka ʻōpū a me ka uterus ma mua o ka ʻōpū. Hāʻawi ʻia ka makuwahine i kahi anesthetic ma mua o ke kaha ʻana e numb ka wahi mai ka ʻōpū a i lalo o ka pūhaka.

ʻO ke ʻokiʻoki kokoke kokoke i ka ākea, ma ka ʻaoʻao haʻahaʻa o ka paia o ka ʻōpū. I kekahi mau hanana, kū i luna ke kihi mai ka midline a i lalo o ka pihi ʻōpū.

ʻO ka lūlū i loko o ka kōpū he ākea hoʻi, koe wale nō i kekahi mau hihia paʻakikī. Kapa ʻia kahi ʻoki kū i luna o ka kōpū i kahi ʻāpana C kahiko. Haʻalele kēia i ka puʻupuʻu uterine i hiki ʻole ke ʻae i nā haʻihaʻi i kahi hāpai e hiki mai ana.

E omo ʻia ka waha a me ka ihu o ka pēpē ma hope o ka hānau ʻana i hiki ai iā lākou ke lawe i ko lākou hanu mua, a hāʻawi ʻia ka placenta.

ʻAʻole ʻike ka hapa nui o nā wahine inā loaʻa iā lākou kahi C-ʻāpana a hiki i ka hoʻomaka ʻana o ka hana. Hoʻonohonoho ʻia nā ʻāpana C inā he pilikia me ka makuahine a pēpē paha. Nā kumu ʻē aʻe e pono ai i kahi ʻāpana C e komo pū me:

• kahi paukū C i hala me kahi incision vertical
• kahi maʻi fetal a i ʻole kīnā hānau
• he maʻi kō ka makuahine a ua koho ʻia ka pēpē e ʻoi aku ma mua o 4,500 g
• placenta previa
• ʻO ka maʻi HIV i ka makuahine a me ka ukana viral kiʻekiʻe
• breech a i ʻole transverse fetal kūlana

ʻO ka hānau hānau ʻana ma hope o ka ʻāpana C (VBAC)

Ua manaʻo ʻia inā loaʻa iā ʻoe kahi ʻāpana C, pono mau ʻoe e kiʻi i hoʻokahi e hāʻawi i nā pēpē e hiki mai ana. I kēia lā, ʻaʻole pono nā ʻāpana C i nā manawa āpau. ʻO ka hānau hānau ʻana ma hope o ka ʻāpana C (VBAC) hiki ke lilo i koho palekana no nā mea he nui.

ʻO nā wahine i loaʻa i kahi incision uterine haʻahaʻa haʻahaʻa (papamoe) mai kahi ʻāpana C e loaʻa ka manawa kūpono i ka hānau ʻana i kahi pēpē pēpē.

ʻAʻole ʻae ʻia nā wahine i loaʻa i kahi incision vertical maʻamau e hoʻāʻo i kahi VBAC. Hoʻonui ka ʻoki paʻa i ka makaʻu o ka haki o ka uterine i ka wā hānau hānau.

He mea nui e kūkākūkā i kāu mau hāpai mua a me ka mōʻaukala olakino me kāu kauka, i hiki ai iā lākou ke loiloi inā he koho ʻo VBAC nāu.

Hāʻawi ʻia i kōkua ʻia

Aia kekahi mau manawa i ka hopena o ke kahua hoʻokeke kahi e pono ai i kahi wahine i kahi kōkua keu i ka hānau ʻana i kāna pēpē. Hiki ke hoʻohana ʻia kahi mea hakahaka a i ʻole nā ​​forceps e kōkua i ka lawe ʻana.

Episiotomy

ʻO kahi episiotomy kahi ʻoki lalo i lalo o ke kumu o ka puʻupuʻu a me nā mākala perineal e hoʻonui ai i ka wehe no ka puka ʻana o ka pēpē. Manaʻoʻiʻo ʻia ʻo kēlā me kēia wahine e pono i kahi episiotomy e hānau i kahi pēpē.

Hana wale ʻia nā Episiotomies inā kaumaha ka pēpē a pono ke kōkua e hele wikiwiki i waho. Hana ʻia lākou inā hāʻawi ke poʻo o ka pēpē akā paʻa ka poʻohiwi (distocia).

Hiki paha ke hana i kahi episiotomy inā lōʻihi ka lōʻihi o ka hoʻokikina ʻana o ka wahine a ʻaʻole hiki ke hoʻokuʻi i ka pēpē i hala i ka ʻaoʻao haʻahaʻa loa o ka wehe ʻana o ka ʻōpū.

Hōʻalo ʻia nā Episiotomies inā hiki, akā ʻo ka ʻili a i kekahi manawa e haehae nā mākala ma kahi o. ʻOi aku ka ʻeha o ka waimaka ʻili a hoʻōla wikiwiki ma mua o ka episiotomy.