He aha ka mea e hewa ai i ke kolu o ka Trimester?

Anter

• Hōʻike Overview
• He aha ka mimikō hānau?
• Lapaʻau
• He aha ka preeclampsia?
• Nā ʻōuli
• Lapaʻau
• Kumu a me ka pale ʻana
• He aha ka hana preterm?
• Nā ʻōuli
• Lapaʻau
• ʻO ka haki mua o nā membrane (PROM)
• Lapaʻau
• Nā pilikia me ka placenta (previa a me abruption)
• Placenta previa
• Pākuʻi Placental
• Kaohi ulu ulu Intrauterine (IUGR)
• Hāpai hāpai hope
• Meconium aspiration maʻi maʻi
• Malpresentation (breech, transverse lie)

Hōʻike Overview

Nā wiki 28 a 40 e hōʻea i ka trimester ʻekolu. ʻO kēia manawa pīhoihoi ka mea e hoʻolōʻihi i ka home no nā makuahine e kali ana, akā he manawa ia e hiki ai nā pilikia. E like me ka hiki i nā trimesters mua ʻelua ke lawe i kā lākou mau pilikia ponoʻī, pēlā nō ke kolu.

He mea nui ka mālama Prenatal i ke kolu o ka trimester no ka mea ʻoi aku ka maʻalahi o ka mālama ʻana i nā ʻano pilikia e hiki ke ala aʻe i kēia manawa inā ʻike ʻia i ka wanaʻao.

E hoʻomaka paha ʻoe e kipa i kāu kauka hānau maʻi i kēlā me kēia pule ʻē aʻe mai 28 a i 36 mau pule a laila hoʻokahi i kēlā me kēia pule a hiki i kāu keiki liʻiliʻi.

He aha ka mimikō hānau?

ʻO ka nui o nā wahine hāpai i ka United States i loaʻa i ka maʻi diabetes.

Kū ka maʻi diabetes Gestational ma muli o ka hoʻololi ʻana o ka hormonal o ka hāpai ʻana i mea paʻakikī i kou kino e hoʻohana pono i ka insulin. Ke hiki ʻole i ka insulin ke hana i kāna hana o ka hoʻohaʻahaʻa ʻana i ke kō i ke kiʻekiʻe i nā pae maʻamau, ʻo ka hopena he kiʻekiʻe kiʻekiʻe o ka glucose (ke kō kō).

ʻO ka hapa nui o nā wahine ʻaʻohe ʻōuli. ʻOiai ʻaʻole weliweli kēia ʻano no ka makuahine, waiho ia i mau pilikia no ka ʻōpū. ʻO ke kikoʻī, hiki i ka macrosomia (ulu nui) o ka ʻōpū ke hoʻonui i ka likelika o ka hānau cesarean a me ka makaʻu o ka hānau hānau. Ke mālama maikaʻi ʻia nā pae glucose, he liʻiliʻi ka macrosomia.

I ka hoʻomaka o ke kolu o ka trimester (ma waena o nā pule 24 a me 28), pono e hoʻāʻo ʻia nā wahine āpau no ka maʻi kō.

I ka wā o ka hoʻāʻo hoʻomanawanui ʻana o ka glucose (ʻike ʻia ʻo ia ka hoʻāʻo ʻana o ka ʻaukake glucose), e hoʻopau ʻoe i kahi mea inu i loaʻa kahi nui o ka glucose (kō). Ma kahi manawa kikoʻī ma hope, e hoʻāʻo kāu kauka i kāu mau kō kō kō.

No ka hoʻāʻo ʻana o ka glucose tolerance oral, hoʻokē ʻai ʻoe no ʻewalu mau hola a laila he 100 mau milligrams o ka glucose, a ma hope e nānā ʻia kāu pae kō kō. E ana ʻia kēlā mau pae ma hoʻokahi, ʻelua, a me ʻekolu mau hola ma hope o kou inu ʻana i ka glucose.

ʻO nā kumukūʻai i manaʻo ʻia he:

• ma hope o ka hoʻokēʻai ʻana, ma lalo o 95 milligrams no deciliter (mg / dL)
• ma hope o hoʻokahi hola, ʻoi aku ka haʻahaʻa ma mua o 180 mg / dL
• ma hope o ʻelua mau hola, ma lalo o 155 mg / dL
• ma hope o ʻekolu mau hola, ʻoi aku ka haʻahaʻa ma mua o 140 mg / dL

Inā kiʻekiʻe loa ʻelua o nā hopena ʻekolu, loaʻa i ka wahine i ka maʻi diabetes.

Lapaʻau

Hiki ke mālama ʻia ka maʻi diabetes Gestational me ka papaʻai, nā loli nohona, a me nā lāʻau, i kekahi mau hanana. Paipai kāu kauka i nā loli o ka papaʻai, e like me ka hoʻēmi ʻana i kāu lawe ʻana i ka momona a me ka hoʻonui ʻana i nā hua a me nā mea ʻai.

Hiki ke kōkua i ka hoʻohui ʻana i ka hana hoʻohaʻahaʻa haʻahaʻa. I kekahi mau manawa, hiki i kāu kauka ke kuhikuhi i ka insulin.

ʻO ka nūhou maikaʻi e hele maʻamau ka mimikō ʻōpū i ka wā postpartum. E nānā ʻia nā kō kō ma hope o ka lawe ʻana e ʻike pono.

Eia nō naʻe, ʻoi aku ka nui o ka pilikia o ka wahine i loaʻa i ka maʻi kō ma mua o ka wahine ma mua o ka wahine i loaʻa ʻole i ka maʻi kō.

Hiki i ke kūlana ke hoʻopili i ka manawa o ka wahine e hāpai hou. E paipai paha ke kauka i ka nānā ʻana i nā pae kō kō o ka wahine e ʻike pono ua kāohi ʻia lākou ma mua o ka hoʻāʻo ʻana e loaʻa kahi pēpē hou.

He aha ka preeclampsia?

ʻO Preeclampsia kahi kūlana koʻikoʻi e hoʻolilo i nā kipa prenatal maʻamau i mea nui aku. Kū pinepine ke ʻano ma hope o 20 mau pule o ka hāpai ʻana a hiki i nā pilikia a me nā pēpē koʻikoʻi.

Ma waena o 5 a me 8 pākēneka o nā wahine ʻike i kēia ʻano. ʻO nā ʻōpio, nā wahine 35 a ʻoi aku, a me nā wahine hāpai me kā lākou pēpē mua i kahi ʻoi aku ka nui o ka makaʻu. ʻOi aku ka makaʻu o nā wahine ʻAmelika ʻAmelika.

Nā ʻōuli

ʻO nā ʻōuli o ke ʻano me ke koko kiʻekiʻe, ka protein i ka mimi, ka loaʻa koke o ke kaupaona, a me ka pehu ʻana o nā lima a me nā wāwae. ʻO kekahi o kēia mau ʻōuli e hōʻoia hou i ka loiloi.

Pono nā kipa Prenatal ma muli o ke kānana ʻana i hana ʻia i kēia mau kipa hiki ke ʻike i nā ʻōuli e like me ke kiʻekiʻe o ke koko a me ka hoʻonui ʻana o ka protein i ka mimi. Inā haʻalele ʻole ʻia, hiki i ka preeclampsia ke alakaʻi i ka eclampsia (ka hopu ʻana), ka holo pono ʻole ʻana o ka puʻupaʻa, a i kekahi manawa ka make i ka makuahine a me nā ʻōpū.

ʻO ka hōʻailona mua a kāu kauka e ʻike mau ai ke kahe koko kiʻekiʻe i ka wā o ka kipa prenatal maʻamau. Eia kekahi, e ʻike ʻia ka protein i loko o kou mimi i kahi urinalysis. Hiki i kekahi mau wahine ke hoʻonui i ka kaumaha ma mua o ka mea i manaʻo ʻia. ʻIke kekahi i nā maʻi poʻo, hoʻololi i ka ʻike, a me nā ʻeha o luna o ka ʻōpū.

ʻAʻole pono nā wahine e nānā ʻole i nā ʻōuli o preeclampsia.

E ʻimi i ka lāʻau lapaʻau maʻi inā loaʻa koke ka pehu ʻana i nā wāwae a me nā wāwae, nā lima a i ʻole ke alo. ʻO nā ʻōuli pilikia ʻē aʻe e like me:

• ʻeha ke poʻo i hala ʻole me ka lāʻau
• nalo o ka hihiʻo
• "Floaters" i kāu hihiʻo
• ʻeha ʻeha ma kou ʻaoʻao ʻākau a i ʻole ma kou wahi ʻōpū
• paopao maʻalahi
• ua emi ka nui o ka mimi
• pokole o ka hanu

Hōʻike paha kēia mau hōʻailona i ka preeclampsia koʻikoʻi.

ʻO nā hoʻāʻo ʻana o ke koko, e like me ka hoʻāʻo ʻana o ka hana ate a me nā hakuʻala a me nā hoʻāʻo ʻana o ke kāpili ʻana i ke koko, e hoʻokūpaʻa i ka hōʻoia a hiki ke ʻike i nā maʻi koʻikoʻi.

Lapaʻau

Ke mālama nei kāu kauka preeclampsia i kona koʻikoʻi a pehea ka lōʻihi o kou hāpai ʻana. Pono paha ka hāʻawi ʻana i kāu pēpē e pale iā ʻoe a me kāu keiki liʻiliʻi.

E kūkākūkā kāu kauka i kekahi mau manaʻo me ʻoe e pili ana i kāu mau pule hānau. Inā kokoke ʻoe i kāu lā kūpono e palekana paha ia e hānau ai i ka pēpē.

Noho paha ʻoe i ka haukapila no ka nānā ʻana a mālama i kou kaomi koko a hiki i ka nui ʻana o ka pēpē no ka hānau. Inā ʻoi aku ka liʻiliʻi o kāu pēpē ma mua o 34 mau pule, e hāʻawi ʻia ʻoe i ka lāʻau e hōʻeleu ai i ka ulu ʻana o ka pēpē.

Hiki i ka Preeclampsia ke hoʻomau i ka wā i hala, akā no ka hapa nui o nā wahine e hoʻomaka e hōʻemi ma hope o ka hānau ʻana. Eia naʻe, i kekahi manawa ua kau ʻia ka lāʻau lapaʻau koko no ka manawa pōkole ma hope o ka lawe ʻana.

Kau ʻia nā diuretics e mālama i ka edema pulmonary (kahe i nā akemāmā). Hāʻawi ʻia ka magnesium sulfate ma mua, i ka wā, a ma hope o ka lawe ʻana e hiki ke kōkua i ka hōʻemi ʻana i nā pilikia hopu. ʻO ka wahine i loaʻa i nā ʻōuli preeclampsia ma mua o ka hānau ʻana e hoʻomau ʻia ka nānā ʻia ma hope o ka hānau ʻana o ka pēpē.

Inā ua loaʻa iā ʻoe ka preeclampsia, ʻoi aku ka nui o ka makaʻu no ka loaʻa ʻana o ke ʻano me nā hāpai keiki e hiki mai ana. E kamaʻilio mau me kāu kauka e pili ana pehea e hoʻohaʻahaʻa ai i kāu makaʻu.

Kumu a me ka pale ʻana

Me nā makahiki o ka noiʻi ʻepekema, ʻaʻole ʻike ʻia ke kumu maoli o ka preeclampsia, a ʻaʻohe mea e pale pono ai. Akā, ua ʻike ʻia ka mālama ʻana i nā makahiki he nui a ʻo ka hānau ʻana o ka pēpē.

Hiki ke hoʻomau i nā pilikia e pili ana i ka preeclampsia ʻoiai ma hope o ka lawe ʻana, akā ʻokoʻa kēia. ʻO ka hōʻoia manawa kūpono a me ka lawe ʻana ke ala ʻoi loa e hōʻalo i nā pilikia koʻikoʻi no ka makuahine a me ka pēpē.

He aha ka hana preterm?

Hana ʻia kahi hana Preterm ke hoʻomaka ʻoe i ka loaʻa ʻana o nā ʻaoʻao e hoʻololi i nā ʻōpū ma mua o kou hāpai ʻana he 37 mau pule.

ʻOi aku ka makaʻu o kekahi mau wahine no ka hana mua, e like me ka poʻe:

• hāpai keiki me nā multiple (māhoe a ʻoi paha)
• loaʻa i ka maʻiʻaʻai o ka amniotic sac (amnionitis)
• Loaʻa i ka wai amniotic nui (polyhydramnios)
• ua hānau mua ma mua

Nā ʻōuli

Hiki i nā hōʻailona a me nā ʻōuli o ka hana preterm ke maʻalea. Hiki i kekahi makuahine ke kali aku iā lākou ma ke ʻano he hapa o ka hāpai keiki. ʻO nā hōʻailona me:

• pāhoehoe
• urination pinepine
• ʻeha ʻeha o lalo
• paʻa i ka ʻōpū o lalo
• hoʻokuʻu hoʻokuʻu
• puʻe puʻupuʻu

ʻOiaʻiʻo, ʻike paha kekahi mau wahine i nā ʻōuli hana nui. Hoʻopili kēia i nā kuʻikuʻi maʻamau, ʻeha, kahe ʻana o ka wai mai ka pūnana, a i ʻole ke kahe koko.

Lapaʻau

ʻO nā kamaliʻi i hānau prematurely i kahi makaʻu no nā pilikia olakino no ka mea ʻaʻole i loaʻa i ko lākou mau kino ka manawa e ulu piha ai. ʻO kekahi o nā mea e hopohopo nui loa ai ka ulu ʻana o ka māmā no ka mea ulu maikaʻi nā māmā i ke kolu o ka trimester. ʻO ka wā ʻōpio kahi pēpē ke hānau ʻia, ʻoi aku ka nui o nā komikina hiki.

ʻAʻole maopopo i nā kauka ke kumu pololei o ka hana wawe. Eia nō naʻe, he mea nui nāu e mālama i ka wā e hiki ai. I kekahi manawa hiki i nā lāʻau e like me ka magnesium sulfate ke kōkua i ka hoʻōki ʻana i ka hana mua a hoʻopaneʻe i ka lawe ʻana.

ʻO kēlā me kēia lā e hoʻolōʻihi ʻia ai kou hāpai ʻana e hoʻonui i kou manawa kūpono no kahi pēpē olakino.

Hāʻawi pinepine nā kauka i kahi lāʻau steroid i nā makuahine nona ka hana mua i hoʻomaka ma mua o 34 mau pule. Kōkua kēia i nā māmā o kāu pēpē e oʻo a hoʻoliʻiliʻi i ke koʻikoʻi o ka maʻi maʻi inā ʻaʻole hiki ke hoʻokū ʻia kāu hana.

Loaʻa ka hopena kiʻekiʻe o ka lāʻau lāʻau Steroid i loko o ʻelua mau lā, no laila ʻoi aku ka maikaʻi o ka pale ʻana i ka lawe ʻana no ʻelua mau lā, inā hiki.

ʻO nā wahine āpau me ka hana preterm ʻaʻole i hoʻāʻo ʻia no ke kū ʻana o ka pūʻulu B streptococcus pono e loaʻa nā lāʻau ʻaloʻalo (penicillin G, ampicillin, a i ʻole kahi koho ʻē aʻe no ka poʻe e maʻi āpau i ka penicillin) a hiki i ka wā e lawe ai.

Inā hoʻomaka ka hana preterm ma hope o 36 mau pule, hānau pinepine ka pēpē mai ka haʻahaʻa loa o ka makaʻu o ka maʻi māmā mai ka wā ma mua.

ʻO ka haki mua o nā membrane (PROM)

ʻO ka rupture o nā membrane kahi ʻāpana maʻamau o ka hānau ʻana. ʻO ia ka huaʻōlelo olakino no ka ʻōlelo ʻana ua "haki ka wai." ʻO ka manaʻo o ka ʻeke amniotic e hoʻopuni ana i kāu pēpē ua haki, e ʻae ana i ka wai amniotic e kahe i waho.

ʻOiai he mea maʻamau no ka ʻeke e haki i ka wā o ka hana, inā hiki wawe, hiki ke hana i nā pilikia koʻikoʻi. Kāhea ʻia kēia ka preterm / premature rupture of membrane (PROM).

ʻOiai ʻaʻole maopopo mau ke kumu o PROM, i kekahi manawa he maʻi o nā membrane amniotic ke kumu a me nā kumu ʻē aʻe, e like me nā genetics, e pāʻani.

Lapaʻau

Lapaʻau ka hoʻomaʻamaʻa no PROM. Lawe pinepine ʻia nā wahine i ka haukapila a hāʻawi ʻia i nā lāʻau antibiotic, steroid, a me nā lāʻau e hoʻōki i ka hana (tocolytic).

Ke kū ʻo PROM ma 34 mau pule a ʻoi paha, ʻōlelo paha kekahi mau kauka e hāʻawi i ka pēpē. I kēlā manawa, ʻoi aku ka liʻiliʻi o nā pilikia o ka prematurity ma mua o nā pōpilikia maʻi. Inā loaʻa nā hōʻailona o ka maʻi, pono e hoʻokomo i ka hana e hōʻalo i nā pilikia koʻikoʻi.

ʻO ka manawa maʻamau, ʻike ka wahine me PROM i ka resealing o nā membrane. I kēia mau hihia kakaikahi, hiki i ka wahine ke hoʻomau i kona hāpai ʻana a kokoke i ka manawa, ʻoiai e nānā mau ʻia ana.

ʻO nā pilikia e pili ana i ka prematurity e emi nui me ka kokoke o ka fetus. Inā loaʻa ka PROM ma ke kaha o 32 a 34 mau pule a ʻo ke koena o ka wai amniotic e hōʻike ana ua lawa pono nā māmā o ke fetus, hiki i ke kauka ke kūkākūkā i ka lawe ʻana i ka pēpē i kekahi mau hihia.

Me nā ʻoihana mālama pēpē i hoʻomaikaʻi maikaʻi ʻia, nui nā keiki hānau mua i hānau ʻia i ke kolu o ka trimester (ma hope o 28 mau pule) e hana maikaʻi loa.

Nā pilikia me ka placenta (previa a me abruption)

ʻO ke kahe ʻana i ka trimester ʻekolu he mau kumu paha. ʻO nā kumu i ʻoi aku ka koʻikoʻi nā placenta previa a me ka abruption placental.

Placenta previa

ʻO ka placenta ka meaola e hānai i kāu pēpē ʻoiai ʻoe hāpai. ʻO ka maʻamau, hāʻawi ʻia ka placenta ma hope o kāu pēpē. Eia nō naʻe, loaʻa i nā wahine me ka placenta previa kahi placenta e hele mua a ālai i ka hāmama o ka cervix.

ʻAʻole maopopo nā kauka i ke kumu kūpono o kēia ʻano. ʻO nā wahine i loaʻa i ka hānau cesarean ma mua a i ʻole ke ʻoki ʻana o ka uterine e ʻoi aku ka makaʻu. ʻO nā wahine puhipaka a i ʻole kahi placenta ʻoi aku ka nui ma mua o ka maʻamau a ʻoi aku ka makaʻu.

Hoʻonui ka placenta previa i ka makaʻu o ke kahe ʻana ma mua a ma ka wā o ka lawe ʻana. Hiki i kēia ke hoʻoweliweli i ke ola.

ʻO kahi ʻōuli maʻamau o ka placenta previa he ʻulaʻula ʻulaʻula, ʻāwīwī, profuse, a me ke kahe ʻole o ke kahe wahine maʻi ʻole, a maʻa mau ia ma hope o ka hebedoma 28th o ka hāpai keiki. Hoʻohana maʻamau nā kauka i kahi ultrasound e ʻike ai i ka placenta previa.

Pili ka mālama ʻana inā paha he preterm ka hē a me ka nui o ke kahe ʻana. Inā ʻaʻole hiki ke kāohi ʻia ka hana, aia i loko o ka pēpē ka pīpī, a i ʻole ke kahe ʻana o ke ola e hoʻoweliweli ʻia, hōʻike koke ʻia ka lawe cesarean no ka makahiki o ka fetus.

Inā kū ke kahe a ʻaʻole kaumaha nui paha, hiki ke hōʻalo pinepine i ka lawe ʻana. ʻAe kēia i ka manawa hou e ulu ka fetus inā kokoke ka fetus. Paipai pinepine ke kauka i ka hoʻouna cesarean.

Mahalo i ka mālama hānau hou ʻana, ka ʻike ultrasound, a me ka loaʻa ʻana o ke koko, inā pono, maikaʻi maikaʻi nā wahine me ka placenta previa a me kā lākou pēpē.

Pākuʻi Placental

ʻO ka abruption Placental kahi ʻano maʻamau kahi e kaʻawale ai ka placenta mai ka pūpū ma mua o ka hana. Hiki ia i loko o nā hāpai. Hiki i ka ʻōpala Placental ke hopena i ka make o ka fetal a hiki ke kumu i ke kahe nui a me ka haʻalulu i ka makuahine.

ʻO nā kumu pilikia no ka abruption placental pū:

• makahiki makua holomua
• hoʻohana kokain
• diabetes
• hoʻohana nui i ka waiʻona
• kahe koko kiʻekiʻe
• hāpai keiki me nā lehulehu
• rupture prématurative mua o nā membrane
• hāpai keiki ma mua
• kaula umbilical pōkole
• puhipaka
• hōʻeha i ka ʻōpū
• ʻo ka uterine distention ma muli o ka nui o ka wai amniotic

ʻAʻole hiki i ka ʻōpala Placental ke kumu i nā ʻōuli. Akā ʻike kekahi mau wahine i ke kahe ʻana o ka maʻi puʻupuʻu, ka ʻeha o ka ʻōpū nui, a me nā kuikui ikaika. ʻAʻohe kahe o ke koko i kekahi mau wahine.

Hiki i ke kauka ke loiloi i nā ʻōuli o ka wahine a me ka puʻuwai o ka pēpē e ʻike ai i ke kūpē ʻana o ka fetal. I nā hanana he nui, pono ka lawe cesarean wikiwiki. Inā lilo ka wahine i ka nui o ke koko, pono paha ia i kahi kōpili.

Kaohi ulu ulu Intrauterine (IUGR)

I kekahi manawa ʻaʻole ulu ka pēpē e like me ka mea i manaʻo ʻia i kekahi wā i ka hāpai ʻana o ka wahine. ʻIke ʻia kēia ʻo ka palena ulu ulu intrauterine (IUGR). ʻAʻole loaʻa nā pēpē liʻiliʻi IUGR - i kekahi manawa hiki ke hāʻawi ʻia i ko lākou nui i ka liʻiliʻi o ko lākou mau mākua.

Hiki i ka IUGR ke hopena i ka ulu simmmetrical a asymmetrical paha. ʻO nā pēpē me ka ulu asymmetrical he poʻo maʻamau maʻamau me kahi kino liʻiliʻi.

Nā kumu makuahine e hiki ai ke alakaʻi iā IUGR i loko:

• anemia
• maʻi maʻi maʻi paʻa
• placenta previa
• infarction placental
• maʻi ʻaʻai koʻikoʻi
• kaumaha loa o ke kino

Hiki i nā Fetus me IUGR ke liʻiliʻi i ka hoʻomanawanui i ke koʻikoʻi o ka hana ma mua o nā pēpē o ka nui maʻamau. Mālama pū nā pēpē IUGR i ka momona o ke kino a ʻoi aku ka pilikia i ka mālama ʻana i ka mahana o ke kino a me nā pae glucose (ke kō o ke kō) ma hope o ka hānau ʻana.

Inā kuhi ʻia nā pilikia ulu, hiki i ke kauka ke hoʻohana i kahi ultrasound e ana i ka fetus a helu i kahi kaupaona fetal kaumaha. Hiki ke hoʻohālikelike ʻia ke kuhi me ke ana o nā kaupaona maʻamau no nā pēpē o nā makahiki like.

No ka hoʻoholo ʻana inā liʻiliʻi ka fetus no ka makahiki hānau a i ʻole ka palena o ka ulu ʻana, hana ʻia ke kaʻina o nā ultrasound i kahi manawa e palapala i ke kaupaona ʻana a i ʻole nele.

Hiki i kahi ultrasound kūikawā ke kiaʻi ʻana i ke kahe umbilical ke hoʻoholo pū kekahi iā IUGR. Hoʻohana ʻia ka amniocentesis e nānā ai i nā pilikia chromosomal a i ʻole ka maʻi. ʻO ka nānā ʻana i ke ʻano o ka naʻau fetal a me ke ana ʻana o ka wai amniotic i maʻa mau.

Inā kū ka pēpē e ulu ana i ka ʻōpū, hiki i ke kauka ke koi i ka hoʻokomo a i ʻole ka hānau cesarean. ʻO ka mea pōmaikaʻi, ʻo ka hapa nui o nā pēpē ulu-ulu e ulu maʻamau ma hope o ka hānau ʻana. Kūleʻa lākou i ka ulu ʻana e ʻelua mau makahiki.

Hāpai hāpai hope

Ma kahi o 7 pākēneka o nā wahine e hānau ma 42 mau pule a i ʻole. ʻO kēlā me kēia hāpai hāpai ʻoi aku ka lōʻihi ma mua o 42 mau pule e noʻonoʻo ʻia ma hope o ka lā a ma hope paha. ʻAʻole maopopo ke kumu o ka hāpai ʻana ma hope o ka wā, ʻoiai hormonal a me nā mea hoʻoilina i manaʻo ʻia.

I kekahi manawa, ʻaʻole helu pono ʻia ka lā kūpono o ka wahine. Loaʻa i kekahi mau wahine i ke kaulike ʻole a lōʻihi paha o ka menstrual cycle e paʻakikī ai ka wānana. I ka wanaʻao o ka hāpai ʻana, hiki i kahi ultrasound ke kōkua e hōʻoia a hoʻomaʻa i ka lā kūpono.

ʻAʻole weliweli ka hāpai ma hope o ke ola o ka makuahine. ʻO ka hopohopo no ka ʻōpū. ʻO ka placenta kahi ʻōnaehana i hoʻolālā ʻia e hana no kahi o 40 mau pule. Hāʻawi ia i ka oxygen a me ka meaʻai no ka fetus ulu.

Ma hope o 41 mau pule o ka hāpai ʻana, ʻaʻole maikaʻi ka maikaʻi o ka placenta, a ʻo kēia ka hopena o ka hoʻemi ʻia o ka wai amniotic a puni ka fetus (oligohidramnios).

Hiki i kēia ʻano ke hoʻopilikia i ka umbilical cord a hoʻoliʻiliʻi i ka lako o ka oxygen i ka fetus. Hōʻike ʻia paha kēia i ka puʻuwai puʻuwai fetal i kahi ʻano i kapa ʻia he decelerations lohi. Aia ka makaʻu o ka make fetal hikiwawe i ka wā o ka hāpai ʻana ma hope o ka manawa.

I ka manawa i hōʻea ai ka wahine i 41 mau pule o ka hāpai ʻana, loaʻa iā ia i ka manawa maʻamau ka nānā ʻana o ka puʻuwai fetal a me ke ana o ka wai amniotic. Inā hōʻike ka hoʻāʻo i nā pae wai haʻahaʻa a i ʻole nā ​​kumu helu puʻuwai fetal maʻamau, hoʻokomo ʻia ka hana. Inā ʻole, kakali ka hana kūlohelohe a hiki i ka 42 a 43 mau pule hou aʻe, a laila hoʻokomo ʻia.

Meconium aspiration maʻi maʻi

ʻO ka pilikia ʻē aʻe he meconium. ʻO Meconium kahi ʻōpū o ka ʻōpū. ʻOi aku ka maʻamau i ka wā o ka hāpai ʻana ma hope o ka manawa. ʻO ka hapa nui o nā fetus i loaʻa i kahi ʻōpū i loko o ka kōpū ʻaʻohe pilikia.

Eia nō naʻe, hiki i kahi pēpē koʻikoʻi ke hanu i ka meconium, e hoʻoulu ana i kahi ʻano koʻikoʻi loa o ka pulumonia a, kākaʻikahi ka make. No kēia mau kumu, hana nā kauka e hoʻomaʻemaʻe i ke ala o ke pēpē e like me ka hiki ke loaʻa i ka wai a ka amniotic pēpē i meconium.

Malpresentation (breech, transverse lie)

I ka wā e hoʻokokoke ai ka wahine i ka ʻeiwa o kona hāpai ʻana, kū ka ʻōpū i kahi kūlana poʻo i lalo o ka kōpū. ʻIke ʻia kēia ʻo vertex a i ʻole cephalic hōʻike.

ʻO ka ʻōpū i lalo a i ʻole nā ​​wāwae ma mua (ʻike ʻia ma ke ʻano he hōʻike breech) ma kahi o 3 a 4 pākēneka o nā wā hāpai hāpai piha.

ʻO ka maʻamau, e moe ʻaoʻao ana ka pēpē (hōʻike transverse).

ʻO ke ala palekana loa no ka hānau ʻana o kahi pēpē ke poʻo mua a i ʻole i ka hōʻike vertex. Inā breech a transverse paha ka fetus, ʻo ke ala ʻoi loa e hōʻalo ai i nā pilikia me ka lawe ʻana a pale i kahi cesarean e hoʻāʻo e hoʻohuli (a i ʻole vert) i ka fetus i ka hōʻike vertex (poʻo i lalo). ʻIke ʻia kēia ma ke ʻano he cephalic waho. Hoʻomaʻa pinepine ʻia ma 37 a 38 mau pule, inā ʻike ʻia ka malpresentation.

ʻO ka mana cephalic kūwaho e like me kahi massage paʻa o ka ʻōpū a hiki ke hōʻoluʻolu ʻole. ʻO ka maʻa mau kahi papa hana palekana, akā kekahi mau pilikia paʻakikī e komo pū me ka abruption placental a me ka pēpē pōpilikia, e pono ai i ka hoʻouna cesarean pilikia.

Inā huli maikaʻi ʻia ka pēpē, hiki ke kali ʻia nā hana kūlohelohe a i ʻole hiki ke hoʻokomo ʻia i ka hana. Inā ʻaʻole i kūleʻa, kali kekahi mau kauka i hoʻokahi pule a hoʻāʻo hou. Inā kūleʻa ʻole ma hope o ka hoʻouka hou ʻana, e hoʻoholo ʻoe a me kāu kauka i ke ʻano ʻoi loa o ka lawe ʻana, ka ʻopa a cesarean paha.

ʻO ke ana ʻana i nā iwi o ka auwai hānau o ka makuahine a me ka ultrasound e koho ai i ke kaumaha o ka fetal e kiʻi pinepine ʻia i ka hoʻomākaukau no nā hānau liʻiliʻi breech. Hāʻawi ʻia nā fetus transverse e cesarean.