Nebasa & Dhirivhari: Episiotomy

Zvemukati

• Kuchengetedza kweEpisiotomy Mushure meKununurwa
• Taura nachiremba wako

Chii chinonzi Episiotomy?

Izwi rekuti episiotomy rinoreva kudonhedza kwechikadzi kuvhurika kwekusununguka kana kudzivisa kana kuderedza kubvaruka. Episiotomy ndiyo yakajairika maitiro anoitwa mumazuva ano obstetrics. Vamwe vanyori vanofungidzira kuti vazhinji sevanosvika makumi mashanu kusvika makumi matanhatu muzana yevarwere vanounza nepanhengo mukati mevachave neepisiotomy. Mitengo yeepisiotomy inosiyana pasirese yepasi uye inogona kunge yakadzika kunge 30% mune dzimwe nyika dzeEurope.

Maitiro episiotomy akatanga kutsanangurwa muna 1742; yakazowana kugamuchirwa kwakapararira, ichikwira muma1920. Kubatsirwa kwaro kwakasanganisira kuchengetedzwa kwehunhu hwepelvic pasi uye kudzivirira uterine prolapse uye kumwe kusangana kwemukadzi. Kubva kuma1920, huwandu hwevakadzi vanogashira episiotomy panguva yekusununguka kwavo yakaramba yakadzikira. Mukuzvara kwemazuva ano, episiotomy haiwanzo kuitwa. Nekudaro, mune mamwe mamiriro uye kana ichiitwa nachiremba ane hunyanzvi, episiotomy inogona kubatsira.

Zvikonzero zvakajairika zvekuita episiotomy:

• Yakareba chikamu chechipiri chevashandi;
• Kushushikana kwe fetal;
• Kusununguka kwevakadzi kunoda rubatsiro nekushandiswa kwemasimba kana mudziyo wekubvisa;
• Mucheche mune breech mharidzo;
• Twin kana akawanda kuendesa;
• Mwana muhombe;
• Nzvimbo isina kujairika yemusoro wemwana; uye
• Kana amai vane nhoroondo yekuvhiyiwa chiuno.

Kuchengetedza kweEpisiotomy Mushure meKununurwa

Kuchengetedza kwepisiotomy ronda kunotanga nekukurumidza mushure mekusununguka uye kunofanirwa kusanganisira musanganiswa wekuchengetwa kwemaronda emuno nekurwadziwa kwekurwadziwa. Pakati pemaawa gumi nemaviri ekutanga mushure mekusununguka, ice pack inogona kubatsira mukudzivirira marwadzo nekuzvimba kwenzvimbo yeepisiotomy. Iyo incision inofanira kuchengetwa yakachena uye yakaoma kudzivirira hutachiona. Kazhinji sitz mabhati (kunyorova nzvimbo yechironda mune shoma mvura inodziya kwemaminitsi makumi maviri kazhinji pazuva), zvinogona kubatsira kuchengetedza nzvimbo yakachena. Iyo episiotomy saiti inofanirwawo kucheneswa mushure mekufamba ura kana mushure mekuita weti; izvi zvinogona kuitwa nekushandisa bhodhoro repiritsi uye nemvura inodziya. Bhodhoro rekupfapfaidza rinogona zvakare kushandiswa panguva yekuita weti kudzikisa marwadzo anoitika kana weti ikasangana neronda. Mushure mekunge saiti yasaswa kana kunyoroveswa, nzvimbo yacho inofanirwa kuomeswa nekudzima zvinyoronyoro nebepa rezvinyama (kana bvudzi rinoomeswa rinogona kushandiswa kuomesa nzvimbo pasina kutsamwiswa nebepa rinonyangadza).

Iko kuomarara kwechikadzi kusangana kana episiotomy kana kuchema kunowanzo kutaurwa mumadhigirii, zvichienderana nehukuru hweiyo incision uye / kana kucheka. Chechitatu- uye yechina-degree episiotomies inosanganisira incision yean anal sphincter kana iyo rectal mucosa. Muzviitiko izvi, zvigaro zvekudzivirira zvinogona kushandiswa kudzivirira kumwe kukuvara kana kukuvara zvakare kwenzvimbo yeepisiotomy. Kugonesa kupora kweronda rakakura, murwere anogona kuchengetwa pazvinyoro zvishoma kweinopfuura vhiki.

Ongororo dzinoverengeka dzakaongorora mashandisirwo emishonga yekurwadziwa dzakasiyana mukutungamira kwekutambudzika kwakabatana neepisiotomies. Iyo nonsteroidal, anti-kupisa mishonga, senge ibuprofen (Motrin), yakagara yakawanikwa iri mhando yepamusoro yekurapa marwadzo. Zvisinei, acetaminophen (Tylenol) yakashandiswawo nemhedzisiro inokurudzira. Kana episiotomy hombe yaitwa, chiremba anogona kupa mushonga wekubatsira kudzikamisa marwadzo.

Varwere vanofanirwa kudzivirira kushandiswa kwematamponi kana madouchi munguva yekusununguka kuti vaone kupora kwakakodzera uye kudzivirira kukuvara zvakare kwenzvimbo. Varwere vanofanirwa kurairwa kuti varege kuita zvepabonde kusvikira episiotomy yaongororwa uye yapora zvachose. Izvi zvinogona kutora kusvika kumavhiki mana kusvika matanhatu mushure mekusununguka.

Taura nachiremba wako

Kune mashoma, kana zviripo, zvikonzero zve episiotomy kuti zviitwe pane zvakajairwa hwaro. Chiremba kana mukoti-nyamukuta anofanira kutora danho panguva yekusununguka maererano nekudiwa kweepisiotomy. Vhura nhaurirano pakati pemupi nemurwere panguva yekushanyirwa kwepamuviri uye panguva yekusununguka chikamu chakakosha chekuita sarudzo. Pane mamiriro ezvinhu apo episiotomy inogona kubatsira zvakanyanya uye inogona kudzivirira kudiwa kwechikamu chekusiyiwa kana kubatsira kubereka kusangana (pamwe nekushandisa kwe forceps kana yekutsvaira mweya).