txheem
Lub sij hawm "dystocies"Los ntawm ancient Greek"ua dys", Lub ntsiab lus nyuaj, thiab"tokos”, Lub ntsiab lus yug me nyuam. Lub npe hu ua obstructed yug yog li ntawd ib tug nyuaj yug me nyuam, as opposed to ib tug eutocic me nyuam, uas tshwm sim ib txwm, tsis muaj hindrance. Yog li peb pab pawg ua ke nyob rau hauv lub sij hawm obstructed yug tag nrho cov khoom xa tuaj thaum muaj teeb meem tshwm sim, Nyob rau hauv tshwj xeeb tshaj yog hais txog uterine contractions, dilation ntawm lub ncauj tsev menyuam, qhovntsej thiaj tsis mob thiab kev koom tes ntawm tus me nyuam nyob rau hauv lub plab mog, tus me nyuam txoj hauj lwm thaum yug me nyuam (nyob rau hauv breech tshwj xeeb), thiab lwm yam. Muaj ob lub ntsiab ntawm dystocia:
- - dynamic dystocia, txuas mus rau qhov tsis ua haujlwm ntawm lub tsev menyuam "lub cev muaj zog" lossis nthuav dav ntawm lub ncauj tsev menyuam;
- -thiab mechanical dystocia, thaum obstructed, ntawm fetal keeb kwm (loj thiab / los yog kev nthuav qhia ntawm tus me nyuam…) los yog tsis ( qog, placenta praevia, cyst…).
Nco ntsoov tias kev ua haujlwm obstructed yog qee zaum cais raws li seb nws yog leej niam leej txiv (kev nthuav dav ntawm lub ncauj tsev menyuam, kev cog lus ntawm lub tsev menyuam, placenta previa, pelvis nqaim dhau, thiab lwm yam) lossis ntawm lub hauv paus chiv keeb.
Obstructed Labor: Thaum obstructed Labor yog dynamic
Raws li kev kwv yees ntawm obstetrician-gynecologists, dynamic obstructed ua hauj lwm sawv cev rau ntau tshaj 50% ntawm cov ua rau obstructed zog. Nws tuaj yeem cuam tshuam nrog uterine ua haujlwm tsis txaus, thaum uterine contractions tsis zoo txaus kom tus menyuam raug tshem tawm. Hloov pauv, ua nruj ua tsiv heev kuj tuaj yeem ua rau muaj kev cuam tshuam kev ua haujlwm. "Tshwj xeeb" contractions, tsis muaj zog los yog khaus dhau, tuaj yeem ua tau tiv thaiv kom raug dilation ntawm lub ncauj tsev menyuam, thiab yog li ntawd nyuaj rau kev yug menyuam. Lub tsev me nyuam nws tus kheej yuav muaj peculiarities uas tiv thaiv nws los ntawm dilating kom zoo thiab txaus.
Obstructed Labor: thaum lub obstructed ua hauj lwm yog mechanical
Muaj peb yam tseem ceeb ntawm txhua yam dystocia ntawm no, thaum muaj kev cuam tshuam rau kev ua rau lub plab zom mov:
- -Peb tham txog pob txha dystocia thaum leej niam-rau-ua lub plab zom mov nthuav tawm qhov loj me, zoo li lub cev lossis qhov xav tau, uas ua rau muaj kev nyuaj siab ntawm tus menyuam los ntawm qhov sib txawv ntawm lub phiab;
- -Peb tham txog mechanical dystoniantawm fetal keeb kwm Thaum nws yog tus menyuam hauv plab uas nyuaj rau kev yug menyuam vim nws txoj haujlwm (tshwj xeeb hauv kev ua tiav lossis tsis tiav), nws qhov loj thiab nws qhov hnyav (peb hais txog fetal macrosomia, thaum tus menyuam qhov hnyav tshaj 4 kg) lossis tag nrho. rau malformation (hydrocephalus, spina bifida, thiab lwm yam);
- peb thaum kawg tham txog cov nqaij mos mechanical dystocia Thaum lub cev tsis muaj zog yog vim qhov placenta previa tsawg kawg yog ib feem ntawm lub ncauj tsev menyuam, zes qe menyuam, teeb meem hauv tsev menyuam (fibroids, malformations, nti, thiab lwm yam) thiab lwm yam.
Ib rooj plaub tshwj xeeb ntawm kev siv tshuab ua haujlwm ntawm lub hauv paus chiv keeb yog lub xub pwg nyom dystocia, thaum tus me nyuam lub taub hau tau raug tshem tawm tab sis lub xub pwg nyom tau tawm tsam rau hauv lub plab tom qab. Peb tham kom dav ntxiv txog dystocie d'kev koom tes thaum lub fetus tawm tsam kom koom nrog hauv lub plab mog, txawm tias lub ncauj tsev menyuam zoo.
Obstructed kev ua haujlwm: Puas yog kev phais phais tas li tsim nyog?
Nyob ntawm seb hom thiab qib ntawm kev ua haujlwm cuam tshuam thaum yug menyuam, ntu ntu ntu yuav qhia tau.
Nco ntsoov tias kev nce qib hauv ultrasound niaj hnub no ua rau nws muaj peev xwm zam tau qee qhov kev xa khoom tsis zoo, los ntawm kev xaiv rau qhov teem caij phais mob, thaum muaj cov placenta previa npog lub ncauj tsev menyuam, piv txwv li, lossis thaum twg. tus me nyuam loj heev rau qhov dav ntawm niam-rau-ua lub plab mog. Txawm li cas los xij, qhov chaw yug me nyuam tuaj yeem ua pov thawj tias muaj kev vam meej txawm tias muaj teeb meem tau hais los saum no.
Nyob rau hauv lub ntsej muag ntawm dynamic dystocia, cov khoom tsim rupture ntawm daim nyias nyias thiab txhaj tshuaj oxytocin tuaj yeem ua rau nws ua tau. ua kom cov contractions zoo dua thiab lub ncauj tsev menyuam dilated.
Kev siv cov cuab yeej xws li forceps lossis suction khob tej zaum yuav tsim nyog nyob rau hauv qee yam dystocia.
Tab sis yog tias cov kev ntsuas no tsis txaus rau kev xa tus menyuam, thiab / lossis cov tsos mob ntawm kev ntxhov siab hauv fetus tshwm sim, ib qho kev phais mob xwm txheej ceev tau ua.