Nthawi imeneyi imatha pafupi maola 7. Kwa nthawi yoyamba mikangano yokonzekera ikhoza kuchedwa, zomwe zikutanthauza kuti zidzatchinjiriza amayi amtsogolo kuti apumule ndi kupeza mphamvu pa "ntchito" yomwe ikubwera. Kenaka adokotala amadziwitsa mankhwala osokoneza bongo kuti amuthandize kugona. Kwa amayi onse, oyamba, obadwa kachiwiri ali okhaokha, mfundo - m'nkhani yokhudza mutu wakuti "Kubadwa koyamba kumasiyana ndi yachiwiri."
- Nthawi yoyamba - kutseguka kwachiberekero
Izi zimachitika ngati gawo la kukonzekera kumayendedwe kanthawi ndikutopa ndi mayi woyembekezera kapena amniotic fluid yomwe inapita patsogolo pake. Pachifukwa ichi, dokotala amupatsa mankhwala othandiza kuti azitha kupuma ndi kubwezeretsa chiyero. Izi zimachitikanso kuti panthawi ya kubadwa kwa chiberekero, amayi a "debutante" sadakonzedwe, ndiko kuti, sichifewetsa ndipo sichifupikitsa. Mmenemo amathandizidwa ndi kutsutsana: amakhala ozolowereka komanso okhwima. Pansi pa zochita zawo, khosi limachepetsedwa, kufupikitsidwa ndi kutsegulidwa pang'ono. Khosi likufanana ndi chubu yomwe ili ndi mphamvu ziwiri: yoyamba "imatseka" pakhomo la chiberekero (apo, mwana amasambira mumadzi amniotic), ndipo wina - "kutuluka" kunja. Ndikumangirira kotsiriza kumene kumakhala kolemetsa kwambiri panthawi yobereka: iyenera kutsegula zambiri kuti mwanayo adutse. Kuti muwone bwino, ganizirani buluni (chiberekero), mwendo (khola lachiberekero) yomwe imamangidwa ndi zingwe ziwiri (mkati ndi kunja kwa chiberekero). Nthawi yoyamba ya amayi "osadziŵa zambiri" amatha maola 12-18 (izi zikuphatikizapo 7 akukonzekera), panthawi yoberekera yotsatira pamafunika maola 6-8. Kwa nthawi yoyamba kayendedwe ka mikangano pamasitepewa akhoza kusiyana ndi chikhalidwe, ndiye amakhala ochepa, osasintha, ndipo chiberekero sichikutseguka. Kenaka dokotala amayamba kukonzekera kachilombo ka chithandizo cha mankhwala, monga gelisi, yomwe imaphatikizapo zinthu zogwirira ntchito - prostaglandins, kapena makandulo ndi zinthu zomwe zimatsitsimula minofu yake.
- Nthawi yachiwiri - kubadwa kwa mwana
Zimayamba ndi nthawi yoyamba yotsegula chibelekero ndipo zimatha ndi kubadwa kwa mwanayo. Panthawiyi, mavutowo amakula kwambiri, ndipo amayesedwa kwa iwo. Mutu wa mwanayo umakanikiza pamisomo ya pansi pachitsime cha mkaziyo, kumapweteketsa mapeto a mitsempha, kumene iye ali ndi chikhumbo chosagonjetseratu cha kuuma. Nthawi yachiwiri imakhala yaitali kwa "oyamba", kuyambira ora limodzi kupita ku 2. Izi zimakhala chifukwa chakuti akazi omwe amakhala amayi nthawi yoyamba, minofu ya pansi pamtambo, ziwalo zapakati zimakhala zochepa kwambiri, zomwe zikutanthauza kuti sali okonzeka kutambasulira ndi kuchita zambiri kukana kubadwa kwa mwana. Pachifukwa ichi, zovuta za pakhomo la kubadwa mu "debutant" zimachitika katatu kawiri kawiri. Pofuna kupewa izi, dokotala amalowetsamo minofu. Nthawi yachitatu ndi kubadwa kwa pambuyo pake. Zimayamba ndi maonekedwe a mwanayo ndipo zimatha ndi kubadwa kwa chiberekero (ndiko kuti, placenta ndi fetal membranes). Nthawi yachitatu imakhala pafupifupi 5-10 mphindi. Panthawiyi, chiberekero chacheperachepera, chimagwera pamtunda, ndipo chifukwa chake kugwirizana kwake ndi pulasitiki kumaphwanyidwa, kumatulutsa mphamvu, ndipo mothandizidwa ndi ndewu, imatulutsidwa kunja ndi memphane. Palibe kusiyana kwakukulu momwe amayi omwe alibe "nzeru" ndi "odziwa" amakumana nawo nthawiyi, ayi. Kubadwa kwachirengedwe kobwerezabwereza kuli ndi zofunikira zawo. Khoma la m'mimba la m'mimba ndi ine la khoma la uterine m'mayi oterewa ndi otsika kwambiri, choncho mutu wa mwana, womwe uli pafupi ndi kutuluka, mpaka kumayambiriro kwa nkhondo, ukhoza kukhalabe wodutsa pamtunda pamwamba pa khomo la pakhosi, m'malo molimbikitsako, monga nthawi yoyamba kubereka. Chifukwa cha ichi, mkazi samamva ngati "mimba imataya" - kawirikawiri imachitika masabata 2-3 asanabadwe. Mphepete mwazitsulo zakucha zosavuta komanso mofulumira. Kupatulapo amayi okhawo omwe adzalandira chisawawa chachikulu pa nthawi yomwe anabadwa. Mwamwayi, tsopano zochitika zoterozo sizodziwika. Ngati kachilombo ka khola kanali kutalika kwake ndipo sanachiritse kapena chilonda chinawoneka m'malo awo, madokotala amatha kulondolera mkaziyo ku gawo lokonzekera. Kuwululidwa kwa chiberekero pakugwira ntchito mobwerezabwereza ndi mofulumira ndipo kumatenga maola 6-8. Pamodzi ndi nkhondo yoyamba, kutsegula ndi kuchepetsa chibelekero kumayambira.
Chifukwa chakuti kubereka mobwerezabwereza kumapita mofulumira ndipo siteji ikamakhala yopweteka siimathera nthawi yaitali, kufunika kwa anesthesia kumayambira mobwerezabwereza Ngati mwana wabadwa sali wamkulu kuposa kukula kwake koyamba ndipo ndikulondola, nthawi yachiwiri ikugwira ntchito mwamsanga . Mwanayo amapita "kumtunda", ndipo ngati kwa nthawi yoyamba kuchokera pa nthawi yomwe mwanayo akubadwa mwanayo amatha kutenga maola 1-1.5, kenako mphindi 20-30. Mankhwalawa amagwiritsidwa ntchito mobwerezabwereza kwa analgesia, omwe amajambulidwa kamodzi kamodzi kowopsa kapena mwachangu. Kuwonongeka kwa chiberekero ndi perineum nthawi yogwira ntchito mobwerezabwereza sikokwanira kusiyana ndi nthawi yoyamba, pokhapokha ngati tizilombo tomwefe timapsa. Inde, mimba iliyonse ndi kubereka ndi mayeso kwa mkazi. Ndipo kubadwa koyamba, kupatula ngati iwo adapanga mwachilengedwe, nthawizonse amakhalabe akumbukira amayi awo aang'ono ngati ntchito yovuta, pamene ochepawo amasiya nkhawa ndi kutopa. Tsopano tikudziwa kuti kubadwa koyamba kumasiyana bwanji ndi kachiwiri. Komanso ana, chifukwa chakuti njira yobadwa nayo imatha mofulumira, nthawi zambiri imakhala yogwira ntchito bwino komanso imapatsa bere nthawi yoyamba kudya. Popeza kuti kubereka kumeneku kumawonjezera chiopsezo cha magazi kwa mayi wamng'ono, mkhalidwe wa makolo odziwa bwino ntchito mu gawo lachitatu la ntchito ndi maola oyambirira ataphunzira, adokotala ndi mzamba ali maso kwambiri. M'masiku oyambirira atabwerezedwa mobwerezabwereza, amayi ena amawona kupwetekedwa kowawa kwa chiberekero, nthawi zina ngakhale kumafuna analgesia wofatsa. Komabe, malingalirowa amatha msanga, komanso kutopa pang'ono kuchokera pa ndondomekoyi komanso zomwe zinachitikira ndi chisamaliro cha mwana woyamba kubadwa zimathandiza amayi kuti azikhala mofulumira kwambiri.