Kab lus no yuav hais txog qhov tsis muaj zog ntawm kev ua haujlwm. Peb yuav qhia rau koj paub meej txog qhov ua rau, cov tsos mob, qhov tshwm sim thiab kev daws teeb meem ntawm kev yug menyuam.
Rau qhov peb qhia tias yog dab tsi. Qhov tsis muaj zog ntawm kev ua haujlwm yog qhov tsis ua haujlwm ntawm lub tsev menyuam. Qhov ntawd yog, kev yug menyuam yog qhov nyuaj thiab ntev, vim tias lub tsev menyuam tsis cog lus zoo, lub tsev me nyuam qhib nrog nyuaj, thiab tus menyuam hauv plab tuaj qeeb heev thiab nyuaj. Kev yug me nyuam tsis yog ib txwm mus zoo, raws li qhov xav tau, muaj kev tsis sib haum xeeb hauv kev ua haujlwm. Koj yuav kawm txog ib qho ntawm cov ncauj lus kom ntxaws los ntawm kab lus no.
Kev ua haujlwm tsis muaj zog
Txawm hais tias nws yuav nyuaj siab npaum li cas, tab sis kev tsis sib haum xeeb hauv kev ua haujlwm muaj ntau heev. Cov laj thawj rau qhov tshwm sim no muaj ntau heev. Tam sim no peb yuav tham txog qhov tsis muaj zog ntawm cov generictxheej txheem.
Qhov no yog ib qho ua txhaum cai ntawm kev ua haujlwm. Nrog rau qhov kev kuaj mob no, kev ua haujlwm ntawm lub tsev menyuam, uas yog qhov tsim nyog rau kev tshem tawm ntawm tus menyuam hauv plab, tsis muaj zog. Qhov no yog vim:
- low myometrial tone;
- tsis tshua muaj kev cog lus;
- tsis muaj zog amplitude ntawm contractions;
- predominance ntawm diastole;
- lub sijhawm cog lus qeeb qeeb tom qab lub sijhawm so;
- ncua lub ncauj tsev menyuam;
- slow fetal advance.
Cov tsos mob ntxaws ntxiv yuav nthuav tawm hauv lwm ntu. Tam sim no cia saib qee qhov kev txheeb cais. Qhov kev kuaj mob hauv obstetrics thiab gynecology yog qhov nrov tshaj plaws, vim nws yog ib qho teeb meem ntawm kev yug me nyuam thiab ua rau muaj ntau yam pathologies ntawm leej niam thiab tus menyuam. Cov ntaub ntawv pov thawj hais tias ntau tshaj li xya feem pua ntawm kev yug menyuam yog qhov nyuaj los ntawm kev ua haujlwm tsis muaj zog. Thiab ib qho ntxiv qhov tseeb: qhov kev kuaj mob no tau tsim ntau dua los ntawm cov poj niam uas yug lawv tus menyuam thawj zaug. Raws li txoj cai, kev yug me nyuam tom ntej dhau mus yam tsis muaj teeb meem, txawm li cas los xij, muaj cov xwm txheej ntawm kev kuaj pom tsis muaj zog ntawm kev ua haujlwm thaum yug tom qab.
Yog vim li cas
Peb tau piav qhia tias qhov tsis muaj zog ntawm kev ua haujlwm yog dab tsi. Cov laj thawj tuaj yeem yog ntau yam. Peb thov kom sau lawv. Cov laj thawj rau kev ua haujlwm tsis muaj zog tuaj yeem yog:
- morphological inferiority ntawm lub tsev menyuam;
- tsis muaj kev tswj hwm hormonal ntawm kev yug menyuam;
- functional inertia ntawm paj hlwb;
- kab mob sib kis;
- hypoplasia;
- myoma;
- mob endometritis;
- adenomyosis;
- bicornuate uterus;
- saddle uterus;
- medabortion;
- scraping;
- kev saib xyuas myomectomy;
- muag tom qab kho lub ncauj tsev menyuam (yog tias tus poj niam tsis tau yug yav tas los).
Muaj qee qhov laj thawj ntxiv. Kev qaug zog ntawm pab pawg neeg tuaj yeem tshwm sim vim qhov tsis sib xws ntawm cov yam ntxwv uas cuam tshuam rau kev ua haujlwm. Yam zoo muaj xws li hauv qab no:
- Yprostaglandins;
- estrogens;
- Yoxytocin;
- calcium;
- tus neeg nruab nrab thiab lwm yam.
cuam tshuam tsis zoo:
- Yprogesterone;
- magnesium;
- enzymes uas rhuav tshem neurotransmitters thiab lwm yam.
Nws yog ib qho tseem ceeb heev uas yuav tsum nco ntsoov tias cov poj niam uas muaj qee yam kev tsis sib haum xeeb (vegetative-metabolic) feem ntau ntsib qhov teeb meem no thaum yug me nyuam. Cov kev ua txhaum cai no suav nrog:
- obesity;
- hypothyroidism;
- ua haujlwm tsis txaus ntawm adrenal cortex;
- Yhypothalamic syndrome.
Hnub nyoog ntawm primiparous kuj muaj kev cuam tshuam zoo. Yog tias tus ntxhais hluas heev los yog nws muaj hnub nyoog tshaj 35 xyoo, ces kev ua haujlwm yuav nyuaj. Lub sijhawm pib ua haujlwm tseem ceeb heev. Lub tsev menyuam tsis muaj zog tuaj yeem ua rau muaj kev xeeb tub qeeb lossis ntxov ntxov.
Yog tias cev xeeb tub ntau, ces qhov no pathology yog ua tau thaum yug menyuam. Nrog ntau cev xeeb tubuterine distension tshwm sim. Overstretching tuaj yeem tshwm sim nrog tus menyuam hauv plab loj lossis polyhydramnios.
Cov ntxhais hluas feem ntau ntsib teeb meem hauv kev ua haujlwm, vim qhov nqaim ntawm lub plab kuj yog qhov ua rau lub tsev menyuam ua haujlwm tsis muaj zog. Qhov laj thawj yog qhov tsis sib xws ntawm qhov loj ntawm tus menyuam thiab lub plab ntawm tus poj niam.
Cov laj thawj tseem muaj ntau heev, hmoov tsis, nws yuav tsis tuaj yeem sau tag nrho. Tam sim no cia peb qhia qee qhov nrov tshaj plaws ntawm lawv:
- overwork;
- kev nyuaj siab;
- kev ua lub cev;
- khoom noj phem;
- pw tsaug zog;
- Ntshai muaj menyuam;
- kev xa khoom tsis zoo thiab lwm yam.
Yog li, peb tuaj yeem faib txhua qhov laj thawj raws li hauv qab no:
- los ntawm niam;
- muaj teeb meem xeeb tub;
- ntawm ib sab ntawm tus menyuam.
Views
Kev ua haujlwm tsis muaj zog tuaj yeem tshwm sim ntawm txhua theem ntawm kev yug menyuam. Hauv qhov no, nws yog ib txwm ua kom pom qee yam tsis muaj zog:
- primary;
- secondary;
- tsis muaj zog.
Peb muab cov ncauj lus kom ntxaws me ntsis ntawm txhua hom sib cais.
Kev qaug zog ntawm kev ua haujlwm tseem ceeb yog qhov tshwm sim los ntawm kev ua haujlwm tsis muaj zog hauv thawj theem ntawm kev ua haujlwm. Lawv yog cov tsis muaj zog heev, luv luv thiab tsis nyob rau hauv tag nrho cov suab. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias nrog thawj qhov tsis muaj zog, ib qho kev ntsuas qis ntawm lub tsev menyuam (tsawg dua 100 mm Hg) tau pom. Nyob rau theem no, tus poj niam muaj peev xwm kuaj tau qhov teeb meem ntawm nws tus kheej. Yuav ua li casua nws? Lub sij hawm kaum feeb thiab suav tus naj npawb ntawm contractions nyob rau lub sij hawm no. Yog tias tus lej tsis tshaj ob thiab koj xyaum tsis hnov lawv, ces qhov kev kuaj mob tau lees paub. Koj tuaj yeem ntsuas lub sijhawm ntawm ib qho kev cog lus, nws yuav tsum yog ntau tshaj 20 vib nas this thaum tsis muaj zog ntawm kev ua haujlwm. Diastole, lossis lub sijhawm so, yuav luag ob zaug ntev. Lub palpability ntawm contractions qhia tau hais tias muaj teeb meem li cas? Nws yooj yim, yog tias lawv tsis mob lossis mob me ntsis, ces qhov siab ntawm lub tsev menyuam tsis txaus qhib lub ncauj tsev menyuam.
Kev qaug zog ntawm kev ua haujlwm thib ob yog qhov tsis muaj zog ntawm kev ua haujlwm ntawm lub tsev menyuam. Ua ntej qhov no, kev cog lus yuav zoo li qub. Qhov ua rau ntawm txoj kev loj hlob zoo ib yam li nrog lub hauv paus tsis muaj zog ntawm cov poj koob yawm txwv rog. Lwm qhov taw qhia yog qhov kev loj hlob ntawm qhov qhib ntawm lub uterine os. Yog tias qhov kev vam meej tsis pom tom qab tsib mus rau rau centimeters ntawm dilatation, ces peb tuaj yeem ntseeg siab hais txog kev ua haujlwm ntawm lub tsev menyuam hypotonic theem nrab.
Thaum thawj zaug thiab theem nrab tsis muaj zog tshwm sim hauv kaum feem pua ntawm cov neeg mob tsis zoo thaum yug los thiab yog qhov zoo rau primiparas, tom qab ntawd qhov tsis muaj zog ntawm lub sijhawm puerperal yog qhov tsawg heev (ob feem pua ntawm tag nrho cov xwm txheej ntawm kev yug me nyuam), thiab nws yog qhov zoo rau Cov poj niam uas muaj ntau yam yug los yog rog.
Symptoms
Cov tsos mob ntawm thawj qhov tsis muaj zog ntawm kev ua haujlwm suav nrog:
- txo qis uterine excitability;
- txoov uterine tone;
- txo qis ntawm kev cog lus (kuj mus rau ob hauv kaum feeb);
- lub sijhawm luv ntawm kev cog lus (txognees nkaum vib nas this);
- lub zog ntawm kev cog lus tsis pub tshaj 25 mm Hg. Art.;
- luv luv luv;
- ncua sijhawm so;
- tsis nce qhov kev siv zog thiab zaus;
- tsis mob lossis tsis mob;
- ncua kev hloov pauv hauv cov qauv ntawm lub ncauj tsev menyuam (qhov no suav nrog kev ua kom luv, smoothing thiab qhib).
Txhua yam no tuaj yeem ua rau lub sijhawm ua haujlwm tag nrho. Qhov no, nyob rau hauv lem, cuam tshuam rau leej niam thiab tus me nyuam phem. Tus poj niam ua haujlwm hnyav heev, raug tshem tawm sai sai.
Cov tsos mob ntawm qhov tsis muaj zog thib ob:
- qaug zog ntawm kev siv zog ntawm kev cog lus (tej zaum txawm tias lawv ua tiav);
- txo qis hauv excitability;
- tsis muaj kev loj hlob ntawm ncauj tsev menyuam dilatation;
- tso tseg kev vam meej ntawm tus menyuam hauv plab yug.
Qhov no tsis muaj kev phom sij tsawg dua li qhov pib tsis muaj zog. Tus menyuam tuaj yeem tsim asphyxia lossis tuaj yeem tuag. Rau leej niam, qhov no yog qhov txaus ntshai vim muaj kev kis kab mob ntawm lub tsev menyuam, kev raug mob thaum yug. Ntev ntev ntawm tus menyuam lub taub hau nyob rau hauv lub kwj dej yug me nyuam tuaj yeem ua rau muaj qhov nqaij tawv lossis fistulas.
Diagnosis
tshooj no yuav tsom mus rau kev kuaj xyuas qhov teeb meem ntawm kev qaug zog (thawj thiab theem nrab) ntawm kev ua haujlwm. Kev kuaj mob thawj zaug tsis muaj zog yog raws li hauv qab no:
- txo qis uterine kev ua haujlwm;
- txo caj dab smoothing npaum li cas;
- ncua kev qhib lub ncauj tsev menyuam;
- ntev fetus;
- nce lub sijhawm ua haujlwm.
Qhov tseem ceebNws yuav tsum raug sau tseg tias partogram (lossis cov duab piav qhia txog kev yug menyuam) muaj txiaj ntsig zoo rau kev kuaj mob. Txhua yam yog qhia hauv daim duab no:
- caj dab qhib;
- fetal promotion;
- pulse;
- siab;
- baby heartbeat;
- kev cog lus thiab lwm yam.
Yog tias tsis muaj kev vam meej hauv kev nthuav dav ntawm lub ncauj tsev menyuam rau ob teev, uas tau qhia meej meej hauv partogram, ces qhov kev kuaj mob no tau tsim.
Kev kuaj mob ntawm qhov tsis muaj zog thib ob yog nyob ntawm cov ntsuas no:
- partogram;
- KTG;
- mloog lub plawv dhia.
Qhov no yog qhov tsim nyog kom tus me nyuam mos tsis tsim hypoxia. Muaj qee qhov nyuaj ntawm kev yug me nyuam uas muaj cov tsos mob zoo ib yam li kev ua haujlwm tsis muaj zog. Cov no suav nrog:
- pathology ntawm lub sijhawm ua ntej;
- kev sib koom ua haujlwm ntawm kev ua haujlwm;
- clinically nqaim pelvis.
Kev kho mob
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias kev kho mob raug xaiv ib tus zuj zus rau txhua tus poj niam hauv kev ua haujlwm. Thaum kho, tus kws kho mob yuav tsum coj mus rau hauv tus account tag nrho cov ntaub ntawv uas nws muaj (tus mob ntawm tus poj niam thiab tus me nyuam).
Ib qho tshuaj zoo rau kev ua haujlwm tsis muaj zog yog kev siv tshuaj tsaug zog. Ua li no, kev npaj tshwj xeeb tau qhia kom tus poj niam tau so, tom qab ntawd kev ua haujlwm yuav hnyav zuj zus.
Yog qhov no tsis pab, ces lawv mus ntswj lub zais zis. Tom qab cov txheej txheem no, kev ua haujlwm ua haujlwm ua haujlwm hnyav dua. Tus nqinco ntsoov tias qhov puncture yog nqa tawm tsuas yog lub caj dab npaj txhij.
Qee zaum cov kws kho mob siv tshuaj stimulation. Tam sim no peb yuav tham luv luv txog cov tshuaj "Miropriston" los txhawb kev ua haujlwm. Cov tshuaj no yuav tsum tau noj nruj me ntsis raws li kev saib xyuas ntawm kws kho mob. Nws suppresses progesterone, uas muaj txiaj ntsig zoo ntawm kev ua haujlwm ntawm lub tsev menyuam.
Kev xa khoom
Yog tias tsis muaj txoj hauv kev tau pab, suav nrog Miropriston los txhawb kev ua haujlwm, tus kws kho mob tuaj yeem ua qhov kev phais xwm txheej ceev. Cov txheej txheem dab tsi tau ua ua ntej ua haujlwm:
- dab pw tsaug zog;
- amniotomy;
- tshuaj stimulation.
Ntawm lwm yam, tej zaum yuav muaj kev qhia ntxiv rau kev phais. Muaj ib daim ntawv teev cov contraindications rau kev ua hauj lwm induction (lub plab pelvis, uterine scars, life hem, thiab hais txog).
Kev Tiv Thaiv
Peb tau tshuaj xyuas kom meej qhov teeb meem ntawm qhov tsis muaj zog ntawm kev ua haujlwm. Cov lus pom zoo rau kev tiv thaiv tuaj yeem muab los ntawm obstetrician-gynecologist uas tswj koj cev xeeb tub. Nws yuav tsum tham txog cov teeb meem tshwm sim thaum yug me nyuam thiab ua kev npaj lub cev thiab kev xav ntawm tus poj niam hauv kev ua haujlwm. Ntxiv nrog rau rhodostimulation, kev tiv thaiv cov teeb meem tshwm sim hauv fetus yog qhov yuav tsum tau ua.
Txhais tau
Dab tsi yog qhov teeb meem ntawm kev ua haujlwm tsis muaj zog? Rau niam, qhov no tuaj yeem yog:
- hematoma tsim;
- fistula tsim;
- possible infection.
Cov teeb meem hauv qab no tuaj yeem ua rau tus menyuam:
- hypoxia;
- acidosis;
- cerebral edema;
- tuag.
Nws tag nrho yog nyob ntawm tus kws kho mob. Nrog kev txhawb nqa kom zoo thiab tswj xyuas tus menyuam thiab niam, yuav tsum tsis muaj qhov tshwm sim.
Huab cua
Tam sim no luv luv txog kev kwv yees qhov tsis muaj zog ntawm kev ua haujlwm. Raws li tau hais ua ntej, nws tag nrho yog nyob ntawm kev tshaj lij ntawm tus kws kho mob thiab lub xeev kev xav ntawm tus poj niam. Tsis txhob ntshai, tab sis mloog cov lus pom zoo ntawm tus kws tshaj lij. Cov teeb meem tom qab obstructed ua haujlwm tsis tshua muaj.
Kev yug me nyuam tom ntej
Qhov tsis muaj zog ntawm kev ua haujlwm thaum yug thawj zaug tsis tau txhais hais tias txhua tus tom ntej yuav zoo ib yam. Lub hauv paus pib thiab theem nrab tsis muaj zog yog tshwm sim hauv cov poj niam uas yug lawv tus menyuam thawj zaug. Ib feem me me ntawm cov poj niam uas muaj ntau tus poj niam tuaj yeem muaj kev qaug zog hauv lub sijhawm muaj kabmob.
