Cov tsis muaj zog ntawm zog kev ua si: ua, txim thiab forecasts

Qhov tsab xov xwm yuav xav txog cov tsis muaj zog ntawm txoj hauj lwm. Peb yuav qhia rau koj nyob rau hauv kom meej txog qhov ua, cov tsos mob, teebmeem thiab kev daws teeb meem ntawm txoj hauj lwm.

Yuav kom txhais hais tias nws yog. Cov tsis muaj zog ntawm zog - yog cov tsis muaj kev ua si ntawm lub tsev menyuam. Xws li tus me nyuam tsis yooj yim thiab lub sij hawm-siv raws li lub tsev me nyuam phem heev txo, lub ncauj tsev menyuam ceev ua hauj lwm thiab cov txiv hmab txiv ntoo mus qeeb heev thiab tsis yooj yim. Labor tsis yeej ib txwm mus zoo, raws li nws yuav tsum, muaj anomalies ntawm zog kev ua si. Nyob rau ib tug ntawm lawv koj yuav kawm tau nyob rau hauv zoo meej nyob rau hauv no tsab xov xwm.

uterine inertia

Raws li ntau li ntau nws yuav sound tu siab, tab sis ua hauj lwm rau kev txawv txav heev heev. Yog vim li cas rau qhov no tshwm sim yog heev heev heev. Tam sim no peb yuav tham txog cov tsis muaj zog ntawm lub zog txheej txheem.

Qhov no yog ib tug ntawm cov tau ua txhaum cai ntawm txoj hauj lwm. Nrog rau qhov no mob ntawm uterine muaj nuj nqi, uas yog tsim nyog rau lub ntiab tawm ntawm lub fetus, nws yog tsis muaj zog txaus. Qhov no yog vim:

• tsawg suab nrov ntawm lub myometrium;
• tsawg lus;
• tsis muaj zog amplitude txo;
• loj heev ntawm diastole;
• yuav txo tau lub sij hawm yog nyob deb tom qab so lub sij hawm;
• ncua qhib ntawm lub ncauj tsev menyuam;
• pab nce qib ntawm fetus.

Nyob rau hauv ntau yam symptomatology yuav tsum tau nthuav tawm nyob rau hauv lwm seem. Tam sim no peb muab ib co txheeb cais. Qhov no mob nyob rau hauv Obstetrics thiab Gynecology yog lub nrov tshaj plaws, vim hais tias nws yog ib tug heev heev mob yug menyuam thiab qhov ua rau ntawm ntau yam pathologies ntawm ob niam thiab tus me nyuam. Txheeb cais kom paub tseeb tias ntau tshaj xya rau ib xees ntawm kev yug me nyuam yog nyuab los ntawm cov tsis muaj zog ntawm zog kev ua si. Thiab lwm fact: qhov mob yog feem ntau cov poj niam uas muaj lawv thawj tus me nyuam. Raws li ib tug txoj cai, lub tiam neeg tau dhau tsis muaj tej teeb meem, tab sis muaj mob ntawm diagnosing cov tsis muaj zog ntawm ua hauj lwm thiab tom ntej yog tau me nyuam.

yog vim li cas

Peb piav qhia hais tias qhov no tsis muaj zog ntawm zog kev ua si. Yog vim li cas yuav tsum muaj ntau yam. Peb muaj sau lawv. Yog vim li cas rau cov tsis muaj zog ntawm zog yog:

• morphological inferiority ntawm lub tsev menyuam;
• tsis muaj hormonal cai generic txheej txheem;
• haumxeeb inertia ntawm poob siab lug;
• ekstragenital'nye kab mob;
• hypoplasia;
• fibroids;
• mob endometritis;
• adenomyosis;
• ob-horned tsev menyuam;
• eeb tsev menyuam;
• medabort;
• curettage;
• conservative myomectomy;
• nti tom qab kev kho mob ntawm ncauj tsev menyuam yaig (yog hais tias tus poj niam twb tsis tau yug).

Koj yuav tau nco ntsoov ib co ntawm cov yog vim li cas. Cov tsis muaj zog ntawm lub pab pawg neeg rog yuav tshwm sim vim ib tug tsis txaus ntawm yam uas muaj feem rau txoj hauj lwm. Yuav kom muaj xws li cov nram qab no zoo yam:

• prostaglandins;
• estrogens;
• oxytocin;
• calcium;
• kev sib kho thiab hais txog.

Adversely cuam tshuam rau:

• progesterone;
• magnesium;
• degrading enzymes thiab lwm yam kev sib kho.

Nws yog ib qho tseem ceeb yuav tau nco ntsoov tias cov poj niam uas raug kev txom nyem los ntawm tej yam mob (vegetative-pauv), feem ntau ntsib nrog qhov teeb meem thaum lub sij hawm yog tau me nyuam. Tej kev ua txhaum xws li:

• rog;
• hypothyroidism;
• hypofunction ntawm lub adrenal cortex;
• hypothalamic syndrome.

Zoo heev los ntawm lub hnub nyoog thiab nulliparous. Yog hais tias ib tug hluas nkauj yog hluas heev, los yog nws muaj hnub nyoog tshaj 35 xyoo, cov uas ua hauj yuav tsis yooj yim. Nws tseem ceeb heev thiab lub sij hawm uas pib ntawm txoj hauj lwm. Cov tsis muaj zog ntawm lub tsev me nyuam tej zaum yuav ua kom muaj lub caij nyoog uas cev xeeb tub, los yog ntxov ntxov.

Yog hais tias koj cev xeeb tub yog muaj menyuam coob coob, nws puas yuav tau no pathology thaum lub sij hawm yog tau me nyuam. Thaum muaj ib tug ntau yam uas cev xeeb tub uterine hyperextension. Hyperextension kuj tshwm sim thaum ib tug loj txiv hmab txiv ntoo los yog polyhydramnios.

Feem ntau uas muaj teeb meem ua hauj lwm rau kev nyuaj siab me me ntxhais ua ib tug nqaim plab mog nws kuj yog ib tug ua ntawm uterine pluag kev ua hauj lwm. Yog vim li cas - cov disproportion ntawm qhov luaj li cas ntawm tus me nyuam lub plab mog thiab cov poj niam.

Yog vim li cas yog tseem heev heev heev, hmoov tsis, tsis tau enumerated. Tam sim no xaiv txawm ib co ntawm cov feem ntau nrov sawv daws yuav:

• qaug zog;
• puas siab puas ntsws kev nyuaj siab;
• lub cev ua ub no;
• txom nyem noj haus;
• tsis muaj cov pw tsaug zog;
• ntshai me nyuam;
• tsis xis nyob;
• cov neeg pluag txij nkawm ntawm lub niam thiab thiaj li nyob.

Yog li, nws yog ua tau cais tag nrho cov yog vim li cas raws li nram no:

• nws niam lub sab;
• cev xeeb tub mob;
• los ntawm tus me nyuam.

hom

Uterine inertia yuav tshwm sim kiag li txhua ntu ntawm tus me nyuam. Nyob rau hauv no hais txog, nws txiav txim siab los faib ib co hom tsis muaj zog:

• thawj;
• theem nrab;
• tsis muaj zog me nyuam.

Peb muaj ib tug me ntsis saib xyuas nyob rau hauv kom meej txhua yam nyias.

Lub hom tsis muaj zog ntawm zog yog yus muaj los ntawm cov uas tsis muaj kev ua si cov lus nyob rau hauv thawj theem ntawm txoj hauj lwm. Lawv yog cov heev tsis muaj zog, luv luv thiab tsis zoo. Ceeb tshaj, cov cai understated suab nrov ntawm lub tsev me nyuam thaum lub sij hawm thawj tsis muaj zog (tsawg tshaj li 100 mm hg. V.). Rau ntawm no theem, ib tug poj niam tsis tau tshawb nrhiav qhov teeb meem xwb. Yuav ua li cas koj ua li cas? Haiv neeg tiv thaiv lub moos rau kaum feeb thiab suav cov xov tooj ntawm fights li no lub sij hawm. Yog hais tias cov xov tooj tsis pub tshaj ob thiab koj yuav luag tsis xav tias lawv, tus mob twb paub tseeb hais tias. Koj yuav ntsuas lub sij hawm thiab ib tug sib ntaus sib tua, nws yuav tsum tau ntau tshaj 20 vib nas this nyob rau hauv lub qhaj ntawv ntawm uterine inertia. Diastole, los yog so lub sij hawm, lub ncua yuav luag ob zaug. Raws li palpability lus yuav tham txog qhov teeb meem? Heev tsuas, yog hais tias lawv yog tsis mob los yog maloboleznennye, lub siab nyob rau ib feem ntawm lub tsev menyuam yog tsis txaus los qhib lub ncauj tsev menyuam.

Secondary tsis muaj zog ntawm zog yog tsiag ntawv los ntawm weakening ntawm qhov kev siv ntawm uterine ua hauj lwm. Ua ntej ntawd sib ntaus yuav ua tau li qub. Cov ua tib yam, raws li nyob rau hauv cov thawj tsis muaj zog ntawm pab pawg neeg rog. Lwm qhov taw qhia - qhov muaj mob ntawm kev qhia tawm ntawm uterine caj pas. Yog hais tias kev kawm yog tsis pom tom qab tsib los sis rau centimeters ntawm ntaub ntawv, peb yuav confidently tham txog ob hypotonic uterine kawg.

Yog hais tias cov thawj thiab thib ob tsis muaj zog cai nyob rau hauv kaum feem pua ntawm cov neeg mob kev phiv yug thiab yog cov yam ntxwv ntawm cov thawj yug tus me nyuam, cov tsis muaj zog ntawm tus kabmob-down lub sij hawm yog tsis tshua muaj heev (ob rau ib xees ntawm txhua tus neeg mob obstructed zog), thiab nws yog raug rau multiparous cov poj niam los yog nyob rau hauv rog.

cov tsos mob

Cov tsos mob ntawm thawj tsis muaj zog ntawm zog muaj xws li:

• txo excitability ntawm lub tsev menyuam;
• poob suab nrov ntawm lub tsev menyuam;
• txo zaus ntawm cov lus (txog li ob lub rau kaum feeb);
• luv luv ntev ntawm cov lus (mus txog nees nkaum vib nas this);
• txiav hwj chim tsis pub tshaj tus nqi ntawm 25 mm hg. Tsab xov xwm.;
• ib tug luv luv lub sij hawm ntawm contraction;
• ncua sij hawm so;
• tsis muaj cai nce nyob rau hauv cov kev siv thiab zaus;
• tsis mob maloboleznennost los yog lus;
• Qeeb hloov lub tsev me nyuam lug (no muaj xws li shortening, smoothing thiab qhia tawm).

Tag nrho cov no yuav ho ua rau kom lub zuag qhia tag nrho lub sij hawm ntawm tus me nyuam. Qhov no, nyob rau hauv lem, yog ua phem rau leej niam thiab tus me nyuam. Poj niam nyob rau hauv zog los yog qaug, tej zaum thaum ntxov ntiab tawm ntawm cov dej.

Cov tsos mob ntawm ob tsis muaj zog:

• tsaus muag siv battles (tej zaum txawm lawv tsis tiav tas);
• tsaus muag laus;
• txo lub excitability;
• tsis muaj kev vam meej qhia tawm uterine caj pas;
• nres nce qib ntawm fetus los ntawm cov me nyuam yug kwj dej.

Nws yog tsis muaj tsawg txaus ntshai tshaj li tus thawj tsis muaj zog. Tus me nyuam tej zaum yuav tsim asphyxia, los yog nws tej zaum yuav tuag. Rau niam txaus ntshai uterine kab mob yuav yug raug mob. Ntev sawv taub hau ntawm ib tug me nyuam nyob rau hauv cov me nyuam yug kwj dej tej zaum yuav ua rau cov tsim ntawm haematomas los yog fistula.

diagnostics

Nyob rau hauv seem no peb yuav tsom rau diagnosing cov teeb meem ntawm tsis muaj zog (thawj thiab) ua hauj lwm rau. Tus kab mob cov thawj tsis muaj zog yog muab tso rau hauv cov nram qab no hauv paus:

• txo nyob rau hauv kev ua si ntawm lub tsev menyuam;
• Txo tus nqi ntawm smoothing ntawm lub ncauj tsev menyuam;
• ncua qhia tawm ntawm uterine caj pas;
• deb txiv hmab txiv ntoo;
• nce zog.

Nws yog ib qho tseem ceeb yuav tau nco ntsoov hais tias ib tug loj feem nyob rau hauv qhov mob muaj partogram (los yog graphical piav qhia ntawm genera). Qhov no daim ntawv qhia txog tag nrho:

• caj dab qhib;
• nce qib ntawm txiv hmab txiv ntoo;
• mem tes;
• siab;
• tus me nyuam lub plawv dhia;
• sib ntaus sib tua thiab hais txog.

Yog hais tias muaj yog tsis muaj kev kawm nyob rau hauv lub tsev me nyuam dilatation rau ob teev, uas yog kom meej meej pom nyob rau hauv lub partograph, ces muab tso rau qhov no kuaj mob.

Mob ntawm ob tsis muaj zog yog raws li tej cim no:

• partogram;
• CTG;
• mloog lub plawv dhia.

Qhov no yog tsim nyog los xyuas kom meej tias lub fetus tsis tsim hypoxia. Muaj ib co teeb meem generative txheej txheem uas symptomatically xws li ib tug tsis muaj zog txaus zog. Cov muaj xws li:

• pathology yam ua ntej lub sij hawm;
• diskoordinirovanie zog;
• clinically nqaim plab mog.

kev kho mob

Ceeb tshaj, cov kev kho mob yog xaiv ib lub zuj zus rau txhua tus cev xeeb tub poj niam. Thaum tus kws kho mob yuav tsum coj mus rau hauv tus account tag nrho cov ntaub ntawv hais tias nws muaj (mob ntawm tus poj niam thiab tus me nyuam).

Ib tug zoo tshuaj rau tsis muaj zog ua hauj lwm rau - ib tug txheej txheem pw tsaug zog tshuaj. Rau lub hom phiaj no yog tshwj xeeb npaj, tus poj niam so, ces tej hauj lwm tej zaum yuav ua rau kom.

Yog hais tias qhov no tsis ua hauj lwm, ces resorted mus rau hno week. Tom qab txoj kev ua no hauj lwm nws yuav ntau npaum li cas mob siab heev. Nws yuav tsum tau muab sau tseg tias tej yam tsuas yog lub ncauj tsev menyuam yog npaj txhij.

Tej zaum cov kws kho mob muaj resorted mus rau yeeb tshuaj stimulation. Tam sim no peb kawm seb cov "Miropriston" tshuaj induce zog. Cov tshuaj no yuav tsum tau coj nruj me ntsis nyob rau hauv lub saib xyuas ntawm cov kws kho mob. Nws cheeb progesterone, uas muaj ib tug nyhuv lig rau uterine kev ua si.

tus me nyuam

Yog hais tias tsis muaj kev xaiv tej hauj lwm, xws li "Miropriston" induce zog, tus kws kho mob tej zaum yuav ua tau ib qho xwm ceev phais plab seem. Yuav ua li cas txoj kev yog nqa tawm ua ntej lub lag luam:

• tshuaj hob pw tsaug zog;
• amniotomy;
• tshuaj stimulation.

Nyob rau hauv tas li ntawd, tej zaum yuav muaj ntxiv indications rau kev phais. Muaj yog ib tug tej yam daim ntawv teev cov contraindications rau induction ntawm zog (nqaim mog, uterine caws pliav, txoj sia, thiab thiaj li nyob).

kev tiv thaiv

Peb soj ntsuam nyob rau hauv kom meej lo lus nug ntawm cov tsis muaj zog ntawm txoj hauj lwm. Soj ntsuam cov lus qhia rau kev tiv thaiv muaj peev xwm muab ib tug obstetrician-gynecologist leej twg yog koj cev xeeb tub. Nws yuav tsum qhia rau koj txog cov tau mob thaum lub sij hawm yug menyuam thiab cev nqaij daim tawv thiab puas siab puas ntsws txoj kev kawm niam. Dhau li rodostimulyatsii obligatory nyob rau hauv kev tiv thaiv ntawm tau teeb meem nyob rau hauv lub fetus.

los

Yuav ua li cas yog qhov teeb meem ntawm uterine inertia? Rau ntsiag to nws yuav ua tau:

• nqaij doog;
• fistulas;
• tau kab mob.

Rau cov me nyuam, cov hauv qab no mob:

• hypoxia;
• acidosis;
• lub hlwb edema;
• txoj kev tuag.

Txhua yam nyob rau tus kws kho mob tus tshaj lij. Nrog rau txoj cai stimulation, thiab meej tswj raws li txoj cai ntawm tus me nyuam thiab leej niam tsis muaj txim yuav tsum tsis txhob yuav.

outlook

Tam sim no luv luv txog cua cov tsis muaj zog ntawm txoj hauj lwm. Raws li hais ua ntej lawm, nws tag nrho cov nyob rau tus kws kho mob professionalism thiab puas siab puas ntsws mob ntawm tus poj niam. Tsis txhob ntshai, thiab mloog mus rau lub tswv yim pom zoo ntawm cov kws txawj. Teeb meem los ntawm obstructed zog tsis tshua muaj.

Cov chav kawm ntawm lub tom ntej no tus me nyuam

Cov tsis muaj zog ntawm zog ua si thaum xub thawj yug tus me nyuam yog tsis txhob hais tias tag nrho cov lwm leej lwm tus yuav npaj mus zoo li ntawd. Thawj thiab theem nrab tsis muaj zog yog ib qho ntawm cov poj niam uas muab yug ua ntej tus me nyuam. Nyob rau hauv ib tug me me feem pua tej zaum yuav muaj tsis muaj zog multiparas kev coj tus kheej-down lub sij hawm.