N'èzí conjugate: pụrụ iche Ob

Nwaanyị ọ bụla nke chọrọ inweta ọṅụ nke nne. Ọ bụ eke na-akwadoghị akwado jikọtara putakarisiri ọdịdị mmadụ. Otú ọ dị, ọtụtụ ndị na-adịghị njikere maka eziokwu na i nwere ịhụ dọkịta gị mgbe niile ma na-atachi obi ụfọdụ bụghị nnọọ obi ụtọ mkpachapụ. Ma ka na ime wee were were na-eji nwayọọ, ọ kasị mma soro ntuziaka ndị ọkachamara na, kama ịdabere n'ihe chioma.

Nkwadebe maka ule

Tupu ya abịa antenatal n'ụlọ ọgwụ ka ga-aha na ime ma ọ bụ nanị maka zubere nnyocha, na ladies mkpa freshen elu. Ọ dịghị pụrụ iche a chọrọ mgbalị, ma ka na-atụ aro na-a ịwụ. Na ọ bụrụ na-ekwesịghị douche ma ọ bụ ihe dị ka, ọ bụ n'ozuzu picture nke ọrịa (ma ọ bụrụ na ọ bụla), ga-bịara ikiri, dọkịta adịghị chọta ihe ọ bụla. Ọ bụ ihe amamihe ọcha na ọhụrụ ákwà ọcha na ákwà a ịdị ọcha towel (ma ọ bụrụ na ọ dị mkpa).

General na pụrụ iche akụkọ ihe mere eme

Ka ọ bụla ọzọ dọkịta, ihe obstetrician-ọkachamara n'ọrịa ụmụ nwanyị nwere a na fọm iji nyochaa ọrịa mere eme. Ọ na-agụnye paspọtụ data, mkpesa, ndekọ nke obi na-arụ ọrụ, na-egosi na mkpụrụ ndụ ihe nketa nke ọrịa na ọrịa.

Special akụkọ ihe mere eme lekwasịrị anya n'eziokwu na dọkịta ghọtara ọdịdị zuru oke nke nsogbu na nke nwanyi jụrụ. Ọ na-agụnye ajụjụ banyere ịhụ nsọ, mmekọahụ, ime na-ete ime. Ke adianade do, achọrọ nchịkọta nke ọrịa ma ọ bụ nwunye ma ọ bụ onye, dị ka nke ọma dị ka ya na ya ọmụmụ.

Mgbe ahụ na-amalite a nnyocha e mere na nke ugbu a ime. Mee gestational afọ, kpebisie ike site na pelvic size na ọnọdụ nke nwa na akpanwa.

Mkpebi siri ike nke gestational afọ

E nwere ọtụtụ ụzọ gbakọọ gestational afọ na ụbọchị nke nnyefe. The mbụ n'ime ha - a kalenda. Ọ bụ ihe kasị mfe. Mkpa ka i cheta na ọnụ ọgụgụ nke ụbọchị mbụ nke ikpeazụ gị oge na tinye na ya 280 +/- 7 ụbọchị, ma ọ bụ 10 amị n'ọnwa n'ọnwa. N'ihi ya, i nwere ike ịchọpụta kpọmkwem ụbọchị nke ememe obi ụtọ. Ọ bụrụ na a nwaanyị nwere ike na-echeta ụbọchị nke tụụrụ ime, mkpa re-tinye niile ahụ 40 izu, na inweta azịza ha ajụjụ.

Ọzọ usoro dabeere na ultrasound. Diagnostician site dị ihe nwere ike ikpebi gestational afọ nke nwa ebu n'afọ na-enye kpọmkwem ụbọchị nke nnyefe. Mgbe Ob elu nke eriri akpa nwa fundus ebe a na-gbakọọ gestational afọ. Site 12 na 38 izu akpanwa elu sentimita kwekọrọ na izu nke afọ ime. I nwekwara ike ịdabere na mbụ na-akpali akpali nke nwa ebu n'afọ. Na nulliparous ọ na-adị iri na asatọ izu na multiparous - iri na isii.

The akụkụ nke nnukwu pelvis

Maka dibịa, ihe ọmụma nke size nke pelvis nwaanyị nwere a bara uru, na data dị mkpa ma n'oge nwa ebu n'afọ na mmepe na na usoro nke na-amụ nwa. Iji a nnukwu pelvic akụkụ bụ elu conjugate na atọ anya kwekọrọ protruding akụkụ nke pelvic na hip ọkpụkpụ.

1. Distantia spinarum - bụ ọdịiche dị n'etiti ihe ndị kasị elu isi nke iliac spines. Ọ bụ banyere iri abụọ na isii sentimita.

2. Distantia cristarum - na mbara n'etiti crests nke iliac ọkpụkpụ, na ọ bụ ihe dị ka iri abụọ na asatọ sentimita.

3. Distantia trochanterica - a anya na bụ n'etiti ukwuu trochanter ewekarị na thighs, bụ 31-32 sentimita, karị.

Elu conjugate nwere a dị iche iche mkpebi. Ọ bụrụ na ndị gara aga atọ na-emi odude ke frontal ụgbọelu, mgbe ahụ, a bụ sagittal. Elu conjugate - bụ anya n'etiti projecting abụba ise lumbar vertebra na elu spain pubic symphysis. Tụọ ya, ụfọdụ preparations dị mkpa. Mkpebi Siri Ike elu conjugates-amalite na eziokwu na ọrịa dina n'elu ya n'akụkụ. Ụkwụ, nke dabeere na a n'ihe ndina ya, nwaanyị na-eduga ná afo, na overlying - akwusila. N'agba tazomera diluted ma dọba n'elu pubic articulation na suprasacral olulu nke mere na ha na-fọrọ nke nta ẹbiet. Nke a - ná mpụta conjugate. N'ihe na-adabere na iwu nke nwaanyị ahụ na ọkpụrụkpụ nke ya ọkpụkpụ. The thicker ha, nke ukwuu njehie na ngụkọta oge. Size elu conjugates - banyere iri abụọ sentimita. Ya ngụkọta oge dị mkpa iji chọpụta na-ezi conjugate. Ná nkezi, ihe dị iche n'etiti ha kwekọrọ 9 sentimita. Ka ihe atụ, ọ bụrụ na n'èzí conjugate bụ iri abụọ sentimita, ezi bụ 11 cm.

The akụkụ nke pelvic

E nwere ihe dị otú ahụ dị ka a tapered nnukwu efere. Ọ nwere ike na-narrowed clinically ma ọ bụ anatomically. Iji dokwuo anya na anatomical parameters nke ọkpụkpụ yiri mgbaaka, ka nha nke pelvis.

1. Diagonal conjugate - a ogologo si na ala onu nke symphysis pubis kasị sepụtara òkè nke sacrum. Ọ bụ hà 13 sentimita. Ọ nwere ike kpebisie naanị mgbe mmamiri nyochaa. Ngụkọta oge nke ezi conjugates elu na diagonal mejupụtara ke eziokwu na site ná mpụta na-ewe 9 cm, na diagonal nke - 2 cm. A, ezi conjugate bụ dịkarịa ala 11 sentimita. Ọ bụ iji gbakọọ a oke, na mkpa mpụga conjugate. Norma ya nwere ike ịdị iche iche, dabere na ọkpụrụkpụ nke ọkpụkpụ nke ndị inyom, ka ndị dọkịta na-reinsured na-eduzi esịtidem nchọpụta. Na diagonal conjugate ọkpụkpụ ọkpụrụkpụ na-adịghị emetụta.

2. Direct size nke pelvic tinyekwa na a kọwara dị ka nkeji n'etiti ala riiji nke pubic articulated na n'ọnụ nke coccyx. N'ihe na-rụrụ tazomera na hà 11 cm.

3. The transverse size of pelvic tinyekwa - ọdịiche n'etiti ischial tuberosities. I nwere ike na-emefu ka tazomera na atụ teepu. Nọmalị, ọ bụ hà itoolu sentimita, ma ọ bụrụ na kwukwara ọkpụrụkpụ nke adụ anụ ahụ, mgbe ahụ, anyị na-enweta 11 cm.

4. Mpụta akụkụ nke pelvis na-mkpa iji chọpụta symmetry nke ndokwa nke ọkpụkpụ. Ha ga-dịkarịa ala 14 cm, ma ọ bụghị nnyefe ga-esi ike ma ọ bụ agaghị ekwe omume.

rhombus nke Michaelis

Elu conjugate nwere ụfọdụ mmekọrita na rhombus na Michaelis, ebe ọ na-egosikwa pelvis akụkụ. Nke a bụ a n'elu ikpo okwu kpụrụ n'azụ elu nke sacrum. Ókè ya:
- spinous usoro nke ise lumbar vertebra;
- paired caudineural iliac spain;
- n'ọnụ nke sacrum.

The size bụ ejikari 11 ruo 11 sentimita. Elu conjugate nwere izugbe rhombus na ihe elu ebe.

Manual usoro na ịmụ nwa

Mgbe nke iri abụọ izu obstetrician nwere ike ikpebi na aka n'isi, azụ, na aka na ụkwụ nke nwa n'afọ. N'ihi nke a, ụzọ nke mpụga obstetric nnyocha.

Mbụ usoro: dọkịta ga-ekpebi elu nke eriri akpa nwa fundus na ahụ, nke nwa ebu n'afọ, nke bụ n'akụkụ ya. Iji mee nke a, dọkịta na-ewepụta ya aka na elu afo na-ele ya.

Nke abụọ usoro na-ekpebi ọkwá na echiche nke nwa. Iji mezuo nke a, ihe obstetrician nwayọọ nwayọọ lowers ya aka n'elu nke afo, na-agbasa ha iche. Pushing n'akụkụ elu nke akpanwa, mkpịsị aka na nkwụ nke onye dibịa na-ele backrest ma ọ bụ nta akụkụ ahụ nke nwa ebu n'afọ, si otú na-ekpebi, chlenoraspolozhenie nwa.

Nke atọ usoro a chọrọ iji chọpụta na-akụkụ nke ahụ bụ na akụkụ nke ahụ ahụ, bụ nke dị n'elu symphysis pubis. Ha nwekwara ike ikpebi na-agagharị nke isi.

The anọ oru complements atọ. Ọ na-ekwe na ị bụghị nanị ka a mata akụkụ nke isiokwu, ma ịghọta otú ọ na-positioned na mmekọrita n'ọnụ ụzọ a obere efere. Iji mee nke a, dọkịta na-akawanye azụ onye ọrịa na nwere a aka n'ụzọ dị otú ahụ na mkpịsị aka converge n'elu pubic symphysis.

View na nwa ebu n'afọ na ọnọdụ na akpa nwa

Ọnọdụ - a ọnọdụ nwa azụ ka eriri akpa nwa n'akụkụ. Ịmata ihe dị iche nke mbụ ọnọdụ mgbe ndị backrest emi odude na n'aka ekpe, na nke abụọ - mgbe nwa tụgharịa azụ nri. The mbụ ọnọdụ bụ karịa ikpeazụ.

View ọnọdụ - azụ àgwà kwupụta n'ihu ma ọ bụ n'azụ mgbidi nke akpanwa. Ntem, ọ bụrụ na nwa ahụ ruru eruru megide n'ihu mgbidi nke akpanwa, sị n'ihu ọnọdụ, na Anglịkan.

Mgbe ná mpụta Ob Leopold-Levitsky usoro ekwe ka dibịa iji chọpụta ọnọdụ nke nwa ebu n'afọ n'oge ọrụ na ịkọ.

esịtidem ọmụmụ

Esịtidem midwifery research nwere ike rụrụ site abụọ ma ọ bụ mkpịsị aka anọ ma ọ bụ dum n'aka. Na na aka dibịa nwere ike ikpebi n'ókè nke cervical dilatation, mata-eweta akụkụ, ike n'ezi ihe nke membranes, ọnọdụ ọmụmụ kanaal. Ke adianade do, usoro a bụ ofu ike nkwalite nke nwa mụrụ kanaal.

Otú ọ dị, nke a bụ nnọọ a dị oké njọ aka, na ịrụ a usoro kwesịrị nditịm dị ka iwu si: na mbanye ụlọ ọgwụ ma ghara karịa awa abụọ ọ bụla. The obere, mma.

The ọmụmụ-amalite na nnyocha nke mpụga genitalia na perineum. Mgbe ahụ na mkpịsị aka na-ẹkenam n'ime ikpu ma kọwaa n'ogologo, obosara, ekwedo nke mgbidi, scars, strictures ma ọ bụ adhesions na pụrụ igbochi nkịtị eruba nke nnyefe. Mgbe ahụ, na-akpụ akpụ kwupụta cervix. Ọ nwalere ntozu okè, udi, size na udidi, shortening na softening. Ọ bụrụ na a nwaanyị na-aga n'ime oru, nke ngosi nke cervix na-tụrụ na mkpịsị aka-ụzọ. Ke adianade do, dọkịta na-agba mbọ ịchọta eweta akụkụ na-ekpebi ọnọdụ nke isi iji kwadebe maka na o kwere omume nsogbu.

Mkpebi Siri Ike nke nwa isi ọnọdụ

E nwere atọ degrees nke ndọtị isi dị ka ọ na-agabiga ọmụmụ kanaal.

The akpa ntaifiọk (perednegolovnoe ntinye) pụtara na isi ga-agabiga ya kpọmkwem pelvis size. Ọ bụ hà 12 cm. Nke a pụtara na cervix na ikpu kwesịrị ka a bara uru.

Nke abụọ ogo (frontal ntinye) kwekọrọ na a nnukwu size nke eriri ukwuu (13-13.5 cm). Ọ ga-abụ nnukwu akụkụ nke na-gabiga ọmụmụ kanaal.

Nke atọ Degree (ọdịdị ihu ntinye) na-ekwu midwife na nwa-akpali site na pelvis ihu n'ihu, na mgbe ahụ, ndị kasị ibu isi size ga-dabara 9.5 cm.