Outdoor Conjugate: chinokosha Ob

Mukadzi wose anoda mufaro amai. Zviri muropa zvairatidza chokuita chaizvo zvinorehwa evanhu. Zvisinei, vakawanda havana kugadzirira chokwadi kuti unofanira kuona chiremba wako nguva dzose uye kutsungirira vamwe kuchinja hazvifadzi chaizvo. Asi kuti nokuda pamuviri pakabuda zvakanaka uye chinyararire, zvakanaka kutevera mirayiridzo nyanzvi, pane kuvimba nemhanza.

Kugadzirira kuongorora

Asati auya antenatal kukiriniki inyoreswe pamusoro pamuviri kana chete nokuda vakaronga rokuongorora, pavasikana vanofanira freshen kumusoro. No chaicho kunodiwa, asi achiri varumbidzwa kutora yokugezera. Hapana nyaya harifaniri suihku kana chinhu chakadaro, chinhu zvizere chirwere (kana), achaiswa avhiringidzwa uye chiremba asingadi kuwana chinhu. Zvinokurudzirwa kuchenesa uye yakachena wakaisvonaka uye utsanana tauro (kana zvakakodzera).

General uye nhoroondo inokosha

Kufanana nevamwe chiremba upi, ane obstetrician-gayinakorojisiti vane mwero chimiro kudzokorora murwere nhoroondo. Zvinosanganisira pasipoti data, zvichemo, zvinyorwa dzokugara uye basa, akaratidza kuvapo masero zvirwere uye chirwere.

Special nhoroondo yaitaura nezvokuti chiremba kunzwisisa musimboti dambudziko nako mukadzi akabvunza. Zvinosanganisira mibvunzo pamusoro kumwedzi, zvepabonde, pamuviri uye pamuviri. Mukuwedzera, runodiwa pfupiso murwere wako kana mumwe, uyewo ake uye wake kubereka.

Zvadaro kutanga kuongorora zviri kuitika pamuviri. Simbisai gestational zera, pakutsvaga pelvic Ukuru nzvimbo mwana ari dumbu.

Kutsunga gestational zera

Pane nzira dzakawanda kuverenga gestational zera uye waichengetwa pakukurukura. Wokutanga wavo - karenda. Ndiye kupfuura nyore. Unofanira kuyeuka kuwanda zuva rako rokupedzisira nguva yokutanga uye kuwedzera pamusoro payo 280 +/- 7 days, kana 10 zvomwedzi. Saka unogona kuwana kubva anofungidzirwa zuva chinofadza. Kana mukadzi asina kuyeuka musi pamuviri, kudiwa kuzodzosera kuwedzera zvose zvakafanana vhiki 40, uye kuwana mhinduro mubvunzo wavo.

Chimwe nzira hunovakirwa Ultrasound. Diagnostician ne nemamiriro ezvinhu uchapupu anogona kuona gestational makore ari mudumbu uye kupa anofungidzirwa musi makurukuriro. Kana Ob kukwirira uterine fundus nzvimbo iri rinowanikwa gestational zera. Kubva 12 kusvika 38 vhiki dumbu nokukwirira masendimita unoenderana vhiki pamuviri. Munogona kuvimba achitamba azvarwa wokutanga. In nulliparous aiona kuti vhiki namasere uye multiparous - nemitanhatu.

The kukura guru chiuno

Nokuti chiremba, ruzivo ukuru chiuno mukadzi ane kukosha, uye mashoko kunokosha zvose panguva fetus uye muitiro yokusununguka. To huru pelvic kukura vari yokunze Conjugate uye zvitatu daro akaenzana yakabudikira zvikamu pelvic uye muhudyu mapfupa.

1. Distantia spinarum - ndiwo musiyano uri pakati kupfuura akakwirira pfungwa yacho iliac spines. Zviri masendimita anenge maviri nezvitanhatu.

2. Distantia cristarum - nzvimbo pakati crests ari iliac pfupa, uye zviri anenge maviri navasere masendimita.

3. Distantia trochanterica - kure kuti riri pakati mukuru trochanter dzinongoda pamusoro pezvidya, ndiye 31-32 masendimita, ukuwo.

Rokunze Conjugate ane zvakasiyana chisarudzo. Kana yapfuura vatatu riri frontal mundege, zvino ichi ndicho sagittal. Rokunze Conjugate - iri kure pakati projecting nemanda wechishanu lumbar vertebra uye yokumusoro nomuzongoza pubic symphysis. Kuti usaruyera, dzimwe gadziriro zvinokosha. Kutsunga dzokunze verlauf kunotanga chokuti murwere akarara parutivi rwake. Foot, riri panhoo, mukadzi inoenda mudumbu, uye overlying - kuminyuka. Shaya tazomera rakasanganiswa uye akaisa pamusoro pubic nekunyatsotsanangura uye suprasacral gomba kuitira kuti vari anenge kuenderana. Izvi - chokunze Conjugate. Chipimo kunobva bumbiro mukadzi uye pakukora mapfupa aro. The mukobvu ndivo kunonyanya kukanganisa dzemaitirwe. Size dzokunze verlauf - masendimita anenge maviri. kukarukureta Its zvinodiwa kuona Conjugate wechokwadi. Paavhareji, musiyano pakati pavo anoenderana 9 masendimita. Somuenzaniso, kana rokunze Conjugate iri masendimita makumi maviri, wechokwadi ndiye masendimita 11.

The kukura pelvic

Pane kudaro chinhu sechinhu tapered mbiya. Inogona kujekesa akaora kana anatomically. Kuti kujekesa anatomical parameters pfupa marin'i, kuti kuyerwa chiuno.

1. Diagonal Conjugate - mumwe kureba apasi kumucheto pakati symphysis pubis kuti vakawanda yakabudikira chikamu sacrum. Zviri akaenzana 13 masendimita. Rinogona tsunga chete kana kuongorora kusangana nekutsi kwemukadzi. Kukarukureta of verlauf dzokunze uye diagonal yechokwadi inoumbwa pakuti achibva kuruvanze unoparadza 9 masendimita uye diagonal pakati -. 2 cm Kazhinji, kuti Conjugate yechokwadi zvinenge 11 masendimita. Zviri kuti overenga parameter ichi, uye vanoda kwokunze Conjugate. Norma zvinogona siyana, zvichienderana pakukora mapfupa vakadzi, saka vanachiremba vari reinsured uye kuitisa munhu zvemukati kuongorora. On the diagonal Conjugate mapfupa ukobvu haisi kukanganiswa.

2. Direct kukura pelvic nzira yokubudisa rinorondedzerwa so penguva pakati rezasi akatevedzana ari pubic articulated uye muromo coccyx. Chipimo rinoitwa tazomera uye kuenzana masendimita 11.

3. The transverse Ukuru pelvic nzira yokubudisa - musiyano uri pakati ischial tuberosities. Unogona kupedza sezvo tazomera uye kuyera tepi. Kazhinji, zviri akaenzana pfumbamwe masendimita, asi kana tainge ukobvu ari nyoro zvinyama, ipapo isu tiwane masendimita 11.

4. The lateral kukura chiuno inodiwa kuona symmetry pakati urongwa mapfupa. Vanofanira kuva masendimita anenge 14, zvikasadaro hurukuro achava kwakaoma kana zvisingabviri.

rhombus pamusoro Michaelis

Rokunze Conjugate ane mumwe chokuita rhombus uye Michaelis, sezvo rinoratidzawo chiuno miganhu. Ichi chikuva inoumbwa rwemberi pechiso sacrum. miganhu yayo:
- spinous urongwa wechishanu lumbar vertebra;
- aiwanzopiwa wokushanda caudineural iliac muzongoza;
- muromo sacrum.

The saizi dzinowanzoona 11 kusvika masendimita 11. Rokunze Conjugate ane vakawanda rhombus ane repamusoro pfungwa.

Manual unyanzvi mu Obstetrics

Mushure rechimakumi maviri vhiki obstetrician anogona kuona kubata musoro, musana, uye maoko nemakumbo mwana ari mudumbu. Nokuti chinangwa ichi, nzira kwokunze obstetric tsvakurudzo.

nzira rokutanga; chiremba achasarudza kukwirira uterine fundus uye mutumbi mudumbu, riri pedyo nayo. Kuti aite izvi, chiremba anoisa maoko ake pamusoro yokumusoro dumbu uye anonzwa nayo.

nzira wechipiri anosarudza nzvimbo uye maonero mwana. Kuti izvi zvidaro, imwe obstetrician zvishoma nezvishoma lowers maoko ake pamusoro mudumbu, vachiawaridza kunze. Kukuvadza divi pemvura dumbu, minwe emichindwe chiremba anonzwa backrest kana zvikamu zviduku muviri ari mudumbu, nokudaro kusarudza, chlenoraspolozhenie mwana.

nzira yechitatu kunodiwa kuona kuva chikamu ndiko kuti chikamu muviri, riri kumusoro symphysis pubis. Vanogonawo kuona mufambo musoro.

Kugadzwa wechina anotsigira wechitatu. Kunoitawo iwe kwete chete kuziva chikamu yacho, asi kuti tinzwisise sei akaiswa pachinhu wokupinda mumudziyo wokugezera duku. Kuti aite izvi, chiremba paanodzoka murwere uye ane ruoko nenzira yakadaro kuti minwe wekuita pamusoro pubic symphysis.

View uye fetus nzvimbo mudumbu

Chinzvimbo - chinzvimbo mwana shure uterine divi. Kusiyanisa rokutanga nzvimbo kana backrest iri kurutivi rworuboshwe, uye wechipiri - apo mwana akadzoka kurudyi. Chokutanga zvinzvimbo zvakawanda zvakajairika pane chechipiri.

View nzvimbo - musana mafungiro kurutivi kumberi kana rwemberi kumadziro dumbu. Saizvozvowo, kana mwana akanga akasendamira pamusoro pamadziro pamberi dumbu, vanoti pamberi chinzvimbo, uye vakutarisire.

Kana rokunze Ob Leopold-Levitsky unyanzvi kubvumira chiremba kuona nzvimbo mudumbu panguva basa uye kufembera.

zvemukati kudzidza

Internal tsvakurudzo kusununguka zvinogona kuitwa maviri kana mana minwe kana yose ruoko. At chiremba kubatwa anogona kuona kukura kwakaita remuromo dilatation, ziva kupa chikamu, kuvimbika membranes, mamiriro ezvinhu yokuberekwa Canal. Uyezve, nzira iyi ndee simba kukurudzira mwana atoberekwa Canal.

Zvisinei, izvi ndizvo chaizvo zvakakomba kupindira, uye kuita muitiro kuva zvakasimba maererano nemirau: iri kubvuma kuchipatara uye haana kakawanda kupfuura maawa maviri ose. The zvishoma, nani.

Kudzidza rinotanga uongorore kwokunze nhengo dzokubereka nadzo uye perineum. Ipapo minwe nezvevanakomana kupinda nepanhengo uye tsanangura kureba, upamhi, elasticity masvingo, mavanga, strictures kana adhesions kuti kudzivisa chakaipa chokubuda pakukurukura. Pashure paizvozvo, kutamira akananga cervix. Rakanga akaedzwa kuti kukura, chimiro, ukuru uye magadzirirwo, vachigurisira uye kuderedza. Kana mukadzi unopinda basa, kuti Kuziviswa kwemashoko cervix vari akayera mu munwe-munzira. Mukuwedzera, chiremba anoedza kuwana kupa chikamu uye kuona nzvimbo musoro kuti tigadzirire zvichibvira matambudziko.

Kutsunga mwana musoro nzvimbo

Kune madhigirii nhatu kuwedzera musoro sezvo ichipfuura pakuberekwa Canal.

Rokutanga dhigirii (perednegolovnoe kupinza) zvinoreva kuti musoro achapfuura zvakananga chiuno ayo ukuru. Zviri akaenzana masendimita 12. Izvi zvinoreva kuti cervix uye nyinyo vanofanira kuwedzera pamusoro ukoshi ichi.

Second dhigirii (frontal kupinza) unoenderana zhinji kukura internet tsapo (13-13.5 cm). Richava mukuru chikamu chiri kupfuura pakuberekwa Canal.

Third Degree (chiso kupinza) inoti nyamukuta kuti mwana zvinofamba kuburikidza chiuno vanosangana mberi, uye ipapo, chikuru kukura musoro kuchaita kukodzera 9,5 cm.