Waxaad ku haleelay cudur halis ah, sida cudurka wadnaha ama dhiig karka
Sababta kale waa in ilmahaagu u baahan yahay inuu si dhakhso leh u dhasho, tusaale ahaan sababta oo ah la-dagaallanka placental (halkaasoo mandheerta ay goor dhow kala baxdo).
Haweenka badankood waxay lahaan doonaan suuxin laf-dhabarka si aysan u dareemin qalliinka, si kastaba ha noqotee xaaladaha qaarkood oo xanuunka uusan ku filnayn, ama aysan jirin waqti ku filan oo laf-dhabarka lagu dhigo, suuxin guud ayaa lagula talin karaa.Dhakhtarka uurjiifku wuxuu sameyn doonaa 10 ilaa 15cm oo goynaysa caloosha hoose, kaliya dusha sare ee hawo-mareenka, taas oo weyn oo ku filan in ilmahaaga lagu soo gudbiyo, ka dib goyn ilmo galeenka si aad loo gaaro cunuggaaga, badiyaa kadib dib u dhac hal daqiiqo ah. Waxaad dareemi kartaa xoogaa xanaaq ah markii ilmahaagu kor u qaadayo – mararka qaarkood tan waxaa lagu sameeyaa gacanta iyo mararka qaarkood laba xoog.Ilmahaagu wuxuu lahaan doonaa xadhiggooda xudunta ah oo la gooyo, si dhakhso ah ayuu u hubiyaa dhakhtarka ilmaha, haddii wax walbana ay hagaagsan yihiinna waa lagu gudbin doonaa adiga ama lammaanahaaga, si aad u qaban karto oo aad u yeelato xiriir taabasho jireed ah ah. Dhuunta iyo xuubka ayaa la keenaa ka dib goynta uurkaaga caloosha ayaa lagu xira tolmo.Waxay caadi ahaan qaadataa 10 daqiiqo in la keeno cunuggaaga, iyo 30 illaa 40 daqiiqo si loo dhammaystiro tolmada.Waxaa jira qaar ka mid ah khataraha la xiriira gaarsiinta qaybta caesarean, adiga iyo cunuggaaga iyo kooxdaadaba waad kala hadli doontaan khatarahaas ka hor qalliinka.Ka soo kabashada qaliinka-ka degdegga ah waxay la mid tahay soo kabashada caesareanka qorshaysan.
Xaaladaha qaarkood dhaqtarkaagu wuxuu kugula talin karaa caawinta dhalashada cunuggaaga adoo adeegsanaya venthouse ama forceps.Tani waxay dhici kartaa halka marxaladda labaad ee fooshu (marxaladda riixmada) ay ka dheeraato sidii la filayay, halka madaxa ilmahaagu uusan ku jirin meesha ugu wanaagsan ee uu ku soo maro kanaalka dhalashada ama haddii ay jiraan isbeddelo ku yimid garaaca wadnaha oo macnaheedu yahay in dhalashada ay u baahan tahay inay dhacdo sida ugu dhaqsaha badan.Ventouse waa koob bir ama caag ah oo lagu dhejiyo madaxa cunuggaaga.Forceps waa afaf bir ah oo lagu meeleeyo madaxa ilmahaaga.Waxaa lagu siin doonaa xanuun baabiiye dhalashada xubinka taranka ee la caawiyay, oo leh suuxin maxalli ah ama epidural. Dhalashada waxaa maamuli doona dhaqtarkaaga. Umulisadaada ayaa joogi doonta si ay kuu caawiso oo ay kuu taageerto.Dhakhtarkaagu si tartiib ah ayuu u jiidi doonaa isagoo adeegsanaya venthouse ama forceps inta aad riixeyso inta lagu jiro. Mararka qaarkood dhowr jiiditaan ayaa loo baahan yahay, ama haddii hal qaab uusan shaqeynin, kan kalena waa la isku dayi karaa. Waxaad u badan tahay episiotomy, gaar ahaan haddii xoog loo isticmaalo.Duruufaha dhif ah, haddii labada ventouse ama forceps aysan si guul leh u dhalin cunuggaaga, dhalashada qaliinka ayaa lagu talin karaa.
‘Episiotomy’ waa goyn la sameeyay (ogolaanshahaaga) perineum (aagga u dhexeeya xubinka taranka iyo dabada) si looga caawiyo dhalashada cunuggaaga.Umulisadaada ama dhaqtarkaaga ayaa kugula talin kara tan haddii:
Garaaca wadnahaaga ee ilmahaagu wuxuu soo jeedinayaa inuu isagu ama iyadu u baahan yahay inuu ku dhasho sida ugu dhakhsaha badan ee suurogalka ah.
Haddii aad leedahay dhalasho caawin ah; ama
Haddii ay jirto halis sare oo ilmada daran ee saameysa malawadka. ‘episiotomy’ waxaa lagu hagaajiyaa iyadoo la adeegsanayo tolmo aan la kala saari karin oo caadi ahaan bogsato bil gudaheed dhalashada.
Oxytocin waa hormoonka dabiiciga ah ee dhaca ee sababa in uurkaagu yeesho ka hortag.Haddii ka hortaggaagu hoos u dhaco, ama aan waxtar u lahayn inay keenayso in ilmo-galeenka uu ku milmo, waxaa lagu talin karaa inaad haysato dhibic isku-dhafan oo loo yaqaan ‘oxygentocin drip’ kaas oo lagu bixiyo qaddar yar si toos ah xididka iyada oo loo marayo cannula. Oxytocin wuxuu ka dhigayaa ka hortaga waxyaabaha ka hor imanaya mid sii xoog badan oo joogto ah. Haddii aad leedahay dhibic oxytocin ah, kormeer dhow oo adiga iyo cunuggaaga ah (adoo adeegsanaya kormeer joogto ah oo uurjiif ah, oo mararka qaarkood loo yaqaan wadnaha ama CTG) ayaa lagula talinayaa.
Kahor, ama inta lagu gudajiro foosha biyahaagu caadi ahaan way jabayaan waqti uun (in kasta oo mararka qaar aysan sameynin – iyo dhallaanka qaarkood waxay ku dhasheen sacadooda amniyootiga).Haddii fooshaadu u muuqato inay hoos u dhacday ama ay jiraan walaac ku saabsan caafimaadka cunuggaaga, umulisadaada ayaa kugula talin karta inay biyahaaga jabiso. Tan waxaa la sameeyaa inta lagu gudajiro baaritaanka joogtada ah ee xubinka taranka, ma dhaawaceyso cunuggaaga, waxaana la muujiyey inuu mararka qaar yareeyo dhererka shaqada.Haddii aad u maleynaysid in biyahaagu jabeen waxaa muhiim ah inaad ugu yeerto unuggaaga dhalmada/qeybta qiimeynta isla markiiba, gaar ahaan haddii aad u maleynaysid inaad arki karto meconium, oo cagaar ama bunni midab leh. Haddii aad ka yar tahay 37 toddobaad uur tani waxay calaamad u noqon kartaa fool dhicis ah.
Inta lagu guda jiro hawusha foosha, mararka qaarkood arrimuhu way gaabi karaan ama walaac ayaa ka soo bixi kara caafimaadkaaga ama ka cunuggaaga. Haddii tani dhacdo umulisadaada iyo/ama dhakhaatiirtu waxay kugula talin karaan ikhtiyaarro gaar ah oo kaa caawinaya inaad dhasho cunuggaaga si badbaado leh.
U diyaar garowga foosha: Su’aalaha badanaa la isweydiiyo
Ma la ii diyaarin kara wakhti ii gaar ah foosha ka hor?
Umulisadaada/dhaqtarkaaga ayaa sharxi doona sababta taas lagugula taliyay adiga iyo cunuggaaga, oo ay kujirto halista iyo faa’iidooyinka ay leedahay in waqtigaas lagaa keeno fool, iyo sugitaanka. Haddii aad dooratid inaadan ku biirin, ama dib u dhigto, waxaa lagu siin karaa kormeer si loo ilaaliyo adiga iyo samaqabka cunuggaaga.
Haddii uusan ku guuleysan umulisadaada iyo dhaqtarkaagu waxay kaala hadli doonaan xulashooyinkaaga. Xulashooyinkaan waxaa ka mid noqon kara sugitaan, iskuday wax kale ama qeyb caesarean ah.
iska keenka foosha ma xanuun badan tahay?
Baadhitaannada xubinka taranka ah ayaa laga yaabaa inay noqdaan kuwo aan raaxo lahayn laakiin waa inaysan xanuun lahayn. Waxaa la dareemayaa in foosha la kiciyay (gaar ahaan dhibic oxytocin ah) ay ka xanuun badan karto shaqada dabiiciga ah. Waxaad kala hadli kartaa xulashooyinkaaga xanuun baabiiyaha umulisadaada marxalad kasta oo ka mid ah habka soo kicinta.Tilmaanta qaran waxaa ka mid ah bixinta epidural ee xanuunka baabiiya ka hor bilowga, oxytocin (hoormoonka aan dabiiciga aheyn), si loo kordhiyo (kordhinta) ka hortagga.
Around 30% of women are recommended an induction of labour for various reasons.Depending on assessments done throughout your pregnancy, you may be offered an induction. To enable you to make a fully informed decision, your midwife or obstetrician will provide you with information regarding the risks and benefits of induction. They will discuss the different methods of induction and suggest which may be best based on your personal circumstances. Considering the different methods will enable you to advise your healthcare professional of your preference.When you come into the maternity unit for your induction, a midwife will undertake a full assessment of you and your baby. This will include electronic monitoring (CTG) of your baby’s heartbeat and any contractions that you may be having. Your midwife will assess your cervix by undertaking a vaginal examination. You will have plenty of time to ask any questions, and your midwife will take you through your options and what to expect in detail.Some people may need only one of the steps below, and others will need a combination to go into active labour (4cm dilated with strong, regular contractions). Induction may be a long process which can be frustrating, however the aim is to mimic the body’s natural process in the best way possible.
Step 1 – Preparing (“ripening”) your cervix
Many find that their cervix is not quite ‘ready’ for labour yet. In that case, a step is necessary to ‘ripen’ your cervix to prepare it for labour. The aim of this step is not to start active labour, but to open your cervix enough to break your waters, ready for active labour to be induced.The different induction of labour options are listed below. Your hospital may only offer one method, or they may give you a choice. Depending on your circumstances, you may be able to go home for a period of time during your induction.Some people may not experience any changes during ripening and for others, it may be enough to start active labour. You may need more than one ‘round’ before your waters can be broken, in which case you may be offered more than one method one after the other. The order they are offered may vary between hospitals.
Option 1 – Mechanical methods
There are two mechanical methods available, which do not contain any drugs (artificial hormone). They help to promote your body’s natural initiation of labour – they won’t start contractions artificially and side effects are less likely. Some hospitals may allow you to go home with these methods.
Dilapan-S
This is a thin dilator that absorbs fluid from your cervix to gradually expand in diameter, helping to dilate your cervix and change its consistency for labour. The dilators remain in place for 12-24 hours and help your body release natural hormones associated with labour. Most people experience minimal pain during the process, and it doesn’t extend outside of the vagina, so you will be encouraged to relax or to go about your usual daily activities to help prepare your body.More information about: Dilapan-S.
Balloon catheter
This is a small balloon which is inserted into the cervix and inflated with water. By putting pressure on the cervix, it encourages the release of your natural hormones and dilation. The balloon catheter remains in for 12-24 hours to stretch and soften the cervix in preparation for labour. The catheter tube will be taped to your leg during that time to keep it in place.
Option 2– Medicinal Methods
Prostaglandins are medicines that use an artificial hormone to help ripen the cervix. There are two options available; a gel or a pessary that are inserted just behind your cervix. The gel works over 6 hours, while the pessary is released slowly over 24 hours.If you and your baby are responding well, some units may allow you to return home during this time, however, as with all medicines, side effects are possible, so your doctors may prefer to keep you in for continued monitoring. Cramps and pain can be common with prostaglandin methods, and your midwife will be able to discuss pain relief options with you.
Step 2 – Breaking your waters
Amniotomy
Some people (particularly those who have had a baby before) may be told that their cervix is favourable for an amniotomy or ‘ARM’. This where your waters are broken artificially. A midwife will insert a small sterile hook into the vagina to make a hole in the bag of waters that surrounds your baby. After the waters are broken, labour may start on its own. Your waters will continue to drain from the vagina for the duration of your labour.
Step 3 – Helping with your contractions
Oxytocin drip
A hormone called oxytocin may be offered to those who do not progress into active labour. Oxytocin is given continuously in small amounts until your baby is born. It is given directly into a vein through a cannula inserted into your hand or arm. The oxytocin aims to stimulate contractions and progress your labour. A midwife will be caring for you and your baby closely throughout your labour.
Understanding induction of labour – a video developed by clinicians, women and a local hospital charity in North West London.
Waad soo daahday, taasoo la micno ah in ilmahaagu uusan weli dhalan oo aad ugu yaraan 10-13 maalmood dhaaftay taariikhda aad ku habboon tahay. Tani waa sababta ugu badan ee la isugu booriyo foosha.
Taariikhdaada caafimaad waxay soo jeedineysaa dhalasho hore si aad u nabad gasho adiga ama cunuggaaga
Waxaa jira walaac laga qabo wanaagga cunuggaaga, taasoo la micno ah inay ka nabad badnaan laheyd inay ku dhashaan si dhakhso ah intii ay sugi lahaayeen foosha si ay dabiici ahaan u bilaabaan
Biyahaagu way baxeen, fooshuna si dabiici ah uma bilaaban.
In la kiciyo foosha ayaa had iyo jeer lagala hadli doonaa, si loo hubiyo inaad si buuxda u fahanto khataraha iyo faa’iidooyinka oggolaanshahaagana waa la heli doonaa ka hor wax kasta oo dhaca.
Qiyaastii 15% dhallaanka waxay ku dhashaan qaybta degdegga ah ee caesarean, ha ahaato xilliga uurka ama foosha. Waxaad u baahan kartaa qaybta caesarean-ka degdegga ah haddii:
