Momwe mungapereke chithandizo choyenera chamankhwala kwa mayi woyembekezera wokhala ndi zowawa?
Amayi oyembekezera omwe ali ndi vutoli ndi amodzi mwa odwala omwe ayenera kuwachira. Imfa zambiri za mwana wosabadwayo zimachitika chifukwa changozi. Zikuwoneka kuti sizachilendo, komabe, kuvutika kwamimba kumakhudza 7% ya mimba zonse.
Poyamba chifukwa cha zovuta, pali ngozi ya galimoto, tili pamalo achiwiri timachitirana nkhanza za anzathu, omwe a zamalonda sayenera kupatula. Nkhaniyi ifotokoza za njira zomwe mayi woyembekezera afunika kutenga ndi mayi wapakati yemwe akuwatsutsa kapena akuwatsimikizira kuti angadzisinthe.
Zambiri zasonkhanitsidwa ndi kafukufuku wokhudza kuvutika mwadzidzidzi komwe kumakonzedwa ndi Brave African Discussion in Emergency Medicine (#badEM). Maulalo akumapeto kwa nkhaniyo.
Kubwezeretsanso mayi woyembekezera - Funso loyamba: tingayang'anire bwanji odwala 2?
Tiyerekeze kuti mtsikana, ali ndi pakati pa trimester yachiwiri yapakati, atakumana ndi ngozi yamgalimoto kapena ngozi yapagalimoto. Sankavala lamba. Amafika ku ED yoperekedwa ndi a chithandizo chamoyo chofunikira ambulansi ogwira ntchito, omwe adamulepheretsa kuyenda gulu la msana. Ndi diaphoretic, tachypnoea ndipo amawoneka wotuwa. Ali tcheru koma ali ndi nkhawa, akudandaula za chifuwa ndi kupweteka kwa m'mimba. Zofunikira zoyambira ndi Sats 82% pamlengalenga, HR 120 BPM, BP 80/60. Tiyeni tiwone masitepe omwe ndi amodzi:
3. Amayi oyembekezera amakhala ovuta mwamphamvu komanso mwakuthupi zimavuta kulowa. Imapempha gulu lodziwa bwino komanso lokonzekera. Pezani mpweya wowonjezera ngati pakufunika kutero, kutsata mpweya wama 95-98%.
4. Kumbukirani kuti kutaya mwana kumakhala kwakukulu pamene pali chisokonezo cha amayi. Muyenera kuzindikira chomwe chayambitsa kudandaula ndikuchiza. Makamaka, mayi woyembekezera ali ndi magazi ochulukirapo ozungulira, zomwe zikutanthauza kuti amataya magazi ake ochulukirapo kuti asonyeze kuchuluka kwa magazi kuposa kuti sanakhale ndi pakati.
5. Azimayi sanapatsidwe mayesero kuti aphunzire za katemera wa Tranexamic acid (TXA). Amagwiritsidwa ntchito monga mankhwala a chigawo B pamene ali ndi pakati, kutanthauza kuti palibe maphunziro a zinyama omwe asonyeza zotsatira zovuta ndi ntchito zake, koma palibe maphunziro aumunthu alipo. TXA akuwoloka pa placenta. Ngakhale kuti palibe kafukufuku wofalitsidwa, TXA ikhoza kukhala yopindulitsa mwazi, kuvulaza odwala kwambiri.
Kumbukirani kuti mutha kupita kumalo osungirako uterine onse odwala matenda opweteka oyembekezera pa masabata a 20.
Chenjezo lina lomwe mungachite ndi kupeŵa vasopressors kulikonse kotheka chifukwa iwo akugwirizana ndi zotsatira zoipitsitsa. Pazomwe zili choncho, nthawi zambiri zimapangitsa kuti pakhale bedi la placental, kuwonjezera chiopsezo cha fetal hypoxia.
6. Pendekerani wodwala kumanzere m'mbali mwake musanayambe makina oyambiranso. Njira yodziwika bwino ndikumusunga supine, kenako ndikuchotsa chiberekero cha IVC, pochikoka kumanzere kapena kuchikankhira kumanja. Ngati njirayi itha kukhala nthawi yayitali, zitha kukhala zosavuta kukankhira chiberekero kuchokera kumanja mmalo mokoka kumanzere.
7. Azimayi ovulala ovulala sayenera kunyalanyazidwa bwino.
Anti-tetanus toxoid ndi otetezeka, monga opiates, mu mimba. Pofuna kumvetsetsa ndi kudziwa kuthekera kwa fetal, ndi blockretic ultrasound iyenera kuchitidwa. M'badwo womwe mwana wakhanda amawaganizira kuti ndiwothandiza, umasiyana pakati pa mayiko ambiri. Pankhaniyi, palibe kuwunikira kunja kwa fetus komwe kumalangizidwa, ndipo kuwongolera kwina kumayang'ana pakukweza amayi.
Mu ma LMICs (Maiko Ochepa ndi Okhazikika Pakatikati), kutha kwa fetal kumatha kuonedwa kuti ndi wopitilira masabata 28, kutengera zomwe zingatheke kuyang'anira makanda asanakwane. Munjira ina iyi, kuwunika mtima ndi mtima kumalangizidwa kuti azitsata ubwino wa mwana wosabadwayo ndikuwunika momwe chiberekero chimayambira, pokhapokha ngati kuwunikira sikusokoneza kuyambiranso kwa amayi ndi chisamaliro.
Zoopsa mwa amayi oyembekezera - WERENGANI ZAMBIRI
10 Njira Zowonetsera Mmodzi Wodwala Wopweteka
Prehospital spine immobilization in kuloweza zovulala: inde kapena ayi? Kodi kafukufuku amati chiyani?
Kuthiridwa magazi pazinthu zoopsa: Momwe imagwirira ntchito ku Ireland
Kodi kuyambitsa ma ambulansi akumidzi, zidawakhudza bwanji amayi apakati ku kubereka ku Tanzania?
CPR mwa amayi apakati: mavuto ndi maphunziro atsopano