Wikipedia

Ọrụ a na-egbochi

Obstructed labour nke amara dika labour dystocia but mgbe NWA na anoghi na pelvis Maka mmeche mgbe ana Acho imu nwa na agbanyeghi na uterus na eji aka ya emechi. Nsogbu na afiri NWA ahu bu ekuteghi ume ofuma nke nwere Ike eme ka NWA ahu nwuo. Ona emekwa nke nne ya Bute infection nwekwa uterus rupture maobu post-partum igba obara. Nsogbu na anote aka bu obstetrical fistula. Obstructed labour ka ana ama n'ime ka omumu NWA no tee aka.[1].[1][1]

Ọrụ a na-egbochi

Isi ihe na-akpata mgbochi ime gụnyere nwa buru ibu ma ọ bụ nke dị n'ọnọdụ na-adịghị mma, obere pelvis, na nsogbu na ọwara ọmụmụ.[1] Ọnọdụ na-adịghị mma na-agụnye dystocia ubu ebe ubu ihu anaghị agafe n'okpuru Ọkpụkpụ pubic.[1] Ihe ize ndụ maka obere pelvis gụnyere nsogbu na-edozi ahụ na enweghị ìhè anyanwụ na-akpata ụkọ vitamin D.[2] Ọ bụkwa ihe a na-ahụkarị n'oge uto n'ihi na pelvis nwere ike ọ gaghị etolite mgbe ha na-amụ nwa. Nsogbu na ọwara ọmụmụ na-agụnye akụkụ ahụ nwanyị dị warara na perineum nke nwere ike ịbụ n'ihi nkwarụ ma ọ bụ akpụ.[1] A na-ejikarị partograph eme ihe iji soro ọganihu ọrụ na ịchọpụta nsogbu.[3] Nke a jikọtara ya na nyocha ahụike nwere ike ịchọpụta ọrụ mgbochi.[3]

Ọgwụgwọ nke ịrụ ọrụ mgbochi nwere ike ịchọ ịwa ahụ ma ọ bụ iwepụ ikuku na ohere ịwa ahụ nke symphysis pubis. Nzọụkwụ ndị ọzọ gụnyere: idebe ụmụ nwanyị na mmiri na ọgwụ nje ma ọ bụrụ na membrane agbajiela ihe karịrị awa 18.[1] N'Africa na Eshia, ọrụ mgbochi na-emetụta n'etiti pasent abụọ na ise nke ọmụmụ.[4] N'afọ 2015, ihe dị ka nde mmadụ 6.5 nwere nsogbu ịrụ ọrụ ma ọ bụ mgbawa akpa nwa.[5] Nke a mere ka ọnwụ nne 23,000 gbadata site na ọnwụ 29,000 na 1990 (ihe dị ka 8% nke ọnwụ niile metụtara ime). [1][6][7] Ọ bụkwa otu n'ime ihe ndị na-akpata ịmụ nwa nwụrụ anwụ.[8] Ọtụtụ ọnwụ n'ihi ọnọdụ a na-eme na mba ndị na-emepe emepe.

Ihe kpatara ya

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Isi ihe na-akpata mgbochi ime gụnyere nwa buru ibu ma ọ bụ nke dị n'ọnọdụ na-adịghị mma, obere pelvis, na nsogbu na ọwara ọmụmụ.[1] Ma ogo na ọnọdụ nke nwa e bu n'afọ nwere ike iduga n'ịrụ ọrụ. Ọnọdụ na-adịghị mma na-agụnye dystocia ubu ebe ubu ihu anaghị agafe n'okpuru Ọkpụkpụ pubic.[1] Obere pelvis nke nne nwere ike ịbụ n'ihi ọtụtụ ihe. Ihe ize ndụ maka obere pelvis gụnyere nsogbu na-edozi ahụ na enweghị ìhè anyanwụ na-akpata ụkọ vitamin D.[2] Enweghị calcium nwekwara ike ịkpata obere pelvis dịka ọdịdị nke ọkpụkpụ pelvic ga-adị ike n'ihi enweghị calcium.[9] Mmekọrịta dị n'etiti ịdị elu nke nne na ogo pelvis dị ma enwere ike iji ya mee ihe iji buo amụma na enwere ike ịrụ ọrụ mgbochi. Mmekọrịta a bụ n'ihi ahụike na-edozi ahụ nke nne ya n'oge ndụ ya niile na-eduga n'ịmụ nwa. Ndị nne na-eto eto nọkwa n'ihe ize ndụ maka ọrụ mgbochi n'ihi uto nke pelvis na-arụchabeghị.[3] Nsogbu na ọwara ọmụmụ na-agụnye akụkụ ahụ nwanyị dị warara na perineum nke nwere ike ịbụ n'ihi nkwarụ ma ọ bụ akpụ.[1] Ihe ndị a niile na-eduga na ọdịda na ọganihu nke ọrụ.

Ọdịdị

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Ọrụ mgbochi bụ ihe a na-ahụkarị n'ime ụmụ mmadụ karịa ụdị ọ bụla ọzọ ma na-aga n'ihu ịbụ isi ihe na-akpata nsogbu ọmụmụ taa.[10] Ụmụ mmadụ nke oge a agbanweela ka ha dịrị ndụ dị ka ụkwụ abụọ, Otú ọ dị, ịnya ụkwụ abụọ emeela ka mgbanwe ọkpụkpụ nke mere ka ọkpụkpụ na ọwa ọmụmụ dị mkpụmkpụ.[11] Njikọ nke oke ụbụrụ na mgbanwe na ọdịdị pelvic bụ isi ihe na-enye aka na ọrụ mgbochi n'ime ụmụ mmadụ nke oge a. Ọ bụkwa ihe a na-ahụkarị maka ọrụ mgbochi n'ime ụmụ mmadụ site n'ubu sara mbara nke nwa e bu n'afọ. Otú ọ dị, mgbanwe ọdịdị nke ọdịdị pelvic ka na-akpata enweghị ike nke nwa e bu n'afọ ịgafe n'ụzọ dị irè n'ụzọ ọmụmụ n'enweghị nnukwu nsogbu [12]

Ụmụ anụmanụ ndị ọzọ nwere ọwa ọmụmụ sara mbara ma kwụ ọtọ nke na-enye ohere ka nwa e bu n'afọ gafee nke ọma.[13] Enweghị nkwekọ n'etiti ogo ọwa ọmụmụ na obosara na ogologo okpokoro isi nwa n'ihi ihe achọrọ maka locomotion abụọ a na-akpọkarị nsogbu obstetric, ebe ọ bụ na e jiri ya tụnyere nnukwu apụl ndị ọzọ, ụmụ mmadụ nke oge a nwere nnukwu enweghị nkwekọ dị n'etiti oke okpokoro okpokoro nwa na ogo ọwa ịmụ nwa.[14] Mbelata nke aka elu na nkwonkwo nke ọkpụkpụ azụ emetụtawokwa ụzọ ụmụ mmadụ nke oge a si amụọ. Anụ enwe nwere ụkwụ anọ nwere aka elu dị ogologo nke na-enye ha ohere iru ala ma wepụ nwa ha n'ọwara ọmụmụ n'enweghị enyemaka.[12] Ụmụ anụmanụ ndị ọzọ nwekwara ụzọ ọmụmụ sara mbara ma kwụ ọtọ nke na-enye ohere ka nwa e bu n'afọ gafee nke ọma.[1] Akụkụ elu dị mkpụmkpụ nke mmadụ nke oge a na ọganihu nke ụgbọ ala abụọ nwere ike itinye ego na enyemaka n'oge ọrụ. N'ihi nke a, ndị na-eme nchọpụta na-arụ ụka na ọrụ enyemaka nwere ike ịmalite site na bipedalism.[3] E dekọrọ ọrụ mgbochi dị ka mgbagwoju anya nke ịmụ nwa kemgbe ngalaba obstetrics malitere. Ruo ihe karịrị otu puku afọ, ndị dọkịta na-ahụ maka ịmụ nwa aghaghị iji ike wepụ nwa e bu n'afọ iji gbochie ọnwụ nne.[15]

Tupu ịdị adị nke ngalaba ịwa ahụ, ụmụ e bu n'afọ ndị a na-egbochi nwere ọnụ ọgụgụ dị ala nke ndụ.[15] Ọbụna na narị afọ nke iri abụọ na otu, ọ bụrụ na a hapụrụ ọrụ mgbochi na-enweghị ọgwụgwọ, ọ nwere ike ịkpata ọnwụ nne na nwa ọhụrụ.[14] Ọ bụ ezie na ịwa ahụ wepụrụ nwa e bu n'afọ bụ usoro kachasị mma iji chịkwaa ọrụ mgbochi, iwepụ aka site na iji ngwá ọrụ ahụike bụkwa ihe a na-ahụkarị.[13]

Nnyocha

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Ana eyocha obstructed labour site na physical examination. Eji ultrasound achoputa mgbe nwata na anoghi ofuma.[3].[9]

Mgbochi

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Ịnweta ọrụ ahụike kwesịrị ekwesị nwere ike belata mmụba nke ọrụ mgbochi.[9] Mpaghara ndị na-emepebeghị emepe nwere ọrụ ahụike ezughi oke iji gaa na ọrụ mgbochi, na-akpata mmụba dị elu n'etiti mpaghara ndị na-emeghịpe emepe. Imeziwanye nri na-edozi ahụ nke nwanyị, ma tupu ma n'oge ime, dị mkpa maka ibelata ihe ize ndụ nke ịrụ ọrụ mgbochi.[1] Ịmepụta mmemme agụmakwụkwọ gbasara ọmụmụ na ịbawanye ohere maka ọrụ ọmụmụ dịka igbochi afọ ime na atụmatụ ezinụlọ na mpaghara ndị na-emepe emepe nwekwara ike belata mgbasa nke ọrụ mgbochi.[16]

Ọgwụgwọ

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Tupu ịtụle nhọrọ ịwa ahụ, ịgbanwe ọnọdụ nne n'oge ịmụ nwa nwere ike inye aka n'ịrụ ọrụ n'ihu.[16] Ọgwụgwọ nke ịrụ ọrụ mgbochi nwere ike ịchọ ngalaba cesarean ma ọ bụ iwepụta ikuku na ohere ịwa ahụ nke symphysis pubis. Akụkụ ịwa ahụ bụ usoro na-awakpo ma ọ na-abụkarị naanị usoro ga-azọpụta ndụ nne na nwa ọhụrụ.[1] Symphysiotomy bụ oghere ịwa ahụ nke symphysis pubis. Enwere ike ịmecha usoro a ngwa ngwa karịa ngalaba Caesarean ma ọ dịghị achọ anesthesia, na-eme ka ọ bụrụ nhọrọ dị mfe n'ebe ndị na-enweghị teknụzụ ahụike dị elu.[1] Usoro a anaghị ahapụkwa ọnyá n'akpa nwa nke na-eme ka ime ime na ịmụ nwa dịkwuo mma maka nne. Ihe ọzọ dị mkpa n'ịgwọ ọrụ mgbochi bụ nlekota ike na mmiri nke nne.[9] Mgbatị nke akpa nwa chọrọ ike, yabụ ka nne ahụ na-amụ nwa, ọ na-emefu ike ka ọ na-etinye. Mgbe ike gwụrụ nne, mgbanaka ahụ na-adịwanye ike ma ọrụ ga-adịwanye ogologo.[3] Antibiotics bụkwa ọgwụgwọ dị mkpa ebe ọ bụ na ọrịa nwere ike ịbụ n'ihi na a na-egbochi ọrụ.[4][9]

Ihe omuma

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Ọ bụrụ na a na-enweta akụkụ ahụ n'oge, amụma dị mma.[17] Ogologo oge a na-egbochi ịmụ nwa nwere ike iduga n'ịmụ nwa nwụrụ anwụ, obstetric fistula, na Ọnwụ nne.[18] Ọnwụ nwa e bu n'afọ nwere ike ibute site na asphyxia.[1] Ọrụ mgbochi bụ isi ihe na-akpata mgbawa akpa nwa n'ụwa niile.[1] Ọnwụ nne nwere ike ịpụta site na mgbawa akpa nwa, nsogbu n'oge ịwa ahụ, ma ọ bụ sepsis.[16]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 (2008) Education material for teachers of midwifery : midwifery education modules, 2nd, Geneva [Switzerland]: World Health Organization (WHO), 17–36. ISBN 978-92-4-154666-9. 
  2. ↑ 2.0 2.1 (2008) Education material for teachers of midwifery : midwifery education modules, 2nd, Geneva [Switzerland]: World Health Organization (WHO), 38–44. ISBN 978-92-4-154666-9. 
  3. ↑ 3.0 3.1 (2008) Education material for teachers of midwifery : midwifery education modules, 2nd, Geneva [Switzerland]: World Health Organization (WHO), 45–52. ISBN 978-92-4-154666-9. 
  4. ↑ Usha (2004). Pregnancy at risk : current concepts. New Delhi: Jaypee Bros.. ISBN 978-81-7179-826-1. 
  5. ↑ (October 2016) "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet 388 (10053): 1545–1602. DOI:10.1016/S0140-6736(16)31678-6. PMID 27733282. 
  6. ↑ (October 2016) "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet 388 (10053): 1459–1544. DOI:10.1016/s0140-6736(16)31012-1. PMID 27733281. 
  7. ↑ GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet 385 (9963): 117–71. DOI:10.1016/S0140-6736(14)61682-2. PMID 25530442. 
  8. ↑ (May 2011) "Stillbirths: the vision for 2020". Lancet 377 (9779): 1798–805. DOI:10.1016/S0140-6736(10)62235-0. PMID 21496912. 
  9. ↑ 9.0 9.1 9.2 9.3 9.4 (July 2000) "Nutrition and obstructed labor". The American Journal of Clinical Nutrition 72 (1 Suppl): 291S–297S. DOI:10.1093/ajcn/72.1.291s. PMID 10871595. 
  10. ↑ (2003-12-01) "Global burden of maternal death and disability". British Medical Bulletin 67 (1): 1–11. DOI:10.1093/bmb/ldg015. PMID 14711750. 
  11. ↑ (January 1971) "Bipedal behavior and the emergence of erect posture in man". American Journal of Physical Anthropology 34 (1): 55–60. DOI:10.1002/ajpa.1330340105. PMID 4993117. 
  12. ↑ 12.0 12.1 (November 2002) "Birth, obstetrics and human evolution". BJOG 109 (11): 1199–206. DOI:10.1046/j.1471-0528.2002.00010.x. PMID 12452455. 
  13. ↑ 13.0 13.1 Dunsworth (2015-10-21). "The Evolution of Difficult Childbirth and Helpless Hominin Infants". Annual Review of Anthropology 44 (1): 55–69. DOI:10.1146/annurev-anthro-102214-013918. 
  14. ↑ 14.0 14.1 (November 2007) "The evolutionary origins of obstructed labor: bipedalism, encephalization, and the human obstetric dilemma". Obstetrical & Gynecological Survey 62 (11): 739–48. DOI:10.1097/01.ogx.0000286584.04310.5c. PMID 17925047. 
  15. ↑ 15.0 15.1 (May 2002) "The start of life: a history of obstetrics". Postgraduate Medical Journal 78 (919): 311–5. DOI:10.1136/pmj.78.919.311. PMID 12151591. 
  16. ↑ 16.0 16.1 16.2 (June 2004) "Obstructed labor: using better technologies to reduce mortality". International Journal of Gynaecology and Obstetrics 85 (Suppl 1): S62-72. DOI:10.1016/j.ijgo.2004.01.011. PMID 15147855. 
  17. ↑ (2003) "Obstructed labour". British Medical Bulletin 67: 191–204. DOI:10.1093/bmb/ldg018. PMID 14711764. 
  18. ↑ Dolea (July 2003). "Global burden of obstructed labour in the year 2000". Evidence and Information for Policy (EIP), World Health Organization. 
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