Conjugate woona, zakunja opendekera. Miyeso ya mkazi m'chiuno

mafupa a chiuno muyeso wapangidwa kuvomerezedwa kwa amayi apakati. Izi mwamsanga, sabweretsa chisoni ndipo mwamtheradi chabwinobwino ndondomeko yomwe ndi choyambilira makadi kulembetsa kwa amayi apakati pa yoyamba kuitana gynecologist lapansi. Kuganizira pa kukula kwa mafupa a chiuno ndi, mukhoza kukonza pa kayendetsedwe ka ntchito: mwina mwachibadwa kapena opaleshoni (Kaisara gawo). Panthawi yake osankhidwa machenjerero kupewa zambiri mavuto ndi zimene zingawononge moyo wa mayi ndi mwana wake. Bwino anakonza pobereka - chitsimikizo kuti abadwe idzakhala yophweka ndi otetezeka.

Conjugate woona - mtunda yayifupi pakati pa Cape ndi olemekezeka mu M'mimbamo m'chiuno mfundo padziko lamkati la symphysis lapansi. Mwachibadwa, mtunda izi ndi 11 cm.

Kodi mafupa a chiuno?

Taz ngati nyumba anatomical umaimiridwa ndi mafupa awiri m'chiuno ndi msana wapotalikira (sacrum ndi coccyx). Mu obstetrics lofunika, kundu kuti wotchedwa mafupa a chiuno yaing'ono. malo awa okha ndi gulu kunsi kwa mafupa m'chiuno, sacrum ndi coccyx. Lili ziwalo izi: a chikhodzodzo, chiberekero ndi rectum. Mu dongosolo zake zinayi ndege. Aliyense wa iwo ali mbali zingapo zomwe ndi zofunika kuchita obstetric.

magawo athandizira mu beseni ang'onoang'ono

1. Direct kukula. chizindikiro ichi ali maina ena - obstetric conjugate ndi conjugate woona. Wofanana 110 mm.
2. Kukula kwa mtanda. Ndiyofanana ndi 130-135 mm.
3. Makulidwe oblique. Wofanana 120-125 mm.
4. The opendekera conjugate. Wofanana 130 mm.

Magawo a gawo linafalitsidwa kwambiri a m'chiuno cha

1. Direct kukula. Wofanana 125 mm.
2. Kukula kwa mtanda. Wofanana 125 mm.

Magawo a gawo yopapatiza a m'chiuno cha

1. Direct kukula. Ndiyofanana ndi 110-115 mm.
2. Kukula kwa mtanda. Wofanana 105 mm.

magawo linanena bungwe la m'chiuno ndi

1. Direct kukula. Pa ntchito achuluke monga patsogolo mwa kubadwa ngalande mutu wa mwana wosabadwayo anaŵerama pa coccyx posteriorly. Ndi 95-115 mm.
2. Kukula kwa mtanda. Wofanana 110 mm.

Muyeso mafupa a chiuno pakati

Ziwerengero pamwamba ndi anatomical, ie iwo akhoza kudziwa mwachindunji kwa mafupa m'chiuno. Mu munthu amene ali kuyeza iwo sikutheka. Choncho, mungachite izi ndi zofunika kwambiri kuchita obstetric:

1. Mtunda pakati pa spines wa iliac fupa, yomwe ili m'mphepete kutsogolo kwa lokwera lapansi.
2. Mtunda pakati pa mfundo za iliac Crest, kutali Chrixitu ndi mtunda munthu pazipita.
3. Mtunda pakati pa kafukufuku wa femurs mu dera tinganene kumtunda kwa khosi.
4. Akunja conjugate (mtunda kuchokera ku symphysis obisika kuti patsekeke lumbosacral).

Choncho, mwakale a mafupa a chiuno ndi 250-260, 280-290, 300-320 ndi 200-210 mm, motero. Elucidation la magawo zofunika mu chiphunzitso cha kalembera pakati. kayesedwe The ikuchitika wapadera chida (tazomera), zomwe, poyamba, Angagwiritsidwenso ntchito kuyeza mutu wobadwa mwana.

Nkofunika kuzindikira kuti kuchuluka kwa minofu zofewa sikumangotikhudza zotsatira kuphunzira. magawo m'chiuno anayeza pa prominences Bony, ndipo iwo safuna kuwasuntha kwa kuwonda kapena, pa mwake, kunenepa. miyeso m'chiuno kukhala zikutsatiridwa akafika zaka mkazi pamene kukula fupa mabasi.

Kwa matenda a kuchepetsa a mafupa a chiuno ndi zofunika conjugates awiri kwambiri - chenicheni (obstetrics) ndi opendekera. Komabe, sikutheka kuti mwachindunji kuyeza awo adzaweruzidwa miyeso awo angakhoze kokha zina. The conjugate opendekera mu obstetrics nthawi osati anayeza. Kuwonjezeka kuganizira conjugate obstetric.

Kudziŵa conjugates koona mwa chilinganizo zotsatirazi: kufunika conjugates akunja opanda 9 cm.

Kodi beseni yopapatiza?

Musanayambe kukamba za tanthauzo la mawu amenewa, tisaiwale kuti pali mitundu iwiri ya mafupa a chiuno yopapatiza - anatomical ndi matenda. Zikhulupiriro izi, ngakhale zofanana, koma n'zogwirizana.

An mafupa a chiuno anatomically yopapatiza tiyenera kunena, pamene mmodzi wa magawo ndi wocheperako kusiyana ndi mwakale cha mafupa a chiuno cha. Kuonetsetsa digiri ya kuchepetsa, pamene conjugate woona zosakwana zachilendo:

• 15-20 mm.
• 20-35 mm.
• 35-45 mm.
• zoposa 45 mm.

Otsiriza awiri amasonyeza digiri ya opaleshoni kutero. Conjugate kalasi woona 1-2 limalola mwayi kupitiriza kubadwa mwachibadwa, malinga palibe kuopseza chikhalidwe monga mafupa a chiuno kukomoka yopapatiza. Kukomoka yopapatiza mafupa a chiuno - vuto limene magawo a yoopsa mutu sakugwirizana mafupa a chiuno cha mayi. Pankhaniyi miyeso onse otsiriza akhale mu uthunthu yachibadwa (ie, kuchokera amazionera wa thunthu la mafupa a chiuno si nthawi zonse yopapatiza). Mwina zinthu zosiyana, pamene mafupa a chiuno anatomically yopapatiza wolingana ndendende ndi kasinthidwe wa mutu yoopsa (mwachitsanzo, ngati mwanayo si chachikulu), ndi matenda a mafupa a chiuno kukomoka moperewera Pankhaniyi funso.

mafupa a chiuno kukomoka yopapatiza

zifukwa zazikulu chikhalidwe ichi:

1. mbali mayi: ndi anatomically yaing'ono mafupa a chiuno kukula, osasamba mawonekedwe a mafupa a chiuno (mwachitsanzo, mapindikidwe pambuyo choipa).
2. Pa gawo la mwana wosabadwayo: Hydrocephalus, lalikulu kukula, yaitali mimba, kujambula kumbuyo kwa mutu pamene kulowa mwana wosabadwayo mu mafupa a chiuno ndi.

Malinga mmene kusiyana pakati pa magawo anasonyeza mafupa a chiuno akuchikazi ndi mutu yoopsa, pali kusiyana atatu a mafupa a chiuno kukomoka chopapatiza;

1. The mismatch wachibale. Pankhaniyi, genera palokha ndi zotheka, koma dokotala ayenera kukhala okonzeka kusankha yake za opaleshoni.
2. Chochititsa chidwi zikusiyana.
3. Mtheradi mismatch.

Kubereka mu mafupa a chiuno kukomoka yopapatiza

Mlingo wachiwiri ndi wachitatu kumasonyeza kuti alowererepo pa opaleshoni. ntchito wodzilamulira mu zinthu zimenezi n'zosatheka. zipatso angathe kubwezeretsedwanso yekha pa gawo la Kaisara. Pamene wachibale disparity kubadwa mwachibadwa chovomerezeka. Komabe, kudziwa za kuopsa kusintha zinthu choyipa. Funso cha zovuta sanali kugwilizana dokotala ayenera kutenga ngakhale pa ndewu kudziwa m'njira yake ndi njira zina. Anachedwa matenda a zikhalidwe kumene rodorazreshat kokha ndi opaleshoni, kungachititse kuti mavuto aakulu ndi kuswana kwa mutu yoopsa. Mu Amowabu kulakwika kwa otsiriza adzakhululukidwa kumenyedwa mu m'chiuno M'mimbamo m'mbuyo chiberekero, kuchititsa kwambiri m'mutu choipa ndi imfa. Nthawi za- kuchotsa wosabadwa kuchokera M'mimbamo m'chiuno simungathe ngakhale kukhala moyo pa gawo la Kaisara. Zikatero, yobereka ali kutsiriza plodorazrushayuschey ntchito.

kuti adzimvera

Kudziwa kukula kwa mafupa a chiuno n'kofunika. M'pofunika mwamsanga akuganiza zinthu zimenezi pathological monga anatomically ndi kukomoka mafupa a chiuno yopapatiza. Kuchepetsa kukula wamphamvu ukhale amawasonyeza mosiyanasiyana kwa mwamphamvu. Nthawi zina, ngakhale n'zotheka ntchito ufulu pa zochitika m'pofunika kuchita gawo cesarean. Kukomoka mafupa a chiuno yopapatiza - boma ndi sioneka kwambiri. Si nthawi zonse pamodzi ndi mfundo za mafupa a chiuno anatomically yopapatiza. Yotsirizira mwina magawo wabwinobwino, koma n'zotheka mutu kukula mismatch kukula kwa mafupa a chiuno akadali apo. Nthawi zoterozo zinthu pobereka zingachititse mavuto oopsa (chipatso adzavutika Choyamba). Choncho n'kofunika yake matenda ndi zochita mwamsanga pa machenjerero zina.