Dipatuka dia mashi mu ngondo isatu, dinyanguka dia tshifu, ne dinyanguka dia muonji wa tshifu¶

Nomba ya malu a tshimpitshimpi idi mishilangane bilondeshile ditunga. Dibeji edi didi dienza mudimu ne 911, nomba wa ditunga dia États-Unis ne dia Canada. Matunga makuabu a bungi adi ne nomba wa 112, 999 anyi nomba mukuabu. Keba nomba wa ditunga dienu.

Dipatuka dia mashi mu tshifu, disama dia tshimpitshimpi didi kadiyi dijika, dipatuka dia mâyi a mu tshifu tshilonda kudi tshijengu tshia muonji wa difu, anyi mutu usama bikole ne tshimuenekelu tshia mêsu kunyima kua mbingu 20 ya dimita difu (ne mu tshitupa tshisatu tshijima tshia difu, kubangila ku mbingu 28 too ne ku diledibua) mmalu a tshimpitshimpi a dilela adi atekesha muoyo wa mamu ne minite ya dilela. Bishilangane na disama dia kumpala dia dimita anyi disama dia tshiadi dia kumpala didi dilua ne dipita ne bikondo bia dikisha bidi kabiyi ne kanyinganyinga, bilumbu bia mu ngondo muisatu bu mudi: dijimija dia difu, difu dia kumpala, vasa previa, dipatuka dia difu, dipatuka dia muonji wa difu, ne **eclampsia bidi mua kukebesha **difu dia oxygène dia lukasa (as physique physique) anyi tshipupu tshia mashi tshia mamu kumpala kua bimanyinu bia pambelu bimueneka bikole.

Bujitu buebe bua lukasa mu tshikondo tshia njiwu ya dimita dia ndekelu budi bua kubikila baminganga ba kumpala badi bambuluisha bua kulela, kuenji tshikebelu nansha tshimue tshia mu tshifu anyi kubueja minu anyi tampon mu tshifu, kuteka mamu ku luseke lua dia bakaji (bua kubandisha tshifu tshinene tshia difu tshidi tshipingana ku mashi ende manene) anyi mu **mushindu wa tshifu (bikala muonji wa tshifu mupatuke), ikala ne luya ne NPO mujima (kakuyi tshintu tshia ku mishiku) bua kudilongolola bua dilela dia lukasa lukasa, ne londa dijimija dia mashi ne dikuma dia mamu ne bungi bua mupuya wa mamu too ne padi baminganga bangata mudimu.

Enza nunku mpindieu¶

Bikila bena mudimu ba lupitadi lua lukasa lukasa: Bikila nimero ya lukasa lukasa ya muaba unudi (911 mu États-Unis ne Canada, 112 mu Union européenne mujima, 999 mu Royaume-Uni, 000 mu Australie) anyi tangila mukanda wetu wa nomba ya tshimpitshimpi. Uleje mbingu milelela ya dimita dia mamu ne uleje ni kudi mashi adi apatuka mu tshifu, disama dia mu difu didi dienda dikola, muonji wa tshifu udi umueneka anyi disama dia tshimpitshimpi.
Wewe mumone anyi mumvue muonji wa tshifu ku tshibuelelu tshia tshifu, enza mudimu ne tshiadi ne tshiadi diakamue: Bikala mâyi matshibuka ne muonji wa tshifu udi bu tshingoma umueneka pambelu pa tshifu anyi umvua tshikuma ku tshibuelelu, lomba mamu bua kufukama ku bianza ne ku binu ne kuela tshiadi ne mpala panshi panshi anyi ne tshifu tshibandile kadi tshiadi tshiende tshibandile mu lupepele (muaba wa dikasa ne tshiadi). Bukole budi bukoka mutu wa muana udi ne bujitu bua kupingana panyima mu tshifu bua buimane kutshibula muonji wa oxygène wa muana nkayende.
Bua mashi makuabu onso adi apatuka mu ngondo isatu anyi kanyinganyinga, ela mamu ku luseke luende lua dia bakaji: Enza bua mamu alale ku luseke luende lua dia bakaji (anyi ela tshilamba tshikole anyi tshilamba tshia kuowa mâyi tshia 15 too ne ku 30 muinshi mua tshiadi tshiende tshia balume bikalaye ne bua kulala pa mukolo). Kulekedi muntu mukaji udi ku ndekelu kua ngondo muibidi anyi muisatu ulala panshi pa mukolo to, bualu bujitu bua difu budi butshibula tshitupa tshia muinshi tshia vena cava ne butekesha mashi adi aya mu placenta ne mu mutshima wa mamu too ne ku 30 pa lukama.
Kuena ne bua kubueja minu, tampon anyi bilamba munda mua tshifu to: Bikala mashi apatuka mu tshifu, teka tshilamba tshia kulela natshi tshikezuke, tshinene anyi tshilamba tshia kuowela natshi tshidi tshilengeja bimpe ku pambelu kua tshifu ne ulame bilamba bionso bidi ne mashi mu tshibombi tshia plastique bua bena mudimu ba mu lupitadi bamone mua kubipima bua kupima bungi bua mashi adibu bajimije. Munu umua mubueja mu tshifu tshia mukaji udi ne placenta previa udi mua kutapa tshifu ne kuenza bua mashi apatuke mu tusekonde tukese.
Kuenzeja NPO mikole (kakuyi bualu nansha bumue ku mishiku): Kupeshi mamu mayi, jus, biakudia, anyi manga a ku mishiku to. Malu a bungi a tshimpitshimpi a mashi a mu ngondo muisatu adi akengela dipanda dia lukasa dia lukasa mu dipanda dia tshifu ne anesthésie générale padibu bafika ku lupitadi.
Lama mamu mu tshikondo tshia tshipupu tshia eclampsia ne kutangila bua kumanya ni udi ne tshipupu: Shi mamu udi ne tshipupu tshia tshimpitshimpi (eclampsia), umuteke ku mutu, umulame ku luseke lua dia bakaji, ne umbusha bintu bia mu nzubu. Umulame ne bilamba biume ne udilongolole bua kuenza mudimu CPR wa mamu mutangile ku dia bakaji yeye mufike ku dibenga kuteleja ne kulekela kupuyakana.

flowchart TD
    Start["Lungenyi lua ku ndekelu kua dimita (mu mbingu 20 ya dimita): Dipatuka dia mashi, Disama dikole, Dipatuka dia mayi, anyi Disama dia tshimpitshimpi"] --> Call["1. Bikila bena mudimu ba tshimpitshimpi (911 / 112 / 999) ne uleje mbingu milelela ya dimita difu"]
    Call --> CheckCord{"2. Mâyi avua matshibuka ne muonji wa tshifu uvua umueneka anyi umvua ku tshibuelelu tshia tshifu anyi?"}
    CheckCord -->|Yes: Umbilical Cord Prolapse| KneeChest["Teka mamu mu muaba wa dikasa-tshifu (mpala/tshifu panshi, mataku muulu mu lupepele), ufuke tshingoma ne tshilamba tshitoke tshia kapia, kupinganyi tshingoma munda nansha kakese"]
    CheckCord -->|No Cord Visible| CheckSeizure{"3. Mamu udi ne disama dia tshiadi anyi mutu usama bikole anyi dipanga dia kumona (Eclampsia) anyi?"}
    CheckSeizure -->|Yes: Eclampsia| LeftSideSeizure["Dikunguluja ku luseke lua dia bakaji, mutu wa tshilamba, umbusha bintu bia mu nzubu, kuyi uteka tshintu nansha tshimue mukana, ikala ne NPO"]
    CheckSeizure -->|No Seizure: Bleeding or Severe Belly Pain| LeftTilt["Ela mamu ku luseke lua dia bakaji (ku dia bakaji) bua kujikija disama dia Vena Cava"]
    LeftTilt --> BleedRule["4. Kuenji nansha kakese tshikebelu tshia tshifu anyi kuela tampon; Teka tshilamba tshikezuke anu pambelu ne ulame tshilamba tshikezuke"]
    KneeChest --> NPO["5. Lama mamu ne luya ne bilamba ne NPO (Kakuyi mayi anyi biakudia) bua C-Section wa tshimpitshimpi"]
    LeftSideSeizure --> NPO
    BleedRule --> NPO

Kushilangana pa bintu binayi bidi bifikisha ku dipatuka dia mashi mu ngondo muisatu (dipatuka dia mashi kumpala kua dilela)¶

Bamanyi ba malu a dilela badi bumvuija dipatuka dia mashi kumpala kua dilela (APH) bu dipatuka dia mashi mu bitupa bia mubidi kunyima kua mbingu 20 ya dimita difu (anyi mbingu 24 mu Royaume-Uni) ne kumpala kua diledibua dia muana. Nansha mudi tshitupa tshikese tshia mutoyi wa rose anyi wa brown ("tshilejilu tshia mashi") padi tshifu tshienda tshiteketa ku tshikondo tshia diledibua katshiena ne bualu to, mashi onso adi amueneka bu a tshikondo tshia kumona ngondo, adi ne bitupa bia mashi, anyi adi alondangana ne kanyinganyinga adi akengela dishilangana dia lukasa pankatshi pa malu anayi adi mua kunyanga muoyo.

Tshimanyinu tshia luondapu	Dibutuka dia tshifu (Abruptio Placentae)	Placenta Previa	Vasa Previa	Ditapuluka dia tshifu
Disama dia muinshi mua buloba	Muana wa munda udi muaba muimpe udi upatuka kumpala kua dîba ku tshimanu tshia munda tshia tshifu kumpala kua muana kuledibua, ne mashi adi asangisha panyima pa tshifu.	Muana wa bakaji uvua mukola muinshi mu difu ne uvua ubuikila tshitupa anyi mujima tshibuelelu tshia munda tshia tshifu tshia mamu (os wa munda); padi tshifu tshia kuinshi tshienda tshikepela, mijilu ya mashi ya mu tshifu idi ipasuka.	Mishipa ya mashi ya mu tshifu idi kayiyi mikubibue idi ipitshila mu bitupa bia munda bidi bipita buludiludi mu tshibuelelu tshia mu tshifu; padi mâyi apueka, mijilu ya muana nkayende itu isunguluka.	Tshimanu tshia misunya tshia mu tshifu tshidi tshibuluka tshishiki, misangu ya bungi pabuipi ne tshilonda tshia dipanda dia kumpala anyi dipanda dia fibrome wa mu tshifu mu tshikondo tshia dikokangana.
Ngikadilu wa kanyinganyinga	Disama dia mu tshimpitshimpi, dikole, dia tshiendelele, dia bu muele anyi dia kutshibula mu difu ne mu mukolo. Disama kadiena dijika pankatshi pa dikokangana to.	Kakuyi kanyinganyinga nansha kakese: Mamu utu misangu mivule ujuka munkatshi mua butuku mu tshina tshia mashi makunze kayi umvua nansha kanyinganyinga nansha kamue.	Kakuyi kanyinganyinga: Dipatuka dia mashi didi dituadija dîba menemene didi tshibombi tshia difu tshipatuka (mayi apatuka).	Disama dia tshimpitshimpi, dikole dia ditshibula kuinshi kua difu (misangu ya bungi pa mutu pa tshilonda tshia C-section tshia kumpala), imue misangu dilonda kudi diumvua dia dishima dia tshitupa tshîpi padi dikokangana dijika mu tshimpitshimpi.
Dikala ne bunene bua mashi a mu tshifu	Mashi a tshitoke tshifiike, a mvinyo wa port, anyi mashi adi kaayi amueneka a pambelu mu bilumbu 20 pa lukama (dipatuka dia mashi disokoka mudi litre 1 anyi 2 ya mashi ishala mikuate panyima pa tshifu).	Mashi a mamu makunze, mapiamapia, kaayi ne kanyinganyinga. Misangu ya bungi adi atuadija ne didimuija dikese dia "mashi a tshididi" pabuipi ne mbingu 28 too ne ku 32 adi ajika, pashishe mashi a bungi adi apatuka.	Mashi a muana wa munda mutoke anyi mafiike masangisha ne mayi a mu difu diakamue padi mayi apueka. Bualu muana udi mu difu udi anu ne 250 too ne ku 300 mL (1 dikopo) ya mashi onso, dijimija anu 100 mL (tshitupa tshia dikopo) didi mua kushipa muana.	Mashi adi apatuka mu tshifu adi ashintuluka (misangu ya bungi adi makese pambelu bualu mashi a bungi adi apueka buludiludi mu tshifu tshia mamu), adi alondangana ne tshipupu tshia lukasa tshia mamu.
Diumvua dia tshifu (Dilenga dia mu difu)	Uterus udi bu mabaya, wa mutshi, mukole bu dibue ("dikokangana dia tetanic"):** Difu didi dikola misangu yonso ne kadiena diteketa anyi dipuekesha, ne didi dikola bikole padibu badilenga.	Uterus mupepele, mupole, kayi mutekete: Difu didi diumvuika dimpe ne dia pa tshibidilu pankatshi pa dikolesha dia Braxton Hicks, ne muana utu misangu ya bungi mulale ku luseke (mu tshitupa) anyi mu tshiadi.	Uterus wa pa tshibidilu, mupepele.	Dijimija dia tshimuenekelu tshia muana wa munda: Dikokangana didi dijimina mu tshimpitshimpi, ne bitupa bia mubidi wa muana (maboko, binu, mutu) bidi mua kumvuika bipepele menemene muinshi mua dikoba dia difu dia mamu bualu muana mmupatuke mu difu ne mubuele mu difu.
Malu manene adi mua kufikisha ku njiwu	Disama dia mashi dikola / disama dia preeclampsia, disama dia mu difu (dikuluka dia mashinyi, dikuma dia mukaba wa bukubi, dikuluka, tshikisu tshia mu nzubu), dinua dia makanya, dikuatshika dia cocaïne/methamphetamine, bana ba mapasa, disama dia tshifu dia kumpala.	Mputa ya kumpala ya C-section, kumpala kua placenta previa, multiparity (diledibua dia bungi dia kumpala), bidimu bia mamu bipite pa 35, dibueja dia muana mu tshiadi (FIV), dinua dia makanya.	Dibueja dia muonji wa velamentous, bilobed anyi succenturiate placenta, placenta mupuekele mu ngondo muibidi, dimita dia IVF, mapasa.	Diteta dia dilela kunyima kua dipanda (TOLAC / VBAC), nangananga ne tshilonda tshia mu tshifu tshia kale, dibueja dia oxytocine mu dose mikole, anyi dilela dipangisha.

Bua tshinyi kuena ne bua kulenga anyi kutangila tshifu padi mukaji udi ne difu upatuka mashi

Mu dilela dia tshimpitshimpi kakuyi dipatuka dia mashi, kutangila ne mêsu bua kumanya ni udi ne tshifulu tshia butumbi ntshilele. Ino, padi mukaji udi ne difu ku ndekelu kua ngondo muibidi anyi muisatu udi ne mashi makunze adi kaayi ne kanyinganyinga, tshidi tshikebesha ntshia se: placenta previa too ne padibu baleja ne: kabiena nanku ku diambuluisha dia ultrason wa mu lupitadi to. Mu placenta previa, placenta muwule tente ne mashi udi anu pa mutu pa tshifu bu tshibuikidiji pa tshibombi. Kubueja nansha munu umua mu tshifu anyi mu tshifu bua "kutangila mushindu udiye mualabale" kudi kutapa buludiludi mu sinusoïdes ya placenta, kuenza bua mashi a mamu apatuke adi kaayi mua kuimanyika adi mua kupatula mashi a mamu too ne ku lufu mu minite mikese kumpala kua ambulanse kufikaye. Lama bianza, minu, ne bintu kule menemene ne tshina tshia mu tshifu.

Dibutuka dia tshifu tshisokoka ne disama dia mu difu (Dikuluka dia mashinyi ne dikuluka)¶

Umue wa ku mateyi adi ne njiwu ya bungi mu diambuluisha dia kumpala dia dilela udi dibutuka dia mu tshifu tshisokoka, didi dienza 20 pa lukama ya dibutuka dionso. Padi tshitupa tshia munkatshi mua tshifu tshipatuka ku tshimanu tshia tshifu eku miaba ya pambelu ya tshifu mishala milamakaja panshi, 1,5 too ne ku 2,5 litre (3 too ne ku 5 pints) ya mashi a mamu adi mua kuela mu muaba udi panyima pa tshifu (hematoma wa panyima pa tshifu) kakuyi ditontolola nansha dimue dia mashi didi dipatuka mu tshifu.

Bua tshinyi dikuluka dionso dikese anyi njiwu ya mashinyi mu difu didi dilomba dilonda dia lukasa dia lupitadi¶

Mu ngondo muisatu, tshifu tshidi ne misunyi tshidi tshikole ne tshidi tshikola paditshi tshinyunguluka, kadi tshifu tshidi tshikole ne katshiyi tshikole to. Padi mukaji udi ne difu mubuela nansha mu dishipangana dia mashinyi adi enda lubilu lukese (mudi mukaba wa ku tshiadi anyi tshiamu tshia kuendesha natshi mashinyi tshifina difu diende), udi unyanguka pa bibandilu ne upona pa mataku anyi ku luseke, anyi upeta tshipupu mu difu, bukole bua dikosa pankatshi pa tshimanu tshia mu tshifu tshidi tshikole ne tshia munda mua difu tshidi tshilekela tshifu.

Dinyanguka dia panyima pa disama: Dinyanguka dia tshifu kunyima kua njiwu ya mashinyi anyi dikuluka didi mua kuenzeka diakamue anyi kukola mu mêba 4 too ne ku 24 kunyima kua dikuluka.
Mukenji wa diteka dia mukaba wa bukubi: Bakaji badi ne difu badi ne tshia kuvuala mukaba wa bukubi wa nsongo isatu, ne mukaba wa ku tshiadi muteka panshi ne mupepele pa mifuba ya tshiadi ne pa muelelu wa tshiadi muinshi mua tshitupa tshia difu dia mukaji udi ne difu (kayi muanji kupita pa tshifu tshia difu to) ne tshilamba tshia pa makaya tshiteka bimpe pankatshi pa tshiadi ne tshiadi bua kuikala ku luseke lua tshiadi.
Dilonda dia muana udi mu difu: Tshilongelu tshia baminganga ba mu Amerike tshia baminganga ba dilela ne bakaji (ACOG) ne tshilongelu tshia baminganga ba dilela ne bakaji (RCOG) badi balomba ne: mukaji yonso udi ne difu udi ne bidimu bipite pa 20 udi ne disama dia mu difu, njiwu ya mashinyi anyi udi upona udi ne bua kuenza mêba 4 too ne ku 24 a disama dia mutshima ne dia nzembu dikonkonona dia dikokangana dia tshifu mu lupitadi, nansha yeye mudiumvue bimpe ne kayi ne mashi adi apatuka mu tshifu.
Rh-negative blood type sensitization ( Fetomaternal hemorrhage): Shi mamu udi ne Rh-negative blood type (A-negative, B-negative, AB-negative, anyi O-negative), nansha dipatuka dia mashi dikese pankatshi pa placenta ne uterus mu tshikondo tshia disama anyi dia tshimpitshimpi didi disangisha Rh-positive mu mashi ende, dilomba dia dibenga kupatuka mu mashi ende anti-D immunoglobulin (RhoGAM) mu mêba 72 ku lupitadi bua kukuba muana wa munda ne dimita dia matuku atshilualua.

Disokoka dia mubidi wa mamu: bua tshinyi bakaji badi ne difu badi bamueneka bashindame too ne padibu bakuluka¶

Padiye ne difu, bungi buonso bua mashi a mukaji budi buvula ne 40 too ne ku 50 pa lukama (kusakidila 1,5 too ne ku 2,0 litre ya mashi makuabu), ne dikuma dia muoyo wende padiye uikisha didi divula ne bikuma 10 too ne ku 15 ku minite. Bua bualu ebu bua bungi bua mubidi budibu balame, padi mukaji udi ne difu upatuka mashi munda anyi pambelu bua dinyanguka dia tshifu anyi ditshibuka dia tshifu, mubidi wende udi utuma mashi kule ne tshifu tshia mukaji udi ne difu ne tshifu bua kulama buongo buende ne mutshima wende bimpe.

Bua bualu ebu, muana udi ubuela mu dikenga dikole, didi mua kumushipa matuku a bungi kumpala kua mashi a mamuende kupueka. Mukaji udi ne difu udi mua kujimija 30 too ne ku 35 pa lukama ya bungi bua mashi ende onso (1 500 too ne ku 2 000 millilitre) padi mashi ende amueneka anu bu a pa tshibidilu; Dîba didi mashi ende apueka ne yeye ulua mashika, mupuya, ne mubungame, udi kale mu tshipupu tshia mashi tshia mu tshitupa tshia III anyi tshia IV ne udi mu njiwu mikole ya disseminated intravascular coagulation (DIC) (mudi thromboplastine wa mu tshitupa tshia mubidi tshidi tshipatuka mu placenta mutshibule udia bintu bionso bidi bienza bua mashi ikale akola, bienza bua mashi apatuke pa mutu pa tshintu tshionso tshidi katshiyi mua kukokeshibua).

Dibutuka dia muonji wa mu tshifu: dienza dia lukasa dia bukole budi bukokela bintu panshi¶

Dibutuka dia muonji wa difu didi dienzeka mu bana 1 pa 300 too ne ku 500 padi tshibombi tshia difu tshipatuka (mayi atshibuka) ne tshitupa tshia muonji wa difu tshipatuka mu tshifu kumpala anyi ku luseke lua tshitupa tshia muana (mutu, makaya, anyi tshiadi). Bidi bitamba kuenzeka padi muana kayi muanji kukuluka mu tshifu mu tshikondo tshidi mayi apatuka, bu mudi mu dileja dia tshifu, dishima dia ku luseke, diledibua dia kumpala kua dîba, mapasa, anyi polyhydramnios (mashi a bungi a mu difu adi apatuka ne bukole bu mudi tshiamu tshia kapia).

Bua tshinyi dinyanguka dia muonji didi dishipa muana mu minite 5 anyi 10 pa kumbusha wewe muenze bualu kampanda¶

Padi mayi a mu difu apatuka, bukole budi bukokela bintu panshi ne dikokangana dia mu tshifu bidi bifikisha tshifu tshikole tshia muana anyi mataku panshi buludiludi ku mifuba ya tshifu tshia mamuende, bitshibula muonji wa mu tshifu tshitekete bu mudi muntu uditua pa tshiamu tshia mu budimi. Kabidi, padi muonji wa tshifu udi ne mâyi upatuka mu tshifu tshidi ne luya lua 37,5-degree Celsius (99,5-degree-Fahrenheit) mu luya lua mashika lua 20-degree-Celsius (68-degree-Fahrenheit) mu nzubu, anyi padi muntu mukuate ne ufina muonji wa mu tshifu, udi ulama bimanu bibidi bia mu tshifu ne mijilu ibidi ya mu tshifu mushipa wa mu tshifu udi uya mu vasospasm wa tshikisu, udi ukanga tshishiki.

Diambuluisha dia kumpala dia tshitupa ku tshitupa bua dinyanguka dia muonji wa mu tshifu¶

Bikila 911 / 112 / 999 ku telefone diakamue ne umanyishe ne: "Tshilumbu tshia lukasa tshia dilela: dinyanguka dia muonji wa tshifu." Baminganga nebamanyishe lupitadi ludi luangata bua kulama nzubu wa dipanda bua dipanda dia "crash".
Diakamue, teka mamu mu muaba wa dikasa ne tshiadi (disungula dia kumpala kumbelu):
Enza bua mamu afukame pa bulalu anyi panshi pa bianza ne binu biende.
Umupuekeshe mutu wende, makaya, ne tshiadi tshia kuulu pa matela anyi panshi eku wenda ulama binu biende muinshi mua tshifuka tshiende bua matamba ende aleje muulu mu lupepele.
Bua tshinyi bidi bienza mudimu: Kutenteka tshitupa tshia mubidi wa mamu panshi bikole kudi kuenza mudimu ne bukole budi bukokela bintu panshi bua kupatula mubidi wa muana ne mutu wende mu tshibombi tshia mu tshifu batangile ku diaphragme wende, diakamue kumbusha bujitu budi bumutshibula ku muonji wa mu tshifu.
Muaba mukuabu wa Sims / Trendelenburg (Bikala mamu mutshioke anyi mu mashinyi a lupitadi):
Shi mamu kena mua kulama dikasa dia tshiadi munkatshi mua minite 15 to ne 20, umukudimune pa ku dia bakaji ne dikasa diende dia kuulu (dia balume) dikoka mutangile ku tshiadi, ne wela makunji asatu anyi anayi manene anyi bilamba bikuate muinshi mua tshifuka ne mataku bua kubandisha tshifu tshiende 50 ** too ne ku 120 centimetre (180 centimeters) inches) muulu kupita makaya ende ne mutu wende.
Lama tshingoma tshidi pambelu kuyi utshikuma:
Kutetshi nansha kakese bua kuela anyi kubueja muonji wa mu tshifu udi mupatuke munda mua tshifu. Kuela muonji kudi kunyangakaja mishipa ne kuenza bua mijilu ikale mikole, kunyanga mashi adi mashale a muana.
Shi tshilamba tshia tshingoma tshidi tshilengeja pambelu pa tshifu, ela tshilamba tshikezuke tshia butoyi anyi tshilamba tshia gaze tshidi katshiyi ne disama mu mayi a mu pompi anyi saline sterile (luya lua mubidi, kaluyi ne kapia ne kaluyi ne mashika nansha kakese) ne utshibuikile bipepele pa tshingoma tshidi tshipatuke bua kutshilama tshikale ne luya ne luya lukole padi nzubu kayi wenza mashika.
Dibandisha dia munda dia muena mudimu mulonge (Anu pikalabu bamuambila kudi baminganga ba lukasa): Shi mutu wa muana utshidi anu ufina bikole ku tshingoma nansha mudiye muimane ku dikasa ne tshiadi ne munganga mulongesha, muledi, anyi munganga udiku (anyi tshibambalu tshia malu a luondapu tshidi tshileja patoke mufidi wa diambuluisha mu tshikondo tshile tshia luendu lua mu mpata), udi ne bua kuela glosters minu ibidi mu tshifu ku tshifu tshia muana tshidi ne mifuba mikole (kuepuka ne budimu bua kulenga anyi kufina tshingoma nkayatshi), ne wela mutu wa muana muulu bikole kule ne tshingoma, ulama tshienzedi atshi tshia kuulu tshitekete too ne mu nzubu wa dipanda too ne padi munganga upatula muana ku diambuluisha dia C-section.

Disama dia dipanga dia mashi mu tshiadi (dikuma dia mu mikolo) ne ditenteka dia ku dia bakaji¶

Ku ndekelu kua ngondo muibidi ne muisatu (kubangila ku mbingu 20 kuya kumpala), bujitu buonso bua muana wa munda, tshia munda, tshia mayi a mu difu, ne tshia tshifu tshinene tshidi tshifika ku 6 too ne ku 10 kilo (13 too ne ku 22 pounds).

Padi mukaji udi ne difu dia ndekelu mulale pa mukolo (mulala panshi) pa bulalu, panshi, anyi pa tshibandilu tshia ambulanse, tshifu tshinene tshidi tshibuela buludiludi panyima pa mukolo wende ne tshitshibula mishipa ibidi minene idi ilonda ku luseke lua dia balume lua mukolo wa tshiadi:

The Inferior Vena Cava: Mushipa munene udi ne bimanu bitekete udi upingaja mashi onso adi kaayi ne oksijene a mu maulu ne a mu tshiadi ku luseke lua dia balume lua mutshima wa mamu.
Aorta wa mu difu: Mushipa munene udi ufila mashi adi ne oxygène too ne ku mishipa ya mu tshifu ne ku placenta.

Mu minite 2 anyi 5 ya kulala panshi pa mukolo, dipingana dia mijilu mu mutshima wa mamu didi dipueka ne 25 anyi 30 pa lukama. Mamu udi umvua mu tshimpitshimpi tshiji, mutoyi, mutu, mupuya mutekete, ne mutoke, mashi ende adi apueka, ne mashi adi aya mu tshifu tshia muana adi apueka lukasa (supine hypotensive syndrome).

Mushindu kayi wa kuteka mubedi yonso udi ne difu kunyima kua mbingu 20¶

Mubedi udi mumanye (Diondopangana / Muaba wa ku dia bakaji): Ela mamu mujima pa luseke luende lua dia bakaji (bualu vena cava wa kuinshi udi uya anu ku dia balume dia mukolo, dikunguluja ku dia bakaji didi dimbusha difu dikole dijima ku mushipa). Teka tshilamba tshia kulala pankatshi pa binu biende binama ne tshikuabu muinshi mua difu diende bua kupeta busambi.
Disama dia mukolo anyi dipanga dia kuenda: Shi mamu uvua mukuluke kuulu anyi mu njiwu ya mashinyi muvua disama dia mukolo udi wela meji ne udi ne tshia kuikala mulongolola, bilamba bia kuowela nabi, bilamba, anyi tshilamba tshia kulala tshidi muinshi mua luseke lua dia balume lua tshiadi tshiende ne tshia kuinshi kua mukolo (anyi kutenteka tshitupa tshijima tshia mukolo) mu angle wa 15 too ne ku 30 degrés ku dia bakaji.
Dipanga dia lungenyi / Dipanga dia muoyo mu difu (Dishintuluka dia tshifu tshia ku dia bakaji): Shi mukaji udi ne difu udi umueneka mukuluke mu disama dia mutshima ne udi dijinga ne CPR, kumulala mutenteka pa matadi kudi kuenza bua dikuma dia tshiadi dikale ditekete ne kadiyi dienza mudimu. Pamutu pa nanku, ikala mukolo wende mutekete pa buloba bukole bua dikuma dia tshiadi dikole (munkatshi mua tshiadi, 100 too ne ku 120 ku minite, 5 too ne ku 6 cm / 2 too ne ku 2,4 inches mu butshiama), padi musungidi muibidi ufukama ku luseke luende, ukuata bianza bionso bibidi ku luseke lua dia balume lua difu diende, ne umukoka ku luseke lua dia balume tshifu tshikole tshia 4 too ne ku 6 santimetre (1,5 too ne ku 2,5 inches) mutangile ku luseke luende lua dia bakaji katupa katupa mu tshikondo tshionso tshia dibisha (dishintuluka dia tshifu tshia ku dia bakaji ku bianza).

Disama dia preeclampsia dikole, disama dia HELLP, ne disama dia eclampsia¶

Kabiena bionso bia tshimpitshimpi bia mu ngondo muisatu bidi bitangila dipatuka dia mashi mu tshifu to. Preeclampsia i disama dia difu dia mishindu ya bungi didi dimanyibua ku dijimija dia mashi dia mamu (vasospasme) ne ku dikola dia mashi (140/90 mmHg anyi kupita apu, anyi 160/110 mmHg anyi kupita apu mu disama dikole dia preeclampsia) didi dienzeka kunyima kua mbingu 20, too ne ku lumingu 6** panyima pa dimita kulela (preeclampsie postpartum)**.

Padi disama dia preeclampsia didi kadiyi diondapibua dienda difika ku HELLP syndrome (Hemolyse wa globules rouges, Elevated Lenzymes ya iver, ne Low Platelets) anyi eclampsia (grand mal generalized tonic-clonic seizures mu mukaji udi ne difu anyi udi mupatuke matuku mashale aa), disama dia tshiadi tshia mu buongo (anyi disama dia tshifu tshia mu buongo) dibutuka, dibutuka dia tshifu, ne lufu lua muana udi mu difu bidi mua kuenzeka lukasa.

Bimanyinu bikunze bia disama dikole dia preeclampsia ne dia eclampsia didi dilua (Bikila 911 / 112 / 999 diakamue)¶

Kulekedi nansha kakese bimanyinu ebi mu tshitupa tshibidi tshia dimita anyi mbingu 6 ya kumpala kunyima kua diledibua bu "disama dia pa tshibidilu dia dimita" anyi dipanga dia tshiadi:

1. Mutu udi usama bikole: Mutu udi usama bikole udi kayi ujika mu minite 30 anyi 60 ya kuikisha mu nzubu wa mîdima anyi ya kunua manga a acetaminophen adi kaayi mua kunyangakaja padiye ne difu.
2. Dipanga dia kumona (divulangana dia tshitupa tshia mu buongo): Kumona bimuenekelu bidi bikenka (photopsia), mabala adi akenka (scotomata), milongo idi ne mavuala, dimona dia patupu, dimona dia misangu ibidi, anyi difofoma dia tshimpitshimpi.
3. Disama dikole dia mu tshitupa tshia kuulu tshia ku dia balume anyi dia mu tshifu ("The HELLP Pain"): Disama dikole, dikole, difina, anyi diosha buludiludi muinshi mua mufuba wa difu anyi muinshi mua tshitupa tshia ku dia balume (misangu ya bungi badi babifuanyikija ne disama dia mutshima dikole, disama dia mu tshifu, anyi disama dia tshifu). Disama edi didi difumina ku divulangana dia tshifu tshia mamu ne dipatuka dia mashi muinshi mua tshiamu tshia Glisson tshia pambelu tshikole, tshidi tshileja dinyanguka dia tshifu dia lufu. Kuena ne bua kulenga anyi kufina bikole pa difu dia kuulu dia dia balume dia mukaji udi ne difu udi ne kanyinganyinga aka to.
4. Divula dia lukasa, dia tshimpitshimpi (Edema) dia mpala, dia bipese bia mêsu, ne dia bianza: Nansha mudi disama dia tshikasa ditekete ku ndekelu kua dituku ditamba kuenzeka mu dimita, kujuka ne mêsu mavuba pabuipi ne kukanga, mpala mufuba, anyi minu miumbuke idi ne bua kukosa bidi bileja dipatuka dia kapila dikole.
5. Dipanga dia mupuya mu dikisha anyi dikokola dia tshipupu tshia rose: Dileja ne: mâyi adi apita mu mikolo ya mamu (pulmonary edema).
6. Hyperreflexie ne clonus: Kukankamika kua mifuba anyi kutuluka kua maboko kumpala kua tshipupu tshia eclamptic kulua.

Diambuluisha dia kumpala dia lukasa bua tshipupu tshia eclampsie¶

Bikila bena mudimu ba lukasa lukasa ne umanyishe "Mukaji udi ne difu dia [X] mbingu udi ne tshipupu tshia eclamptic, udi dijinga ne magnésium sulfate mu mushipa."
Kupangisha dikuluka ne kukuluka ku luseke lua dia bakaji: Lekela mamu panshi, umbusha bintu bia mu nzubu bikole, uteka tshilamba anyi tshilamba tshia ku mutu muinshi mua mutu wende, ne umulame mukuluke ku luseke luende lua dia bakaji bua mate, mashi (a ludimi ludi lusuma), anyi nsukadi bipatuke mukana muende eku ulama mushipa wa difu pambelu pa tshifu.
Kuteka tshintu nansha tshimue mukana muende ne kumukuata panshi nansha kakese: Kutetshi bua kumuenzeja tshibombi, tshibombi tshia makuta anyi minu pankatshi pa meno ende to.
Ikala mudimuke kunyima kua tshipupu tshijika: Bipupu bia bungi bia eclamptic bitu bienza tusunsa 60 too ne ku 90, pashishe dipanga lungenyi anyi dipanga dia lungenyi (tshitupa tshia postictal) mu tshikondo tshidi mutshima wa muana upueka bua tshitupa tshîpi bua dipanga dia luya lua mamuende. Ikala ne njila wende wa luya mutangile ku dia bakaji ne utangila mushindu udiye upuyakana too ne padi baminganga balua ne sulfate de magnésium mu mishipa anyi mu mishipa (tshintu tshidi tshiluisha disama dia eclampsie) ne manga a dikolesha dia mashi.

Dikepesha dia ngendu ya muana wa munda: dîba dia kuya buludiludi ku disungula dia maternity¶

Kubangila ku mbingu 24 too ne ku 28 ya dimita, muana udi ne makanda a mubidi udi wenza tshilele tshia dituku dionso tshia dikuma, dikunguluka, dikuma ne dikuma. Mikenji ya pa buloba bujima idi itangila dikuba dia bana bafue idi ifumina kudi bulongolodi bua malu a bukola bua mubidi pa buloba bujima (OMS), tshibambalu tshia malu a bukola bua mubidi tshia mu ditunga dia Grande-Bretagne (NHS Saving Babies’ Lives), ne ACOG idi ileja mikenji mikole idi itangila dikepesha dia dienda dia muana udi mu difu (RFM):

Myth to discard: Bana kabatu **"batekesha" anyi benda kakese ku ndekelu kua dimita bualu badi bajimija muaba. Ngikadilu wa ngendu udi mua kushintuluka kumbukila ku dikuma dia nsongo too ne ku dikuma dia nsongo ne diolola, kadi misangu ne bukole bua ngendu bidi ne tshia kushala anu bia muomumue too ne ku dilela.
Mukenji wa mbingu 28 ("Bala too ne ku 10"): Mu ngondo muisatu, kulala ku luseke luebe lua dia bakaji mu tshikondo tshidi muana wenza mudimu wa pa tshibidilu kudi ne bua kufila nansha malu mashilangane 10 mu mêba 2 (bana ba bungi badi ne makanda a mubidi badi benza malu 10 mu minite 15 too ne ku 45).
Kuindidi too ne makelela ne kueyemenyi Doppler wa ku nzubu to: Wewe mumone dipueka anyi dipanga dia ngendu ya muana webe, kulala bua kuindila bua kumona ni muana udi wenda mu dinda, ne kuenji mudimu ne tshiamu tshia Doppler tshia ku nzubu anyi tshiamu tshia telefone tshia ku bianza bua kudijadikila. Doppler wa ku nzubu utu misangu ya bungi wangata tshitupa tshia mashi tshia mu tshiadi tshia mamu nkayende ku tshilema, ne nansha mudi mutshima wa muana utshidi anuku, muana udi ne nzala ya mu difu udi ulekela kuenda bua kulama oxygène mêba makese kumpala kua mutshima kuimana. Ndaku diakamue ku nzubu wa disungula dia baledi ba mu lupitadi bua kuenza mudimu wa cardiotocography (CTG / non-stress test).

Enza kalasa ka diambuluisha dia kumpala ne CPR

Baledi badi ne difu, bena dibaka, ne bankambua badi bapeta masanka a bungi padibu balonga malu a CPR ne a diambuluisha dia kumpala dia bantu bakole ne bana batekete ku diambuluisha dia Croix-Rouge, dia St John Ambulance, dia American Heart Association, anyi dia lupitadi lua baledi lua muaba udibu basombele kumpala kua ngondo muisatu wa difu kutuadija.

Nkonko itubu bela misangu ya bungi¶

How can you tell the difference between placenta previa and placental abruption when bleeding occurs in late pregnancy?

Placenta previa (where the placenta covers the cervix) classically causes painless, bright red vaginal bleeding with a soft, relaxed uterus. Placental abruption (where the placenta prematurely tears away from the uterine wall) typically causes sudden, severe, continuous abdominal or back pain, a hard "woody" uterus that does not relax between contractions, and dark red blood (or no visible external blood if the bleeding is trapped behind the placenta). Both require an immediate ambulance and strict avoidance of any vaginal examination.

What should you do right away if a pregnant woman's water breaks and you see the umbilical cord coming out?

This is an umbilical cord prolapse, where the baby's head can crush its own oxygen line within minutes. Immediately call your local emergency number, have the mother get onto her hands and knees with her chest and face flat on the floor or bed and her buttocks raised high in the air (the knee-chest position) so gravity pulls the baby off the cord, loosely cover any exposed cord with a cloth soaked in warm water, and never try to push the cord back inside.

Why must a woman in her third trimester never lie flat on her back during an emergency?

After 20 weeks of pregnancy, lying flat on the back allows the heavy pregnant uterus to press directly down onto the inferior vena cava (the main vein returning blood from the lower body to the heart). Within minutes, this compression cuts maternal cardiac output by up to 30 percent, causing the mother's blood pressure to crash and starving the placenta of oxygen; always roll her onto her left side or tilt her hips 15 to 30 degrees to the left.

Why is pain under the right ribs or a severe headache in the third trimester dangerous?

A pounding headache that will not go away, flashing lights or blurry vision, and sharp pain underneath the right rib cage or upper stomach after 20 weeks of pregnancy (or up to 6 weeks after birth) are classic warning signs of severe preeclampsia and HELLP syndrome. The upper right belly pain is caused by dangerous swelling and bleeding inside the mother's liver, which can lead to liver rupture, stroke, or eclampsia seizures unless treated immediately at a hospital.

Does a pregnant woman need to go to the hospital after a minor car accident or fall if she has no bleeding?

Yes, every pregnant woman past 20 weeks who experiences any motor vehicle collision, seatbelt jolt, or fall onto her stomach, side, or buttocks must go to a hospital maternity unit for at least 4 to 24 hours of electronic fetal monitoring. Shear forces can cause a delayed or concealed placental abruption where liters of blood pool behind the placenta without any blood showing externally, and Rh-negative mothers may need an anti-D immunoglobulin injection within 72 hours.

Miaba mifumina¶

Tshilongelu tshia bena Amerike tshia baminganga ba malu a dilela ne a bakaji (ACOG, mu États-Unis): Malu a mudimu adi atangila disama dia mashi a bungi mu difu ne disama dia kumpala dia difu (No. 222), Dipatuka dia mashi mu difu, ne Dilama dia babedi badi ne disama dia difu.
Royal College of Obstetricians and Gynecologists (RCOG, United Kingdom): Green-top Guidelines on Antepartum Haemorrhage (No. 63), Umbilical Cord Prolapse (No. 50), and Reduced Fetal Movements (No. 57).
Bulongolodi bua makanda a mubidi pa buloba bujima (OMS, pa buloba bujima): Mibelu ya OMS bua dikuba ne diondapa dia disama dia preeclampsia ne dia eclampsia ne Dilama dia ntatu idi ifumina ku dimita ne ku dilela (MCPC).
Tshisumbu tshia muoyo tshia mu Amerike (AHA, États-Unis) ne Tshipangu tshia dikolesha dia muoyo tshia ku Mputu (ERC): Mibelu ya dikolesha dia muoyo ne mikolo ne dijika dia mutshima mu difu (Mikenji ya dishintulula dia tshifu tshia ku dia bakaji).
Society of Obstetricians and Gynecologists of Canada (SOGC) and Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG): ALARM Course Obstetric Emergency Triage Standards.