Waa maxay shoulder dystocia.

 

Waa maxay Shoulder Dystocia?

Shoulder dystocia waa marka garbaha ilmaha – gaar ahaan garabka hore – uu ku xayirmo ama ku dhego pubic symphysis-ka (lafaha miskaha hore), taasoo keenaysa in ilmaha uusan si fudud usoo bixi karin kadib marka madaxu kasoo baxo.

 

Maxaa sababa?

Waxaa jira dhowr arrimood oo kordhiya halista shoulder dystocia:

1. Ilmo weyn (Macrosomia) – Miisaan ka badan 4kg, gaar ahaan haddii uu ka weyn yahay 4.5kg.
2. Hooyo leh sonkorow (Gestational diabetes) – Carruurta ay dhalaan hooyooyinka sonkorowga leh waxay noqon karaan kuwo culus.
3. Dhalmada hore ee ay dhacday shoulder dystocia.
4. Hooyo buuran (obesity).
5. Isticmaalka vacuum ama forceps.
6. Dhalmada dheer ee qeybta labaad (second stage of labor).

 

Sidee loo xaliyaa? (Daaweynta Degdega ah)

Tani waa xaalad u baahan xirfad iyo deganaan degdeg ah. Waxaa la isticmaalaa "maneuvers" kala duwan si loo caawiyo in garbaha ilmaha ay kasoo baxaan:

1. McRoberts Maneuver

– Lugaha hooyada ayaa loo laalaa caloosha si miskaha u furaan, taasoo badanaa wax taraysa.

2. Suprapubic Pressure

– Cadaadis laga saaro xagga sare ee miskaha si garabka ilmaha hoos loogu riixo.

3. Delivery of Posterior Arm

– Gacanta dambe ee ilmaha ayaa la bixiyaa si boos ugu banaanaado garabka hore.

4. Woods Corkscrew Maneuver

– Ilmaha ayaa si tartiib ah loo rogayaa si garbaha uga baxaan lafta miskaha.

5. Zavanelli Maneuver (halis leh)

– Ilmaha madaxiisa dib ayaa loogu riixaa gudaha si qaliin degdeg ah (C-section) loo sameeyo – tani waa ikhtiyaar xad dhaaf ah oo la adeegsado kaliya haddii wax kale aysan shaqeyn.

 

Khataraha suurtagalka ah:

• Ilmaha: dhaawac loo geysto neerfaha gacanta (brachial plexus injury), hypoxia (neef la’aan), ama xitaa dhimasho haddii la daaho.
• Hooyada: dillaac gudaha ah, dhiig bax, ama u baahan qaliin degdeg ah.

 

 Tallaabooyin looga hortago ama lagu yareeyo khatarta shoulder dystocia:

1. Qiimeyn hore ee khatarta (Risk assessment):

• Waxaa muhiim ah in hooyada la baaro inta lagu jiro uurka si loo ogaado haddii ay jiraan arrimo halis ah:
• Ilmo miisaankiisu sareeyo (macrosomia).
• Hooyo qaba sonkorow (gestational diabetes).
• Dhalmo hore oo ay ka dhacday shoulder dystocia.
• Hooyo buuran ama miisaanka aad uga badan caadiga.

2. Kormeer joogto ah inta uurka socdo:

• Baaritaanka ultrasound-ka wuxuu ka caawin karaa ogaanshaha cabbirka ilmaha.
• Haddii ilmaha la tuhmo inuu aad u weyn yahay, dhakhtarku wuxuu tixgelin karaa in la qorsheeyo qaliin (C-section).

3. Maamulka wanaagsan ee sonkorowga uurka:

• Xakameynta sonkorta hooyada waxay si weyn u yareyn kartaa fursadda ilmaha inuu aad u weynaado.

4. Qorsheynta habka dhalmada:

• Haddii ilmaha la qiyaaso inuu ka weyn yahay 4.5kg (hooyo sonkorow qabta) ama 5kg (hooyo aan qabin sonkorow), C-section ayaa lagu taliyay si looga fogaado khatarta.
• Ka fogaanshaha isticmaalka vacuum ama forceps haddii aysan si sax ah loogu baahneyn.

5. In la diyaariyo shaqaalaha dhalmada:

• In shaqaalaha caafimaadka ay diyaarsan yihiin, tababarna u leeyihiin sida loo maareeyo shoulder dystocia haddii ay dhacdo.

 

 Xusuus muhiim ah:

• In kasta oo dhammaan taxaddarradaas la qaado, mararka qaar shoulder dystocia waxay dhici kartaa iyadoo aan wax halis ah la saadaalin karin. Sidaas darteed, ka hortagga saxda ah waa isku dhaf qiimeyn hore, taxaddar, iyo diyaar garow xirfadeed.