Budewar Gaban Mace Da Kuma Yadda Yake Samun Kari Yayin Haihuwa

Gabatarwa:

Samun ƙari ko kuma yagewar gaban mace a lokacin haihuwa shi ake kira da “perineal tear” ko “perineal laceration” a likitance. Zurfi da kuma faɗin gaban mace yana bambanta a tsakanin mata. Binciken masana ya nuna cewa zurfin ramin gaban mace wadda ta balaga ya danganta ne da halin da take ciki, misali:

1. A lokacin hutu: Zurfin sa ya kan kama daga 6.99 cm (2.75 inches) zuwa 8.26 cm (3.25 inches). Faɗin sa ya kan kama daga 4.8 cm (1.9 inches) zuwa 6.3 cm (2.5 inches).

2. A lokacin motsawar sha’awa ko jima’i: Zurfin sa ya kan kama daga 10.80 cm (4.25 inches) zuwa 12.10 cm (4.75 inches). Faɗin sa ya kan kama daga 5.3 cm (2.1 inches) zuwa 5.5 cm (2.16 inches).

3. A lokacin haihuwa: Faɗin sa ya kan kai 10 cm (3.94 inches).

A taƙaice wannan yana nufin cewa zurfin gaban mace ya kan kama ne daga 7 cm zuwa 8 cm (2.75 inches zuwa 3.15 inches) idan ana zaune ƙalau. Idan kuma sha’awarta ta motsa ko kuma ana saduwa da ita, toh ya kan ƙara zurfi zuwa 11 cm (4.33 inches). Ita kuma matar da ba ta taɓa yin saduwar aure ba, faɗin gaban ta ya kan kai 1.5 cm (0.6 inches). Amma a lokacin haihuwa ya kan kara faɗi zuwa 10 cm (3.94 inches). 

Abubuwan Da Ke Kawo Yagewar Gaban Mace Yayin Haihuwa (Causes Of Perineal Tear)

1. Haihuwar farko ta farji (first vaginal delivery)

Mace mai haihuwar farko tafi fuskantar barazanar yagewar gaba, saboda a wannan lokacin faɗin gaban ta baya da yawa kuma gaban ta bai taɓa buɗewar da ake buƙata wajen haihuwa ba. Don haka, turowar da kan jariri yake yi domin fitowa za ta iya sanya yagewar gaban mace. 90% na masu haihuwar farko ana musu ƙari ko  gaban su ya yage da kan sa.

2. Girman jariri (fetal size): 

Jaririn da girman sa ya wuce 4 kg zai iya sanya uwarsa ta fuskanci hatsarin yagewar gaba, saboda girmansa yayiwa kofar gaban ta yawa duk da talewar da gaban ta ya keyi a lokacin haihuwa.

3. Doguwar naƙuda (prolonged labour)

Yin doguwar naƙuda, ma’ana mannewar kan jariri ta ƙaramar ƙofar gaba na lokaci mai tsawo zai iya sanya tsokar wurin tayi laushi har ta yage.

4. Makalewar kafaɗar jariri (Shoulder dystocia)

Maƙalewar kafaɗa tana faruwa ne a lokacin da kan yaro ya fito amma kafaɗar sa ta maƙale ta kasa fitowa duk da ƙoƙarin janyo ta da unguzoma ke yi. Hakan yana faruwa ne idan jariri yayi girma sosai kuma kafadarsa ta kasa wucewa cikin sauki a ramin gaban mace.

5. Taimakon mace da na'ura wajen fito da jariri (assisted vaginal delivery)

Idan naƙuda tayi tsawo har mace ta galabaita sosai, kuma ta kasa yin yunkuri a lokacin da bakin mahaifarta ya buɗe gaba ɗaya, to, likitoci sukan yi anfani da wasu ƙarafa masu kama da almakashi ko cokali (forceps) domin kamowa da janyo kan jaririn ya fito waje. 

Yin hakan zai iya sanya gaban mace ya yage. Wani lokaci a kan yi amfani da reza ko almakashi a kara faɗin ramin gaban mace, abin da ake kira “episiotomy” a likitanci.

6. Rashin kwanciyar jariri daidai a mahaifa (fetal  malpresentation)

Gicciyewar jariri tare da kasancewar bayansa yana fuskantar ƙofar gaba a lokacin haihuwa yakan sanya yagewar gaba. Wani lokaci ma haihuwar ta gaba ba za ta yiwuba, sai anyi tiyatar CS.

7. Gajeruwar naƙuda (precipitate labour)

Hakan yana faruwa ne idan mace ta haihu farat-ɗaya, watau naƙuda da ba ta wuce awa 3 ba. Saurin fitar jaririn zai iya sanya yagewar gaba, domin rashin baiwa tsokar ƙofar gaba dama ta bude a hankali.

Rabe-Raben Yagewar Gaban Mace Yayin Haihuwa (Types of Perineal Tear)

Yagewar gaban mace yayin haihuwa ya rabu gida huɗu idan anyi la’akari da tsananin yagewar:

1. Matakin yagewar gaba na ɗaya (first degree perineal tear)

Wannan ita ce ƙaramar yagewar gaban mace, yagewa mataki na farko tana taƙaita ne kawai ga fatar kofar gaba kwai. Ba ta da faɗi kuma ba ta da zurfi, don haka takan warke da kanta ba sai ansha magani ko anyi ɗinki ba. Sannan ba ta daɗewa take warkewa.

2. Matakin yagewar gaba na na biyu (second degree perineal tear)

Wannan ita ce yagewar gaba wacce ta wuce fatar ƙofar gaba har ta kai ga tsokar gaban mace. Wannan yagewar tana bukatar ayi ɗinki domin magance ta.

3. Matakin yagewar gaba na uku (third degree perineal tear)

Wannan ita ce yagewar gaba wacce tayi zurfi daga tsokar cikin gaba ta gangara zuwa marufin tsokar ƙofar duburan mace (anal sphincter). Macen da ta sami wannan yagewar takan kasa iya riƙe tusa. Dole sai anyi ɗinki ake magance ta.

4. Matakin yagewar gaba na hudu (fourth degree perineal tear)

Wannan itace yagewar gaba wacce tayi zurfi daga tsokar cikin gaba zuwa mahaɗar dubura da uwar hanji. Macen da ta sami wannan yagewar takan kasa iya riƙe tusa, fitsari, ko kashi. Dole sai anyi ɗinki ake magance wannan yagewar. Wannan Yagewar tana buƙatar ƙwarewa wajen gyaran gaban mace.

Matakan Kariya Daga Yagewar Gaban Mace Yayin Haihuwa 

1. Yin yunƙuri kaɗan-kaɗan (gentle pushing) a lokacin da bakin mahaifa ya gama buɗewa. Hakan zai sanya fa ta da tsokar gaba su riƙa buɗewa a hankali kafin ainihin haihuwar ta zo. Kuma hakan zai san yagewar gaban mace ta zo da sauƙi idan Allah ya nufi hakan sai ta faru. 

Misalin wannan shine idan mutum zaiyi kashi mai tauri, toh, yunƙuri farat-ɗaya zai iya sa duburan sa ta yage. Idan kuwa yana yin yunƙuri ne kaɗan-kaɗan, toh, kashin zai fito a hankali. Idan fatar duburar zata yage kuma, toh, abin zai zo da sauƙi.

2. Ɗumama gaba lokacin naƙuda (perineal warming) ta hanyar rufe shi da zani mai nauyi. Hakan zai hana bushewar gaba da kuma rage hatsarin yagewa.

3. Mammatsa kofar gaba (perineum massage) a lokacin da naƙuda ta fara nisa. Jami’an da ke kula da mai naƙudar ne suke yin wannan ta hanyar sanya yatsu a gefen gaba ana zagaye shi kaɗan-kaɗan. Hakan yana kyautata gudanar jini a ƙofar gaba kuma yana sanya ta ta buɗe cikin sauki. Akan iya amfani da vitamin E oil, coconut oil, almond oil, ko duk wani vegetable oil da ake yin girki dashi wajen mammatsa ƙofar gaban.

4. Yin naƙuda a tsugunne ko zaune (upright labour position). Hakan zai sanya jaririn ya matso zuwa ƙofar gaba cikin sauki a lokacin da mace take yin yunƙuri saboda nauyin ƙasa yana ƙara janyo shi. Kwanciya a rigingine ba zai taimaka sosai ba wajen fitar jariri cikin sauƙi.

Maganin Yagewar Gaban Mace Yayin Haihuwa 

Tsawon lokacin da yagewar gaba takan ɗauka kamin ta warke ya danganta ne da yagewar. Amma yawanci ba ta wuce makonni 4 zuwa 6. Sannan abubuwan da zasu taimaka wajen saurin warkewar su ne kamar haka:

• 1. Zama (yin gashi) a cikin ruwan ɗumi mai gishiri (sitz bath).
• 2. Samun isasshen hutu.
• 3. Yin ‘yar tafiya a tsakar gida.
• 4. Kaucewa yin aiki mai tsanani.
• 5. Tsaftar gaba ta hanyar yin tsarki da ruwan ɗumi.
• 6. Shan magungunan da likita ya bayar akan ka’idar su.
• 7. Cin isasshen kuma ingantaccen abinci.
• 8. Samun wadataccen jini
• 8. Tuntuɓar likita idan an ga wani abin da ba’a gane ba kamar zubar ruwa, warin gaba, zazzaɓi mai tsanani, da sauransu.

Kammalawa 

Daga ƙarshe ya kamata mu san cewa idan mace ta sami yagewar gaba a haihuwar farko, hakan baya nufin duk haihuwa sai gaban ta ya yage. A’a, yagewar ta danganta ne da dalilan da muka yi bayani a farko.

WalLahu A’lam.