Postpartum period

**Mudda caggal jibineede** (walla caggal jibineede) fuɗɗotoo ko caggal jibineede, ina heewi hiiseede ko jonte jeegom haa jeetati. Ina waɗi geɗe tati ceertuɗe e sahaa caggal jibineede ; faɗo ɓuuɓngo, duumotoongo waktuuji jeegom haa sappo e ɗiɗi caggal jibineede ; faɗo subacute, duumotooɗo jonte jeegom ; e faɗo leelngo, duumotoongo haa lebbi jeegom. E nder daawal leelngal, won mbayliigaaji e nder ɓalndu ina juuta no feewi ngam safrude, ina mbaawi kadi addande ɗum en ngonkaaji ko wayi no ŋakkere ƴiiƴam. Fedde Adunaare Cellal (OMS) ina siftina wonde sahaa caggal jibineede ko sahaa ɓurɗo teeŋtude, tee kadi ko sahaa ɓurɗo teeŋtude e nguurndam yummiraaɓe e sukaaɓe. Ko ɓuri heewde e maayɗeele yumma e jibinannde ina mbaɗa e ooɗoo sahaa.

E nder binndanɗe ganndal, helmere ndee ina heewi limteede e Px, ɗo x woni limoore ; yeru, "ñalngu P5" ina foti janngeede ko "ñalngu joyaɓuru caggal jibineede". Ɗuum fotaani jiiɓde e nomenklatuur safaara kuutortooɗo G P ngam daranaade limoore e batte reedu (gravidité et parité).

Debbo jibinoowo e nder safrirde ina waawi yaltude so tawii o sellii, ɗum noon ina waawi wonde ko adii waktuuji seeɗa caggal jibineede, hay so tawii noon jibinannde e nder reedu ko balɗe gooto haa ɗiɗi. Hakindo balɗe tati haa nayi caggal jibineede ko balɗe tati haa nayi.[3] E nder oon sahaa, yumma oo ina ƴeewtee ngam anndude ƴiiƴam, golle ɓalndu e ƴiiƴam, e toppitagol cukalel ngel. Cellal cukalel ngel kadi ina ƴeewtee.[4] Ko adii fof, yaltugol e opitaal caggal jibineede ina heewi siforeede ko yaltugol yumma e jibinaaɗo keso e nder opitaal e nder waktuuji 48 caggal jibineede.

Mudda caggal jibineede ina waawi fecceede e daawe tati ceertuɗe ; faɗo adanngo walla ɓuuɓngo, waktuuji 8–19 caggal jibineede ; subacute postpartum period, ko jonte ɗiɗi haa jeegom, e sahaa leelɗo caggal jibineede, ko ina waawi juutde haa lebbi jeegom.[5] E nder sahaa jibinannde subacute, 87% haa 94% e rewɓe ina kaala ko famɗi fof caɗeele cellal goote.[6][7] Caɗeele cellal juutɗe (jokkiiɗe caggal nde jibinaa) ina kaalee e 31% e rewɓe.[8]

Juɓɓule keewɗe ina wasiyoo ƴeewndo caggal jibinannde e nder sahaaji goɗɗi e nder sahaa caggal jibinannde.[9]

## Fase akut
Cukalel ngel waɗetee ko e dow ɓalndu caggal jibineede

Masaas reedu caggal jibineede ina wallita reedu nduu ɓuuɓde caggal nde ɓiɗɗo oo yalti e faɗo ɓuuɓngo.

Waktuuji 6 haa 12 gadani caggal jibineede ko dumunna gadano walla ɓuuɓɗo e sahaa caggal jibineede.[10] E nder oo sahaa yumma oo ina heewi ƴeewteede e juuɗe safrooɓe walla jibinannde sabu caɗeele ina mbaawi feeñde.

Ko ɓuri bonde e cellal e nder faɗo ɓuuɓngo ko ƴiiƴam caggal jibinannde. Caggal jibineede nokku ɗo ɓiɗɗo oo jokkondiri e ɓalndu nduu ina ɓuuɓta, reedu nduu ina foti ɓuuɓde ngam haɗde ƴiiƴam ustaade. Caggal nde ɓuuɓri waɗi, fundus (dow) reedu ina waawi paltaade no ɓuuɓri tiiɗndi to tolno ɓuuɓri. Ina moƴƴi reedu nduu heddoo e tiiɗnaare, tawa kadi ko jom suudu walla jibinannde waɗata ƴeewndo keewngo e nder ɓuuɓri ndii kam e keewal ƴiiƴam ɗam. Masaas reedu ina heewi huutoreede ngam wallude reedu ɓuuɓde.[11]

Caggal jibineede, so yumma oo waɗii episiotomi[12] walla ɓuuɓde e udditgol reedu nduu, ina seernda. E jamaanu ɓennuɗo, episiotomi ko huunde woowaande. Kono tan, wiɗtooji baɗanooɗi ko ɓooyaani ina kollita wonde episiotomi (episiotomi) gonɗo e sahaa kala, so jibinannde no haanirta nii tawa alaa caɗeele walla kuutorɗe, rokkataa nafoore to bannge ustude mboros perineal walla vaginal. Huutoraade episiotomi cuɓaaɗo ina addana neɗɗo ustude mboros perineal.[13] Koolaaɗo kuuɓal cellal ina waawi wasiyaade peeje wellitaare ngam wallitde ustude ñawu perineal.[11]

Toppitagol cukalel e nder faɗo akute

Cukalel ɓuuɓngel ko juuti caggal jibineede

Debbo ina ñammina ɓiɗɓe ɗiɗo balɗe jeegom caggal jibineede. Linea nigra ina yiyee haa jooni.

E nder leƴƴanɗe 10 caggal jibineede, cukalel ngel ƴetta fooftere mum adannde, toppitiiɗo ngel waɗta ngel e dow ɓanndu yumma ngel. Ngonka cukalel ngel ina ƴeewtee e nder njuuteendi Apgar.[14] Njoɓdi Apgar ina anndiree e ƴeewtaade cukalel jibinaaɗo oo e dow sarɗiiji joy ɗi ciimtol ngol huutortoo ko kelme cuɓaaɗe ngam waɗde akronim (Nafoore, Pulse, Grimace, Activité, Respiration). Haa ko ɓooyaani koo, sukaaɓe ina keewi ittude e yumma mum en caggal jibineede. Kono, tuggi hedde hitaande 2000, won laamuuji puɗɗiima wiyde wonde jokkondiral ɓalndu e ɓalndu (jogaade cukalel ngel e dow ɓalndu yumma mum) ina nafta yumma oo e cukalel ngel fof. Tuggi hitaande 2014, jokkondiral gadanal hakkunde ɓalndu e ɓalndu, ko wiyetee kadi toppitagol kangaroo, ina jaɓee e denndaangal juɓɓule mawɗe toppitiiɗe wellitaare cukalel. Nii woni, ngam wallitde tabitinde jokkondiral e ñamri ndi moƴƴaani, toppitiiɗo oo ina waɗa ƴeewndorɗe yumma e cukalel ɗoon e ɗoon nde cukalel ngel lelni e dow ɓalndu yumma. Toppitiiɗo oo ina itta cukalel ngel ngam ɓeydaade ƴeewndaade ɗum tan ko caggal nde ngel heɓi ɓiɗɗo ngel gadano, fawaade e yiɗde yumma ngel. Fedde Adunaare Cellal (OMS) ina hirjina kadi jokkondirde e ɓalndu e ɓalndu e nder waktuuji 24 gadani caggal jibineede ngam wallitde reentaade nguleeki ɓiɗɗo.[15]

## Mudda caggal jibinannde subacute
Postpartum subacute fuɗɗotoo ko caggal nde dumunna postpartum acute joofi, ina waawi jogaade jonte ɗiɗi haa jeegom.[10]

Sellinde ɓanndu e nder sahaa caggal jibinannde subacute

### Ƴeew kadi: Maayde yumma
E nder balɗe seeɗa gadane caggal jibinannde, baasal trombose veineuse profonde (DVT) ina mawni no feewi sabu hiperkoagulabilite ina ɓeydoo e nder reedu, ina ɓeydoo heewde e sahaa caggal jibinannde,[16] haa teeŋti noon e rewɓe wonduɓe e C-section ɓe ustaaki dille. Anti-coagulants walla laabi ɓalli ko wayi no compression ina mbaawi huutoreede e nder safrirde, haa teeŋti noon so tawii debbo oo ina jogii geɗe kaawniiɗe, ko wayi no ŋakkere teddeendi, ŋakkere nguura juutnde, ŋakkere ƴiiƴam (C-section) ko ɓooyaani, walla banndiraawo mo alaa ko woni e mum so wonaa taariindi mboros trombose. Wonande rewɓe wonduɓe e taariindi kewu trombose e nder reedu walla ko adii reedu, ina heewi wasiyaade ko antikoagulant.[17]

Ɓeydagol ƴiiƴam (ƴiiƴam) e ɓuuɓri (ɓuuɓri) e nder reedu debbo ina ustoo seeɗa-seeɗa e nder yontereeji tati.[citation needed] Reedu ina ɓuuɓtoo seeɗa-seeɗa, ina juuta e nder yontereeji seeɗa.[18] Infections caggal jibineede ina mbaawi addude sepsis, so safraaka, maayde.[19] Ko ina wona 33% e rewɓe fof ina keɓa ɓuuɓri caggal jibinannde ; rewɓe jibinɓe e reedu ina mbaawi heɓde mboros oo fotde laabi ɗiɗi e rewɓe jibinɓe e seernaaɓe.[20] Ɓooygol ƴiiƴam e ooɗoo sahaa ina ɓeyda baasal juutngal.[10] E nder sahaa jibinannde subacute, 87% haa 94% e rewɓe ina kaala ko famɗi fof caɗeele cellal goote.[6][7] Kuutoragol Kegel ina wasiyee ngam semmbinde ƴiye ɓalndu e haɓaade ɓuuɓri ƴiiƴam.[21]

Paɗe mawɓe ina mbaawi ɓoorneede e sahaa caggal jibinannde subacute ngam lochia, kam e ŋakkere ƴiiƴam e ŋakkere ƴiiƴam.

Ƴiiƴam ummortooɗam e reedu, ina wiyee lochia, ina ustoo seeɗa seeɗa, ina wayloo gila e boɗewol ɓuuɓngol, ina wayloo, ina wayloo, ina joofna hedde jonte joy walla jeegom. Rewɓe ina wasiyee e ooɗoo sahaa yo ɓoorno paɗe walla paɗe mawɓe, paɗe jibinannde ɗe njuumtata, paɗe jibinannde walla paɗe jibinannde, walla paɗe jibinannde. Huutoraade tampon walla koppi lewru ina haɗaa sabu ina waawi addude bakteriiji e ɓeydude baasal.[22] Ɓeydagol lochia hakkunde balɗe 7-14 caggal jibineede ina waawi hollude leelgol ƴiiƴam caggal jibineede.[23]

Hemorrhoids e ɓuuɓri e nder ooɗoo sahaa ina keewi, kadi softeende ɓuuɓri ina rokketee e kala sahaa.[24] So tawii episiotomi walla gonɗi perineal ina poti sutureede, huutoraade pillow donut ina addana debbo oo jooɗaade tawa alaa ko nafata walla ko famɗi fof ina usta mette.

Won e rewɓe ina njiya ɓuuɓri reedu, ina wiyee afterpains, e nder balɗe seeɗa caggal jibineede. Ɗe cifaa ko e nanndugol e ɓuuɓri lewru, ɗe ɓuri heewde ko e sahaa nde ɓiɗɗo oo ñamlata, sabu yaltinde oksitosin. Ko ɓuuɓri woni ɓuuɓri ƴiiƴam nder reedu ngam haɗde ƴiiƴam yaltude.[25]

Toppitagol cukalel e nder sahaa subacute

### Ƴeew kadi: Maayde cukalel
Balɗe ɗiɗi haa nayi caggal jibineede, kosam debbo ina heewi naatde.[26] E nder daartol, rewɓe ɓe njibinaaka (ina njibina sukaaɓe mum en) ina ndokkee leɗɗe ngam haɗde njiimaandi, kono ɗum nattii holliteede e safaara. E nder ooɗoo sahaa, caɗeele e ñamminde ina mbaawi feeñde. Ɗaanaade yumma ina heewi jiiɓde sabu ummital jamma ina woodi e sahaa jibinannde, kadi jibinannde ina foti ñamleede waktuuji ɗiɗi haa tati kala, haa arti noon e jamma.[27] Konsul laktaasiyoŋ, njillu cellal, lewru kala, doula caggal jibineede, walla kraamverzorgster ina mbaawi wallitde e oo sahaa.

Rafiiji hakkille

### Ƴeew kadi: Rafiiji hakkille jibinannde
E nder sahaa jibinannde subacute, ina waawi feeñde e rafiiji hakkille. Ina jeyaa e ɗeen caɗeele : ɓuuɓri caggal jibinannde, ɓuuɓri gonndi caggal jibinannde, e nder geɗe seeɗa, ɓuuɓri gonndi caggal jibineede.[28] Ñawu hakkille caggal jibineede ina waawi heɓtaade yumma e baaba, tee ina heewi.[29] Ina ɗaɓɓi yiytude ɗum ko yaawi e safrude ɗum no haanirta nii. Ko ina wona 70–80% e rewɓe jibinɓe maa keɓ "baby blues" balɗe seeɗa. Hakkunde 10 e 20 e nder teemedere ina mbaawi heɓde depression clinique, tawi noon ko ɓuri heewde e rewɓe wonduɓe e taariindi depression caggal jibinannde, depression clinique, anxiété, walla caɗeele goɗɗe e nder ɓernde.[30] Jaagol PTSD caggal jibinannde no haanirta nii (ina heen jibinannde maaynde walla caɗeele mawɗe) ina hiisaa ko hakkunde 2,8% e 5,6% e nder yontereeji jeegom caggal jibinannde.[31]

### Ƴeewndo caggal jibineede yumma-ɓiɗɗo
Juɓɓule keewɗe e nder winndere ndee ina wasiyoo ƴeewndorɗe baɗɗe faayiida caggal jibinannde e nder sahaa caggal jibinannde. Koolaaɗo kuuɓal Ameriknaajo (ACOG) ina anndi sahaa caggal jibinannde (« lewru nayaɓuru ») ina tiiɗi wonande rewɓe e sukaaɓe. E nokku njillu gooto gaadanteejo caggal jibineede, ACOG, tuggi 2018, ina wasiyoo nde toppitagol caggal jibineede ngol wona golle jokkondirɗe. Ɓe mbiyata ko rewɓe fof njokkondirta (so tawii ko e yeeso walla e telefoŋ) e doktoor mum en e nder yontereeji tati gadani caggal jibinannde ngam ƴeewtaade caɗeele teeŋtuɗe, tawa ina toppitii caggal ɗuum no haanirta nii. A ɓuri faamde

## Tuugnorgal