RC Musanze: Abo muri Kavumu-Byangabo bagaragaje akarengane ababyeyi babyarira mu nzira bakorerwa, Virunga Today yerekana uburemere bw’ikibazo cy’ababyeyi batabyarira imbere ya muganga

Kuri uyu wa kabiri taliki ya 3/03/2026, kuri Radiyo y’abaturage ya Musanze, mu kiganiro umuti ukwiye, abanyamakuru Robert na Madia ku ncuro ya kabiri mu gihe kitageze ku kwezi bagarutse ku bibazo byugarije abatuye akagari ka Kavumu, umurenge wa Busogo, ibibazo bikomoka ku kuba aka kagari gakomeje kuba mu bwigunge kubera kubura ibikorwaremezo by’imihanda n’amavuriro.

By’umwihariko iki kiganiro cyibanze ku bibazo ababyeyi batwite bahura nabyo igihe bageze igihe cyo kubyara, urugendo bakora ngo bagere ku kigo nderabuzima cya Busogo rungana n’amasaha 3 ku maguru rukaba rurangira hari ababyariye mu nzira, byongeye kandi aba babyeyi muri icyo gihe bagacibwa n’amafranga ibihumbi 5 by’amande yo kuba babyariye mu nzira.

Umunyamakuru wa Virunga Today wakurikiramye iki kiganiro, yahisemo gutegura inkuru isesengura ibyago biba bitegereje umubyeyi, igihe habayeho ko abyarira mu nzira cyangwa mu rugo kubera impamvu zitandukamye.

I.Ni ibihe bice by’umubiri w’umubyeyi bigira uruhare mu ibyara
Mu gikorwa cy’ibyara, hari imyanya myibarukiro igira uruhare rukomeye mu gutuma umwana avuka neza. Iyo myanya ni nyababyeyi, umuyoboro w’inda, n’uruhago, ndetse n’ibindi bice bifasha mu gutwara no gusohora umwana. Ibi bice byose bikorana mu buryo bwihariye kugira ngo ibyara bigende neza.

Nyuma y’ibi bice by’umubiri, hakenerwa kandi imisemburo y’ingenzi irimo oxytocin, estrogen, na progesterone. Iyi misemburo niyo ituma nyababyeyi ikomera cyangwa igororoka, igafasha mu gutangira no gukomeza imihango y’ibyara, bityo igikorwa cyose kikagenda mu buryo bwizewe.

 

Nyababyeyi (Uterus)

Ni igice gikomeye giherereye imbere mu nda, aho umwana aba ari mu mutekano mu gihe cyose umubyeyi atwite. Nyababyeyi iha intungamubiri n’umwuka binyuze mu ngobyi (placenta ) ikanamuha urwinyagamburiro rwo gukuriramo neza. Iyo igihe cyo kubyara kigeze, nyababyeyi ni yo isunika umwana kugira ngo avuke.

Inkondo y’umura (Cervix)
Ni igice gihuza nyababyeyi n’inzira y’umwana asohokeramo. Mu gihe cyo kubyara, inkondo y’umura  igenda yaguka buhoro buhoro kugira ngo umwana abone aho anyura. Iyo itaguka neza, kubyara biragorana.

 

Inzira y’umwana asohokeramo (Vagina)
Ni inzira umwana anyuramo agiye kuvuka. Ni igice kigomba kuba cyoroshye kandi gifite imbaraga zo kwaguka kugira ngo umwana asohoke neza.

Ingobyi ( placenta)
Ni urutiriro rw’inda rufasha umwana kubona amaraso, intungamubiri, n’umwuka.  Placenta  ikunze kwifata ku rukuta rw’inyababyeyi (uterine wall), cyane cyane mu gice cyo hejuru cy’inyababyeyi (fundus) cyangwa inyuma (posterior wall). Aha ni ho haba amaraso menshi, bikayiha ubushobozi bwo guha umwana ibiryo n’umwuka.
Kuba placenta ikunze kwifata hejuru cyangwa inyuma bituma inzira y’umwana (inkondo y’umura) idahagarikwa, bityo kubyara bikagenda neza.

Imitsi y’amaras0 (uterine blood vessels)
Mu ibyara, imitsi y’amaraso igira uruhare mu gutanga oxygen n’ibindi bikenerwa ku myanya myibarukiro, ndetse no gufasha mu mikorere y’inyababyeyi. Iyo mitsi irimo:

– Imitsi mito (capillaries): niyo itanga amaraso ku bice byose bya nyababyeyi.
– Imitsi minini (arteries and veins): zifasha mu gutwara amaraso menshi, zigatanga imbaraga n’ibikenerwa mu gihe nyababyeyi ikora.
– Uterine arteries: imitsi itanga amaraso ku nyababyeyi, ikaba ingenzi cyane mu gihe cyo kubyara.

Imitsi y’amaraso rero ikorana n’imyanya myibarukiro kugira ngo ibyara rigende neza, ikanafasha mu kugabanya amaraso atakara cyane nyuma yo kubyara.

 

II.Inda y’umubyeyi itameze neza

imiterere y’inda y’umubyeyi ishobora kugira uruhare rukomeye ku buryo ibyara bigenda. Iyo inda itameze neza, bishobora gutera ibibazo bikomeye mu gihe cyo kubyara, bikaba intandaro y’impfu cyangwa ibindi byago ku mubyeyi n’umwana.

Ibibazo by’inda y’umubyeyi itameze neza
1- Nyababyeyi idateye neza (Uterine malformation): Iyo nyababyeyi ifite imiterere idasanzwe, (nko kuba igabanyijemo ibice bibiri, cyangwa ikaba nto cyane) , umwana ashobora kubura urwinyagamburiro, ntakure neza, bikagora kubyara.

2- Placenta itameze neza:Placenta iba ishobora kuba ifashe nabi kuri nyababyeyi cyangwa ikaba iri hasi cyane (placenta previa), ishobora kubuza inzira y’umwana cyangwa gutera kuva. Iyo itandukanye hakiri kare (placental abruption), bishobora gushyira ubuzima mu kaga. Ubusanzwe placenta isohoka…

3- Cervix idakora neza: Iyo inkondo y’umura idafite imbaraga zihagije zo gufunga neza inda, bishobora gutera inda kuvamo kare cyangwa kubyara umwana utarageza igihe.
4- Nyababyeyi idakomeye nyuma y’ibyara (Uterine atony):
Nyuma yo kubyara, nyababyeyi igomba gukomera kugira ngo izirike imitsi y’amaraso. Iyo idakomeye, umubyeyi ashobora kuva c

Icyitonderwa ku miterere y’umugore mugufi cyangwa ufite bassin nto
Imiterere y’umugore ishobora kugira ingaruka ku buryo kubyara bigenda.
– Umugore mugufi cyane: akenshi aba afite bassin (pelvis) nto cyangwa ifunganye.
– Iyo bassin ari nto, inzira umwana anyuramo ishobora kuba ifunganye, bigatuma kubyara bisaba imbaraga nyinshi cyangwa bikaba ngombwa gukoresha ubundi buryo (nko kubaga).
– Ibi bituma abaganga bita ku miterere y’umugore mbere y’uko abyara, kugira ngo bamenye niba ashobora kubyara mu buryo busanzwe cyangwa hakenewe ubundi bufasha.

III. Ibyara

Kubyara ni urugendo rugira ibyiciro bitatu bikurikirana. Buri cyiciro gifite igihe gishobora kumara, kandi muganga ashobora gukurikirana ibimenyetso by’umubiri w’umubyeyi kugira ngo amenye neza aho ibyara bigeze n’igihe bizabera.

Ibyiciro byo kubyara n’igihe bimara

– Icya mbere: Gutangira kubyara (Labor onset)
Nyababyeyi itangira kwikwega  (contractions), cervix igenda ikagenda yaguka buhoro buhoro. Iki gice gishobora kumara amasaha menshi (ku babyeyi babyaye bwa mbere  (hagati y’amasaha 8–12) naho  ku babyeyi babyaye mbere, gishobora kuba kigufi.

– Icya kabiri: Gusunika umwana (Delivery of the baby)
Nyababyeyi ikomeza gukurura, umubyeyi agasunika, umwana akanyura mu nzira y’umwana asohokeramo (vagina). Iki gice gishobora kumara hagati y’iminota 30 n’amasaha 2, bitewe n’imbaraga z’umubyeyi n’uko umwana ameze mu nda.

– Icya gatatu: Gusohora placenta (Delivery of the placenta)
Nyuma y’uko umwana avutse, placenta igomba gusohoka. Iki gice gikunze kumara hagati y’iminota 5–30. Nyababyeyi igomba kuba ikomeyea kugira ngo izirike imitsi y’amaraso, bityo umubyeyi ntave cyane.

Icyitonderwa

Kwa muganga bamenya igihe ibyara rizabera
– Muganga akurikirana ibimenyetso by’umubyeyi: contractions, uko cervix iguka, n’uko umwana ameze mu nda.
– Hifashishwa ibipimo by’ubuvuzi nka echographie cyangwa monitoring y’umutima w’umwana n’imbaraga za nyababyeyi.
– Muganga ashobora gutanga ubumenyi bushingiye ku mibare n’uburambe, akamenya igihe ibyara bizatangira cyangwa igihe umubyeyi agomba kwitabwaho byihuse.

-IV-Ibyago mu ibyara
N’ubwo kubyara ari igikorwa gisanzwe mu buzima bw’umugore, hari igihe gishobora kuzamo ibyago (complications) bigatuma umubyeyi cyangwa umwana bahura n’ibibazo bikomeye. Ibyo byago bishobora kuba bifitanye isano n’imyanya myibarukiro, imitsi y’amaraso (uterine blood vessels), cyangwa imisemburo itari gukora neza.

1. Kuva cyane (Postpartum hemorrhage)
Ni ikibazo gikomeye aho umubyeyi atakaza amaraso menshi nyuma yo kubyara. Akenshi giterwa na nyababyeyi idakomeye (uterine atony), aho nyababyeyi inanirwa gukomera no kuzirika imitsi y’amaraso nyuma yo gusohora placenta. Ibi bishobora guterwa no kubyarira igihe kirekire  kuba  inda yari nini, cyangwa kuba umubyeyi yarabyaye inshuro nyinshi. Hari n’igihe placenta isigaye imbere cyangwa ikitandukanya kare, byose bikongera ibyago byo kuva.

2. Kudahumeka neza k’umwana (Birth asphyxia)

Kudahumeka neza bivuze ko umwana ashobora kuvuka adahumeka cyangwa afite umwuka muke. Ibi bibaho mu gihe umwana atabonye umwuka uhagije mu nda cyangwa mu gihe cyo gusohoka.

Inkomoko y’iki kibazo
– Kwivanga nabi mu nda (Malpresentation): Umwana ashobora kuba aticaye neza mu nda, nko kuba ikibuno ari cyo kiri hasi cyangwa aryamye ku ruhande, bigatuma gusohoka bigorana kandi bikabuza umwana umwuka.
– Placenta ifashe nabi cyangwa ikitandukanya kare: Iyo placenta iri hasi cyane (placenta previa) cyangwa ikitandukanya hakiri kare (placental abruption), umwana ashobora kubura umwuka.
– Kubyarira igihe kirekire cyane: Iyo nyababyeyi ikurura igihe kirekire, bishobora gutuma umwana ahura n’ibibazo byo kubura umwuka.

Ingaruka
Umwana ashobora kuvuka adahumeka, bikaba bisaba ubufasha bwihuse bwo kumutera umwuka. Iyo bidakemuwe vuba, bishobora gutera ubumuga bw’igihe kirekire cyangwa urupfu rw’umwana.

3. Cervix itaguka uko bikwiye
Umuyoboro w’inda ugomba kwaguka kugeza ku rugero rukwiye (santimeteri 10, uvuye kuri 0) kugira ngo umwana abone aho anyura. Iyo itaguka neza, kubyara biragorana, bikaba intandaro y’ibibazo bikomeye ku mubyeyi n’umwana.

4. Placenta previa cyangwa abruption
– Placenta previa: Placenta iri hasi cyaneyitambikaa  inzira y’umwana, bikaba bigoye kumusohora.
– Placental abruption: Igihe Placenta yitandukanya hakiri kare, bigatera kuva cyane no kubuza umwana umwuka. Ibi bibazo byombi bishobora gushyira ubuzima bw’umubyeyi n’umwana mu kaga.

5. Umwana utari mu mwanya mwiza mu nda (Malpresentation)

Mu buryo busanzwe, umwana aba yicaye mu nda ku buryo umutwe ari wo uri hasi mu nkondo y’umura, kugira ngo kubyara bigende neza. Iyo bigenze ukundi, biba ari malpresentation.

Ingero z’ukwivanga nabi mu nda
– Breech presentation:

Breech Presentation (Umwana yicaye nabi ku kibuno cyangwa amaguru)

Mu buryo busanzwe, umwana aba yicaye mu nda ku murongo uhuza umutwe n’ikibuno, kandi umutwe ari wo uri hasi mu nkondo y’umura kugira ngo kubyara bigende neza.

Ariko mu Breech presentation:
– Ikibuno cyangwa amaguru ni byo biba biri hasi aho umutwe ugomba kuba.
– Ibi bituma mu gihe cyo kubyara, umutwe w’umwana uba uri hejuru, bikagora cyane gusunika no gusohora umwana mu nzira isanzwe.

 

– Transverse lie:

Transverse Lie (Umwana aryamye ku ruhande)

Mu buryo busanzwenanone , umwana aba yicaye mu nda ku murongo uhuza umutwe n’ikibuno (longitudinal lie). Ariko hari igihe umwana aba aryamye ku ruhande, ibi bikitwa transverse lie:

– Icyo bivuze: Umwana aba yicaye mu nda ku buryo umutwe we n’ikibuno bye biri ku mpande zinyuranye z’inyababyeyi, bityo ntibibe biri mu murongo wo gusohoka. Ni nko kuba umwana aryamye ku ruhande mu nda.
– Ingaruka:
– Kubyarira mu buryo busanzwe ntibishoboka, kuko inkondo y’umura iba itabonye umutwe cyangwa ikibuno mu mwanya wo gusohoka.
– Akenshi bisaba kubagwa (cesarean section) kugira ngo umwana avuke neza.
–

Oblique Lie (Umwana yicaye mu buryo buteruye)

Nk’uko tubibonye hejuru, mu bisanzwe  umwana aba yicaye mu nda ku murongo uhuza umutwe n’ikibuno (longitudinal lie). Ariko hari igihe umwana aticara neza, akicara mu buryo bita oblique lie:

– Icyo bivuze: Umwana aba yicaye mu nda mu buryo buteruye, atari ku murongo uhuza umutwe n’ikibuno (longitudinal), kandi atari ku ruhande rwose (transverse). Ni nko kuba umutwe we uri mu gice kimwe cy’inkondo y’umura, ikibuno kikaba kiri mu gice cy’inyababyeyi hejuru, ku buryo umwana aba “ateruye” mu nda.
– Ingaruka:
– Kubyarira mu buryo busanzwe bigorana cyane, kuko inkondo y’umura iba itabonye umutwe cyangwa ikibuno neza.
– Umwana ashobora guhindura umwanya mu gihe cy’ibise, ariko iyo akomeje kuguma muri oblique lie, akenshi bisaba kubagwa (cesarean section).

– Occiput posterior position (Inkondo y’umutwe ireba inyuma)
Mu buryo nanone  busanzwe, umwana aba yicaye mu nda ku buryo umutwe we ureba imbere (occiput anterior), bityo mu maso he herekeza ku gice cy’inyuma cy’umubyeyi. Ibi bituma gusunika bigenda neza.Ariko mu Occiput Posterior Position:- Umwana aba yicaye ku buryo inyuma y’umutwe (occiput) ireba inyuma y’umubyeyi, mu gihe mu maso he herekeza imbere ku gice cy’inda y’umubyeyi.
– Ibi bivuze ko mu gihe cyo gusunika, umutwe w’umwana uticaye neza mu nkondo y’umura, bigatuma inzira iba ngufi kandi igoranye.
– Umubyeyi ashobora kugira ibise bimara igihe kirekire, akababara cyane mu gice cy’inyuma (lower back pain), kandi gusunika bikaba bigorana.

– Face presentation:

Face Presentation (Umwana agaragaza mu maso aho umutwe ugomba kuba)

Mu buryo busanzwe, umwana aba yicaye ku murongo uhuza umutwe n’ikibuno, kandi umutwe ari wo uri hasi mu nkondo y’umura. Ariko mu Face presentation:

– Mu maso h’umwana ni ho haba herekana mu nkondo y’umura, aho umutwe ugomba kuba.
– Umutwe w’umwana uba uzunguruka cyane inyuma (hyperextended), ku buryo mu maso ari bwo bugaragara mu nzira yo gusohoka.
– Ibi bituma kubyara mu buryo busanzwe bigorana cyane, kuko umutwe ntuba mu mwanya mwiza wo gusunika.

Ingaruka
– Umubyeyi ashobora kugira ibise bimara igihe kirekire kandi bikababaza cyane.
– Umwana ashobora kubura umwuka cyangwa kugira ibikomere mu maso.
– Akenshi bisaba ubufasha bwihariye: kubyara hakoreshejwe ibikoresho (forceps/vacuum) cyangwa kubagwa (cesarean section).

– Shoulder presentation (Umwana agaragaza igitugu)

Mu buryo busanzwe, umwana aba yicaye mu nda ku murongo uhuza umutwe n’ikibuno (longitudinal lie), kandi umutwe ari wo uri hasi. Ariko mu Shoulder presentation:

– Icyo bivuze: Umwana aba yicaye ku buryo igitugu ari cyo kiri hasi mu nkondo y’umura, aho umutwe cyangwa ikibuno byari bikwiye kuba.
– Ingaruka:
– Kubyarira mu buryo busanzwe ntibishoboka, kuko igitugu ntigishobora gusohoka mu nzira y’umwana.
– Akenshi bisaba kubagwa (cesarean section) kugira ngo umwana avuke neza.

Impamvu zishoboka za malpresentation
– Imiterere y’inda itameze neza: Nyababyeyi idasanzwe cyangwa inkondo y’umura ifite ikibazo ishobora kubuza umwana kwicara neza.
– Amazi y’inda (amniotic fluid): Iyo ari menshi cyane cyangwa make cyane, bishobora gutuma umwana yicara nabi.
– Umwana muto cyane cyangwa inda nini cyane: Umwana ashobora kwicara mu buryo butari bwo kubera umwanya ufite.
– Placenta ifashe nabi: Iyo placenta iri mu mwanya utari wo, ishobora kubuza umwana kwicara neza.

Ingaruka
Igihe umwana atari mu mwanya mwiza mu nda ya nyina,  bituma kubyara bigorana, bishobora gutera umwana kubura umwuka cyangwa umubyeyi kuva cyane. Akenshi bisaba ubufasha bwa muganga, harimo kubyara hakoreshejwe ibikoresho byihariye cyangwa kubagwa (cesarean section).

V.Impamvu atari byiza kubyarira mu rugo

Kubyarira kwa muganga ni inzira yizewe yo kurinda ubuzima bw’umubyeyi n’umwana. Ariko iyo umubyeyi atabyariye kwa muganga, ahura n’ibibazo byinshi bishobora guturuka ku miterere y’aho abyariye, kubura ubufasha bw’inzobere ziba zifite ibyangombwa byose bikenewe mu ibyara.

Koko rero kubyarira mu rugo si byiza kubera:
– Isuku nke: Mu rugo cyangwa mu bice bitari kwa muganga, hashobora kuba hatari isuku ihagije. Ibi byongera ibyago byo kwandura indwara zituruka ku mikorere mibi y’udukoko (infection), cyane cyane mu gihe umubyeyi ava cyangwa umwana avutse.
– Kubura ababyaza n’abaganga b’inzobere: Iyo umubyeyi abyariye ahatari inzobere, ibibazo bikomeye ntibimenyekana hakiri kare cyangwa ntibifatirwe ingamba.
– Kubura ibikoresho bikenewe: Mu rugo ntihaba amaraso yo gusimbura, imiti yo gufasha nyababyeyi gukomera, cyangwa imashini zifasha umwana guhumeka.
Ibi byose bishyira ubuzima bw’umubyeyi n’umwana mu kaga gikomeye.

Kubyarira kwa muganga  rero ni inzira yizewe kandi yemejwe n’ubushakashatsi ko igabanya cyane impfu z’ababyeyi n’abana. Iyo umubyeyi abyarira ahari inzobere, aba yizeye ubufasha bwihuse mu gihe habaye ikibazo, kandi umwana akavuka mu mutekano. Ni yo mpamvu ari byiza gukanguriraa ababyeyi bose gukora uko bashoboye bakajya kubyarira kwa muganga, kuko ari amahitamo y’ubuzima.

Ku rundi ruhande, inzego za Leta zikwiye gukomeza kongera abakozi b’ubuzima, cyane cyane abajyanama b’ubuzima n’ababyaza, no kwegereza abaturage amavuriro n’imihanda.

Twifashishije: www.prevention-medicale.org na www.elsan.care