Kuchotsa mimba kwa achipatala a matenda ashuga

Funsani funso ndikupeza ufulu wofunsa ndi madokotala. Pofuna kwanu, kuthandizanso kumapezekanso mufoni yam'manja. Musaiwale kuthokoza madotolo omwe adakuthandizani! Patsamba pali chochita "Zikomo - ndizosavuta!"

Kodi ndinu dokotala ndipo mukufuna kufunsa ku portal? Werengani malangizo amomwe Mungakhalire Alangizi.

Osadzisilira. Njira yokhayo yoyenera komanso kufunsira kwa akatswiri azachipatala ndi omwe angathandize kupewa zoyipa zomwe zingachitike chifukwa chodzidzidzimutsa nokha. Chidziwitso chonse chomwe chatumizidwa pa Medihost portal ndi chongowongolera chokha ndipo sichingabwezeretse dokotala. Mukakhala ndi vuto lililonse la matenda kapena malaise, funsani ku dokotala kuchipatala.

Kusankha ndi kutumiza mankhwala kungakhale katswiri wazachipatala. Zizindikiro zakugwiritsa ntchito ndi Mlingo wa mankhwala ziyenera kuvomerezedwa ndi dokotala.

Medihost yachipatala Medihost ndi chidziwitso ndipo imangokhala ndi zidziwitso zakumbuyo. Zipangizo zokhudzana ndi matenda osiyanasiyana ndi njira zochiritsira sizingagwiritsidwe ntchito ndi odwala pakusintha kwazovomerezeka mumakonzedwe a mankhwala ndi malangizo a dokotala.

Oyang'anira a portal satenga udindo pakuwonongeka kwa zinthu, komanso kuwonongeka kwa thanzi lomwe limayambitsa chifukwa chogwiritsa ntchito zomwe zidatumizidwa patsamba la Medihost.

Kodi kuchotsa mimba kumachitika liti?

Pali zinthu zingapo zomwe kupezeka kwake kumafuna kuthetsa pakati. Zotsutsa zoterezi zimaphatikizapo shuga yovomerezeka, chifukwa njira yake imatha kukhala yovulaza osati kwa mkazi yekha, komanso kwa mwana wake.

Nthawi zambiri, ana a amayi omwe ali ndi matenda ashuga amabadwa ndi zotumphukira, zamitsempha yama mtima komanso zolakwika zamafupa. Vutoli limatchedwa fetopathy.

Pakukonzekera kutenga pakati, mtundu wa matenda omwe uli mwa mkazi uyenera kuganiziridwa komanso ngati abambo ali ndi matenda otere. Izi zimakhudza kuchuluka kwa chibadwa cha chibadwidwe.

Mwachitsanzo, ngati mayi ali ndi matenda osokoneza bongo a 1 ndipo abambo ake ali ndi thanzi, ndiye kuti matendawa amakhala ndi mwana ochepa - 1% yokha. Pamaso pa matenda a shuga omwe amadalira insulin mwa makolo onse awiri, mwayi wokhala ndi mwana wawo ndi 6%.

Ngati mayi ali ndi matenda ashuga a 2 ndipo abambo ake ali ndi thanzi, ndiye kuti mwana angakhale wathanzi kuyambira 70 mpaka 80%. Ngati makolo onse ali ndi fomu yodalira insulin, ndiye kuti mwayi woti ana awo asadwale ndi matendawa ndi 30%.

Kuchotsa shuga

kuwonongeka kwa maso
chifuwa chachikulu
mayi wazaka 40,
kukhalapo kwa mkangano wa Rhesus
matenda a mtima
pamene mkazi ndi bambo ali ndi matenda ashuga 2,
nephropathy ndi pachimake aimpso kulephera,
pyelonephritis.

Kupezeka kwa zinthu zonsezi pamwambapa kumabweretsa kuzizira kwa fetus, komwe kumakhala ndi zotsatira zoyipa pa thanzi la mayi. Koma nthawi zambiri funso lomwe limakhudzana ngati ndi zotheka kukhala ndi pakati ndi matenda ashuga limathetsedwa payekhapayekha.

Ngakhale azimayi ambiri amawerenga nkhaniyi mosasamala, osayendera madotolo komanso osapitilira mayeso onse ofunikira. Chifukwa chake, mwayi wokhala ndi mayendedwe olakwika komanso kuchotsa mimba mokakamizidwa ukuwonjezeka chaka chilichonse.

Popewa izi, amayi apakati omwe ali ndi matenda ashuga amayenera kuwunika moyenera mayiyo poyang'anira nthawi yomwe khanda limayandikira. Poterepa, ndikofunikira kutsatira zakudya zapadera zomwe zimaperekera kuchuluka kwa shuga mumtsinje wamagazi. Komanso, pakubala kwa mwana, ndikofunikira kukaonana ndi ophthalmologist, gynecologist ndi endocrinologist.

Kodi kuchotsa pakati kungakhale bwanji kowopsa kwa mayi yemwe ali ndi matenda ashuga? Pambuyo pa njirayi, wodwalayo atha kukhala ndi zovuta zofanananso ndi amayi athanzi. Izi zimaphatikizapo chiwopsezo chowonjezeka cha matenda ndi mahomoni.

Popewa kutenga pakati, odwala matenda ashuga amagwiritsa ntchito intrauterine chipangizo (chokhala ndi antennae, okhala ndi antiseptics, ozungulira), komabe, amathandizira pakufalikira. Mapiritsi othandizira kubereka omwe samakhudza kagayidwe kazakudya amathanso kugwiritsidwa ntchito. Koma mankhwalawa ali ophatikizidwa mu matenda a mtima.

Amayi omwe ali ndi mbiri yodwala matenda ashuga amasonyezedwa mankhwala okhala ndi Progestin. Koma njira yodalirika komanso yotetezeka kwambiri yoletsera kutenga pakati ndi kupopera njira yolera. Komabe, njira yotetezayi imagwiritsidwa ntchito kokha ndi amayi omwe ali ndi ana kale.

Koma nanga bwanji azimayi omwe ali ndi matenda ashuga omwe amafunadi kupilira ndi kubereka mwana wathanzi?

Ndikofunikira kukonzekera mwatsatanetsatane chochitika chotere, ndipo, ngati pakufunika, njira zochiritsira zosiyanasiyana zitha kuchitika.

Spiridonova Nadezhda Viktorovna

Wazamisala. Katswiri kuchokera pamalowa b17.ru

Inde, ndikadatero.
matenda ashuga silingafanane ndi kusowa kwa mwana!

Ngati muli ndi mantha otere, ndiye sichingakhale chanzeru kuganiza za kulera?

ukhoza kubereka, shuga imatha kuwongoleredwa

Ndikudziwa mayi yemwe adabereka ana awiri athanzi ngakhale kuti ali ndi matenda ashuga komanso madokotala akumunyengerera kuti achotse mimbayo

Ngati chiwopsezo cha matenda a shuga, ndiye kuti chiberekanso. Adaphunzira pamsika ndi msungwana, amayi ake adamuwuza kuti madotolo adamupeza (msungwanayo) ali ndi vuto la mtima, komanso adati mwana akabadwa a moron ndikumwalira mchaka choyamba cha moyo wake, iwo adapereka, ndikumulimbikitsa kuti achotse mimbayo. Amayi sanachite izi, panali vuto la mtima, koma adamuchita opareshoni. Pamenepo mukupita! Anamaliza maphunziro ake pa Inst. ndi ulemu! Pamenepo mukupita.

Makanda abwinobwino amabereka ndi matenda ashuga. Zipatala zapadera za amayi ndi akatswiri ndizabwino. Funso lina ndikuti dokotala wotere amayenera kuyang'ana zabwino mu magawo oyambirirawo, kotero kuti chithandizo chamankhwala chimayikidwa, etc. Zotheka kuti mayeso ena amafunika kulipidwa, kapena mwina dokotala. Inde ndikofunikira kulunzanitsa. Ngati ukalamba umalola. Kenako dyetsani mwana wamkulu moyenera kuti cholowa sichingawononge.

Ndili ndi funso lotere. Osatinso gawo la zamankhwala kapena psychology. Ndikungofuna ndidziwe malingaliro anu)) Mukadakhala ndi matenda ashuga (odalira insulin), kodi mungachotsere mimba chifukwa choopa kuti mwina mwana abadwenso kapena akhale ndi matenda ashuga mwana? Kapena ndizinena mwanjira ina: kodi zingabereke mwana ngati zingadziwe kuti pali mwayi uliwonse kuti akadwala?

Ndikudziwa mayi yemwe adabereka ana awiri athanzi ngakhale kuti ali ndi matenda ashuga komanso madokotala akumunyengerera kuti achotse mimbayo

Mlendo 8. Makolo sangakhale ndi mavuto, ndipo ana akudwala. pali madotolo amtundu wa genetic omwe amatchedwa kuti amadziwa bwino. Banja lililonse limakhala ndi matenda oopsa ndipo mwayi wa matenda kwa onse obadwa m'mabanjawo ndiwokwera kwambiri. Pali anthu omwe ali ndi matenda amtima, komanso mwa ana amathanso kukhala. Pano, ena alibe odwala khansa m'banja, kenako amawonekera. Chomaliza sichikudziwika.

Ndili ndi matenda obadwa nawo m'banja la mtima. Ndikudziwa zomwe ziperekedwe. Sitikhala ndi moyo kwamuyaya. Ndipo ngati simumwa kapena kusuta, ndiye chiyembekezo chamoyo, monga wina aliyense. Ngati mumamwa ndikusuta ndipo onse amadya, ndiye mpaka 55.

Sindingabadwe .. momwe ndingakhalire pambuyo pake ndimaganiza kuti ndawonongeratu moyo wa mwana wanga.

Kuchotsa mimba komwe kumachitika chifukwa cha matenda ashuga aimpso kulephera, matenda a shuga siwo cholepheretsa popanda zovuta

Dotolo adalangiza kuti musadzisankhire nokha

1. Matenda a shuga alibe cholowa.
2. Kubala kapena ayi ndi funso kwa dotolo .. Zimatengera gawo la matenda ashuga.

Amayi 10% a mwayi wofalitsa mtundu I wa matenda ashuga omwe odwala matenda ashuga amati nawonso ali athanzi kwathunthu. Amuna anga ndi ine tili ndi thanzi labwino ndipo m'mbuyomu tikuyembekezeka kuti kunalibe anthu odwala matenda ashuga, ndipo mwana wanga wamwamuna adazindikira matenda ashuga mu 14. Mtundu umodzi tsopano ndi matenda ashuga ndi matenda a virus. Osamaganiza.
Vutoli ndilofunika kwambiri kwa ine ngati mwana wanga wamwamuna ndi wamkazi akufuna kukhala ndi ana.

Mwina sindingachotse mimbayo. Akadakhala wotetezedwa mosamala, koma popeza Mulungu adapereka, akanabereka.

Ndili ndi matenda ashuga, komabe, osadalira insulini. The gynecologist adalimbikira kuchotsa pamimba - adatumizidwa. adasintha adotolo ngati gawo la LCD yanga, yokhumudwitsidwa ndi manejala, adabereka SAMA!
tsopano mwana wake wamwamuna ali ndi zaka 5. Mnyamata wathanzi, ttt. koma chachiwiri, mwina, sitingathe kuchita - kale thanzi langa silabwino

Ndikuchotsa mimbayo. Kulibwino mudzisamalire.

Dotolo adalangiza kuti musadzisankhire nokha

Ngati mukufuna ana, aberekeni. Ndi matenda a shuga, mutha kukhala ndi moyo mpaka zaka zana, izi siziri matenda ambiri monga moyo. Masewera ndi zakudya zopatsa thanzi, ngakhale mutakhala ndi matenda ashuga.

Mukadakhala ndi matenda a shuga (odalira insulin), kodi mukanachotsa mimba chifukwa choopa kuti mwina mwana angabadwe kapena kukhala ndi matenda ashuga mwana? Kapena ndizinena mwanjira ina: kodi zingabereke mwana ngati zingadziwe kuti pali mwayi uliwonse kuti akadwala?

Ndi matenda a shuga, mutha kukhala ndi moyo mpaka zaka zana

Matenda a shuga ndi pakati zimagwirizana kwathunthu ndipo inde, ndikadabereka. Chifukwa odwala matenda ashuga ndi anthu omwewo! Inenso ndili ndi matenda ashuga komanso anzanga ambiri omwe adabereka matenda ashuga. Amayi ndi abambo omwe ali ndi matenda ashuga omwe kale ali ndi ana akulu popanda iwo! Kuthekera kwa kufala kwa ana kuchokera kwa mayi ndi 2% ya 5% ya abambo.
Ndipo omwe amalemba pano kuti ndi zamanyazi ndi machimo kwa azimayi omwe apha ana, INU MUYENSE ANTHU OKHALA nawo pankhaniyi!
M'malo mwake, ndikadaletsa kubereka zidakwa ndi aulesi, pomwe ana 5 opanda nyumba amakula ngati zigawenga ndipo amathamangira okha osafunikira!

Woyang'anira, ndikuwonetsetsa kuti malembawo ali:

Pulogalamu: Psychology

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Kukonzekera Kwa Mimba

Choyamba, ndikofunikira kudziwa kuti mayi yemwe ali ndi vuto la kagayidwe kazakudya amalimbikitsidwa kutenga pakati ali ndi zaka 20-25. Ngati ali wamkulu, ndiye kuti izi zimawonjezera chiopsezo cha zovuta.

Si anthu ambiri omwe amadziwa, koma kusokonezeka (anocephaly, microcephaly, matenda a mtima) a chitukuko cha fetal amawaika pachiwopsezo cha mimba (mpaka masabata 7). Ndipo odwala omwe ali ndi matenda osokoneza bongo nthawi zambiri amakhala ndi vuto losunga mazira, kotero sangathe kudziwa nthawi zonse ngati kusamba kwa msambo ndi matenda kapena mimba.

Pakadali pano, mwana wosabadwayo yemwe wayamba kale kukula amatha kuvutika. Pofuna kupewa izi, matenda ashuga ayenera kuwongoledwa, zomwe zingateteze kuwoneka kolakwika.

Chifukwa chake, ngati mulingo wa hemoglobin wa glycated ndi woposa 10%, ndiye kuti kuthekera kwa mawonekedwe a pathologies owopsa mwa mwana ndi 25%. Kuti mwana akhanda kukula bwino komanso zizindikilo siziyenera kupitirira 6%.

Chifukwa chake, ndi matenda a shuga, ndikofunikira kwambiri kukonzekera kutenga pakati. Kuphatikiza apo, lero mutha kudziwa kuti mayi ali ndi chibadwa chotani pakukanika mtima. Izi zikuthandizani kuti mufananitse kuopsa kwa matenda ashuga komanso othanzi.

Komanso, mothandizidwa ndi mayeso amtundu, mutha kuwunika kuopsa kwa matenda osokoneza bongo kwa mwana. Komabe, mulimonsemo, mimba iyenera kukonzedwa, chifukwa iyi ndi njira yokhayo yopewera kukula kwa zovuta zowopsa.

Kuti izi zitheke, osachepera miyezi iwiri isanakwane, shuga iyenera kulipidwa ndi kuchuluka kwa hemoglobin yokhala ndi matenda enaake. Potere, mkazi ayenera kudziwa kuti panthawi yoyembekezera, shuga othamanga ayenera kukhala kuchokera 3.3 mpaka 6.7.

Kuphatikiza apo, mzimayi ayenera kupezeka kuti ali ndi matendawa kwathunthu. Ngati mukufufuza matenda osachiritsika kapena matenda atapezeka, ndikofunikira kuchita chithandizo chawo chonse. Mimba itadwala matenda ashuga koyambirira, mkazi amafunika kuchipatala, zomwe zingachititse kuti madokotala aziwonetsetsa kuti ali ndi thanzi labwino.

Mimba mu odwala matenda ashuga nthawi zambiri amakhala ndi njira yonga mafunde. Mu trimester yoyamba, kuchuluka kwa glycemia ndi kufunika kwa insulin kumachepetsedwa, zomwe zimapangitsa mwayi wa hypoglycemia. Izi zimachitika chifukwa cha kusintha kwa ma horoni, zomwe zimapangitsa kuti mpweya wabwino uchulukane.

Komabe, mu 2nd ndi 3 trimester ya mimba, zonse zimasintha kwambiri. Khanda limakulidwa ndi placenta, yomwe ili ndi zofunikira. Chifukwa chake, pakatha milungu 24 mpaka 26, njira ya matenda ashuga imatha kukula kwambiri. Munthawi imeneyi, kuchuluka kwa shuga kumawonjezeka komanso kufunikira kwa insulin, komanso acetone, kumapezeka m'magazi. Nthawi zambiri pamakhala kupumula koyipa mu shuga.

M'mwezi wachitatu wa pakati, placenta imayamba kukalamba, chifukwa chake zomwe zimapangitsa kuti insulin iwonongeke komanso kufunika kwa insulin kumacheperanso. Koma kumayambiriro kwa matenda ashuga odwala matenda ashuga, siwosiyana ndi nthawi zonse, ngakhale kuti matenda osachiritsika omwe amakhala ndi matenda oopsa a hyperglycemia amapezeka pafupipafupi.

Ndipo chachiwiri ndi chachitatu trimesters samakonda kuyenda ndi zovuta zambiri. Vutoli limatchedwa mochedwa gestosis, pomwe kumatupa kumatuluka ndipo kuthamanga kwa magazi kumakwera. Mu zochita za obstetric, matenda amapezeka mu 50-80% ya milandu.

Koma pamaso pa mavuto a mtima, gestosis imatha kupezeka pamasabata 18-20. Ichi ndi chizindikiro cha kuchotsa mimba. Komanso, mayi amatha kukhala ndi hypoxia ndi polyhydramnios.

Nthawi zambiri, odwala matenda ashuga omwe amabereka mwana amadwala matenda amkodzo thirakiti. Kufooka m'thupi komanso matenda ashuga osawerengeka amalimbikitsa izi.

Kuphatikiza apo, motsutsana ndi maziko a kuchuluka kwa shuga, kusagwira bwino ntchito kwa kufalikira kwa chiberekero kumachitika, ndipo mwana wosabadwayo alibe michere ndi mpweya.

Ndi mavuto ati omwe amabwera pakubereka?

Chovuta chovuta kwambiri pakubala mwana ndicho kufooka pantchito. Anthu odwala matenda ashuga ali ndi malo ochepa osungira, kutengera njira ya anabolic.

Nthawi yomweyo, kuchuluka kwa shuga m'magazi kumatsika, chifukwa shuga wambiri amamwetsa pantchito. Chifukwa chake, azimayi amapatsidwa dontho omwe amakhala ndi insulin, glucose ndi glycemia zizindikiro amayeza ola lililonse. Zochitika zofananazi zimachitika pochita opaleshoni, chifukwa mu 60-80% ya milandu, odwala matenda ashuga amapatsidwa gawo la cesarean, popeza ambiri a iwo amakhala ndi zovuta zam'mitsempha.

Koma ngakhale azimayi omwe ali ndi matenda ashuga nthawi zambiri amakhala obadwa ndi matenda ashuga, nthawi zambiri amadzabereka. Komabe, izi ndizotheka ndi kukonzekera pakati pathupi ndikulipirira matenda oyambitsidwa, omwe amapewa kufa kwa pakati.

Zowonadi, poyerekeza ndi ma 80s, pamene zotsatira zakupha sizinali zachilendo, lero njira yokhala ndi matenda ashuga imayang'aniridwa mosamala. Popeza tsopano mitundu yatsopano ya insulin, cholembera chimbale chimagwiritsidwa ntchito ndipo mitundu yonse ya njira zochiritsira imachitika yomwe imakupatsani mwayi wobala mwana popanda kubereka komanso panthawi. Kanemayo munkhaniyi akuwuzani zoyenera kuchita ndi matenda ashuga.

Lemberani mankhwala a shuga atatu

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Vuto lomwe kuchuluka kwa kuthamanga kwa magazi kumapitilira malire ovomerezeka amatchedwa matenda oopsa. Monga lamulo, tikulankhula za 140 mm RT. Art. kupanikizika kwa systolic ndi 90 mm RT. Art. diastolic. Hypertension ndi matenda a shuga ndi njira zomwe zimatha kukhala limodzi, kulimbikitsa zovuta zoyipa.

Kuwonjezeka kwa kuthamanga kwa magazi motsutsana ndi nthenda ya "matenda okoma", chiopsezo chotenga matenda amtima, kulephera kwa impso, khungu ndi vuto la m'munsi kwambiri zimawonjezeka kasanu. Ndikofunikira kuti manambala azikhala ovomerezeka. Kuti izi zitheke, madokotala amalimbikitsa kudya komanso kupereka mankhwala. Ndi mapiritsi opanikizika omwe amalembedwa pa matenda a shuga a 2, ndizomwe zimagwiritsidwa ntchito, zomwe zimawerengedwa m'nkhaniyi.

Chifukwa chiyani kuthamanga kwa magazi kumabuka ndi matenda ashuga?

Mitundu yosiyanasiyana ya "matenda okoma" ili ndi njira zosiyanasiyana zopangira matenda oopsa. Mtundu wodalira insulini umaphatikizidwa ndi kuchuluka kwa kuthamanga kwa magazi motsutsana ndi zotupa za impso. Mtundu wosadalira insulini umawonetsedwa makamaka ndi matenda oopsa, ngakhale zisanafike zizindikiro zazikulu za matenda akulu, popeza kuthamangitsidwa kwakukulu ndi gawo limodzi la zomwe zimadziwika kuti metabolic syndrome.

Matenda osiyanasiyana a matenda oopsa opezeka kumbuyo kwa mtundu wachiwiri wa matenda ashuga:

mawonekedwe oyamba - amapezeka wodwala aliyense,
mawonekedwe apadera a systolic - amakula mwa odwala okalamba, amadziwika ndi kuchuluka wamba komanso kuchuluka kwapamwamba (40% ya odwala),
matenda oopsa aimpso - 13-18% yamilandu yamankhwala,
kuthamanga kwa magazi mu adrenal gland pathology (chotupa, Itsenko-Cushing's syndrome) - 2%.

Mtundu wa shuga wosadalira insulini umadziwika ndi kukana insulini, ndiye kuti, kapamba amatulutsa kuchuluka kokwanira ka insulini (chinthu chogwira ntchito m'madzi), koma maselo ndi minyewa yomwe imadziwika ndi thupi lake. Njira zopangira zamagetsi zimapangidwira kuphatikiza mahomoni aphatikizidwe, omwe mwa iwowo amawonjezera kukakamiza.

Izi zimachitika motere:

pali kukhazikitsidwa kwa dipatimenti yomvera chisoni National Assembly,
kuchuluka kwa madzi amchere ndi mchere kudzera m'magazi aimpso kumayipa,
Mchere wamchere ndi michere ya calcium
hyperinsulinism kumakwiyitsa zimachitika zovuta za elasticity mitsempha.

Ndi kukula kwa matenda oyamba, zotumphukira ndi ziwalo zamatumbo zimavutika. Mapilogalamu amayikidwa mkati mwake, zomwe zimayambitsa kuchepetsedwa kwa minyewa yam'mimba komanso kukula kwa atherosclerosis. Ichi ndi cholumikizira china pamakina oyambira matenda oopsa.

Kuphatikiza apo, thupi la wodwalayo limakulirakulira, makamaka zikafika pamafuta omwe amayikidwa kuzungulira ziwalo zamkati. Lipids zoterezi zimatulutsa zinthu zingapo zomwe zimapangitsa kuti magazi azitha.

Kodi ndi anthu angati omwe amafunikira kuchepetsa kukakamizidwa?

Anthu odwala matenda ashuga - odwala omwe ali pachiwopsezo chotenga ma pathologies ochokera mu minofu ya mtima ndi mitsempha yamagazi. Ngati odwala alabadira bwino mankhwalawa, m'masiku 30 oyambirira a mankhwala, ndikofunikira kuchepetsa kuthamanga kwa magazi mpaka 140/90 mm RT. Art. Chotsatira, muyenera kuyesetsa kuwerengetsa masentimita a 130 mm Hg. Art. ndi diastolic - 80 mm RT. Art.

Ngati wodwala amavutika kulolera mankhwala, mankhwalawa amayenera kuyimitsidwa pang'onopang'ono, kutsitsa ndi 10% kuchokera pamasiku oyambira m'masiku 30. Ndi kusinthasintha, regimen ya mlingo amawunikiranso, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa.

Momwe mungakonzekerere kutenga pakati komanso kubereka

Mimba iyenera kukonzedwa. Pokhapokha ngati izi zitha kupewedwa pamavuto osiyanasiyana. Kukonzekera nthawi zambiri kumamveka pokhapokha ngati kugwiritsa ntchito njira zakulera - izi sizolakwika.

Choyamba, ichi ndi chindapusa cha matenda ashuga miyezi ingapo isanachitike, hemoglobin wabwinobwino. Amayi onse oyembekezera akuyenera kuphunzitsidwa, koma osangolangizidwa, koma dziwani zonse zomwe zimafunikira kuti mukhale ndi pakati. Mwachitsanzo, m'moyo wabwinobwino wodwala, shuga ayenera kukhala mpaka 5 pamimba yopanda kanthu mpaka 8 mutatha kudya. Ndipo kwa amayi oyembekezera, ndikofunikira kuyambira 3.3-4.4 mpaka 6.7.

Ndikofunikira kuyambitsa matenda athunthu, ndiye kuti, kuzindikira ndi kuchiza matenda onse omwe angayambitse matenda a urogenital omwe amapezeka nthawi zambiri odwala matenda ashuga. Pozindikira pathogen, mwachitsanzo, pyelonephritis, muyenera kuchiritsa matenda asanafike pathupi. Unikani ndalama ndi, ngati nchofunikira, chithandizo cha laser. Ndipo pokhapokha pamayankho awa ndi pamene mimba imachitika. Ndipo zikatha, poyambira mkazi amafunika kugonekedwa kuchipatala ndikumaganizirabe ngati ali ndi pakati, popeza pali azimayi omwe ali ndi matenda ashuga, omwe amatsutsana nawo. Awa ndi odwala matenda a shuga a nephropathy, omwe sanachiritsidwe ndi prinifosic retinopathy, omwe ali ndi chifuwa chachikulu. Amayi omwe amuna awo nawonso amadwala matenda ashuga. Ngati zovuta zam'mitsempha zimakhala zazing'ono, mwachitsanzo, pali microalbuminuria, ndiye kuti kubereka kungathetsedwe. Koma ngati, ngakhale asanakhale ndi pakati, wodwala amakhala ndi mapuloteni, edema, matenda oopsa, ndiye kuti pakati amapezeka ndi iye.

Kodi azimayi omwe ali ndi matenda ashuga a 2 amabereka

Ndi ochepa, koma nawonso ali. Mimba zamtunduwu zimachitika pa insulin, ngati adamwa mapiritsi asanachitike. Mimba ndizotheka ndi mitundu yonse ya matenda ashuga.

Matenda a gestational amapezeka nthawi yomwe mayi ali ndi pakati ndipo amasowa pambuyo pake. Kwenikweni, amakula m'chigawo chachiwiri cha nthawi, chifukwa kapamba sangathe kuthana ndi katundu. Amayi awa amatenga maphunziro, amakhalanso amalowetsa insulin, komanso amakhala ndi chiopsezo chokhala ndi fetopathy.

Ndani ali pachiwopsezo cha matenda ashuga?

Awa ndi azimayi omwe ali ndi cholowa cholemedwa, azimayi omwe ali ndi mbiri yokhala ndi ana akulu wolemera kuposa 4.5 kg, azimayi omwe ali ndi mbiri yoletsa kukonzekera, ndiye kuti, kubereka kwakubadwa kwa etiology yodziwika, kubereka kwapakatikati, polyhydramnios. Pamasabata 24-26, ayenera kuyang'ana shuga.

Kodi pali kusiyana kotani pakati pa dongosolo la mayi yemwe ali ndi matenda ashuga panthawi ya pakati

Pakadali pano, kupatsa thanzi kuyenera kukhala kosakwanira kwa mkazi yekha, komanso kwa mwana. Kuchuluka kwa chakudya kokwanira kumayenera kukhala magawo 12 a chakudya ndi 2000 kcal, 400 omwe akupita kukakulidwe kwa mwana. Kuphatikiza apo, malinga ndi mwezi uliwonse wa pakati, ayenera kulandira mavitamini ena. Zakudya za calcium zambiri ndizofunikira, vitamini E wokhala ndi antioxidant ndi zolinga zamafuta. Ngati mayi yemwe ali ndi vuto la matenda ashuga akaperewera, ayenera kukhala ndi acetone. Muyenera kusungitsa cholembedwa cha kudziletsa, komwe tsiku lililonse mumazindikira ndi "shuga", ndi XE, ndi Mlingo wa insulin.

Momwe ma shuga amasinthira miyezi 9

Matenda a shuga mwa amayi apakati ndi osakhazikika. M'miyezi yoyamba, kufunika kwa insulin kumachepa, chifukwa kuchuluka kwa glycemia kumawonjezera chiopsezo cha hypoglycemia. Izi zikufotokozedwa ndikuwongolera kwa njira zambiri zamahomoni komanso kuti kumwa kwa glucose pachipumi kumayenda bwino. Mu theka lachiwiri la kubereka, zosiyana ndizowona: placenta imayamba, ndipo imakhala ndi zinthu zambiri zotsutsana. Chifukwa chake, nthawi ya matenda ashuga imakulirakulira, makamaka munthawi ya milungu 24 mpaka 26. Pakadali pano, misempha ya shuga imakwera, kufunikira kwa insulin, ndipo acetone nthawi zambiri kumawonekera.

Pofika nthawi yachitatu ya mimba, placenta imayamba kukalamba, zovuta zomwe zimapangitsa kuti insulin izitha, ndikufunika kwa insulin kumacheperanso. Mimba ya azimayi omwe ali ndi matenda ashuga m'magawo oyambira sizosiyana kwambiri ndi masiku onse.

Koma kukhala ndi pakati kumangosokonezedwa nthawi zambiri kumachitika pafupipafupi, ngakhale mkazi atalandilidwa bwino: komabe, kufalikira kwa "shuga" mwa iye kumadutsa kuposa momwe zimakhalira.
Chosasangalatsa kwambiri ndi theka lachiwiri la kutenga pakati, zovuta zingapo zikamagwirizana. Uku ndi kuchedwa gestosis, kukakamiza kukukwera, edema imawoneka. Iyi ndiye njira yofala kwambiri yolepheretsa (kuyambira 50 mpaka 80% ya milandu). Kumayambiriro kwambiri, nthawi zina kuyambira masabata 18-20, gestosis imayamba mwa azimayi omwe ali ndi vuto la mtima wamatenda a shuga. Ndipo nthawi zambiri ichi chimakhala chisonyezo chakuchotsa mimba. Mavuto ena ndi polyhydramnios ndi fetal hypoxia. Nthawi zambiri matenda a kwamikodzo amayamba, matenda a urogenital amayamba kuchuluka.

Chifukwa chiyani izi zikuchitika?

Zachidziwikire, izi zimachitika chifukwa chobwezeretsedwa bwino kwa matenda ashuga komanso kuchepa kwa chitetezo chathupi. Ngati wodwalayo amalipidwa, ndipo ngakhale asanakhale ndi pakati, pamenepo, zovuta izi zimayamba kuchepa. Ndi shuga wambiri, kufalikira kwa utero-placental kumasokonezeka, mpweya ndi michere siziperekedwa kwa mwana wakhanda. Zachidziwikire, vutoli ndi lalikulu, zonse sizingadziwike ndi shuga wokha. Komabe, ichi ndiye chinthu chachikulu.

Kugwiritsa ntchito mankhwala osokoneza bongo

Kusankhidwa kwa mankhwala ochiritsira kumachitika ndi katswiri woyenera yemwe akufotokozera mfundo izi:

mulingo wa glycemia wodwala,
Zizindikiro zamagazi
Mankhwala omwe amagwiritsidwa ntchito kuti apeze chipukuta matenda omwe amayambira,
kukhalapo kwa zovuta za impso, owerengera,
matenda ophatikizika.

Mankhwala othandiza kupanikizika mu matenda ashuga ayenera kuchepetsa ziwonetsero kuti thupi la wodwalayo liyankhe popanda kukulitsa zovuta ndi zovuta. Kuphatikiza apo, mankhwalawa amayenera kuphatikizidwa ndi othandizira a hypoglycemic, osakhala ndi vuto lililonse pamatenda a lipid metabolism. Mankhwala ayenera "kuteteza" aimpso zida ndi minofu ya mtima ku mavuto obwera chifukwa cha matenda oopsa.

Mankhwala amakono amagwiritsa ntchito magulu angapo a mankhwala:

okodzetsa
ARB-II,
ACE zoletsa
BKK,
β-blockers.

Mankhwala owonjezera amatengedwa ngati α-blockers ndi Rasilez.

Kodi zovuta za kubereka ndi ziti?

Chimodzi mwazinthu zovuta kwambiri pakubadwa kwanu ndi kufooka kwa mphamvu yakubala. Amayi omwe ali ndi matenda ashuga ali ndi malo ocheperako mphamvu. Sizitengera minofu, koma njira za anabolic. Mwazi wa magazi nthawi zambiri umatsika chifukwa contractions imafuna kutengeka kwa glucose. Nthawi zonse amakhala ndi dontho - shuga ndi insulin. Shuga amawongoleredwa ola limodzi. Zomwezi zimachitikanso pakuchita opareshoni.

Zomwe zimagwiritsidwa ntchito nthawi zambiri, gawo la cesarean kapena kubadwa kwachilengedwe

Nthawi zambiri (kuchokera pa 60 mpaka 80%) - kuchititsa kantchito. Kupatula apo, monga lamulo, azimayi amabwera kale ndi zovuta zamagazi. Matenda a shuga a ana amayambira kuubwana, ndipo pofika nthawi ya pakati zimachitika kale ndi nthawi ya zaka 10-15 mpaka 20. Pali zotsutsana zambiri zokhudzana ndi kubadwa kwa anthu ashuga.

Koma chaka chilichonse amayamba kubereka, makamaka iwo amene akukonzekera kukhala ndi pakati ndikulipira matenda ashuga. M'mbuyomu, madokotala asanayambe kulipirira zabwino za matenda ashuga, panali imfa yayikulu kwambiri. Shuga sanatengeredwe kawirikawiri - mbiri kawiri pa sabata. Zowona kuti kubwezeredwa kwa shuga sikunali bwino sikunalole kuthetsere kubereka mpaka nthawiyo, ndipo azimayi "adapulumutsidwa" milungu 36, ndipo nthawi zina m'mbuyomu. Ana amabadwa ali akhanda ndipo amatha kufa pambuyo pobadwa. Kufa kwa Perinatal mu 80s kunali 10%. Masiku ano, pali ma glucometer abwino kwambiri am'magazi, ma insulin abwino, ndi zolembera za syringe. Tsopano amabereka munthawi yake, pa masabata 38 mpaka 40, kulibe ana omwe ali ndi vuto lochotsa nkhawa kwambiri.

Kodi ana obadwa kwa amayi omwe ali ndi matenda ashuga amakula bwanji?

Mwanjira, ana si osiyana ndi aliyense. Koma kutha msinkhu, ali pachiwopsezo chachikulu chotenga kunenepa kwambiri. Ndipo anawo ali pachiwopsezo cha matenda ashuga. Malinga ndi kafukufuku wakunja, ngozi iyi ndi 4%. Kukula kwa matenda ashuga mu ana amakhudzidwa osati kokha ndi majini omwe analandila kwa makolo, komanso ndi zovuta za shuga zomwe zimaperekedwa panthawi yomwe ali ndi pakati, zomwe zimawononga zida zapakhanda za mwana. Ana onsewa amawonedwa mu Endocrinology Dispensary.

Kodi owopsa yemwe ali ndi matenda ashuga angachotse mimba?

Mimba imakhala yodzaza ndi zovuta zomwe zimachitika kwa mayi aliyense: kulephera kwa mahomoni, chiopsezo chotenga kachilomboka, koma wachepetsa chitetezo cha mthupi, choncho kumakhala kowopsa kwambiri kwa iye. Akatswiri otsogola m'munda uno amakhulupirira kuti tsopano pali mwayi uliwonse wopewa kutenga pakati komanso kuchotsa mimba.

Zipangizo zapadera za intrauterine zimapangidwira odwala matenda ashuga - ozungulira, okhala ndi antiseptics, opanda antennae (omwe ndi omwe akuwongolera matenda). Mutha kugwiritsa ntchito mapiritsi oletsa kubereka osasokoneza kagayidwe kazachilengedwe. Sangagwiritsidwe ntchito kokha kwa azimayi omwe ali ndi vuto la mtima. Pali njira zakulera za amayi omwe ali ndi mbiri yokhala ndi matenda a shuga a geostationary, omwe ali ndi progestin yokha. Ena amathanso kuwonongeka ngati ali kale ndi ana.

ACE zoletsa

Ndalamazi zimaperekedwa koyamba. Zinthu zomwe zimagwira gululi zimalepheretsa kupanga enzyme yomwe imalimbikitsa kapangidwe ka angiotensin-II. Zinthu zomaliza zimakwiyitsa kuchepa kwa ma arterioles ndi ma capillaries ndipo zimapereka chidziwitso ku gren ya adrenal kuti ndikofunikira kusunga madzi ndi mchere m'thupi. Zotsatira zamankhwala ndizotsatirazi: Madzi ndi mchere wambiri zimachotsedwa, mitsempha yamagazi imakulitsidwa, ziwopsezo zimachepa.

Chifukwa chiyani madokotala amalimbikitsa gululi kwa odwala:

Mankhwala amateteza impso ku mavuto obwera chifukwa cha matenda oopsa,
pewani kupitilira kuwonongeka kwa zida za impso ngakhale pang'ono mapuloteni mumkodzo awonekera kale,
Kuthamanga kwa magazi sikugwera pansi,
mankhwala ena amateteza minofu ya mtima ndi ziwiya zam'mimba,
Mankhwala kukhathamiritsa mphamvu ya maselo ndi zimakhala kuti zochita insulin.

Kuchiza ndi zoletsa za ACE kumafuna kuti wodwalayo akane mchere kwathunthu m'zakudya. Onetsetsani kuti mukuwunika ma elekitirodi a magazi m'magazi (potaziyamu, makamaka).

Mndandanda wa oimira gululi:

Enalapril
Captopril
Lisinopril
Fosinopril
Spirapril et al.

Mwina kugwiritsidwa ntchito kovuta kwa ACE inhibitors ndi oimira mankhwala a diuretic. Izi zimapereka kuchepa kwamphamvu kwa kuthamanga kwa magazi, chifukwa chake, zimaloledwa kwa okhawo omwe amalabadira kulandira chithandizo.

Ngati pakufunika kugwiritsa ntchito gululi, muyenera kusankha oyimilira omwe ali ndi zotsatira zabwino kwambiri. Sikoyenera "kuchita nawo" zodzikongoletsa, popeza amachotsa kwambiri ma ayoni m'thupi, amatha kusunga calcium, ndikuwonjezera kuchuluka kwa cholesterol m'magazi.

Ma diuretics amatengedwa ngati mankhwala omwe amaletsa chiwonetsero cha matenda oopsa, koma osachotsa chomwe chimayambitsa. Pali magulu angapo am'magazi a diuretic mankhwala. Madokotala amalemekeza kwambiri thiazides - amatha kuchepetsa chiopsezo cha kuwonongeka kwa minofu ya mtima chifukwa cha kuthamanga kwa magazi ndi kotala. Ndi gulu ili lomwe limagwiritsidwa ntchito pochiza matenda oopsa motsutsana ndi mtundu wa matenda a shuga 2.

Mlingo wocheperako wa thiazides samakhudza mwayi wopeza chipukutira cha "matenda okoma", osasokoneza njira za lipid metabolism.Thiazides amatsutsana mu kulephera kwa impso. Amasinthidwa ndi loop diuretics, makamaka pamaso pa edema m'thupi la wodwalayo.

Β-blockers

Oimira gulu agawidwa m'magulu angapo. Ngati wodwala adalandira chithandizo cha β-blocker, amatha nthawi yayitali kuti amvetsetse gulu lawo. β-blockers ndi mankhwala omwe amakhudza β-adrenergic receptors. Zotsirizirazi ndi za mitundu iwiri:

β1 - ili mu minofu ya mtima, impso,
β2 - yotchulidwa mu bronchi, pa hepatocytes.

Oimira osankhidwa a β-blockers amachita mwachindunji pa β1-adrenergic receptors, osati osankha pamagulu onse a receptors a cell. Magulu onse awiriwa ndi othandizanso polimbana ndi kuthamanga kwa magazi, koma mankhwala osankhidwa amadziwika ndi zotsatira zoyipa kuchokera m'thupi la wodwalayo. Amalimbikitsidwa odwala matenda ashuga.

Mankhwala a gulu amagwiritsidwa ntchito motere:

Matenda a mtima wa Ischemic,
kusowa kwa myocardial
pachimake pambuyo kugunda kwa mtima.

Ndi insulin-yodziyimira yokhayokha ya matenda a shuga, mitundu yotsatirayi yogwiritsidwa ntchito ngati mankhwala kukakamiza:

BKK (olimbana ndi calcium)

Mankhwala a gulu agawidwa m'magulu akulu awiri:

non-dihydropyridine BCC (Verapamil, Diltiazem),
dihydropyridine BCC (Amlodipine, Nifedipine).

Gulu lachiwiri limakulitsa lumen ya ziwiya popanda chilichonse pa ntchito ya minofu ya mtima. Gulu loyamba, m'malo mwake, limakhudza mgwirizano wa myocardium.

Gulu lopanda dihydropyridine limagwiritsidwa ntchito ngati njira yowonjezera yolimbana ndi matenda oopsa. Oyimira amachepetsa kuchuluka kwa mapuloteni ochulukitsa ndi albumin mu mkodzo, koma osakhala ndi chitetezo pamatumbo a impso. Komanso, mankhwalawa samakhudza kagayidwe ka shuga ndi lipids.

Gulu la dihydropyridine limaphatikizidwa ndi β-blockers ndi ACE inhibitors, koma silinafotokozedwe pamaso pa matenda amitsempha yama mtima mwa odwala matenda ashuga. Makulidwe othandizira a calcium omwe amagwiritsa ntchito magulu onse awiriwa amagwiritsidwa ntchito moyenera kuthana ndi systolic matenda oopsa mwa odwala okalamba. Mwanjira iyi, chiopsezo chokhala ndi stroko chimachepetsedwa kangapo.

Zotsatira zoyipa za mankhwalawa:

chizungulire
Kutupa kwa m'munsi,
cephalgia
kumva kutentha
kugunda kwa mtima
gingival hyperplasia (motsutsana ndi maziko azithandizo zamanthawi yayitali ndi Nifedipine, popeza amatengedwa pang'ono).

ARB-II (angiotensin receptor antagonists)

Wodwala aliyense wachisanu yemwe amathandizidwa ndi matenda oopsa a ACE amakhala ndi chifuwa monga mbali yake. Pankhaniyi, dokotala amasamutsa wodwalayo kuti alandire olimbana ndi angiotensin receptor antagonists. Gulu la mankhwalawa pafupifupi limagwirizana kwathunthu ndi mankhwala a ACE inhibitor. Ili ndi contraindication ofanana ndi mawonekedwe ogwiritsa ntchito.

Mankhwala ndi osokoneza inhibitor wa renin, ali ndi ntchito yotchulidwa. Chithandizo chogwira chimalepheretsa kusintha kwa angiotensin-I kukhala angiotensin-II. Kutsika kwamphamvu kwa kuthamanga kwa magazi kumatheka chifukwa chothandizidwa nthawi yayitali ndi mankhwalawa.

Mankhwalawa amagwiritsidwa ntchito kuphatikiza mankhwala, komanso mawonekedwe a monotherapy. Palibe chifukwa chosinthira kuchuluka kwa mankhwalawa kwa okalamba. Mphamvu ya antihypertensive komanso kuthamanga kwa nthawi yake sizimadalira kuti ndi wodwala kapena wamtundu wanji, kulemera kwake komanso zaka zake.

Rasilez sinafotokozeredwe nthawi yakubala ndi amayi omwe akukonzekera kubereka mwana posachedwa. Mimba ikachitika, mankhwalawa amayenera kusiyidwa nthawi yomweyo.

Zotsatira zoyipa:

kutsegula m'mimba
zotupa pakhungu,
kuchepa magazi
kuchuluka kwa potaziyamu m'magazi,
chifuwa chowuma.

Potengera maziko a kuchuluka kwa mankhwala, kutsika kwa magazi kumatheka, komwe kuyenera kubwezeretsedwanso ndi mankhwala akukonzanso.

Otsatsa-blockers

Pali mitundu itatu yayikulu yamagulu yomwe imagwiritsidwa ntchito pochiza matenda oopsa. Awa ndi Prazosin, Terazosin, Doxazosin. Mosiyana ndi mankhwala ena a antihypertensive, oimira ma cy-blockers amakhudza cholesterol yamagazi, osakhudza glycemia, kuchepetsa kuchuluka kwa magazi popanda kuchuluka kwakukulu kwa mtima.

Kuchiza ndi gulu la mankhwalawa kumayendera limodzi ndi kuchepa kwamphamvu kwa kuthamanga kwa magazi motsutsana ndi maziko a kusintha kwa thupi m'malo. Ngakhale kutayika kwa chikumbumtima. Nthawi zambiri, zotsatira zoyipa zoterezi zimadziwika kuti munthu woyamba kumwa mankhwalawo. A pathological mkhalidwe amapezeka mwa odwala omwe anakana kuphatikiza mchere m'zakudya ndikuphatikiza muyezo woyamba wa alpha-blockers ndi mankhwala a diuretic.

Kupewa matendawa kumaphatikizapo malingaliro otsatirawa:

akukana kutenga okodzetsa masiku angapo tsiku loyamba la kumwa,
Mlingo woyamba ukhale wocheperako,
Mankhwala oyambilira amathandizidwa asanagone usiku, wodwalayo atagona kale.

Kodi mungasankhe bwanji mapiritsi a vuto linalake lachipatala?

Akatswiri amakono amalimbikitsa kugwiritsa ntchito mankhwala angapo a magulu osiyanasiyana nthawi imodzi. Kufanana pamaulalo osiyanasiyana a kayendedwe ka matenda oopsa kumapangitsa kuti mankhwalawa azigwira bwino ntchito.

Kuphatikiza mankhwala kumakupatsani mwayi wogwiritsa ntchito mitundu yaying'ono ya mankhwala, ndipo mankhwala ambiri amaletsa mavuto. Malangizo a mankhwalawa amasankhidwa ndi adotolo poyerekeza ndi vuto la matenda a shuga (matenda a mtima, sitiroko, kulephera kwa impso, matenda amawonedwe).

Pokhala pachiwopsezo chochepa, monotherapy yotsika mtengo imavomerezeka. Ngati ndizosatheka kukwaniritsa kuthamanga kwa magazi, katswiriyo amapanga mankhwala ena, ndipo ngati sangathe, kuphatikiza kwa mankhwala angapo a magulu osiyanasiyana.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Chiwopsezo chachikulu cha kuwonongeka kwa mtima ndi mitsempha yamagazi chimafuna chithandizo choyambirira chophatikiza ndi mitundu iwiri ya mankhwala osachepera. Ngati chithandizo cha mankhwala sichilola kukwaniritsa zotsatira zabwino, dokotala atha kukuwuzani kuti muwonjezere mankhwala ena atatu muyezo wochepa kapena mupeze mankhwala omwewo, koma pa mlingo wokwanira. Pokhapokha kukwaniritsa kuchuluka kwa kutsata kwa magazi, njira yochiritsira yamankhwala atatu imayikidwa muyezo waukulu kwambiri.

Algorithm posankha mankhwala opatsirana oopsa pazotsatira za "matenda okoma" (m'magawo):

Kuchulukitsa kwakukulu kwa kuthamanga kwa magazi ndikusankhidwa kwa ACE inhibitor kapena ARB-II.
Kuthamanga kwa magazi ndiwokwera kuposa masiku onse, koma mapuloteni samapezeka mkodzo - kuwonjezera kwa BKK, okodzetsa.
Kuthamanga kwa magazi ndiwokwera kuposa masiku onse, mapuloteni ochepa amawonekera mumkodzo - kuwonjezera kwa BKK, thiazides.
CHIWONSE chachikulu pazophatikizira ndi kulephera kwa aimpso - kuphatikiza kwa gawo lotupa la diuretic, BKK.

Kumbukirani kuti katswiri amapaka mitundu yonse ya mankhwala pokhapokha atachitanso maphunziro onse othandizira odwala ndi othandizira. Mankhwala odzipatula sawachotsa, chifukwa zotsatira zakumwa mankhwala zimatha kubweretsa zotsatirapo zoopsa komanso ngakhale kufa. Zochitika za katswiri zidzakuthandizani kusankha njira yabwino kwambiri yoperekera chithandizo popanda kuwononga thanzi la wodwalayo.

Kodi ndingathe kuchotsa mimba chifukwa cha matenda ashuga?

Masiku ano, matenda ashuga mwa akazi ndi matenda wamba. Potere, mtundu wa matendawa ungakhale wosiyana: wodalira insulin, osadalira insulini, wothamanga. Koma mtundu uliwonse umayendera limodzi ndi chizindikiro chimodzi - shuga wambiri.

Monga mukudziwa, si matenda a shuga okha omwe ndi owopsa, koma zovuta zomwe zimachitika chifukwa cha kuperewera kwa kapamba. Kuphatikiza apo, m'zaka zaposachedwa, matenda ashuga amtundu wa 2 amakula akadali aang'ono, chifukwa chake, chiwerengero cha azimayi omwe akufuna kukhala ndi mwana chikuwonjezereka ngakhale kukhalapo kwa hyperglycemia.

Zachidziwikire, chifukwa cha matenda ashuga, kukhala ndi mwana sikophweka. Chifukwa chake, nthawi zambiri, madokotala amalimbikira kutaya mimba. Kuphatikiza apo, pali mwayi wokhala wolakwika pangozi.

Matenda a shuga ndi pakati

Zimakhala zovuta kubereka komanso kubereka mwana wathanzi pamaso pa matenda ena monga matenda a shuga. Zaka makumi asanu zokha zapitazo, amakhulupirira kuti shuga ndi kutenga pakati sizigwirizana. Komabe, masiku ano pali njira zambiri zopewera komanso kuchizira matendawa omwe amalola kuti amayi akhale ndi pakati komanso kubereka ana omwe amayembekezeredwa kwa nthawi yayitali. Komabe, izi zimafunikira amayi oyembekezera kuti azikhala ndi mphamvu zambiri, kutsimikiza ndi kuzindikira kuti azikhala ndi nthawi yayitali ya kubereka m'makoma a chipatala.

Mitundu ya matenda ashuga mwa amayi apakati

Pakadali pano, vuto la matenda ashuga mwa amayi apakati lili pakumayang'aniridwa ndi a neonatologists, obstetrician ndi endocrinologists. Izi ndichifukwa choti izi ndi zomwe zimapangitsa kuti pakhale zovuta zingapo zomwe zimakhudza thanzi la mayi ndi mwana. Akatswiri amasiyanitsa mitundu yotsatirayi ya matenda a shuga omwe angatsatire mimba:

Zachidule (zochepa).
Mwanjira imeneyi, zizindikiro zamatenda zodwala sizitha kuonekera, ndipo matendawa amapangidwa pokhapokha chifukwa cha zotsatira zoyesa zomwe zimawonetsa chidwi chapadera cha thupi ku glucose.
Zowopsa.
Uwu ndiye njira yoyambira ya shuga yomwe imatha kupezeka mwa amayi apakati omwe ali ndi chiyembekezo chodwala. Gululi limaphatikizapo amayi omwe ali ndi chibadwa "choyipa", onenepa kwambiri, glucosuria, komanso omwe ali ndi ana omwe ali ndi ana obadwa kale ndi thupi lolemera kuposa makilogalamu 4.5. Kuwoneka kwa glucosuria (glucose mumkodzo) mwa amayi oyembekezera akualumikizidwa, Nthawi zambiri ndimachepetsa chiwopsezo chaimpso. Akatswiri akukhulupirira kuti progesterone, yomwe imapangidwa mwachangu pa nthawi ya pakati, imachulukitsa kuchuluka kwa impso kwa glucose. Ndiye chifukwa chake, atapimidwa mozama, pafupifupi amayi 50% oyembekezera omwe ali ndi vuto la shuga amatha kudziwa glucosuria. Chifukwa chake, kuti vutoli liziyang'aniridwa nthawi zonse ndipo palibe chomwe chikuwopseza thanzi la mayi ndi mwana, azimayi onse omwe ali ndi matenda amtunduwu amayenera kuwayezera kuchuluka kwa shuga m'magazi (izi zimachitika pamimba yopanda kanthu). Ngati manambala apitilira 6.66 mmol / L, kuyesa kowonjezera kwa glucose ndikofunikira. Kuphatikiza apo, kuwopseza matenda a shuga panthawi yomwe ali ndi pakati kumayeneranso kuwunikira ma mbiri a glycosuric ndi glycemic.
Zofotokozedwa.
Matenda amtunduwu amapezeka m'magazi a glucosuria ndi hyperglycemia. Ndi mtundu wocheperako wa matenda ashuga, kuchuluka kwa shuga m'magazi ndi ochepera 6.66 mmol / L, ndipo mulibe matupi a ketone mumkodzo. Nthendayi ya kuperewera kwambiri imatanthawuza kuchuluka kwa shuga osachepera 12,21 mmol / L, ndipo matupi a ketone mumkodzo (ketosis) mwina sangachokere kapena amathetseka mosavuta potsatira kudya. Pa matenda akulu a shuga, shuga m'magazi akhoza kukhala apamwamba kuposa 12,21 mmol / L, ndipo ketosis nthawi zambiri imayamba. Kuphatikiza apo, zotupa zam'mimba zimadziwika kawirikawiri - nephropathy (kuwonongeka kwa impso), retinopathy (kuwonongeka kwa retina) ndi zina zosiyanasiyana angiopathies (trophic zilonda zam'miyendo, matenda a coronary myocardial matenda, ochepa matenda oopsa).

Matenda a shuga

Palinso mtundu wina wa matenda osokoneza bongo omwe amayenera kusamalidwa mwapadera. Matendawa amatchedwa “gestational” kapena osakhalitsa ndipo amayamba kuchuluka mwa azimayi athanzi (nthawi zambiri pambuyo pa milungu 20 ya mimba). Chofunikira chake ndikuti chimagwirizanitsidwa kwambiri ndi pakati: pambuyo pobadwa kwa mwana, zizindikiro zonse za matendawa zimazimiririka popanda kufufuza, koma kuyambiranso kumatheka ndi kubereka mobwerezabwereza.

Mpaka pano, zomwe zimayambitsa matenda a shuga gestational sizinakhazikitsidwebe. Njira yokhayo yothandizira matendawa ndi yomwe imadziwika. The placenta panthawi yoyembekezera imatulutsa mahomoni omwe amayambitsa chitukuko cha mwana wosabadwayo. Izi ndizabwinobwino, koma nthawi zina amayamba kuletsa insulin ya amayi. Zotsatira zake, maselo amthupi amataya chidwi chawo ndi insulin, ndikupangitsa kuchuluka kwa shuga m'magazi.

Matenda a Trazitorny akuwonetsedweratu:

Amayi azaka zopitilira makumi anayi (chiopsezo chotenga matenda amishuga okalamba amakwiranso kawiri kuposa amayi apakati azaka 30).
Amayi oyembekezera omwe ali ndi abale ake enieni omwe ali ndi matenda ashuga.
Oimira osati mtundu "woyera".
Amayi oyembekezera omwe amakhala ndi chindoko chachikulu mthupi (BMI) asadakhale ndi pakati, komanso omwe amapeza mapaundi owonjezera mokwanira muubwana komanso akudikirira mwana.
Kusuta azimayi.
Amayi omwe adabereka mwana wam'mbuyomu wolemera oposa 4.5 kg. kapena kukhala ndi mbiri yokhala ndi mwana wakufa pazifukwa zosadziwika.

Kodi mphamvu ya shuga ya azimayi pa mwana imakhala yotani?

Mwanayo akuvutika kwambiri chifukwa cha kusowa kapena kuchuluka kwa shuga mwa mayi. Ngati shuga atakwera, ndiye kuti glucose wambiri amalowa mwana wosabadwayo. Zotsatira zake, mwana amatha kukhala ndi vuto lobadwa nalo. Koma shuga wocheperako kwambiri ndiwowopsa - pankhaniyi, kukula kwa intrauterine kungachedwe. Ndizoyipa kwambiri ngati kuchuluka kwa shuga m'magazi kukwera kapena kukwera kwambiri - ndiye kuti kutayika kwa padera kumawonjezeka nthawi makumi angapo.

Kuphatikiza apo, ndi gestational kapena matenda abwinobwino a shuga, shuga ochulukirapo amadziunjikira m'thupi la mwana, amasintha kukhala mafuta. Ndiye kuti, mwana amabadwa wamkulu kwambiri, yemwe pa nthawi yobala mwana umawonjezera chiopsezo cha humerus. Komanso, mwa ana oterowo, kapamba amapanga insulini yambiri yogwiritsira ntchito shuga kuchokera kwa mayi. Chifukwa chake, shuga m'magazi awo akhoza kutsitsidwa.

Zizindikiro zoyambirira za matenda ashuga

Chifukwa chake, mayi woyembekezera ayenera kuyang'anira njira zakulera ndikusamala thanzi lake podikirira mwana. Kusamalidwa mosadandaula ndikofunikira ngati zizindikiro zotsatirazi zikuwonekera:

kamwa yowuma
polyuria (kukodza pafupipafupi),
ludzu losalekeza
Kuchepetsa thupi ndi kufooka komanso kuphatikizira chilakolako cha chakudya,
Khungu
furunculosis.

Contraindication kuti apitilize kutenga pakati ndi matenda ashuga

Tsoka ilo, nthawi zina sizikulimbikitsidwa kupitiliza kukhala ndi pakati, chifukwa ndiowopsa kwambiri pamoyo wamayi kapena wadzala ndi vuto losakhazikika la mwana wosabadwayo. Madotolo amakhulupirira kuti kutenga pakati kuyenera kutha pomwe:

Kupezeka kwa matenda ashuga mwa makolo onse awiri.
Matenda a shuga a insulin omwe amakhala ndi chizolowezi cha ketoacidosis.
Matenda a shuga a ana ovuta kwambiri ndi angiopathy.
Kuphatikiza kwa chifuwa chachikulu ndi shuga.
Kuphatikiza kwa mikangano ya Rhesus ndi matenda ashuga.

Zakudya zopatsa thanzi komanso zamankhwala

Ngati madokotala angaganize kuti kukhala ndi pakati kumatha kupitilizidwa, ndiye kuti cholinga chawo chachikulu ndikulipira shuga. Izi zikutanthauza kuti mayi woyembekezera adzafunika kudya chakudya No. 9, chomwe chimaphatikizapo mapuloteni athunthu (mpaka 120 g patsiku) ndikuchepetsa kuchuluka kwa chakudya chamafuta mpaka 300-500 g ndi mafuta mpaka 50-60 g. zinthu, uchi, kupanikizana ndi shuga.Zakudya za tsiku ndi tsiku mu zopatsa mphamvu zake siziyenera kupitirira 2500-3000 kcal. Komabe, chakudyachi chikuyenera kukhala chamagulu komanso mavitamini ndi michere yambiri.

Kuphatikiza apo, nthawi yodziwika bwino yodalira chakudya ndi jakisoni wa insulin iyenera kuonedwa. Amayi onse oyembekezera omwe ali ndi matenda ashuga ayenera kulandira insulin, monga pankhaniyi, mankhwala othandizira pakamwa sagwiritsidwa ntchito.

Kuchipatala ndi njira yotumizira

Chifukwa chakuti pakakhala pathupi kufunika kosintha kwa insulin, azimayi oyembekezera omwe ali ndi matenda osokoneza bongo omwe ali ndi matenda osachepera katatu:

Pambuyo paulendo woyamba kwa dokotala.
Pa milungu 20-16 yoyembekezera, pamene kufunika kwa insulin kumasintha nthawi zambiri.
Pamasabata 32-36, pakakhala chiwopsezo cha mochedwa toxosis, ofuna kuwunika moyenera mkhalidwe wakhanda. Pakugonekedwa komaliza, chisankho chimapangidwa pa nthawi ndi njira yobereka.

Kunja kwa chipatala, amayi apakati oterowo amayenera kuyang'aniridwa ndi endocrinologist ndi obstetrician. Kusankhidwa kwa nthawi yakubereka kumawerengedwa kuti ndi chimodzi mwazovuta kwambiri, chifukwa kuperewera kwa placental kukukula ndipo pali chiwopsezo cha kufa kwa fetal. Vutoli limasokonekera chifukwa chakuti mwana yemwe ali ndi matenda ashuga mwa mayi nthawi zambiri amakhala ndi vuto losakhazikika.

Akatswiri ambiri amawona kuti kutumizidwa koyambirira ndikofunikira (nthawi kuyambira 35th mpaka sabata la 38 imawerengedwa kuti ndiyabwino kwambiri). Njira yakulera imasankhidwa munjira iliyonse payokhapazokha, poganizira mkhalidwe wa mwana, mayi ndi mbiri ya abereki. Pafupifupi 50% ya milandu, azimayi omwe ali ndi matenda a shuga amalandila gawo la cesarean.

Ngakhale mayi woyembekezera adzabereka yekha, kapena angachitidwe opareshoni, chithandizo cha insulin sichimaleka pakubadwa kwa mwana. Kuphatikiza apo, akhanda obadwa kumene kuchokera kwa amayi oterewa, ngakhale ali ndi thupi lalikulu, amawonedwa ndi madokotala ngati asanakwane, omwe amafunika chisamaliro chapadera. Chifukwa chake, m'maola oyamba a moyo, chidwi cha akatswiri ndicholinga chodziwa komanso kuthana ndi kupuma, acidosis, hypoglycemia ndi zotupa za chapakati mantha dongosolo.