Masiku ano, matenda ashuga mwa akazi ndi matenda wamba. Poterepa, mtundu wa matendawa ukhoza kukhala wosiyana: wodalira insulin, osadalira insulini, wothamanga. Koma mtundu uliwonse umayendera limodzi ndi chizindikiro chimodzi - shuga wambiri.
Monga mukudziwira, si shuga yokhayokha yomwe imakhala yoyipa, koma mavuto obwera 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.
Kodi kuchotsa mimba kumachitika liti?
Pali zinthu zingapo zomwe kupezeka kwake kumafuna kuthetsa pakati. Izi zimaphatikizira shuga wambiri, 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 mwa mkazi uyenera kuganiziridwa komanso ngati abambo ali ndi nthenda yotere. Izi zimakhudza kuchuluka kwa chibadwa cha chibadwidwe.
Mwachitsanzo, ngati mayi ali ndi matenda ashuga amtundu woyamba ndipo abambo ake ali ndi thanzi, ndiye kuti mwayi wokhala ndi matenda m'mwana ndi wochepa - 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 mwanayo adzakhala wathanzi kuchokera 70 mpaka 80%. Ngati makolo onse ali ndi fomu yodalira insulin, ndiye kuti mwayi woti ana awo asadwale ndi matendawa ndi 30%.
Kuchotsa matenda a shuga kumafotokozedwa motere:
- kuwonongeka kwa maso
- chifuwa chachikulu;
- mayi wazaka 40;
- kukhalapo kwa mikangano ya Rhesus;
- matenda a mtima;
- pamene mkazi ndi bambo ali ndi matenda ashuga 2;
- nephropathy ndi pachimake aimpso kulephera;
- pyelonephritis.
Kukhalapo kwa zinthu zonsezi pamwambapa kungayambitse kuzizira kwa fetal, komwe kumakhudza thanzi la azimayi. Koma nthawi zambiri funso lomwe limakhudzana ndi ngati kutenga pakati ndi matenda ashuga kumatha kutha 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 pafupipafupi za momwe khanda limakhalira. 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 chipangizo cha intrauterine (chokhala ndi antennae, chokhala ndi antiseptics, chozungulira), koma 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 osokoneza bongo amawonetsedwa mankhwala omwe ali 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 kuchitidwa.
Kukonzekera Kwa Mimba
Choyamba, ndikofunikira kudziwa kuti mayi yemwe ali ndi vuto la kagayidwe kazakudya amalimbikitsidwa kutenga pakati pa zaka 20-25. Ngati ali wamkulu, ndiye kuti izi zimawonjezera chiwopsezo cha zovuta.
Si anthu ambiri omwe amadziwa, koma kusokonezeka (anocephaly, microcephaly, matenda a mtima) a chitukuko cha fetus amawaika koyambirira kwa mimba (mpaka milungu 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 kuwonongedwa koyambirira, 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 pakukumana kwamisempha. 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 magazi ayenera kukhala kuchokera 3.3 mpaka 6.7.
Kuphatikiza apo, mkazi ayenera kupimidwa kwathunthu. Ngati mukufufuza matenda osachiritsika kapena matenda atapezeka, ndikofunikira kuchita chithandizo chawo chonse. Mimba itadwala matenda ashuga koyambirira, mkazi amafunika kugonekedwa m'chipatala, zomwe zingathandize 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 hormonal, zomwe zimapangitsa kuti mpweya wabwino uchulukane.
Komabe, mu 2nd ndi 3 trimester ya mimba, zonse zimasintha kwambiri. Mwana wosabadwayo amakula ndi placenta, yomwe imakhala ndi zotsutsana. Chifukwa chake, pakatha milungu 24 mpaka 26, njira ya matenda ashuga imatha kukula kwambiri. Munthawi imeneyi, kugwiritsidwa ntchito kwa glucose komanso kufunikira kwa kuchuluka kwa insulin, komanso acetone nthawi zambiri 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 kupweteka kwa nthawi yayikulu mu hyperglycemia kumachitika pafupipafupi.
Ndipo chachiwiri ndi chachitatu trimesters samakonda kuyenda ndi zovuta zingapo. Vutoli limatchedwa mochedwa gestosis, pomwe kumatupa kumawonekera 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 amanyamula mwana amatenga 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. Mu odwala matenda ashuga, mphamvu zochepa zosungira, kutengera njira ya anabolic.
Nthawi yomweyo, kuchuluka kwa shuga m'magazi kumatsika, chifukwa shuga wambiri amamwetsa pantchito. Chifukwa chake, amayi amapatsidwa dontho okhala ndi ma insulin, glucose ndi glycemia zizindikiro amayeza ola lililonse. Zochitika zofananazi zimachitika pochita opareshoni, chifukwa mu 60-80% ya milandu, odwala matenda ashuga amapatsidwa gawo la cesarean, popeza ambiri a iwo ali ndi zovuta zam'mimba.
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 kwambiri. Popeza tsopano mitundu yatsopano ya insulin, cholembera chimbale chimagwiritsidwa ntchito ndipo mitundu yonse ya njira zochiritsira imachitika yomwe imakulolani kuti mubereke mwana popanda fetopathy komanso panthawi. Kanemayo munkhaniyi akuwuzani zoyenera kuchita ndi matenda ashuga.
