Kodi ndingathe kubereka ndi matenda ashuga?

Kwa azimayi ambiri, kukhala mayi ndi chinthu chofunikira kwambiri. Chirengedwe chokha sichomwe chimathandizira nthawi zonse ndipo chimapereka kudabwitsika mwa njira yodziwira matenda a shuga. Matendawa asanayambike, onse abambo ndi amayi ali mumikhalidwe yomweyo. Koma asanakwane theka lokhala ndi funso lina: kodi ndizotheka kubereka matenda ashuga? Kodi pali mwayi uliwonse wokudziwa wekha osati munthu, komanso mayi?

Momwe vuto limayambira

Pakubadwa kwa mwana wathanzi, mayi woyembekezera ayenera kukhala ndi thupi lamphamvu. Matenda a shuga amachepetsa mkhalidwe wotere - mtsikana kapena mkazi wadwala matenda a glucose ndikusintha kwake kukhala mphamvu kumaselo amthupi. Ndipo kukula kwa dzira la fetal kumafunikira mphamvu ndi thanzi, zomwe zimatengedwa kudzera mu chingwe cholumikizira.

• Katundu pa thupi la mkazi amawonjezeka ndipo kumatha kubweretsa zovuta mu impso, mu mtima, komanso kulephera mtima.
• Shuga owonjezera m'magazi a amayi amatha kupatsirana kwa mwana wosabadwayo, zomwe zimamupangitsa kukhala ndi vuto lakukhazikika komanso kutulutsidwa kwa insulini yofunikira.
• Hypoglycemic coma imatha kupezeka mwa mayi wapakati chifukwa cha kusadya bwino kapena mlingo woyenera wa insulin.
• Mimba ikakula popanda kutenga akatswiri, pamakhala chiopsezo cha kufa kwa fetal m'masiku oyamba.
• Mayi wamtsogolo wokhala ndi matenda a shuga, ngati malingaliro a madotolo sanatsatidwe, mwana wosabadwayo amatha kufikira kulemera kwakukulu kwa thupi, komwe kumapangitsa kuti mwana abereke mwana.
• Matenda opatsirana ndi owopsa kwa mayi woyembekezera yemwe ali ndi matenda ashuga. Ngati katemera wa mayi wathanzi polimbana ndi fuluwenza pa nthawi yoyembekezera, ndiye kuti katemera wa matenda ashuga amalephera. Ndikofunikira kuyang'anira ukhondo mosamala komanso kupewa kucheza ndi odwala.
• Kubadwa kwa mwana mu mtundu woyamba wa shuga kumayikidwa kale. Nthawi yoyenera ndi masabata 38-39. Ngati izi sizingachitike mwachilengedwe, ndiye kuti mgwirizanowu umalimbikitsa kapena kukonzera masesere.

Zowopsa nthawi yapakati mwa amayi omwe ali ndi matenda ashuga zimatuluka kwa onse mwana wosabadwayo ndi amayi. Mpaka posachedwa, akatswiri azamankhwala akutsutsa adatsutsa kuti mtundu wa 1 ndi mtundu wa 2 wodwala matenda ashuwere amasunga mimba, ngati alipo.

Mankhwala amakono asiya kuikidwa mopambanitsa pankhani yofunsa ngati nkotheka kubereka ndi matenda ashuga.

Kodi mtundu wa shuga umakhudza bwanji kubereka mwana

Ndikosavuta kuyendetsa msinkhu wobala mwana wamkazi kukhala mtundu wanthawi. Mabanja ena amakhala makolo patatha zaka 40 ndipo pambuyo pake. Chifukwa chake, mayi wamtsogolo amatha kudalira insulini yonse (mtundu 1 wobadwa nawo kapena wotenga), ndi matenda a shuga a 2. Chifukwa chake, mavuto okhala ndi mwana wosabadwayo akhoza kukhala osiyana.

Ngati pali mtundu wina wa mankhwala omwe ali ndi mtundu woyamba wa matendawa ndipo mayi woyembekezera angadziwitse dokotalayo za vutoli pasadakhale kuti akonzekere kutenga pakati, ndiye kuti mwina mayiyo sangadziwebe za kukhalapo kwa matenda ashuga amtundu wachiwiri. Kuzindikira kumawonekera m'mimba womwe wakula kale. Zikakhala choncho, kutenga pathupi pang'onopang'ono kapena pakati pouma ndi kotheka.

Kupatula zoterezi, mayi wazaka zoyenera kubereka amafunika kupita ndi pakati mozama ndi kukayezetsa asanatenge mimba.

Mabanja ambiri amayang'aniridwa kuti asankhe mwana payekha kapena kugwiritsa ntchito njira zina chifukwa choopa kuti mwana adzalandira matenda ashuga ndipo adzachotsedwa kubadwa kukamenya nkhondo. Kafukufuku wochitidwa ndi majini, akatswiri azamankhwala ndi ma endocrinologists amatenga zana limodzi peresenti:

• Ngati bambo yekha ali ndi matenda a shuga, kuthekera kwa matenda obadwa nako kumachitika mwa 5% yokha ya 100;
• Ngati matenda a shuga apezeka mwa mkazi, ndi 2% yokha yazakudya zomwe zili pachiwopsezo chodzalandira matendawa;
• Mlingo wokwera kwambiri (25%) wa mwana wobadwa ndi matenda ashuga umachitika mu banja, pomwe onse awiriwa amakhala ndi vuto la glucose wamagazi.

Kupatula mwayi wogwera peresenti yaying'ono iyi, muyenera kuganizira kukonzekera mimba yanu isanakwane.

Muzochitika za kubereka, algorithm yochitapo kanthu idapangidwa kuyambira nthawi yomwe mayi atatenga pakati mpaka kubereka ndi kutsatsa mayi ndi mwana nthawi yobereka.

Funso lomwe lili koyambilira kwa nkhaniyo lingathenso kumveka kuti ndizotheka kubereka matenda ashuga.

Matenda osakhalitsa a amayi apakati

Kuphatikiza pa mitundu yodziwika bwino ya mtundu 1 ndi matenda 2 okoma, mawu oti "gestational shuga" amagwiritsidwa ntchito ngati mankhwala.

Amapezeka mwa amayi athanzi kwathunthu omwe mimba isanakhalepo yopatuka pakuwunika kwamisempha yamagazi.

Pakupita kwamasabata 20, insulin ya amayi imatha kutsekedwa ndi mahomoni omwe placenta imapanga kuti mwana akula. Maselo a mkazi amataya chidwi chawo ndi insulin, shuga simalowetsedwa kwathunthu ndipo shuga owonjezera amapangidwa m'magazi a amayi.

Zodabwitsazi zimachitika pokhapokha mwa 5% azimayi oyembekezera omwe ali ndi thanzi labwino panthawi yomwe mayi ali ndi pakati. Matendawa sakhala okhazikika. Pambuyo pa kubadwa kwa mwana, chidwi cha maselo kupita ku insulin chimabwezeretsedwa, zizindikiro za glucose zimabwereranso.

Ngati matenda ashuga apezeka mwa mayi wapakati:

1. The gynecologist amatipatsa mankhwala apadera;
2. Endocrinologist amalumikizana ndi wodwala;
3. Kuyesa kwina kwa magazi ndi mkodzo kumayikidwa;
4. Zakudya zimapangidwa kuti zigwirizane ndi shuga;
5. Kulemera kwa fetal kumayang'aniridwa, chifukwa kuchuluka kwa shuga kwa mayi kumatha kuyambitsa kupangika kwamafuta mu fetus ndikuwopseza mwana ndi kunenepa kwambiri kapena intrauterine hypoglycemic coma;
6. Pomwe mukusungirako chizindikiro cha matenda ashuga, kuperekera kotheka kwa milungu 37- 38. Ngati kulemera kwa mwana wosabadwayo kukupitirira kuchuluka kwa makilogalamu anayi, mayi wapakati amawonetsedwa gawo la cesarean.

Amayi omwe ali ndi matenda osokoneza bongo amakhala pachiwopsezo chotenga nthawi yapakati. Izi zingayambitse kuwoneka kwa matenda ashuga wamba amoyo.

Mimba sayenera kungokhala zokha

Popewa zovuta zapakati pa amayi omwe ali ndi matenda ashuga, banjali liyenera kufikira nkhaniyi mozama. Choyamba muyenera kufunsira kwa endocrinologist kapena othandizira omwe amasunga mbiri yamatenda a matenda ashuga ndipo amadziwa zochitika zonse.

Pakadali pano, zoopsa ziyenera kuyesedwa, choyambirira, kwa mayi woyembekezera.

Mimba, yovuta ndi matenda osokoneza bongo, imakhala yovuta kwambiri ndipo zimatheka kuti mkazi amakakamizidwa nthawi yayitali kuchipatala.

Kuwongolera amayi apakati ndi kubereka mwana m'matenda a shuga ndikosiyana kwambiri ndi chizolowezi chomwe chimachitika mwa amayi athanzi:

• Njirayi sikumangotengera gynecologist, komanso akatswiri a endocrinologist, othandizira, othandizira zakudya, komanso a nephrologist.
• Mayi woyembekezera nthawi zambiri amapimidwa kukayezetsa ngati akufuna chithandizo chofunikira. Kugonekedwa ku chipatala kumayikidwa masabata oyambilira a umuna, 20, 24, masabata 32 a mimba. Mavuto akabuka, kuchuluka kwa zipatala kungakhale kokulirapo.
• Pankhani ya matenda a shuga omwe amadalira insulin, mlingo umayikidwa payekhapayokha kuti athe kuwunika momwe mayi ndi mwana wosabadwayo akuyembekezera.
• Mkazi ayenera kuyang'anitsitsa zakudya, azisamalira.
• Kubadwa kwa mwana kwa mtundu uliwonse wa matenda ashuga kumachitika mwachibadwa ndipo adokotala amakukonzekera. Gawo la Kaisara limaperekedwa kokha ndi kulemera kwakukulu kwa mwana wosabadwayo (kuchokera ku 4000 gramu) kapena chiwonetsero cha gestosis m'magawo apambuyo.
• Pambuyo pobereka, mayi ndi mwana amayang'aniridwa pamayeso a kukayezedwa kwa magazi.

Pomaliza

M'mankhwala amakono, kwa maanja omwe mnzawo akudwala matenda a shuga, pali mwayi wokhala makolo osangalala. Koma udindo wopanga chisankho chofunikira ukadali ndi mkaziyo. Zowopsa zikupitirirabe. Muyenera kukhala ndi mzimu wamphamvu ndikupeza madokotala odziwa bwino omwe angakuthandizeni kuthetsa mavuto.