Ngaphambi kokukhulelwa
Uma unesifo sikashukela, kufanele ukhulelwe ukukhulelwa. Qala ukuxhumana nodokotela wezifo ze-geologist okungenani izinyanga eziyisithupha ngaphambi kokukhulelwe bese uzama ukuthola isinxephezelo esiqinile sesifo sikashukela.
Izinhlobo zesifo sikashukela nendlela yokuphila
Isifo sikashukela sikhuphuka esingapheliyo ushukela (i-glucose) egazini nasemcinini.
- Kunezinhlobo ezilandelayo zesifo sikashukela:
1. Isifo sikashukela sohlobo lokuqala singaphansi kwesifo se-insulin. Ngesizathu esithile, i-insulini emzimbeni ayikwenziwe ngokwayo, ngenxa yalokho, i-glucose ayicutshungulwa. Izinga eliphansi kakhulu le-glucose egazini elibizwa ngokuthi i-hypoglycemia, eliphakeme kakhulu - i-hyperglycemia. Uma i-hyperglycemia iyadingeka ukuqapha ukutholakala kwemizimba ye-ketone emcinini. Ukudla okunempilo nokusebenza okulinganiselayo, ukuqapha okuqhubekayo kwezinga leshukela egazini kungenza impilo yesiguli nge-type 1 isifo sikashukela isondele ngokusemandleni.
2. Isifo sikashukela sohlobo lwesibili asihlotshaniswa ne-insulini. Ngokuvamile kwenzeka kubantu abaneminyaka engaphezu kwengu-40 ubudala nesisindo somzimba ngokweqile.
3. Isifo sikashukela se-Pancreatic. Ikhula kulabo abanezinhlanzi ezithintekayo, ezithintekayo emzimbeni ngokufihla kwe-insulini.
4. Okubizwa ngokuthi isifo sikashukela sabantu abakhulelwe, noma isifo sikashukela sokubeletha (HSD). Lokhu ukwephulwa kwe-carbohydrate metabolism, eyenzeka noma kuqala ekuboneni ngesikhathi sokukhulelwa. Cishe ingxenye yesigameko, i-GDD idlula emva kokuzalwa ngaphandle kokulandelana, futhi engxenyeni - iba ngohlobo lwe-2 lwesifo sikashukela.
Izimo eziyinhloko yinkinga yesifo sikashukela kanye nokungabikho kwezinkinga ezinkulu (ukuhluleka okungenangqondo kwe-renal, ischemic isifo senhliziyo, ukuphindaphindiwe kwe-retinopathy ezinomzimba omusha kanye ne-hemorrhages fresh kwi-fundus, njll). Ngokumelene nesizinda sokudonswa kwesifo sikashukela, kuyingozi ukukhulelwa: ushukela ophezulu wegazi ungavimbela ukubekwa kahle kwezitho zangaphakathi zesisu, okwenzeka ngokuyinhloko ku-trimester yokuqala yokukhulelwa. Ngaphezu kwalokho, ukukhulelwa kwesisu kungahle kwenzeke. Kunconywa ukuba uhlolwe ngokuningiliziwe kwezokwelapha kusengaphambili: njenganoma yimuphi omunye wesifazane, ngeke kwenzeke ukuhlola izifo ezithunyelwa kakhulu ngokulala ngokocansi, uthintane nesazi sezinzwa zegazi, isazi se-cardiologist (lokhu kuyimfuneko yesifo sikashukela eminyakeni engaphezu kwengu-10), i-oculist - ukuba ihlolwe izitsha ze-fundus, nomfundi ehlanjululwe. Yenza i-ultrasound ye-gland gland futhi uvakashele i-endocrinologist. Uma kunesidingo, vakashela futhi isazi sezinkanyezi bese uya kokubonisana ehhovisi "Isifo sikashukela". Izivivinyo ezilandelayo ze-laboratory kufanele zenziwe:
♦ i-hemoglobin eglycated;
♦ i-microalbuminuria (i-UIA);
♦ ukuhlolwa kwegazi emtholampilo;
♦ Ukuhlola igazi kwegazi (creatinine, amaprotheni aphelele, i-albumin, i-bilirubin, i-cholesterol ephelele, i-triglycerides, i-ACT, i-ALT, i-glucose, i-uric acid);
♦ ukuhlaziywa jikelele komchamo;
♦ Ukuhlola izinga lokuhlunga kwe-glomerular (ukuhlolwa kukaReberg);
♦ Ukuhlaziywa komchamo weNechiporenko;
♦ Isiko sama-urine sokuhlunga (uma kunesidingo);
♦ ukuhlola umsebenzi we -roid (ukuhlolwa kwe-TTG mahhala i-T4, AT kuya ku-TPO).
Ngesikhathi sokukhulelwa
Ukukhulelwa kwabesifazane abane-SD-1 kunezici eziningi. Abantu abanesifo sikashukela bayazi amazinga azo ushukela egazini, kodwa abazi ukuthi njalo ngesikhathi sokukhulelwa, izinga lokushukela kufanele libe ngaphansi kwalesi sivamile. Isimiso sabesifazane abakhulelwe abanesifo sikashukela kufanele sibe isilinganiso esivamile sezinga legazi legazi - okungenani izikhathi ezingu-8 ngosuku. Ku-trimester yokuqala yokukhulelwa, i-hypoglycemia iyatholakala: ingozi yokunyuka kwengcindezi yomzimba kumama, ukwephulwa kwegazi ukugeleza ezitsheni ze-placenta ne-fetus, ukwephulwa kwemiqondo yenhliziyo kumama nasesithombeni, i-hypoxia yesisu. Owesifazane angakwazi ukulahlekelwa ukwazi futhi aze awele ku-coma. Izimpawu ze-hypoglycemia: ikhanda, isizungu, indlala, umbono okhubazekile, ukukhathazeka, izintambo eziningi, ukujuluka, ukuthuthumela, ukukhathazeka, ukudideka. Uma uhlangabezana nanoma yikuphi okungenhla, kufanele uhlole ushukela wegazi. Uma lokhu kungenakwenzeka, udinga ukumisa noma yimuphi umsebenzi womzimba, thatha ama-carbohydrate okusheshayo-digestible (ama-gramu angu-12 yi-100 ml wejusi noma i-soda elimnandi, noma izingcezu ezimbili zeshukela, noma ithebula elilodwa, i-spoonful of honey). Ngemuva kwalokhu, kufanele udle ama-carbohydrates amancane (12-24 g - ucezu lwesinkwa, ingilazi yogurt, i-apula). Izinga eliphakeme eliyishukela egazini lomama lingabangela ekuthuthukiseni ukukhubazeka kwengane, njengokwelashwa kwesifo sikashukela. Kungaba ukukhula okusheshayo noma okusheshayo kokukhula kwe-fetus, polyhydramnios, ukuvuvukala kwezicubu ezithambile. Usana olusanda kuzalwa lungabhekana nezinkinga zokuphefumula kanye neurologic, i-hypoglycemia. Ishukela ephakeme egazini lingakwazi "ukugcoba" ingane kanye ne-endocine kamuva noma ukuphazamiseka kwengqondo ebusheni. Ukuze ugweme imiphumela enjalo, ngesikhathi uhlela ukukhulelwa kanye nazo zonke izinyanga ezingu-9 zokulinda, thintana njalo nodokotela. Njengoba ushukela wegazi okhuphukile, kufanele ukhansele noma yikuphi ukusebenza komzimba futhi uhlole umchamo wamagciwane e-ketone (lokhu kungenziwa ngokusebenzisa ama-test strips athengiswa ekhemisi), bese usebenzisa izincomo zesifo sakho sezinzwa zokubeletha-uma u-glycemia. Gcina idayari lapho urekhoda khona ukulinganisa ushukela, inani lama-carbohydrate, ukwakhiwa kokudla, umthamo we-insulin. Ungakhohlwa ukubheka ukuthi uthola kanjani isisindo, futhi ulinganise ukucindezelwa kwegazi. Kubalulekile ukuqapha ukutholakala kwemizimba ye-ketone emcimbini kanye nokutholakala kwabo ngokushesha kwazise udokotela wakho. Kungadingeka ukuthi ulinganise ivolumu hhayi nje kuphela kokudakwa, kodwa futhi nangoketshezi oluthile (i-diuresis). Ngisho nesifo sikashukela esikhathele ngesikhathi sokukhulelwa, kunzima ukufeza izinga eliqinile leshukela egazini.
Uma kunesidingo, udokotela angakuthumela ku:
♦ Ukuhlukumezeka kwemvelo - ukusebenzisa i-ultrasound, ukugeleza kwegazi kuhlolwe emgqeni we-umbilical, placenta nase-fetus;
♦ i-cardiotocography - ihlolwe ukuthi ngabe ingane isifo se-oxygen (hypoxia).
Ukuhlolwa kokusebenza kwe-insulin ukwelashwa kwenziwa ngokucwaninga nge-fructosamine (isakhi se-albinin blood protein ngegazi glucose). Ku-trimester yesithathu yokukhulelwa, udokotela uzokumema kaningi kunanini ngaphambili. Lokhu kubangelwa ukuthi ngaleso sikhathi ukuthi ingozi yezinkinga ezihlobene nesifo sikashukela iyakhula. Isifo sikashukela sokubeletha sihluke kwi-gestosis yabesifazane abakhulelwe. Isizathu sokubonakala kwayo sinciphise ukuzwela kwamaseli ku-insulin yabo. Ngokusho kososayensi baseYurophu, ukusabalalisa kwe-GDD kuvela ku-1 kuya ku-14% phakathi kwabesifazane abanempilo. Esigabeni sengozini - abesifazane abakhulelwe abanomzimba okhuluphele kakhulu, abanomlando we-obstetric anamnesis. Thatha ukuhlolwa kwegazi ushukela kanye nokuhlolwa kwegazi nge-glucose load. Uma izinkomba zijwayelekile, okwesibili uhlolo luyenzeka ngeviki lama-24-28 lokukhulelwa.
Ukubeletha
Abaningi abakhulelwe abanesifo sikashukela bangakwazi ukubeletha ngokuzimela, uma kungekho zizathu ezengeziwe zokungavunyelwa kwesigaba sokugcina kanye nokuphikisana kwezinkinga zokubeletha kwemvelo. I-polyhydramnios, i-gestosis kanye nezifo ezingenayo i-urogenital zingaholela ekuzalweni okungakafiki. Inkinga ejwayelekile kunazo zonke ekubelethweni kweziguli ezine-diabetes mellitus ukukhishwa kokubeletha kwe-amniotic fluid.
Ngemuva kokubeletha
Ngokuvamile, omama besaba ukuthi ingane yabo izoba nesifo sikashukela. Uma uyise wengane engenalo lesi sifo, khona-ke amathuba okuthuthukisa isifo sikashukela emntwaneni cishe ngo-3-5%. Uma ubaba enesifo sikashukela, ingozi ibalwa cishe ngo-30%. Kulesi simo, kunconywa ukwenza izivivinyo zofuzo ngaphambi kokukhulelwa. Izinsana zidinga ukunakekelwa okukhethekile. Ngokuvamile izinsana zizalwa ngokukhuluphala, kodwa ngamaphaphu angathuthuki. Emahoreni okuqala okuphila, ukuphazamiseka kokuphefumula, kanye nokulimala kwesistimu yomphakathi, i-acidosis, amazinga e-glucose wegazi kufanele agwenywe; ukuqhuba ukuhlolwa kwenhliziyo. Ezinganeni ezisanda kuzalwa, isisindo somzimba ngokweqile, ukuvuvukala kwesikhumba, ukukhuliswa kwesibindi kanye nesipelingi kungaphawulwa. Izinsana ezisuka kumama nge-SD-1 azihambisani kahle futhi ngenxa yalokho zivame ukuhlushwa i-jaundice yezingane ezisanda kuzalwa, i-erythema enobuthi, ilahlekelwe isisindo ngemuva kokuzalwa futhi ibuyiselwe kancane kancane. Kodwa konke kunqotshwa!
U-Vanyusha wazalwa ngesigaba se-cearean emavikini angu-37. U-Ole uneminyaka engu-29 ubudala lapho indodana yakhe izalwa. Eminyakeni emine nesigamu kamuva owesifazane wazala indodakazi. Akukho okukhethekile? Mhlawumbe - uma nje ngesikhathi sokuzalwa komntwana wokuqala u-Olya engenaso isipiliyoni sesifo sikashukela seminyaka engu-19! Inkinga enkulu yabesifazane abafuna ukuba nabantwana bangabesifo sikashukela solu hlobo 1 (SD-1). Odokotela babesaba impilo yomama nengane futhi abahlale bekulungele ukuthatha umthwalo wokukhulelwa. Ngakho kwenzeka ngo-Olya, ongazange athole ukwesekwa kokuqala odokotela. U-Olya uthi: "Nginokusekelwa okuthembekile - umyeni wami. Nguye owayehamba nami kuzo zonke izingxoxo, wayebheke zonke izinhlobo zezihloko, wacabangela zonke izilinganiso ze-insulini, wangilinganisa izingcezu zesinkwa ze-sandwich ukusebenza futhi ngokujwayelekile ukulandela ukudla kwami ngokuqinile. Ukuqeda ukukhanya kwami kwamanga, ngivusa ebusuku, ngezinye izikhathi ngehora ukukala izinga le-glucose, wangilungisa ngejusi uma kunesidingo njalo njalo. Izinkulungwane zezinto ezincane ezinjalo, futhi uzicabange konke - okuyinkimbinkimbi kimi. "Ngale ndlela, umuntu angakugwema imiphumela emibi kumama nengane.Umsebenzi oyinhloko we-endocrinologists nababelethisi kumele kube nokuqinisekisa isinxephezelo esiphezulu se-carbohydrate metabolism kuzo zonke izigaba - kusukela ekukhulelwe kuze kube ukuzalwa.