Koda mace mai lafiya ba zata iya tabbata cewa haihuwarta zata ci gaba ba tare da matsala guda ba. Sabili da haka, marasa lafiya masu ciwon sukari mellitus da son haihuwa suna cikin haɗarin gaske, tunda rashin ƙarfi a cikin tsarin endocrine yana haifar da fetopathy na tayi.
Ciwon sukari fetopathy cuta ce da ke faruwa a gaban cutar sankara a cikin mace a cikin wani matsayi. A jikinta, an lura da tsarin karuwar glucose na jini.
Tare da cututtukan fetopathy, yanayin tayin ya canza da rashin aiki a cikin aikin gabobinsa da tsarin sa. Wannan yana tasiri ga tasoshin jijiyoyin, ƙodan da ƙwayoyin cutar yara.
A cikin mata masu fama da cutar siga, yanayin daukar ciki zai dogara ne kan wasu dalilai:
- nau'in cuta;
- siffofin magani;
- gaban rikitarwa.
Amma yawanci ɗaukar tayi tare da babban sukari a cikin jini yana da matukar wuya a iya jurewa kuma wannan yana faruwa koyaushe. Sabili da haka, yawancin lokuta don ceton ran yaro da uwa, likitoci suna yin sashin cesarean.
Ta yaya ciwon farji ya ke tasowa kuma menene haɗarin jarirai?
Babban dalilin bayyanar cututtukan cututtukan ƙwayar cuta shine hauhawar jini, saboda a cikin mata masu juna biyu hanya na ciwon suga ba shi da tsayayye, wanda ke sa wahalar sarrafa yanayin tayin da uwa.
Sau da yawa wannan yana haifar da matsaloli tare da tasoshin jini. Haka kuma, masu ciwon sukari, kamar su fetopathy na tayin wata cuta mai kamuwa da cuta, na iya bayyana idan mara lafiyan ya sami karuwa sosai a cikin sukarin jini kafin tayi, ko kuma a lokacin haila.
Abun ciki na mahaifa yana da hanyar da ke zuwa ta: glucose da yawa suna shiga tayin ta cikin ƙwayar cuta, wanda shine keɓaɓɓen ƙwayar cuta ta fara samar da insulin a cikin adadi mai yawa. Excessarancin sukari a ƙarƙashin tasirin hodar ya zama mai, saboda haka tayin ya girma a cikin yanayin da ya kara tare da ɗimbin kitse na kitse.
A cikin cututtukan ciwon sukari na mellitus, lokacin da farji baya fitar da adadin insulin da ake buƙata ba, lalacewa yakan faru a kusan makonni 20 na gestation. A wannan mataki, ƙwayar cuta tana aiki sosai, wanda ke haɓaka samar da gonadotropin chorionic. Kwayar hormone a cikin jiki tana rage karfin jijiyoyin kwayoyin zuwa insulin kuma yana sa canje-canje na glycemic ya zama labile.
Abubuwan da ke haifar da yuwuwar samun ciwan rashin lafiyar sun hada da:
- cututtukan mahaifa, na baya;
- shekaru sama da 25;
- nauyin tayin (daga kilogiram 4);
- matsanancin nauyi;
- saurin nauyi a lokacin haihuwa (daga kilogiram 20).
Duk wannan yana da mummunar tasiri a jikin yarinyar. Bayan haka, glucose ya shiga cikin jinin tayin, kuma kafin mako na 12 na ciki, hanjinsa baya iya samar da insulin nasa.
Sannan raunin hyperplasia na sel na iya haɓaka, wanda ke haifar da hyperinsulinemia. Wannan yana haifar da raguwa mai yawa a cikin tattarawar sukari, haɓakar mahaifa da sauran rikice-rikice.
Matsaloli masu haɗari ga jariri:
- ci gaban polyneuro-, retino-, nephro- da angiopathy.
- mai tsanani gestosis;
- mummunan zubar da jini na babban cuta, wanda hyperglycemia ke ba da hanyar hypoglycemia;
- polyhydramnios da aka lura a cikin 75% na lokuta;
- sake haihuwa da kuma rikicewar tayin (10-12%);
- zubar da ciki ba a farkon haihuwa (20-30%).
Tare da ƙarancin ƙwayar ƙwayar ƙwayar ƙwayar cuta da matsaloli tare da tasoshin, an samar da hypoxia intrauterine. Idan ciwon sukari ya haɓaka da haɓakar haɓaka mai ƙarancin ƙarfi a cikin jini, to, yiwuwar eclampsia da preeclampsia suna ƙaruwa.
Sakamakon girman tayin, fara haihuwar na iya farawa, wanda aka lura cikin kashi 24% na lokuta.
Hoton asibiti na fetopathy a cikin ciwon sukari
Babban alamar wannan yanayin shine bayyanar yaro: fatar jikinsa tayi kumbura, suna da shuɗi mai launin shuɗi, suna kama da amai da gudawa (jini mai ƙyalƙyali a cikin mahaifa) kuma akwai dumbin taro. Bugu da kari, nauyin jikin jariri ya kai kilogiram 4 zuwa 6, gabobinsa suna gajeru, gindin kafada yana da fadi, kuma saboda yawan kitse mai yawa, babban ciki ya bayyana.
Sakamakon tsarin mara kyau na huɗaɗɗiya a cikin huhu, numfashin yaron ya rikice. Sabili da haka, ana ganin ƙarancin numfashi ko ma saurin numfashi a cikin 'yan awanni na farko bayan haihuwa.
Hakanan, alamun fetopathy na ciwon sukari cuta ne na rashin hankali, waɗanda suka haɗa da:
- lethargy, alternating with hyper-excitability (rawar jiki da na ƙarshen, barci na sama, damuwa);
- karancin tsotsa maye
- rauni na sautin tsoka.
Wata alamomin alama ta fetopathy shine tsananin zafin cutar idanu da fata. Koyaya, wannan yanayin zai iya rikicewa tare da jaundice, wanda ke faruwa lokacin da ake maye gurbin furotin na sel wanda ke ɗauke da baƙin ƙarfe tare da haemoglobin a cikin manya.
Tare da jan cutar a cikin yara masu lafiya, kwayar ido da fata suma sun zama kamar bakin ciki, amma bayan sati daya alamu da kansu sun gushe.
Kuma a cikin jarirai masu fama da cututtukan cututtukan cututtukan mahaifa, jaundice suna nuna faruwar hanyoyin tafiyar jini a cikin hanta, wanda ke buƙatar kulawa ta musamman.
Binciko
Mafi yawan lokuta, don gano cututtukan cuta a cikin tayin, ana amfani da duban dan tayi don hango abubuwan ci gaban ciki. A cikin sashin farko, ana gudanar da binciken ne sau daya, a na biyu a sati 24-28. A wannan lokacin, zaku iya gano idan akwai lahani a cikin tsarin jijiyoyin zuciya, juyayi, narkewa, tsarin osteoarticular da tsarin jijiyoyin jini.
A cikin sati na uku, ana aiwatar da hanyar duban dan tayi sau 2-3. Idan mai haƙuri yana da nau'in insulin-dogara da ciwon sukari, to ana yin binciken ne a makonni 30-32, sannan kuma sau ɗaya a kowace kwana 7.
Tare da amfrayofetopathy, na'urar duban dan tayi na iya nuna:
- sauya wurin echonegative zone a cikin kwanyar, wanda ke nuna kumburi;
- rashin daidaituwa na jiki;
- ninka biyu na kai;
- polyhydramnios;
- dual tayin;
- macrosomia.
Hakanan ana yin gwajin yanayin rashin lafiyar yaro a cikin mahaifar. Wannan yana ba ku damar gano kasawa a cikin ci gaban ƙwaƙwalwar ƙwaƙwalwa, wanda ake ɗauka alama ce mai haɗari mafi girma ta amfrayo. Don gano rikice-rikice, motsi, raunin zuciya da numfashin tayin suna rikodin awa 1.5.
Idan akwai masu ciwon sukari, to lallai yaron yana yawan aiki, kuma barcinsa yayi gajarta (har zuwa mintina 50). Haka kuma, yayin hutawa, ana yin rikodi akai-akai da tsawan lokaci.
Ko da tare da GDM, ana yin dopplerometry, a cikin lokacin wanda za'a kimanta irin waɗannan alamun kamar yadda ake kimantawa:
- darajar fitowar zuciya;
- myocardial ƙanƙancewa;
- ƙuduri da jigon juriya na juriya na gudanawar jini a cikin ɗumbin ƙwayar mahaifa da dangantakarta da cututtukan systolic;
- kafa lokacin fitarwa na hagu ventricle na zuciya.
Dopplerometry an yi a mako 30, saboda wanda aka ƙaddara yanayin tsarin juyayi na tsakiya. Sabili da haka, ana iya daidaita tsarin zuwa babban binciken duban dan tayi.
Cardiotocography tare da kimantawa na gwaje-gwaje na aiki yana baka damar bin diddigin zuciya a kowane yanayi. A lokacin gwajin KGT ana yinsa wanda likita ya dauki samfurori da yawa.
Tare da ciwon sukari a cikin mata masu juna biyu, ya zama dole a tantance ko akwai alamun FPN (rashin lafiyar fetoplacental). Ana yin wannan ta amfani da fitsari da gwajin jini. Masu nuna alamun alamomin biochemical na tsarin fetoplacental na iya zama kamar haka: α-fetoprotein, oxytocin, progesterone da plactoal lactogen.
Determinedarfin da ke akwai na fetopathy an ƙaddara shi da matakin AFP. A wannan halin, tattarawar furotin ya wuce na al'ada, wanda za'a iya gani a cikin watanin uku na ciki.
Dangane da haka, tare da hyperglycemia, ana ba da shawarar bayanin martaba na hormonal a kowane kwanaki 14, fara daga watan na uku na lokacin haihuwa.
Jiyya da rigakafin
Don hana abin da ya faru na hypoglycemia da haɓaka rikice-rikice masu biyo baya, ana gudanar da maganin glucose (5%) ga jariri bayan haihuwa. A lokaci guda, kowane awanni 2 yana buƙatar a ba shi madara uwar, wanda ba zai ƙyale yanayin ya ci gaba ba.
Lokacin haihuwar yana tare da duba lafiyar likita, wanda likita ke lura da numfashin jariri. Idan matsaloli suka taso, to, an haɗa mai haƙuri zuwa mai ba da izinin motsa jiki.
Idan akwai rikice-rikice na jijiyoyin cuta, to, ana sarrafa magnesium da maganin alli. Tare da rikice-rikice a cikin hanta, wanda ke dauke da yellowness na fata, ana gudanar da taro na radiation ultraviolet.
Bayan haihuwar mace, ana rage adadin insulin ta hanyar kashi 2-3. Wannan saboda matakan glucose a cikin jini yayin wannan lokacin yana raguwa sosai. Amma tsawon lokaci, alamun glycemic sun koma al'ada.
Yin rigakafin kamuwa da ciwon sukari na 2 da kuma fetopathy ga mata masu juna biyu sun ƙunshi ganowa cikin lokaci da kuma lura da cutar kansar. Hakanan yana da mahimmanci a lura da kullun kuma, idan ya cancanta, aiwatar da gyare-gyare don tattarawar glucose.
Hakanan dole ne a yi bincike na duban dan tayi akan lokaci, wanda zai ba ka damar gano duk wata cuta ta haɓaka a matakin farko. Wani abu da ake bukata na rigakafin rikice-rikice shine ziyarar tsarin kula da likitan mata.
Bidiyo a cikin wannan labarin zai yi magana game da nasarar haihuwa a gaban ciwon sukari.
