Sau da yawa macen da take da ciwon sukari tana tambaya: "Shin zan iya haihuwa? Shin zan iya haihuwar kociyar lafiya?"
Kuma tsoronta ba a banza bane. Tare da raunin raunin talauci mai rauni, matsaloli daban-daban na iya yiwuwa. Har ila yau akwai cikakkiyar contraindications ga ciki.
Mun nemi endocrinologist Yulia Anatolyevna Galkina yi magana game da yadda za a shirya yadda ya kamata don daukar ciki, wanda gwaje-gwajen da za su shude da kuma wacce likitocin za su zaga. Ya zama kyakkyawan koyarwa, wanda zai zama da amfani ga iyaye mata da yawa.
Julia Anatolyevna Galkina, endocrinologist, homeopath, likita na mafi girman rukuni
An sauke karatu daga Jami'ar Moscow State Medical-Dental University. Kasuwancin likita.
Zama kan aiki ya danganta da MGMSU. Specialization endocrinology.
Ilimi a Makarantar Homeopathic ta Tsakiya. Specialization homeopathy.
Academyungiyar Ilimi ta Kasa da na Classical Homeopathy na J. Vitoulkas. Specialization homeopathy.
Endocrinologist, homeopath a cikin Family Medical Center "Life Life"
Iri ciwon sukari
Ciwon sukari mellitus cuta ce ta yau da kullun tare da haɓaka glucose na jini da kuma take hakkin samar da insulin na hormone. Akwai manyan nau'ikan 3 na ciwon sukari mellitus (DM):
- Type 1 ciwon sukari. Wannan cuta ce ta mutum wanda kwayoyi masu lalata kwayoyin cuta suna lalata sel B, suna samar da insulin na hormone wanda yakamata domin shawo kan glucose ta sel.
- Type 2 ciwon sukari. Ana nuna wannan cutar ta raguwa a cikin ƙwaƙwalwar ƙwayoyin sel zuwa insulin, kuma a sakamakon wannan, haɓakar haɓakar insulin.
- Ciwon ciki. Wannan cuta ce dake tattare da cutar sikeli wanda ke tasowa yayin daukar ciki. Lokaci mai mahimmanci na ci gabanta shine makonni 24-28.
Hanyar zamani don daukar ciki a cikin iyaye mata masu ciwon sukari
Komawa cikin 80s na ƙarni na karshe, mutum zai iya jin sau da yawa daga likita shawarar don guje wa daukar ciki a gaban ciwon sukari. Kuma idan ciki ya faru, dole ne mace ta kwana a wannan asibiti saboda yawan lokuta mawuyacin hali da ke barazanar dakatar da ita.
Yau, yanayin canzawa ga mata masu ciwon sukari an canza shi sosai. Wannan ya samo asali ne sakamakon bullowar sabbin damar dama don gano farkon cutar cututtukan cututtukan mahaifa, hanyoyin magance su, harma da kirkira da kuma samun dama daga cikin manya-manyan magunguna masu rage sukari da kuma masu kamun kai.
Me ke tattare da cutar sankaran mama a nan gaba ita da jaririnta
Yawancin lokaci yakan faru da mace ta sami labarin rashin kwanciyar hankali da wuri ba jimawa: 1-2 makonni bayan jinkirta haihuwar (wato, tsawon makonni 5-6 na ciki, tunda ana ganin lokacin haihuwar ne daga ranar farko ta haila).
Tare da decompensated (mara kyau ko gaba daya ba tare da kulawa ba) ciwon sukari mellitus, rashin daidaitaccen lokacin al'ada zai yiwu. A wannan yanayin, ana gano ciki daga baya. Amma riga a cikin wannan lokacin rashin tabbas kuma kafin mako na 7 na ciki, wani muhimmin mataki na saka gabobin ɗan da ba a haife su ba.
Idan, a lokacin ɗaukar ciki da kuma a cikin farkon makonni na farko na ciki, mahaifiyar tana da ciwon sukari na mellitus a cikin halin lalata, sakamakon zai shafi mahaifiya da jariri.
Dangane da karatu da lura da yawa, mata masu juna biyu da ke fama da cutar sankara na cikin jiki suna da kaso mai tsoka na ci gaban mahaifa da gabobin mahaifa, zubar da ciki, mutuwar tayi, haihuwar haihuwa, gestosis (saitin cututtukan cututtukan jini, gami da hawan jini, kumburi, asarar furotin a cikin fitsari, da a wasu halaye, raɗaɗi). Hadarin rikitarwa ya danganta da matsayin rage yawan cututtukan ƙwaƙwalwar ƙwayar cutar sankara da kuma matakin glycated haemoglobin, wanda ake kira HBA1c. Attentionarin kulawa yana buƙatar matakin HBA1s> 6.3%.
Amma a cikin matakai na gaba, bayan an gama samar da gabobin, glucose, wanda ke shiga cikin jinin yaro daga mahaifiya fiye da kima, yana haɓaka haɓakar samar da insulin a cikin yaro, shine, hyperinsulinemia. Hyperinsulinemia yana haifar da Macrosomia (ma'anar ma'anar cewa yaro ya zama babba kuma yayi nauyi fiye da 4 kilogiram). A cikin cikakken ciki da haihuwa, wannan yana faruwa ne a cikin kashi 27-62% na yaran da aka haife uwaye masu cutar sankara.
Tsarin ciwon sukari
Tsarin ciki na ciki da cimma daidaitaccen matakin sukari (normoglycemia) watanni 2-3 kafin ɗaukar ciki kuma cikin ɗaukar ciki yana rage haɗarin mummunan sakamako. Tun daga 2013, ka'idojin raunin cutar sankarar fata ga mata masu juna biyu da kuma masu shirin yin juna biyu sun zama masu tsauri.
Glycemic iko
Lokacin da ake shirin yin juna biyu, a cikin watanni 2-3 kafin farawarsa da kuma tsawon lokacin haila, ya zama dole a kula da cutar glycemia akan komai a ciki, kafin cin abinci, awa 1 da awa 2 bayan cin abinci, sannan kuma kafin lokacin bacci a kowace rana. Sau 1-2 a cikin sati daya na sarrafa glucose na jini da karfe 3 na safe. Sau 2-3 a sati safe ana sarrafa ketone a cikin fitsari. Kowane mako na 6-8 yana sarrafa HBA1s.
Ka'idojin Diyya
Cikakken bincike na likitanci don tsara juna biyu
1. Binciken dakin gwaje-gwaje:
- Gwajin jini na asibiti
- Nazarin Urinal
- Nazarin Urinal na UIA (microalbuminuria). Kasancewar microalbuminuria ko proteinuria na iya kasancewa tare da kamuwa da cututtukan urinary fili, kuma yana iya kasancewa alama ce ta cutar sankarau. Waɗannan halayen na iya haifar da rikicewar ciki. A cikin waɗannan halayen: nazarin fitsari bisa ga Nechiporenko, al'adar fitsari don kamuwa da cuta.
- Magungunan jini
- Nazarin matsayin thyroid: kwayoyin hormones na jini, T4 kyauta, gami da kwayoyin cuta zuwa TPO. (Takaddar TSH ga mata masu juna biyu a cikin 1 na farko har zuwa 2.5 shima abin sha'awa ne ga waɗanda ke shirin daukar ciki).
2. Neman kwararru:
Shawarwarin Endocrinologist
Endwararren ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa yana kimanta yanayin ciwon sukari, kasancewar da girman rikice-rikice. Abinci, abubuwan aiki na jiki na mai haƙuri, da yanayin gudanar da aikin sa-ido na glucose na jini da kuma alamomin sa, ana nazarinsu kuma daidaita su dalla-dalla. A cikin nau'in 1 na ciwon sukari na mellitus, yana iya zama dole don gyara tsarin kulawa da insulin, tare da maye gurbin shirye-shiryen insulin tare da waɗanda aka yarda don amfani yayin daukar ciki.
A halin yanzu an yarda da amfani:
- Halittar kayan aikin injiniya na yau da kullun: Humulin R, Insuman Bazal, Actrapid NM
- Halittar kayan aikin injiniya na dogon lokaci: Humulin NRH, Insuman Bazal, Protafan NM
- Ultra-short aiki insulin analogues: Novorapid, Humalog.
- Dogon aiki insulin analogues: Levemir.
A cikin 'yan shekarun nan, hanyar sarrafa insulin ta amfani da famfon insulin ya zama tartsatsi. Wannan hanyar tana ba ku damar yin kwatancen kwayar insulin na rayuwa. Ana bayar da maganin basal da bolus ta hanyar nau'in insulin shiri na gajere ko aikin ultrashort. Amma ko da lokacin amfani da famfo, zaku buƙaci gyaran jumla da allurai na insulin a yayin haihuwa.
Ga matan da ke fama da ciwon sukari na 2 wadanda ke kan hanyar rage cin abinci, idan ba zai yiwu ba a cimma alamun biyan diyya a kai, an wajabta maganin insulin. Aiwatar da maganin rage zafin jiki na tebur, magungunan rage sukari ana soke su kuma idan ba zai yiwu a sami diyya ba kawai tare da taimakon abinci, ana wajabta insulin. Bugu da kari, bisa ga sakamakon bincike da tantance daidaituwar abinci mai gina jiki, duk mata an kaddara su ne da bukatar maganin aidin a kullun, shirye-shiryen folic acid don ingantaccen ci gaban jaririn da ba a haife shi ba.
Tantancewar mahaifa
Likitan kula da lafiyar mahaukata ya kimanta matsayin al'aura, shirye-shiryen mace ga masu juna biyu da haihuwa, haka nan kuma ban da tsarin halittar cututtukan cututtukan mahaifa.
Tattaunawar likitan dabbobi
Likitan likitan ido yana tantance kasantuwa da kuma matsayin cututtukan cututtukan cututtukan mahaifa, da sauran yiwuwar cututtukan kwayoyin halittar hangen nesa.
Shawarar Neurologist
Tare da tsawon lokaci na ciwon sukari fiye da shekaru 10 kuma idan akwai hujja, cikakken nazarin jijiyoyin jiki ya zama dole. Dangane da sakamakon abin da mai ilimin kwantar da hankali ya ƙayyade matakin lalacewar jijiyoyin gefe.
Tattaunawar likitan zuciya
Likita ya kimanta aikin zuciya da jijiyoyin jini. Ana aiwatar da ECG, gwargwadon karanta karatun echocardiogram. Tunda karuwar hawan jini yawanci ana samun shi a cikin cututtukan sukari, kuma yana ƙaruwa yayin daukar ciki, yin cikakken nazari game da hawan jini da sa ido a nan gaba ya zama dole. Ana auna karfin jini a kwance, kuma tare da canji a matsayin jiki, a zaune. Idan ya cancanta, an tsara maganin rigakafin ƙwayoyi don rage amfani da mata masu juna biyu.
Makaranta "Cutar ciki da ciwon sukari"
Ko da mace tana fama da ciwon sukari na dogon lokaci, ya kan kai ziyara sau da yawa "Makarantar ciwon sukari" kuma yana cikin halin diyya, kuna buƙatar zuwa makaranta "Cutar ciki da ciwon sukari". Tabbas, yayin daukar ciki, zata hadu da canje-canje sabon abu a jikinta
Yayin da aka fara samun juna biyu, canje-canje a jikin matar ana nufin ci gaba da daukar ciki ne da kuma shirya haihuwa. A cikin farkon farkon, akwai karuwar jiyya ga insulin kuma, gwargwadon haka, buƙatarta ta raguwa, kuma daga mako na 16, an lura da tsayayyen nama (rigakafi) zuwa insulin tare da haɓaka matakinsa a cikin jini.
A cikin mata masu ciki ba tare da ciwon sukari ba, sauyawa a cikin sukari na jini yayin rana suna cikin ƙaƙƙarfan iyaka: daga 3.3 zuwa 6.6 mmol / L. Bukatar insulin yayin canje-canjen ciki da jikin mace mai lafiya ya dace da wannan da kansa.
A cikin mata masu juna biyu masu ciwon sukari mellitus, koda da zaɓaɓɓu masu kyau da ingantaccen tsarin kula da insulin (don nau'in 1 masu ciwon sukari) wanda aka yi aiki tun kafin lokacin samun ciki dole ne a daidaita su koyaushe lokacin cinikin.
Kimanta sakamakon binciken
Dangane da sakamakon gwajin, likitan mahaifa da endocrinologist tare suna tantance yuwuwar yin juna biyu, da kuma hadarin da ke tattare da rikicewar ciki ga uwa da jariri. Idan gwajin ya bayyanar da duk wasu cututtukan da ke bukatar magani ko gyaran tiyata kafin samun juna biyu, ko kuma matar ta kasance cikin halin rushewar cutar sankarar mahaifa, to don lokacin magani kuma har sai an sami biyan diyya, sannan ga wasu watanni 2-3, an zabi hanyar ba tare da faduwa ba. hana haihuwa.
Cikakken contraindications wa tsarin daukar ciki
Abin takaici, akwai sauran cututtuka da rikice-rikice na ciwon sukari, wanda ciki na iya haifar da tsauraran matakai kuma sau da yawa wanda ba za'a iya juya shi ba a cikin mahaifiyar har ma ya haifar da mutuwar ba kawai yaran ba, har ma da mahaifiyar. Wadannan sun hada da:
- Cutar zuciya.
- Cutar cigaba da yaduwa.
- Rashin nasara na koda yaushe tare da babban matakan creatinine, hauhawar hauhawar jini yayin shan magungunan antihypertensive, an yarda yayin daukar ciki.
- Mai tsananin gastroenteropathy
Haihuwar yaro farin ciki ne, amma kuma babban farin ciki shine haihuwar kyakkyawan yaro! Wannan aikin, kodayake ba mai sauki bane, mai yiwuwa ne ga uwaye masu ciwon suga. Don shirya jikinka don fito da sabuwar rayuwa - manufa da za a iya cim ma gaske!
