Cutar ciki tana da ƙara nauyi a jikin mahaifiyar, a wannan lokacin ne yawancin cututtukan cututtukan cuta suka tsananta, sababbin matsaloli sun bayyana. Daga cikin rikice-rikice na rayuwa a cikin mata masu haifar da yaro, gestational diabetes mellitus (GDM) sun fi yawa. Wannan cutar tana haɗuwa da kusan 4% na ciki, 80% daga cikinsu suna faruwa tare da rikice-rikice ga mahaifiyar, a cikin 45% na lokuta yana haifar da gestosis.
Cutar sankarar mahaifa ba ta wucewa ba tare da wata dabi'a ga yaro ba: saboda karuwa da cutarwar haihuwa, 20% na yara suna da matsala game da yaduwar ƙwayar cuta, 19% suna da karaya. Bayan haihuwa, dole ne su daidaita tsarin jini, daidaita numfashi da kuma magance raunin jijiyoyin jiki.
Yawan mace-mace a cikin yaran da aka haife su ga uwaye tare da GDM ya ninka 2 sau da matsakaita.
Ciwon sukari da hauhawar jini zai zama abin da ya wuce
- Normalization na sukari -95%
- Cirewa kan jijiyoyin mara wuya - 70%
- Cire zuciyar mai karfin zuciya -90%
- Rabu da cutar hawan jini - 92%
- Increasearuwar kuzarin rana, inganta bacci da dare -97%
Yawan rikice-rikice a cikin mace da yaro sun dogara da gano lokacin ciwon sukari, kulawa da ta dace da kuma halayen mahaifiyar da ke zuwa game da yanayin ta.
Ciwon sukari na ciki - menene?
Yayin haihuwar yaro, buƙatar glucose yana ƙaruwa, jiki yana riƙe da shi cikin jini don biyan bukatun makamashin tayi, saboda haka juriya insulin ƙwayar cuta ta taso. Idan wannan tsari ya lalace, cutar sikari ta ci gaba. Lokacin farawa shi ne rabin biyu na ciki, lokacin da jariri ya riga ya girma, yawanci daga 16 zuwa 32 makonni.
Ba kamar mellitus na ciwon sukari na yau da kullun ba, gestational sau da yawa ba a haɗuwa da mummunan ciwo. Ciwon sukari na mata masu juna biyu, kamar yadda ake kira shi kuma, ana iya bayyana shi ba kawai a cikin ƙaruwar sukari ba, har ma da keta haƙurin glucose. Wannan yana nuna cewa ka'idodin sukari na jinin jini ya wuce, amma ba sosai sosai ba don wannan cin zarafin ana ɗaukar ciwon sukari.
Wani bambanci a cikin ciwon sukari na ciki shine yanayinsa na ɗan lokaci. Duk alamun cuta ta ɓace nan da nan bayan isar. A nan gaba, irin waɗannan mata suna cikin haɗari mafi girma na irin wannan rikice-rikice yayin cikin ciki masu zuwa (fiye da 60%), da alama kamuwa da cutar sukari nau'in 2 yana ƙaruwa.
Babban sukari na jini na iya ma'anar GDM, amma bayyanar cutar sankara, wanda zai kasance tare da matar har tsawon rai. Kuna iya bambance tsakanin waɗannan rikice-rikice guda biyu ta hanyar bincika abubuwan da ke cikin jini da kuma tantance yanayin ƙwayar cutar.
Sharuɗɗan ganewar asali ga cututtukan ƙwayar cutar mahaifa:
| Nau'in bincike | Manuniya na GDM | Alamar nuna alamun cutar ciwon sukari mellitus, mmol / l | |||
| mmol / l | mg / dl | mmol / l | mg / dl | ||
| Glucose na azumi (GLU), ana ɗauka ne kawai daga jijiya | 5.1 ≤ GLU <7 | 92 ≤ GLU <126 | GLU ≥ 7 | GLU ≥ 126 | |
| Gwajin glucose a jiki (75 ml glucose) | awa daya daga baya | GLU ≥ 10 | GLU ≥ 180 | GLU ≥ 11.1 | GLU ≥ 200 |
| bayan awa 2 | GLU ≥ 8.5 | GLU ≥ 153 | |||
Dangane da rarrabuwa da cututtukan, an sanya cutar a matsayin cutar sankara ta mellitus, lambar ICD ita ce 10 O24.4.
Sanadin GDM
Tun daga cikin tsakiyar ciki, canje-canje masu girma na hormonal suna faruwa a cikin mahaifiyar: samar da progesterone, placental lactogen, estrogen, cortisol suna aiki. Dukkanin su insulin antagonists ne, wanda ke nufin karuwar su ta zama dalilin raunin ta. Bugu da kari, lactogen da ke cikin mahaifa yana kara matakan kiba a cikin jini, wanda ke kara karfin insulin na kyallen takarda. Bayar da gudummawa ga karuwar glucose da canje-canje na yau da kullun a rayuwar mace mai ciki - karuwa a cikin adadin kuzari, raguwa a cikin motsa jiki da motsi, ƙimar nauyi.
A cikin mace mai lafiya, ana rama ƙwarin insulin juriya. Tsarin insulin yana ƙaruwa saboda hauhawar ƙwayoyin beta na pancreatic, ƙwaƙwalwar shi a cikin hanta yana raguwa. Cutar sankara ta hanji na faruwa a cikin mata masu juna biyu idan wata irin hanyar biyan diyya bata yi aiki ba.
Mafi yawancin lokuta wannan yana faruwa a cikin waɗannan lambobin:
- Wuce kima a cikin mace mai ciki (> 20% sama da na al'ada), wanda aka samo a baya.
- Abincin mai kalori mai yawa tare da carbohydrates.
- Saurin rayuwar ƙasa, gami da ciki kafin haihuwa.
- Shan taba.
- Ciwon sukari mellitus ko tsananin juriya a cikin dangi.
- GDM a cikin wata ta gabata.
- 'Ya'yan farko suna da nauyin fiye da 4 kilogiram a lokacin haihuwa.
- Polyhydramnios.
- Kwayar polycystic.
- Shekaru sama da shekaru 30. Lokacin da ya cika shekaru 40, hadarin kamuwa da cutar mahaifa ya ninka sau 2.
- Tare da tseren Mongoloid da Negroid.
Bayyanar cututtuka da alamun cutar sankaran hanji
Bayyanar cututtukan cututtukan cututtukan mahaifa sun hada da:
- bakin bushewa akai-akai;
- karuwar ci;
- volumeara yawan ruwan sha, ƙarin yawan urination;
- gasarin haɓakar gas a cikin narkewa;
- itching, musamman a kan ciki da kuma perineum;
- gajiya, bacci;
- talauci mai saukin kamuwa;
- wuce haddi nauyi.
Kamar yadda kake gani, duk wadannan alamu marasa amfani ne, dukkansu suna iya haifar da wasu dalilai, gami da daukar ciki kanta. Cutar sankarar mahaifa ba ta da alamu bayyanannu, bayyananniyar alamomin, don haka kowace mace, bayan rajista, tana yin wani gwaji na tilas don gano sinadarin glucose mai rauni.
Matakan bincike
A farkon ziyarar likita, duk mata masu juna biyu an wajabta musu gwajin sukari na jini. Tare da glucose mai azumi sama da 7 mmol / L da gemoclobin jini wanda ya wuce matakin 6.5%, yuwuwar ciwon sukari yana da yawa. Idan ƙididdigar jini mara kyau da haɗe tare da alamun hyperglycemia, ana ganin cutar ta lalace. Idan babu alamun bayyanannu na karuwar sukari, ana yin tazarce-nazarce don magance kurakurai. Mara lafiya mai kamuwa da cutar sankarar mahaifa an kira shi zuwa ga endocrinologist wanda ke gudanar da ƙarin karatu, da yanke hukunci game da nau'in cutar, kuma yana tsara magani. A lokacin daukar ciki a cikin mata, wanda saboda dalilai da yawa ana iya danganta su da ƙungiyar yawan haɗarin kamuwa da cutar sankarar bargo, irin waɗannan gwaje-gwaje ana maimaita su da yawa bayan haka.
Mafi kyawun lokacin don gano ciwon sukari shine lokacin daga makonni 24 zuwa 26 na ciki. Dangane da shawarwarin asibiti na Ma'aikatar Lafiya, ana amfani da gwajin haƙuri na glucose don ganewar asali. Idan mace tana da haɗarin kamuwa da ciwon sukari, babban tayi, alamun fetopathy, za a iya yin bincike a gaba. Karshe makonni 32, daga baya gwajin zai iya zama haɗari saboda ƙaruwa mai ƙarfi a cikin sukarin jini.
Tushen gwajin shine a auna azumin glucose din jini, sannan kuma bayan mintuna 60 da 120 bayan "kaya" na carbohydrates mai saurin motsa jiki. Carbohydrates sune 75 g na gubar glucose ko 82.5 g na glucose monohydrate. An narkar da su a cikin gilashin ruwan dumi kuma an baiwa mace mai juna biyu sha. Gwajin haƙuri a cikin gwajin haƙuri ya bayyana daidai yadda ake ɗaukar glucose daga jini, saboda haka mummunan sakamako guda ɗaya ya isa ya bincika GDM.
Don tabbatar da ingancin gwajin, yana da daraja a ɗauka da muhimmanci shiri don bayar da gudummawar jini: da safe kafin bincike, zaku iya shan ruwa kawai. Ba shan taba, ba magani. Na tsawon kwanaki 3, bai cancanci canza komai a rayuwar ko abinci ba.
Dalilin jinkirta gwajin:
- toxicosis;
- iyakantaccen aiki, kwanciyar bacci;
- m kumburi ko kamuwa da cuta;
- cututtukan ƙwayar gastrointestinal, wanda a ciki yake lalata ƙwayar glucose.
Yadda ake kula da cutar siga a cikin mata masu juna biyu
Bayyanin ciwon sukari yayin daukar ciki ba dalilin fargaba ba. Idan kun fara jiyya a kan lokaci, ziyarci likita a cikin ladabi kuma ku bi duk rubutattun magunguna, zaku iya kawar da mummunan sakamako ga yaran, ku guji rikice-rikice a cikin mahaifiyar, kuma ku yanke hukuncin kamuwa da cuta a nan gaba.
Manufar magani shine cimma matakan glucose: da safe, kafin kowane abinci, kafin lokacin kwanciya, da dare (daskararre a 3:00) ƙasa da 5.1 mmol / l, awa daya bayan kowane abinci - ƙasa da 7 mmol / l. Yakamata ya kasance babu cututtukan jini da ketones a cikin fitsari. Matsin lamba ba ya ƙasa da 130/80.
Don sarrafa waɗannan alamomin, mata masu juna biyu suna riƙe abin tunawa a cikin kullun da suke lura da su: sukari na jini - aƙalla ma'auni 8 a kowace rana, kasancewar ketones a cikin fitsari da safe kafin abinci, matsa lamba, nauyi, aikin tayin, menu da abubuwan da ke tattare da carbohydrate a ciki.
Abun lura yayin daukar ciki ana gudanar da shi ne lokaci guda ta wani likitan mata da mahaifa. Dole ne a ziyarci likitoci sau 2 a wata har sai mako na 29 da kuma sati-sati a wani lokaci mai zuwa. A matsayinka na mai mulkin, rage cin abinci da motsa jiki matsakaici sun isa don daidaita yanayin glucose. A cikin halayen da ba kasafai ba, ana wajabta maganin insulin.
Amfani da magunguna
Magungunan sukari, wanda aka wajabta don ciwon sukari na 2, an haramta su sosai yayin daukar ciki, saboda suna haifar da rashin abinci mai gina jiki na tayin. Sabili da haka, hanya guda ɗaya a wannan lokacin don magance glycemia shine magani - insulin a cikin hanyar injections.
An wajabta insulin a cikin yanayi biyu. Da fari dai, idan rage cin abinci da aikin jiki ba su da karfi, to, ba za a iya samun matakan sukari na jini sati 2 ba daga farawar lafiya. Abu na biyu, idan binciken duban dan tayi ya nuna alamun tasirin tasirin tayin mai girman glucose: nauyi mai nauyi, karuwar kitse mai yawa a jiki, kumburin nama, polyhydramnios.
Tsarin insulin kwantar da hankali na likita ya zaɓi bisa ga bayanin kulawar kai. Dogon insulin da ke aiki yayin daukar ciki, a matsayina na doka, ba a bukatar shi, saboda yana rasa hormone kansa. Don haka, a takaice insulin ne ko kuma ana amfani dasu ana amfani da allurar riga-kafi. An saka insulin a cikin ƙananan ciki zuwa cikin cinya ko cinya ta amfani da sirinji insulin ko alkalami - duba yadda ake allurar insulin daidai.
Magungunan an allurar ne gabanin kowane abinci wanda akwai carbohydrates, ana yin lissafin kashi gwargwadon adadin ɗakunan abinci a cikin abincin. Lokacin ziyartar likita, za a sake nazarin sashi duk lokacin da ya danganci bayanan glycemia don makon da ya gabata. Idan adadin insulin kowace rana da ake buƙata don yawan sukarin jini na al'ada ya wuce raka'a 100, za'a iya shigar da fam ɗin insulin akan mai haƙuri, tare da taimakon wanda za a sarrafa magunguna akai-akai a ƙananan gudu
Abincin da ya dace da abinci
Taimako sosai: Abincin don ciwon sukari a cikin mata masu juna biyu
Yin bita a cikin menu na tsawon lokacin daukar ciki shine ɗayan manyan sharuɗɗan shawo kan cutar sankarar mahaifa. Yawancin mata masu juna biyu da wannan cuta suna da kiba sosai, saboda haka kuna buƙatar iyakance yawan adadin kuzari.
Calories da aka ba da shawarar:
Massididdigar taro na Jiki | Kcal a kowace kilogiram na nauyi |
18-24,9 | 30 |
25-29,9 | 25 |
| 30 kuma mafi | 12-15 |
Don jiki ya karbi dukkanin bitamin da ake buƙata a rage yawan adadin kuzari, menu dole ne ya ƙunshi ganye, kayan lambu, nama da kifi, 'ya'yan itatuwa.
Abin da 'ya'yan itatuwa da kayan marmari an yarda: kowane irin kabeji, cucumbers, albasa, ganye mai yalwa, radishes, zucchini, eggplant, raw karas, avocados, lemons, apples, cherries, strawberries, innabi.
An Haramta: dankali, tafasasshen karas, kwanakin, kankana, ayaba, inabi, musamman raisins mai yawa.
Abincin abinci don ciwon sukari ya kamata ya cika waɗannan buƙatun:
- Tsarin Abinci Har zuwa sau 6 a cikin karamin rabo a kusan daidai lokacin jaka.
- Regular. Kada tsallake ko jinkirta lokacin abincin da aka saita na dogon lokaci.
- Ban da na carbohydrates mai sauri. Cikakken haramci game da sukari, desserts tare da abuncinta, yin burodi, abinci nan take - game da sauri da kuma jinkirin carbohydrates //diabetiya.ru/produkty/bystrye-i-medlennye-uglevody.html.
- Theara yawan adadin fiber a menu. An fi son kayan lambu mai ɗorewa fiye da kayan lambu da aka ba da zafi - abinci mai fiber.
- Iyakance mayukan kitse zuwa 10%. Sauyawa zuwa nama mai durƙusad da abinci, mai dafa tare da mai kayan lambu maimakon kitse na dabba.
- Isasshen ruwan sha. A lokacin daukar ciki, kana buƙatar sha ƙarancin lita 1.5 a kowace rana.
- Karin abubuwan bitamin.
Matsakaicin abubuwan gina jiki (BJU) don ciwon sukari ya kamata suyi kama da: sunadarai = 20-25%, fats <30%, carbohydrates = 38-45%.
Ilmin motsa jiki da Ilimin zazzabin cizon sauro na jiki
Aikin tsoka na yau da kullun yana taimakawa rage jinkirin insulin kuma yana hana ƙima mai nauyi, saboda haka bai kamata a yi watsi da motsa jiki idan ana maganar ciwon suga ba. An tsara shirin horarwa ne ga kowace mace daban, gwargwadon lafiyarta da iyawar jikinta. Yawancin lokaci motsa jiki mara ƙarfi - tafiya, iyo ko ruwa mai ba da ruwa. Ba za ku iya yin darussan kwance a bayanku ko ciki ba, an cire gangar jikin da kafafu an haramta. Wasannin da aka gama tare da raunin da basu dace ba: dawakai, kekuna, skates ko rollers.
Imumaramin darasi kowane mako shine minti 150. Motsa jiki motsa jiki tare da kowane ciwo kuma ya koma tare da ƙoshin lafiya.
Sauran hanyoyin magance GDM
Cutar ciki lokaci ne na tazara mai rauni ga uwa da jariri. Saboda sha'awar guje wa magani, mata da yawa a wannan lokacin sun sauya zuwa magani na ganye. A halin yanzu, yunƙurin warkar da ciwon sukari na gestational, ba tare da ƙwarewa na musamman ba, bisa ga girke-girke daga Intanet na iya ƙare cikin gazawa.
Misali, adon tushen dandelion, wanda ake tallata shi azaman magani ga masu ciwon suga, yakan canza yanayin haihuwar mace mai juna biyu, yarrow da nettle na iya tsokanar haihuwa, da kuma St John's wort da sage yana hana zubar jini a cikin mahaifa.
A kan yawancin kunshe-kunshe tare da kayan shuka, ciki kuma an jera su a cikin jerin contraindications. Sabili da haka, kuna buƙatar yin doka: kowane sabon magani ya kamata halartar likitan halartar.
Iyakar abin da magani wanda amfani a cikin ciwon sukari ba a cikin rikici shine jiko na rosehip. Zai kawar da rashin bitamin C, rage adadin radicals, da kuma sauwake kumburi. Girke-girke mai sauki ne: an ɗora kwatangwalo na kwatangwalo a cikin thermos kafin zuwa gado, zuba lita na ruwan zãfi. Da safe, m jiko a shirye. Sha shi rabin gilashi kafin abinci.
Sakamakon ciwon sukari yayin daukar ciki
Yawan jini a cikin mace mai ciki, hakan yafi hadari ga yaro. Idan ba a ba da cikakkiyar kulawa ba, ƙwayar fetopathy na mahaifa yana tasowa: an haifi jariri mai yawan gaske, tare da ƙwayar ƙwayar cuta, ƙwayar cuta mai ƙiba. Zai iya samun matsalolin numfashi, yawan kumburi, rashin lafiyar narkewar abinci. A nan gaba, irin waɗannan yara suna da haɗarin kiba da ciwon sukari.
Haihuwar da ke dauke da cutar sikari sau da yawa ana ba da ita a sati 38. Idan yaro yana da nauyi mai yawa, ana yin sashin cesarean. Ba kamar yara na yau da kullun ba, iyaye mata masu ciwon sukari suna buƙatar abinci daga mintina na farko na rayuwa, kamar yadda ƙwaƙwalwar su, suka saba da wuce haddi na sukari na jini, suna ci gaba da zubar da adadin insulin na ɗan lokaci. Idan abinci mai gina jiki ba zai yuwu ba ko kuma rashin isasshen maganin glycemia, an allurar da jaririn a ciki.
Mene ne haɗarin ciwon sukari mai haɗari ga uwar: a lokacin daukar ciki - edema, hawan jini, marigayi toxicosis. Yayin haihuwa - haɓakar haɗarin ruptures saboda yawan tayi. Bayan su akwai babban haɗarin ciwon sukari a cikin cikin cikin ciki na gaba da nau'in ciwon sukari na 2.
Shin ina bukatar sa ido bayan haihuwa?
Abubuwan lura da asibiti da sake dubawa game da iyaye mata sun nuna cewa yawancin yawancin cututtukan ƙwayar cuta na haihuwa ke shuɗewa da zaran an haifi jariri. Nan da nan bayan tashi daga cikin mahaifa, wanda shine mafi girman kwayoyin halittar da suke samarda kwayoyin halitta yayin daukar ciki, sukari jini ya zama al'ada. Har sai an fitar da matar, suna ci gaba da lura da matakin glucose din ta.Bayan watanni 2, kuna buƙatar sake sake gwajin haƙuri na glucose kuma don gano idan akwai sauran rikice-rikicen metabolism da kuma idan kuna fuskantar ciwon sukari a nan gaba.
Don rage haɗarin, matan da suka sami GDM suna buƙatar asarar nauyi, guji carbohydrates mai sauri, da kuma faɗaɗa ayyukansu na jiki. A cikin shiri don ciki na gaba, tabbatar cewa ƙwararrun masanin ilimin endocrinologist ne zasu bincika.
