Sakamakon canje-canje na hormonal, daukar ciki shine yawan ci gaba na rashin daidaituwa a cikin tsarin glucose na mata. Sakamakon juriya na insulin, yana haifar da ci gaban ciwon sukari (GDM) a cikin 12% na mata.
Haɓakawa bayan makonni 16, cutar sankarar mahaifa, wanda tasirinsa ga tayin da lafiyar mahaifiya na iya zama haɗari sosai, yana haifar da mummunan sakamako da mutuwa.
Menene haɗarin ciwon sukari mai haɗari yayin daukar ciki?
Rashin daidaituwa a cikin tsarin biyan bashin metabolism yana haifar da ci gaban GDM. Wannan ilimin halitta yana farawa ne lokacin daukar ciki kuma yana farkon asymptomatic, yana bayyana kanta a cikin mafi yawan lokuta tuni a cikin watanni uku.
A kusan rabin mata masu juna biyu, GDM daga baya ya haɓaci zuwa cikin nau'in ciwon sukari na ainihi na II. Ya danganta da matsayin diyya don GDM, sakamakon an bayyana shi ta hanyoyi daban-daban.
Babbar barazanar ita ce nau'in cutar da ba a daidaita ta ba. Tana bayyana kanta:
- ci gaban lahani a cikin tayin ya haifar da karancin glucose. Rashin daidaituwa a cikin metabolism na metabolism a cikin mahaifiya a farkon haihuwa, lokacin da ƙwayar ƙwayar cuta ta farji ba ta kasance a cikin tayi ba, yana haifar da raunin kuzarin sel, wanda ke haifar da haifar da lahani da ƙarancin nauyi. Polyhydramnios alama ce ta halayyar rashin isasshen ƙwayar glucose, wanda ke ba da izinin wannan binciken;
- ciwon sukari fetopathy - ilimin cututtukan cututtukan cututtukan cututtukan zuciya wanda ke tasowa a sakamakon aikin ciwon sukari akan tayin kuma ana nuna shi ta hanyar rashin lafiyar metabolism da rashin damuwa na endocrine, cututtukan cututtukan ƙwayoyin cuta;
- rashi a cikin samar da surfactant, wanda ke haifar da rikice-rikice na tsarin numfashi;
- ci gaban haihuwar jini, tsokani jijiyoyin jiki da rashin hankali.
Fetopathy na Ciwon Mara
Wani ilimin cutar sankara da ake kira fidapathy da ciwon sukari (DF) yana tasowa ne sakamakon tasirin cutar sankarar mama yayin ci gaban tayin.
An kwatanta shi da lalatawar gabobin ciki na yara - tasoshin jini, fitsari, kodan, tsarin numfashi, haifar da cututtukan ƙarancin ƙwaƙwalwa, ƙwanƙwasa cutar hanji, ƙarancin zuciya, haɓaka nau'in ciwon sukari na II da sauran rikice rikice a cikin jariri, gami da mutuwa.
Macrosomy
Intrauterine hauhawar jini (macrosomia) shine bayyananniyar bayyananniyar hanyar DF. Macrosomia yana tasowa ne sakamakon wucewar glucose daga uwa ta mahaifa zuwa tayi.
Wuce kima a ƙarƙashin aikin insulin wanda ƙwayar ƙwayar ƙwayar ƙwayar mahaifa ya haifar da mai zuwa mai, yana sa a sanya shi akan gabobin kuma nauyin jikin yarinyar zai yi girma cikin sauri - fiye da 4 kilogiram.
Rashin daidaituwa ta jiki alama ce ta waje ta yara tare da macrosomia. Suna da babban jiki wanda ba a yarda dashi ba game da kai da wata gabar jiki, babba a ciki da kafadu, shuɗi-ja, fata mai walƙiya, an lullube ta da jijiyoyin wuya, ƙamshi mai kamshi, da ulu a cikin kunnuwa.
Lokacin da ake bincika macrosomia, ba a shawarar yin halitta na halitta saboda babban matakin rauni. Bugu da ƙari, kasancewar sa yana ƙara haɗarin encephalopathy, wanda ke haifar da haɓakar jin daɗin tunani ko mutuwa.
Jaundice
Alamomin halayyar DF a cikin jarirai har ila yau sun haɗa da jaundice, wanda ke bayyana ta launin rawaya, ƙyallen idanu, da tabarma hanta.
Ba kamar sabbin ilimin halittar jiki a jarirai ba, wanda ke da alamu iri ɗaya kuma suna iya wucewa da kansu bayan sati guda, bayyanar jaundice a cikin jariran da ke fama da cutar sankara ta naƙasa yana buƙatar magani mai wahala, tunda yana nuna ci gaban cututtukan hanta.
Hypoglycemia
Essarkewar glucose daga mahaifiya zuwa jariri bayan haihuwarsa a kan asalin ƙara yawan insulin ƙwayar kansa ta hanjin kansa yana haifar da ci gaba da cutar ƙin jini a cikin jariri - wata alama ce ta DF.Hypoglycemia yana haɓaka ci gaban haɓakar ƙwaƙwalwar ƙwaƙwalwa a cikin jarirai, yana shafar ci gaban hankalinsu.
Don guje wa hypoglycemia da sakamakonsa - gurnani, coma, lalacewar kwakwalwa - daga lokacin da aka haife shi a cikin jarirai, ana daukar nauyin sukari, idan ya faɗi, an saka jariri da glucose.
Levelsarancin matakan kalsiya da magnesium a cikin jini
Babban glucose na lokaci-lokaci yayin daukar ciki yana haifar da rashin daidaituwa a tsarin ma'adinai, yana haifar da munafukan ciki da kuma hypomagnesemia a cikin jariri.
Raguwar gangar jikin kalson jini zuwa 1.7 mmol / L ko ƙasa da cikin jariri ana lura da kwanaki 2-3 bayan haihuwa.
Wannan halin ya nuna kansa da taƙuda-excitability - jariri sau biyu tare da wata gabar jiki, yayi kururuwa, yana da tachycardia da tonic convulsions. Irin waɗannan bayyanar cututtuka suna faruwa a cikin jariri kuma tare da hypomagnesemia. Yana haɓaka lokacin da ƙwayar magnesium ta kai matakin da ke ƙasa 0.6 mmol / L.
Ana gano kasancewar irin wannan yanayin ta amfani da ECG da gwajin jini. A cikin 1/5 na jarirai waɗanda suka sami matsala ta dalilin ƙwaƙwalwar ƙwayar cuta ko rashin kyawun jini, ana lura da rikicewar jijiyoyin jiki. Don taimakonsu, an sanya jariran su IM, iv management of magnesium-alli mafita.
Matsalar numfashi
Yaran da ke da DF sun fi wasu damar fuskantar hypoxia na kullum.
Saboda ƙarancin isasshen ƙwayar ƙwayar ƙwayar ƙwayar cuta, wanda ke tabbatar da faɗaɗa huhun huhu a cikin jarirai tare da inhalation na farko, ƙila za su iya haifar da rikicewar numfashi.
An bayyana bayyanar gazawar numfashi, kamawar numfashi.
Isar da bata lokaci
GDM yana daya daga cikin sanadin haifar da daskararre tayin, zubar da ciki, ko haihuwa.
Babban tayin da aka haɓaka sakamakon macrosomia ya fi kilogiram 4, a cikin kashi 24 cikin dari na haifar da haihuwa, wanda yawanci yakan haifar da ci gaba da cututtukan ƙwayar cuta a cikin jarirai a kan asalin jinkirin balaguro a cikin huhun tsarin tsarin.
Me ke barazanar kamuwa da ciwon sukari?
GDM mai rikitarwa yana haifar da mummunan guba a cikin mata masu ciki a cikin watanni uku. Abubuwa masu haɗari masu haɗari ga mace sune preeclampsia da eclampsia. Lokacin da aka yi musu barazanar, za a yi wa mace mai ciki asibiti don sake haihuwa da kuma lokacin haihuwa.
Mai tsananin gestosis
Canje-canje a cikin tasoshin jini saboda take hakkin metabolism shine ke haifar da gestosis.
Asedara yawan hawan jini da edema alamomin sa ne na yau da kullun a cikin 30-79% na mata. Idan aka haɗu da sauran hanyoyin, yana iya haifar da babban sakamako. Misali, hadewar gestosis da DF ke haifar da bayyanar uremia.
Bugu da ƙari, haɓakar gestosis yana haifar da asarar furotin a cikin fitsari, bayyanar farin ciki na ciki, nephropathy, eclampsia, yana haifar da barazana ga rayuwar mahaifiyar.
Haɓaka ƙwayar gestosis mai ƙarfi yana taimakawa ga:
- ciwon sukari na sama da shekaru 10;
- cutar labile (labile diabetes) kafin daukar ciki;
- urinary fili kamuwa da cuta a lokacin daukar ciki.
Hawan jini
Matan da ke fama da hauhawar jini suna cikin nau'in haɗarin kamuwa da cutar GDM yayin daukar ciki.
A cikin mata masu juna biyu, an rarrabe nau'in hawan jini guda 2:
- na kullum - ana lura dashi a cikin mace kafin lokacin ɗaukar ciki ko har zuwa mako na 20 na ciki kuma shine sanadin 1-5% na rikice-rikice yayin gestation;
- lokacin haihuwayana fitowa a cikin 5-10% na mata masu juna biyu bayan sati na 20 kuma zai daɗe har wata 1.5. bayan haihuwa. Haɓakar hauhawar jini yakan faru sau da yawa tare da daukar ciki da yawa.
Preeclampsia
Wani rikice-rikice wanda ke faruwa a cikin 7% na mata masu juna biyu bayan sati na 20, wanda kashi ɗaya bisa hudu - a cikin bayan haihuwa a cikin kwanakin 4 na farko.
An gano shi a asibiti ta hanyar furotin a cikin fitsari. Idan ba a kula da shi ba, yana ci gaba zuwa cutar ƙin ƙwaƙwalwa (a ƙalla 1 a cikin mata 200), har zuwa mutuwa.
Babban abu yana cikin / gabatarwar magnesium sulfate da isar da wuri.
Zina
Hadarin rashin daidaituwa tare da ciwon sukari yana ƙaruwa a wasu lokuta. Increasearuwar ƙwaƙwalwar jini a sakamakon ƙarancin insulin yana haifar da ci gaban rashin ƙarfi, bayyanuwar cututtukan ƙwayoyin cuta na jini da kuma dakatar da juna biyu.
Yaya GDM zai shafi haihuwa?
A cikin mata masu juna biyu da ke fama da cutar sankara ta GDM, an ƙayyade yawan aikin yin aiki gwargwadon tsananin cutar, matsayin biyan diyya, matsalolin rikitarwa.
Mafi yawan lokuta, ana yin aiki ne a makonni 37-38 idan tayin ya fi nauyin kilo 3.9. Idan nauyin tayin yayi kasa da kilogram 3.8, a tsawan ciki zuwa makonni 39 zuwa 40.
Ana amfani da duban dan tayi domin sanin nauyin tayin da kuma yardarta da girman ƙashin ƙugu na mace, da yiwuwar haihuwa.
Idan an yarda da yanayin mahaifiya da jariri, ana yin bayarwa ta hanyar dabi'a tare da maganin hana motsa jiki, ma'aunin sa'a na matakin glycemic, insulin therapy, lura da rashin lafiyar fetoplacental, kulawar zuciya.
Sakamakon motsawar aiki a cikin GDM
Bayyanar cutar GDM a cikin mahaifiya yana ƙara yiwuwar rikice-rikice yayin haihuwa yayin da kanta da jariri.Hadarinsu mafi ƙaranci ne idan an yi sashin cesarean ko kuma aikin tiyata a sati 39.
Imuarfafawa aiki kafin makonni 39 yana barata ne kawai a gaban wasu takamaiman alamun da ke nuna bayyanar hadarin sake haifar haihuwa.
Ga duka biyun, haɗarin rikice-rikice ya zama kadan idan an fara aiki kwatsam a makonni 38-39.
Jiyya da kariya daga rikice-rikice yayin daukar ciki
Yadda ciki zai gudana a cikin mata masu fama da ciwon sukari ya dogara da matakin kula da kansu da ci gaba da cutar sikari. Tsarin kula da jiyya ya dogara ne da alamomin mahaifiyar kuma an zaɓi su daidai da su.
Ana ba da shawarar yin asibiti tsakanin dalilai na ciki sau 3 yayin daukar ciki:
- a farkon sati na farko idan akwai maganar gano cutar;
- a mako na 20 - don gyara tsarin warkewa daidai da yanayin mahaifar da tayin;
- a ranar 36 ga shiri don tsara haihuwa da kuma zabi mafi kyawun hanyar bayarwa.
Baya ga sarrafa matakan glucose da rama magani, mata masu juna biyu da ke da cutar GDM suma an wajabta musu abinci na musamman da tsarin motsa jiki.
Yin rigakafin rikice-rikice na GDM ya ƙunshi:
- gano lokaci na ciwon sukari da ciwon suga da ciwon suga, wanda ke ba da izinin gudanar da bincike da daidaita magani;
- gano farkon DF ta amfani da duban dan tayi;
- saka idanu sosai da gyaran glucose daga ranar farko ta gano ciwon sukari;
- bi da jadawalin ziyarar zuwa likitan mata.
Bidiyo masu alaƙa
Abubuwan haɗari da haɗarin ciwon sukari a cikin bidiyo:
A baya can, bayyanar cutar GDM da kuma kwarewar daukar nauyin biyan diyya a duk tsawon lokacin da za su yi ciki, su zama mabuɗin ƙarancin rikice-rikice da sakamako ga mahaifiyar kanta da ɗanta.
