Idan akwai karancin insulin a jiki, cutar sankarar mahaifa yakan faru.
A da, lokacin da ba a yi amfani da wannan hormone magani ba, mata masu wannan cutar ba su da wata dama ta haihuwar. Kawai 5% daga cikinsu na iya yin juna biyu, kuma mutuwar tayi tayi kusan kashi 60%!
A yau, ciwon sukari a cikin mata masu juna biyu ya daina zama barazanar kisa, tunda maganin insulin yana bawa yawancin mata damar haihuwa da haihuwa ba tare da matsala ba.
Stats
Matsalar ciki mai rikitarwa ta hanyar ciwon sukari mellitus (DM) koyaushe tana cikin kulawa da hankalin masana ilimin endocrinologists da na mahaifa, tun da yake yana da alaƙa da rikice-rikice akai-akai a cikin yanayin haihuwa kuma yana barazana ga lafiyar mahaifiyar da jariri mai ciki.
A cewar kididdigar, a kasarmu nau'in 1 da nau'in ciwon sukari 2 ana gano su a cikin 1-2% na mata masu aiki. Bugu da ƙari, ana rarrabe pregestational (1% na lokuta) da ciwon sukari na ciki (ko GDM).
A peculiarity na karshen cuta shi ne cewa yana tasowa ne kawai a cikin perinatal zamani. GDM yana rikitar da har zuwa 14% na ciki (al'adar duniya). A Rasha, an gano wannan ilimin a cikin 1-5% na marasa lafiya.
Ciwon sukari na mata masu juna biyu, kamar yadda ake kira GDM, ana gano shi a cikin mata masu kiba da ƙwaƙwalwar ƙwayar cuta (dangi tare da cutar sankara). Game da ciwon sukari insipidus a cikin mata masu haihuwa, wannan ilimin cuta ba kasafai yake faruwa ba kuma yakai karancin 1% na lokuta.
Dalilin bayyanar
Babban dalilin shine karuwar nauyi da kuma farkon canje-canje a cikin jiki.
Kwayoyin nama a hankali sukan rasa ƙarfin ɗaukar insulin (sun yi tsauri).
Sakamakon haka, samarwar da ke akwai bai isa ya kula da yawan adadin sukari da ke cikin jini: duk da cewa ana ci gaba da samar da insulin, ba zai iya cika ayyukanta ba.
Cutar ciki tare da ciwon sukari mai gudana
Ya kamata mata su sani cewa yayin daukar ciki ana hana su shan kwayoyi masu rage sukari. Dukkanin marasa lafiya an wajabta su da maganin insulin.
A matsayinka na mai mulki, a cikin farkon sashin farko, buƙatar rage shi kaɗan kaɗan. A cikin na biyu - yana ƙaruwa sau biyu, kuma a na uku - yana sake raguwa. A wannan lokacin, kuna buƙatar yin tsayayya da shawarar rage cin abinci. Yana da wanda ba a ke so don amfani da kowane irin mai dadi.
Don ciwon sukari na gestational, ana bada shawarar abinci mai gina jiki mai-mai. Yana da mahimmanci kada ku ci abinci mai ƙiba: sausages da man alade, madara mai-calorie. Rage abincin carbohydrate a cikin abincin mai ciki zai rage hadarin bunkasa tayin mahaifa.
Don rage ƙimar glycemic a cikin tsinkayen lokacin da safe, ana bada shawara don cin ƙananan carbohydrates. Wajibi ne a lura da ƙididdigar jini koyaushe. Kodayake hyperglycemia mai sauƙi a lokacin daukar ciki ba a la'akari da haɗari ba, an fi dacewa da shi.
A cikin mata masu ciki masu fama da ciwon sukari na 1, cututtukan jini na iya faruwa. A wannan yanayin, ya zama dole a lura da shi ta atomatik ta likitancin endocrinologist da likitan mata.
Ta yaya cutar ta shafi ɗaukar tayin?
Ciwon sukari yana cutar da ciki. Hadarinsa shine cewa glycemia na iya tayar da hankali: a farkon matakin - cutarwar tayin da zubar da ciki, da kuma a ƙarshen mataki - polyhydramnios, wanda ke da haɗari ta koma bayan haihuwa.
Mace na kamuwa da cutar siga idan masu haɗarin nan suka faru:
- kuzarin rikicewar jijiyoyin koda da na retina;
- zuciya ischemia;
- ci gaban gestosis (toxicosis) da sauran rikice-rikice na ciki.
Yaran da aka haifa wa irin waɗannan uwaye galibi suna da nauyi mai yawa: 4.5 kilogiram. Wannan na faruwa ne sakamakon karuwar glucose na haihuwa zuwa cikin mahaifa sannan kuma zuwa cikin jinin yaro.
A lokaci guda, kumburin ƙwayar tayin da ƙari kuma yana haɓaka insulin kuma yana haɓaka haɓakar jariri.
Yayin samun juna biyu, masu ciwon suga ke bayyana kanta ta hanyoyi daban-daban:
- ilimin halin ɗan adam halaye ne na farkon watanni 1: An rage ƙimar glucose jini. Don hana hypoglycemia a wannan matakin, ana rage kashi na insulin ta hanyar kashi uku;
- fara daga mako na 13 na ciki, ciwon sukari ya sake ci gaba. Hypoglycemia mai yiwuwa ne, sabili da haka, adadin insulin yana ƙaruwa;
- a makonni 32 kuma har zuwa lokacin haihuwa, ci gaba a cikin cutar sankarar mama yana faruwa, glycemia na iya faruwa, kuma kashi na insulin ya sake ƙaruwa da kashi ɗaya bisa uku;
- nan da nan bayan haihuwa, yawan sukari na jini ya fara raguwa, sannan ya kara girma, har ya zuwa ga alamun sa na haihuwa kafin ranar 10.
Dangane da irin wannan tsayayyen kumburin sukari, mace na asibiti.
Binciko
Ana la'akari da ciwon sukari mellitus idan, bisa ga sakamakon gwaje-gwajen gwaje-gwaje, ƙimar glucose a cikin jini (a kan komai a ciki) 7 mmol / l (daga jijiya) ko fiye da 6.1 mmol / l (daga yatsa).
Idan ana zargin cutar sankara, ana ƙaddamar da gwajin haƙuri a cikin glucose.
Wani muhimmin alama na ciwon sukari shine sukari a cikin fitsari, amma a hade tare da hypoglycemia. Cutar sukari tana lalata kitsen mai narkewa a jikin mutum, yana haifar da ketonemia. Idan matakin glucose ya tabbata kuma yana da al'ada, ana la’akari da cewa an rama masu ciwon sukari.
Matsaloli da ka iya yiwuwa
Lokacin haila daga asalin ciwon sukari yana hade da rikitarwa da yawa.
Mafi yawan gama-gari - zubar da ciki da gangan (15-30% na lokuta) a makonni 20-27.
Har ila yau, cututtukan ƙwayoyin cuta suna faruwa, hade da cututtukan koda na mara lafiyar (6%), kamuwa da urinary fili (16%), polyhydramnios (22-30%) da sauran abubuwan. Sau da yawa gestosis yana haɓaka (35-70% na mata).
Idan aka ƙara gazawar koda game da wannan cutar, yuwuwar sake haihuwar tayi ƙaruwa sosai (kashi 20-45% na lokuta). A cikin rabin matan da ke fama, polyhydramnios mai yiwuwa ne.
An hana daukar ciki idan:
- akwai microangiopathy;
- maganin insulin baya bada sakamako;
- ma'aurata suna da ciwon sukari;
- haɗuwa da ciwon sukari da tarin fuka;
- A da, mata sun maimaita haihuwar haihuwa;
- an haɗu da ciwon sukari tare da rikici na Rhesus a cikin uwa da yaro.
Tare da rama ciwon sukari, ciki da haihuwa ta ci gaba cikin kwanciyar hankali. Idan ilimin ba ya lalacewa, ana yin tambaya game da isar da wuri ko sashin cesarean.
Tare da ciwon sukari a cikin ɗayan iyaye, haɗarin haɓaka wannan cutar a cikin zuriya shine 2-6%, a duka - har zuwa 20%. Dukkanin wadannan rikice-rikice sun kara haifar da cigaban lokacin haihuwar al'ada. Lokacin haihuwarsa yawanci yana hade da cututtuka masu yaduwa.
Ka'idojin jiyya
Yana da matukar muhimmanci a tuna cewa mace mai ciwon sukari ya kamata likita ta gan shi kafin daukar ciki. Dole ne a ba da cikakken sakamako game da cutar sakamakon isasshen maganin insulin da abinci.
Abincin mai haƙuri ya zama dole tare da endocrinologist kuma yana ɗauke da ƙaramar samfuran carbohydrate, fats.
Yawan furotin abinci ya kamata a ɗan shayar da shi kadan. Tabbatar shan bitamin A, C, D, B, shirye-shiryen aidin da folic acid.
Yana da mahimmanci a kula da adadin carbohydrates kuma a haɗa abinci daidai tare da shirye-shiryen insulin. Yawancin Sweets, semolina da shinkafa shinkafa, ruwan innabi ya kamata a cire su daga abincin. Kalli nauyin ka! Duk tsawon lokacin daukar ciki, bai kamata mace ta sami kilo 10-11 ba.
An ba da izini da hani ga samfuran samfuran ciwon sukari
Idan abincin ya gaza, ana tura mai haƙuri zuwa ilimin insulin. Matsakaicin allura da kuma adadinsu likita ne ya ƙaddara kuma yana sarrafa shi. A cikin ciwon sukari, ana nuna kulawa mai laushi a cikin nau'ikan ganye. An ba da shawarar mata masu juna biyu don ƙananan ayyukan jiki a cikin hanyar yin iyo.
Duk waɗannan matakan sun shafi matan masu fama da ciwon sukari na 1. Nau'in Type 2 da ciwon suga na cikin ƙasa ba su zama ruwan dare a tsakanin mata masu fama da aiki.
Gudanar da juna biyu
Don kula da juna biyu, ya zama dole don cikakken raunin ciwon sukari.
Tunda bukatar insulin a lokutan haila daban-daban, mace mai juna biyu tana bukatar a asibiti sau uku:
- bayan buƙata ta farko don neman taimakon likita;
- karo na biyu a mako 20-24. A wannan lokacin, buƙatar insulin koyaushe yana canzawa;
- kuma a makonni 32-36, lokacin da marigayi toxicosis yakan shiga, wanda hakan babban hatsari ne ga ci gaban tayin. Ana iya warware matsalar asibiti a wannan yanayin ta sashin caesarean.
Cutar ciki yana yiwuwa idan tayin ya zama al'ada kuma idan babu rikitarwa.
Yawancin likitoci sunyi la'akari da bayarwa a makonni 35-38. Hanyar bayarwa yana da cikakken mutum ɗaya. Bangaren Caesarean a cikin marasa lafiya da ciwon sukari suna faruwa a cikin 50% na lokuta. A lokaci guda, maganin insulin baya ƙarewa.
Considereda bornan jariran da aka haife su ga irin waɗannan uwaye ana ɗaukarsu ne kamar tsufa. Suna buƙatar kulawa ta musamman. A cikin sa'o'i na farko na rayuwar yaro, duk hankalin likitocin ya mayar da hankali ne kan hanawa da sarrafa glycemia, acidosis, da cututtukan hoto ko bidiyo mai zagaya yanar gizo.
Bidiyo masu alaƙa
Game da yadda ciki da haihuwa suke tafiya tare da ciwon sukari, a cikin bidiyon:
Cutar ciki babbar jarabawa ce mai mahimmanci ga macen da ke da ciwon suga. Kuna iya dogara da sakamako mai nasara ta lura da duk shawarar da umarni na endocrinologist.
