Namuhla, isifo sikashukela kubantu besifazane yisifo esivamile. Kulokhu, uhlobo lwesifo lungahluka: i-insulin-incike, ayithembi i-insulin, i-gestational. Kepha uhlobo ngalunye luhambisana nesibonakaliso esisodwa esivamile - ushukela wegazi ophezulu.
Njengoba wazi, akusona isifo sikashukela ngokwaso esesabekayo, kepha izinkinga zibangelwa ukungasebenzi kahle kwamanyikwe. Ngaphezu kwalokho, eminyakeni yamuva, isifo sikashukela sohlobo 2 sikhula sisebancane, ngakho-ke, inani labesifazane abafuna ukuba nengane liyakhula yize kukhona i-hyperglycemia engalapheki.
Vele, ngesifo sikashukela, ukuba nengane akulula. Ngakho-ke, ezimweni eziningi, odokotela bagcizelela ukukhipha isisu. Ngaphezu kwalokho, kunamathuba amaningi okuphuphuma kwesisu okuzenzakalelayo.
Ngabe isisu senziwa nini isifo sikashukela?
Kunezici ezimbalwa zokuba khona kwazo kudinga ukunqanyulwa kokukhulelwa. Lokhu kuphulwa kufaka phakathi ushukela olinganiselayo, ngoba inkambo yayo ingaba yingozi hhayi kowesifazane kuphela, kodwa neyomntwana wakhe.
Imvamisa, izingane zabomama ezinesifo sikashukela zizalwa zinemisipha, inhliziyo nenhliziyo kanye nezici zamathambo. Le nto ibizwa ngokuthi yi-fetopathy.
Ngesikhathi sokuhlela ukukhulelwa, uhlobo lwesifo kowesifazane kufanele lubhekwe nokuthi ubaba unaso yini isifo esinjalo. Lezi zinto zithinta izinga lokuphangwa kwefa.
Isibonelo, uma umama enesifo sikashukela sohlobo loku-1 futhi ubaba wakhe enempilo, khona-ke amathuba okuthola isifo enganeni amancane mancane - yi-1% kuphela. Lapho kukhona isifo sikashukela esincike ku-insulin kubo bobabili abazali, amathuba okuvela kwengane yabo angama-6%.
Uma umuntu wesifazane enesifo sikashukela sohlobo 2 futhi uyise esempilweni, amathuba okuba ingane ibe nempilo ihluka kusuka ku-70 kuya ku-80%. Uma bobabili abazali benefomu elimele i-insulin, khona-ke amathuba okuba inzalo yabo ngeke ihlaselwe yilesi sifo angama-30%.
Ukukhishwa kwesisu sikashukela kuboniswa ezimweni ezinjalo:
- ukulimala kwamehlo
- isifo sofuba esingamahlalakhona;
- iminyaka kamama yeminyaka engama-40;
- ukuba khona kwengxabano yeRhesus;
- isifo senhliziyo;
- lapho owesilisa nowesilisa benesifo sikashukela sohlobo 2;
- i-nephropathy kanye ne-acute renal ukwehluleka;
- pyelonephritis.
Ukuba khona kwazo zonke lezi zinto ezingenhla kungaholela ekuqandeni kwengane, okuzoba nomthelela ongemuhle empilweni yabesifazane. Kepha imvamisa umbuzo ohlobene nokuthi ukukhulelwa onesifo sikashukela kungaxazululwa ngakunye.
Yize abesifazane abaningi beluthinta ngokungenankinga lolu daba, bangahambi odokotela futhi bangazidlulisi zonke izivivinyo ezidingekayo. Ngakho-ke, amathuba okuphuphuma kwezisu nokukhipha izisu okuphoqelelwa kuyanda minyaka yonke.
Ukuvimbela lokhu, abesifazane abakhulelwe abanesifo sikashukela kufanele baqaphele ukukhulelwa kwabo ngokucophelela ngokuhlola isimo se-fetus. Kulokhu, kubalulekile ukunamathela ekudleni okukhethekile okunciphisela ukugcwala kwe-glucose emfudlaneni wegazi. Futhi, ngesikhathi sokuzala kwengane, kuyadingeka ukuthi uvakashele i-ophthalmologist, gynecologist kanye ne-endocrinologist.
Isisu singaba yingozi kanjani kowesifazane onesifo sikashukela? Ngemuva kwale nqubo, isiguli singaba nezinkinga ezifanayo nezabesifazane abanempilo. Lokhu kufaka phakathi ingozi yokutheleleka nokuphazamiseka kwama-hormone.
Ukuvimbela ukukhulelwa, abanye abanesifo sikashukela basebenzisa i-intrauterine (ne-antennae, ene-antiseptics, nxazonke), kepha baba nomthelela ekusakazeni ukutheleleka. Amaphilisi okulawula ukuzala angathinti i-carbohydrate metabolism nawo angasetshenziswa. Kepha izidakamizwa ezinjengalezi ziyalelwa ezigulini zemithambo yegazi.
Abesifazane abanomlando wesifo sikashukela sokukhulelwa bakhonjiswa imithi equkethe i-Progestin. Kepha indlela ethembekile nephephile yokuvikela ukukhulelwa yi-inzalo. Kodwa-ke, le ndlela yokuvikela isetshenziswa kuphela ngabesifazane asebevele benezingane.
Kodwa kuthiwani ngabesifazane abanesifo sikashukela abafuna ngempela ukubekezelela ngokuphephile futhi bazale ingane enempilo?
Kuyadingeka ukulungiselela ngokucophelela umcimbi onjalo, futhi, uma kunesidingo, izindlela ezahlukahlukene zokwelapha zingenziwa.
Ukuhlelwa kokukhulelwa kwesifo sikashukela
Okokuqala, kubalulekile ukuthi uqaphele ukuthi owesifazane onenkinga yokudla ngokwe-carbohydrate metabolism uyanconywa ukuba akhulelwe eneminyaka engama-20-25 ubudala. Uma esemdala, khona-ke lokhu kwandisa ubungozi bezinkinga.
Akubona abantu abaningi abazi, kepha ukungasebenzi kahle (i-anocephaly, i-microcephaly, isifo senhliziyo) sokukhula kwengane kubekwa ekuqaleni kokukhulelwa (kuze kube ngamaviki ayi-7). Futhi iziguli ezinesifo sikashukela esiwohlokile zivame ukuba nokungasebenzi kahle kuma-ovari, ngakho-ke ngeke zihlale zisho ukuthi ukungabikho kokuya esikhathini kuyindlela yokugula noma yokukhulelwa.
Ngalesi sikhathi, ingane esevele iqalile ukukhula ingahlupheka. Ukuze uvikele lokhu, isifo sikashukela kufanele sinqunywe kuqala, okuzovikela ukubonakala kwesiphene.
Ngakho-ke, uma izinga le-hemoglobin ye-glycated lingaphezulu kwe-10%, khona-ke amathuba okuvela kwe-pathologies eyingozi enganeni yi-25%. Ukuze ingane ikhule ngokujwayelekile nangokuphelele, izinkomba akufanele zibe ngaphezulu kwe-6%.
Ngakho-ke, ngesifo sikashukela, kubaluleke kakhulu ukuhlela ukukhulelwa. Ngaphezu kwalokho, namuhla ungathola nokuthi yini umama anayo isakhi sofuzo ezinkingeni zamathambo. Lokhu kuzokuvumela ukuthi uqhathanise ubungozi bezinkinga zesifo sikashukela nezokubelethisa.
Futhi, ngosizo lokuhlolwa kofuzo, ungabheka ubungozi besifo sikashukela enganeni. Kodwa-ke, kunoma yikuphi, ukukhulelwa kufanele kuhlelwe, ngoba ukuphela kwendlela yokugwema ukuthuthukiswa kwezinkinga eziyingozi.
Ukufika lapha, okungenani izinyanga ezi-2-2 ngaphambi kokukhulelwa, isifo sikashukela kufanele sinxephezelwe kanye ne-hemoglobin ye-glycated. Kulokhu, umuntu wesifazane kufanele azi ukuthi ngesikhathi sokukhulelwa, ushukela wegazi osheshayo kufanele abe kusuka ku-3.3 kuya ku-6.7.
Ngaphezu kwalokho, owesifazane kudingeka ahlonzwe ngokuphelele emzimbeni. Uma inqubo yokucwaninga izifo ezingamahlalakhona noma ukutheleleka kutholakele, khona-ke kuyadingeka ukwenza ukwelashwa okugcwele. Ngemuva kokukhulelwa unesifo sikashukela ezigabeni zokuqala, owesifazane kufanele alaliswe esibhedlela, okuzovumela odokotela ukuthi baqaphele kahle impilo yakhe.
Ukukhulelwa esikhathini sikashukela kuvame ukuba nenkambo efana ne-wave. Kwi-trimester yokuqala, izinga le-glycemia kanye nesidingo se-insulin kuncishisiwe, okwandisa amathuba okuba ne-hypoglycemia. Lokhu kungenxa yezinguquko ze-hormonal, okuholela ekutholakaleni kwe-glucose okuthuthukile.
Noma kunjalo, ku-2nd ne-3 trimester yokukhulelwa, konke kuguquka kakhulu. Umbungu ugcotshwe nge-placenta, enezici eziphikisanayo. Ngakho-ke, emavikini angama-24- 26, inkambo yesifo sikashukela inganda kakhulu. Ngalesi sikhathi, ukugxila kwe-glucose kanye nesidingo sokwanda kwe-insulin, kanye ne-acetone kuvame ukutholakala egazini. Imvamisa kuba nomoya omubi kushukela.
Ngenyanga yesithathu yokukhulelwa, i-placenta iyaguga, ngenxa yalokho umphumela we-counterinsular udalulwe futhi isidingo se-insulin siyancipha futhi. Kepha ezigabeni zokuqala zokukhulelwa kwabanesifo sikashukela, akufani neze nokujwayelekile, kepha ukuphuphuma kwesisu ku-hyperglycemia engapheli kwenzeka kaningi.
Futhi ku-trimesters yesibili neyesithathu akuvamile ukuthi kuhambisane nezinkinga ezahlukahlukene. Lesi simo sibizwa nge- gestosis sekwephuzile, lapho ukuvuvukala kuvela futhi umfutho wegazi ukhuphuka. Emsebenzini wokubeletha, i-pathology yenzeka ngamacala angama-50-80%.
Kepha phambi kwezinkinga zamathambo, i-gestosis ingakhula emavikini angama-18-20. Lesi yisinkomba sokukhipha isisu. Futhi, owesifazane angakha i-hypoxia ne-polyhydramnios.
Imvamisa, iziguli ezinesifo sikashukela ezithwele ingane ziba nezifo zokuhamba komchamo. Ukuqina kokugomela kanye nesifo sikashukela esingavuthiwe kunomthelela kulokhu.
Ngaphezu kwalokho, ngokumelene nesizinda samazinga aphezulu kashukela, ukungasebenzi kahle kokujikeleza kwesibeletho kwenzeka, futhi umbungu awunazo izakhi nomoya-mpilo.
Yibuphi ubunzima obungaba khona ngesikhathi sokubeletha?
Inkinga ejwayelekile kakhulu yokuzalwa kwengane ngubuthakathaka bokusebenza. Ku-diabetesics, indawo ephansi yamandla, kuya ngenkambiso yezinqubo ze-anabolic.
Ngasikhathi sinye, izinga loshukela wegazi livama ukuhla, ngoba ushukela omningi udliwa ngesikhathi sokubeletha. Ngakho-ke, abesifazane banikezwa ama-droppers anezinkomba ze-insulin, ushukela kanye nezimpawu ze-glycemia kulinganiswa njalo ngehora. Imicimbi efanayo yenziwa ngesikhathi sokuhlinzwa, ngoba emaphesheni angama-60-80%, abanesifo sikashukela banikezwa isigaba secesarean, ngoba abaningi babo banenkinga yemithambo.
Kodwa yize iqiniso lokuthi abesifazane abanesifo sikashukela ezimweni eziningi baphathaniswa ngokuzalwa ngokwemvelo abanesifo sikashukela, bavame ukuzala. Kodwa-ke, lokhu kungenzeka kuphela ngokuhlelwa kokukhulelwa nokunxeshezelwa kwesifo esingaphansi, esivimbela ukufa kwe-perinatal.
Ngempela, uma kuqhathaniswa nama-80s, lapho imiphumela ebulalayo ibingajwayelekile, namuhla inkambo yokukhulelwa onesifo sikashukela ilawulwa ngokucophelela kakhudlwana. Kusukela manje izinhlobo ezintsha ze-insulin, ipeni lesirinji liyasetshenziswa futhi zonke izinhlobo zezindlela zokwelapha zenziwa ezikuvumela ukuba ubelethe ingane ngaphandle kwe-fetopathy nangesikhathi. Ividiyo ekulesi sihloko izokutshela ukuthi wenzeni ngesifo sikashukela.
