Ukuzalwa kwengane kusifo sikashukela kunqunywa ngokuhlukile kucatshangelwa izici zenkathi yalesi sifo, ubukhulu baso, ubungako besinxephezelo kanye nesimo sokusebenza kwengane esakhula, kanye nokuba khona kwezinkinga zokubeletha.
Izinga lanamuhla lokuthuthuka kwezokwelapha livumela ukuzala uhlobo 1 lwesifo sikashukela ngaphandle kokudlulisela lesi sifo kumntwana okhulayo. Ingozi yokudlulisela lesi sifo emntwaneni, uma kungowesifazane kuphela onesifo sikashukela sohlobo 1, ngu-2%, futhi uma kunesifo kubaba, ingozi yokuthola lesi sifo inyukela ku-5%. Ngohlobo 1 noma isifo sikashukela sikashukela kubo bobabili abazali, amathuba esifo kosana olusanda kuzalwa senyukela kuma-25%.
Owesifazane okhulelwe onesifo sikashukela sohlobo 1 nohlobo 2 kufanele athathe indlela efanele yokuhlelela ukukhulelwa. Lokhu kungenxa yokuthi lapho owesifazane okhulelwe onesifo sikashukela ethwala fetus emzimbeni, kwenzeka izinguquko eziba zimbi kakhulu isimo somzimba womama esizayo, futhi lokhu kungayimaza kabi impilo yengane.
Izinguquko ezinjalo zingafaka:
- ukwehla okujwayelekile kwempilo yowesifazane;
- kungenzeka kube nezinkinga ezivimbela ingane ukuthi izalwe;
- ingane esesikhathini sokukhula kwayo kwe-intrauterine ingathola ama-pathologies ahlukahlukene wokuzala.
Owesifazane onesifo sikashukela kufanele ahlele futhi alungiselele ukukhulelwa izinyanga ezi-3-4 ngaphambi kokukhulelwa. Ukulungiselela isikhathi eside okunjalo kuyadingeka ukuze kunxeshezelwe umphumela wesifo esikhulayo esibelethweni.
Uma ukukhulelwa kuhamba kahle, futhi ukugula kusesigabeni sesinxephezelo, khona-ke ukudluliswa kokuzalwa ngesifo sikashukela akubangeli izinkinga, ukulethwa kwenzeka ngesikhathi.
Labo besifazane abazala i-mellitus yesifo sikashukela bayazi ukuthi uma isifo sikashukela singanxephezelwa ngokuphelele, kungenzeka ukuthi kube nezinkinga eziphoqelela ukusetshenziswa kokubangela umsebenzi kwisifo sikashukela i-mellitus.
Ngemuva kwamaviki angama-37, kunconyelwa ukuqoka isigaba se-cesarean esihleliwe.
Ngohlobo lwe-1 noma isifo sikashukela sohlobo 2, owesifazane okhulelwe udinga ukukhetha isikhungo sezokwelapha esesibhedlela esikhethekile sokubeletha. Ukuba sesikhungweni esinjalo, owesifazane okhulelwe ugadwe kakhulu yi-endocrinologist, futhi uma kunesidingo, lona wesifazane usizwa abanye ochwepheshe bezokwelapha.
Wonke umuntu owazala isifo sikashukela uyazi ukuthi ngaphambi kokuzalwa nangemva kokuzalwa kwengane, kubalulekile ukubheka njalo amazinga kashukela emzimbeni.
Yini ingozi yesifo sikashukela sokukhula kwengane?
Isifo sikashukela i-mellitus nokukhulelwa kuyingozi ngoba ngokuthuthuka kwalesi sifo, amathuba okuthi kube nezinkinga ezahlukahlukene kumntwana okhula ngesibeletho. Lokhu kungumphumela wokuthi i-fetus ekhulayo ithola umsoco we-carbohydrate kusuka kumama futhi ngasikhathi sinye njengoba ushukela udliwe, lo mbungu awutholi inani elidingekayo le-insulin ye-hormone, naphezu kweqiniso lokuthi amanyikwe engane awakhuli futhi awakwazi ukukhiqiza i-insulin.
Kuhlobo 1 nesifo sikashukela sohlobo 2, isimo njalo se-hyperglycemia sikhuthaza ukuntuleka kwamandla, ngenxa yalokho umzimba wengane ukhula ngokungafanele.
Ama-pancreas angawakhe esibelethweni aqala ukukhula futhi asebenze ku-trimester yesibili. Endabeni kashukela omningi emzimbeni womama, ama-pancreas ngemuva kokwakheka aqala ukukhathazeka okucindezelayo, ngoba kukhiqiza i-hormone okungafanele isebenzise kuphela ushukela emzimbeni wayo, kodwa futhi ijwayele izinga leshukela egazini likamama.
Ukukhiqizwa kwe-insulin okwandayo kuthuthukisa ukuthuthukiswa kwe-hyperinsulinemia. Ukwanda okwenziwa yi-insulin kuholela ku-hypoglycemia esibelethweni; ngaphezu kwalokho, ukwehluleka ukuphefumula kanye ne-asphyxia kuyabonakala e-fetus.
Okuqukethwe ushukela ophansi kakhulu ku-fetus kungaholela ekufeni.
Isifo sikashukela sokutholwa kwabesifazane abakhulelwe
Abesifazane abakhulelwe banomkhuba wokwandisa inani likashukela ku-plasma yegazi ngemuva kokudla. Lesi simo singenxa yokusheshisa kwenqubo yokufaka ushukela kanye nokwanda kwesikhathi sokufakwa kokudla okuchithiwe. Lokhu kungenxa yokwehla komsebenzi wamapheshana emathunjini. Lapho kukhona ukwephulwa ekusebenzeni kwamanyikwe ngesikhathi sokukhulelwa, owesifazane angaba nesifo sikashukela sokukhulelwa.
Ukubona isisusa kulolu hlobo lokugula, kuhlolwa ukubekezelelwa kweglucose ngesikhathi somuthi wokuqala. Uma umphumela ongemuhle utholakala phakathi nokuhlolwa, khona-ke kufanele kwenziwe ukuhlolwa kwesibili phakathi kwamasonto angama-24 kuya kwangama-28 okukhulelwa.
Uma kuba nomphumela omuhle wokuhlolwa, udokotela kufanele abheke lowesifazane okhulelwe phakathi nokukhulelwa konke, ebheka ukuthuthukiswa kwanoma yiluphi uhlobo lwesifo sikashukela emzimbeni. Ukuhlolwa kokubekezelela kufanele kwenziwe ngemuva kokuzila ukudla amahora angama-8-14, lapho kuvunyelwe khona amanzi kuphela. Isikhathi esihle kakhulu sokuhlolwa sisekuseni.
Ngasikhathi sinye nokuhlolwa kokubekezelela ushukela, igazi lithathwa emthanjeni wokuhlolwa kwelebhu. Ngemuva kokuthatha igazi eline-venous ngokushesha ngendlela yelabhoratri, thola ukuthi ushukela ungakanani ku-plasma.
Uma ukuhlaziya kuthola ushukela wegazi omkhulu kuno-11.1 mmol / l, khona-ke owesifazane uthola ukuthi unesifo sikashukela sokukhulelwa.
Ukwelashwa kowesifazane okhulelwe nokubeletha ngohlobo 1 sikashukela
Ukudla okukhethekile kusetshenziselwa ukunxephezela isifo sikashukela sokukhulelwa. Uma kudingekile ukuthi kwethulwe izondlamzimba zokudla, kufanele kukhunjulwe ukuthi inani lamandla lemikhiqizo esetshenziswa ngowesifazane okhulelwe alikwazi ukwehliswa kakhulu. Ukuqedwa kokuthathwa kokudla okunamandla amakhulu aqukethe inani elikhulu lama-carbohydrate kufanele kwenziwe kancane kancane.
Ukondliwa okufanele kowesifazane okhulelwe kufaka phakathi ukusetshenziswa kwenani elincane lokudla ngasikhathi sinye. Kungcono uma ukudla ukudla kuba yizixaka - amahlandla ayisihlanu kuya kwayisithupha ngosuku. Ama-carbohydrate akhanyayo kufanele angafakiwe ekudleni futhi anciphise ukudla okunamafutha.
Lokhu kungenxa yokuthi ama-carbohydrate akhanyayo angakhuphula kakhulu ushukela wegazi, futhi amafutha ngokuntuleka kwe-insulin kuholela ekwakhekeni kwezidumbu ze-ketone, ezidala ubuthi. Ekudleni kowesifazane okhulelwe, izithelo nemifino emisha, kanye nemifino, kufanele kube khona.
Owesifazane uqobo kumele aqaphe ushukela emzimbeni futhi alawule umthamo we-insulin ngokuya ngale nkomba. Uma, kulandela ukudla, akukho ukwehla kushukela wegazi, khona-ke udokotela obheka ukukhulelwa unquma ukwelashwa nge-insulin.
Amaphilisi okunciphisa ushukela wegazi, akunconywa ukuwasebenzisa ngalesi sikhathi, ngoba angalimaza umbungu. Ngokukhethwa kahle komthamo we-insulin ngesikhathi sokwelashwa, owesifazane okhulelwe kufanele alaliswe esibhedlela emnyangweni we-endocrinology wesikhungo sezokwelapha.
Uma owesifazane etholakala ukuthi unesifo sikashukela sokukhulelwa, khona-ke inketho engcono kakhulu ukuzalwa kwemvelo isikhathi esingeqi amasonto angama-38. Ukugqugquzelwa kokusebenza kufanele kwenzeke ngaphansi kokuqashwa njalo kukadokotela phezu komzimba wowesifazane okhulelwe. Kuyadingeka ukukhuthaza ukusebenza ngemuva kokuhlolwa komzimba wowesifazane nowesibeletho.
Ingane ezelwe ngalesi sikhathi ibekezelela inqubo yokuzalwa komzimba.
Endabeni yokusetshenziswa kwesifo sikashukela sokukhulelwa ekwelapheni isifo se-insulin, i-endocrinologist ngemuva kokubeletha inquma isidingo sokuqhubeka kokusebenzisa i-insulin.
Labo besifazane abazala isifo sikashukela bayazi ukuthi isigaba senkathi esithatha isikhundla sokubeletha senziwa kuphela ezimeni lapho kukhona izinkomba zokuthi bebeletha.
Izinkomba ezinjalo zingaba amathuba we-hypoxia, ukubambezeleka kokuthuthuka noma ezinye izinkinga.
Ukulethwa kweziguli ezinesifo sikashukela
Lapho kukhona isifo sikashukela kanye nokuzalwa kwengane, futhi yonke inqubo yokukhulelwa kufanele ibe ngaphansi kokuqashwa okuqinile kwe-endocrinologist.
Umbuzo wokuthi ungayikhetha kanjani usuku lokulethwa ngudokotela unqunywa ngokuqondile futhi kuya ngezici eziningana, okuyizinto eziyinhloko zazo:
- ubukhulu bendawo yesifo;
- isilinganiso sesinxephezelo esetshenzisiwe;
- isimo sengane esakhula;
- ukuba khona kwezinkinga ezithintekayo zokuvimbela inzalo.
Imvamisa, ngenxa yokwanda kwenani lokuphazamiseka okuhlukahlukene, ukulethwa kwenziwa emavikini angama-37- 38.
Inketho enhle kakhulu indlela yokubeletha, lapho ingane izalwe khona ngomsele wemvelo wokubeletha kukamama. Ngesikhathi senqubo yokubeletha, izinga labesifazane abakhulelwe lilinganiswa njalo emahoreni amabili. Lokhu kuyadingeka ukuze kuhoywe okwenele okwenziwa yisifo sikashukela ngokusebenzisa ukwelashwa kwe-insulin.
Indaba yokuzalwa okuzenzakalelayo ithathwa lapho umntwana esekhanda ekhuthele futhi owesifazana enesikhumba esijwayelekile, kuthi lapho kungekho zingqinamba embusweni nakunina ocasulwe ukuba khona kwesifo sikashukela. Isigaba se-cesarean senziwa uma ingane ekhulelwe ingeyokuqala kanti isibeletho sikhulu nge-pelvis encane kowesifazane.
Ngesikhathi sokulethwa kwesifo sikashukela sohlobo lokuqala, i-glycemia ibhekelwe ngempela, inhloso yale nqubo ukunciphisa amathuba wesimo se-hypoglycemic, kuze kufike ku-hypoclycemic coma. Ngesikhathi sobuhlungu bokubeletha, kusebenza izicubu zomzimba ezisebenzayo, okuholela ekunciphiseni okukhulu kwesilinganiso sikashukela kuyi-plasma yegazi ngaphandle kokusebenzisa izidakamizwa eziqukethe i-insulin.
Ukuthatha izindlela zokuvuselela kosana olusanda kuzalwa
Umgomo oyisisekelo wokuvuselela usana olusanda kuzalwa kuncike esimweni sakhe, izinga lokuvuthwa nezindlela ezisetshenzisiwe ngesikhathi sokubeletha. Ezinganeni ezisanda kuzalwa ezalwa omama abanesifo sikashukela, kaningi kunezimpawu zokuthi isifo sikashukela sinesifo sikashukela, esingenzeka ngemvamisa ehlukahlukene ekuhlanganiseni okuhlukahlukene.
Izingane ezizalwa zinezimpawu zesifo sokusha kwesifo sikashukela zidinga ukunakekelwa okukhethekile. Esikhathini sokuqala ngemuva kokuzalwa, izinsana ezinjalo zidinga ukulawulwa okukhethekile kokuphefumula, i-glycemia, i-acidosis kanye nomonakalo ongaba khona ohlelweni lwezinzwa oluphakathi.
Imigomo eyinhloko yokuvuselelwa kabusha yile:
- Ukuvimbela ukukhula kwe-hypoglycemia.
- Ukwenza ukuqapha okunamandla kwesimo sengane.
- Ukwenza ukwelashwa kwe-syndromic.
Ngesikhathi sokuqala se-neonatal, izinsana ezisanda kuzalwa ezinesifo sikashukela kunzima kakhulu ukuzivumelanisa nezwe langaphandle. Ukujwayela ngokweqile kuvame ukuhambisana nokukhula kwezinkinga ezifana ne-conjugation jaundice, i-erythrem enobuthi, ukwehla kwesisindo okubalulekile nokuvuselela kwayo kancane kancane kumamojuli ajwayelekile. Ividiyo ekulesi sihloko izokusiza uthole ukuthi isilinganiselo soshukela siyini.
