Isifo sikashukela ngesikhathi sokukhulelwa singakhula uma i-insulin (ihomoni yama-pancreas) ikhiqizwa ngamanani anganele.
Ngasikhathi sinye, umzimba wowesifazane udinga ukusebenzela ababili ukuze unikeze i-insulin yena uqobo nengane. Uma umsebenzi wamanyikwe awanele, khona-ke amazinga kashukela wegazi awalawulwa futhi angakhuphuka ngaphezu kokujwayelekile. Kulokhu, bakhuluma nge-gestationalabetes mellitus kwabesifazane abakhulelwe.
Uma odokotela bengakwazi ukwenza ukuxilongwa ngokuhamba kwesikhathi, khona-ke ushukela okhuphukile ngeke ube nomthelela ongemuhle kuzingane nasemzimbeni wowesifazane ngokwakhe. Ngakho-ke, ngokusola kokuqala kokuthuthukiswa kwesifo sanoma yiluphi uhlobo, kuyadingeka ukulandela ngokuqinile konke ukunconywa kukadokotela. Njengomthetho, ngemuva kokuzalwa kwengane, isifo sikashukela esinjalo siyanyamalala. Yize ngasikhathi sinye, ingxenye yabomama abakhulelwe ibeka engcupheni yokuthola le nkinga nokukhulelwa okulandelayo.
Isifo Sikashukela Sikhulelwe: Izinsuku Zingashintshiwe
Isifo sikashukela sokukhulelwa nokukhulelwa, le nkinga ingaqala esikhathini esingamasonto ayi-16 kuye kwangama-20. Lokhu akunakwenzeka ngaphambili, ngoba i-placenta ayikakhiwa ngokuphelele. Engxenyeni yesibili yokukhulelwa, i-placenta iqala ukukhiqiza i-lactogen ne-estriol.
Inhloso esemqoka yalawa ma-hormone ukukhuthaza ukukhula okufanele kwesibeletho, okungeke kuthinte ukuzalwa, kepha futhi kunomphumela we-anti-insulin. Ngaleso sikhathi esifanayo, izinga lama-hormone anomthelela ekwakhiweni kwesifo sikashukela sohlobo 2 (i-cortisol, i-estrogens, iprogesterone) emzimbeni wowesifazane liyakhula.
Konke lokhu kukhula ngeqiniso lokuthi abesifazane abakhulelwe bavame ukungasebenzi njengakuqala, bahambe kancane, baqale ukusebenzisa kabi ukudla okunama-kilojoule amaningi, isisindo sabo sanda ngokushesha, okuzothikameza i-herods ejwayelekile.
Zonke lezi zinto zibangela ukwanda kwe-insulin. Okusho ukuthi, i-insulin iyayeka ukukhipha ithonya layo, izinga likashukela egazini alilawulwa kahle. Ebantwini abaphilile, lesi sikhathi esibi sinxephezelwa ngezinqolobane ezanele ze-insulin yabo. Kepha, ngeshwa, akubona bonke abesifazane abakwaziyo ukumisa ukuqhubeka kwesifo.
Izimpawu ezixwayisa ezilandelayo zikhuluma ngohlobo 2 lwesifo sikashukela:
- - ukukhuphuka kwesifiso sokuchama nokukhulisa umchamo wansuku zonke;
- - umuzwa ongapheli wokoma;
- - Ukwehla kwesisindo ngenxa yokulahlekelwa isifiso sokudla;
- - ukukhathala okwandayo.
Imvamisa lezi zimpawu azinikezwanga ukunakwa okufanele, futhi lesi simo sichazwa ngokukhulelwa uqobo. Ngakho-ke, odokotela, njengomthetho, abanalo izinguquko eseziqalile. Kepha kubalulekile ukukhumbula ukuthi okuqukethwe ushukela omningi kugcwele ngemiphumela emibi, kufaka phakathi:
- -Ukusungulwa kwe-preeclampia (umfutho wegazi uyenyuka, ukuvuvukala kuvela, amaprotheni atholakala emchameni);
- i-polyhydramnios;
- Ukwephulwa emikhunjini (i-retinopathy, nephropathy, i-neuropathy);
- - ukwephulwa kokujikeleza kwegazi kumama we-chain - i-placenta - i-fetus, okuholela ekungapheleni kwe-fetoplacental kanye ne-hypoxia ye-fetus;
- ukufa kwesibeletho esibelethweni;
- Ukwanda kwezifo ezithathelwanayo zomgudu wokuzala.
Yini ingozi yohlobo 1 nohlobo 2 lwesifo sikashukela esibelethweni?
Isifo sikashukela nokukhulelwa kuyingozi ngoba ngalesi sifo amathuba okungalungi kwe-fetus ayanda. Lokhu kungumphumela wokuthi ingane idla i-glucose evela kumama, kepha ayitholi i-insulin eyanele, futhi i-pancreas yayo ayikakhiwa.
Isimo esihlala njalo se-hyperglycemia siholela ekuntulekeni kwamandla, ngenxa yalokho, izitho nezinhlelo zosana olungakazalwa zikhula ngokungalungile. Kwi-trimester yesibili, ingane iyaqala ukukhulisa i-pancreas yayo uqobo, okufanele isebenzise i-glucose hhayi emzimbeni womntwana kuphela, kepha futhi yenze izinga loshukela libe kumama esizayo.
Ngenxa yalokho, i-insulin ikhiqizwa ngamanani amakhulu kakhulu, okuholela ku-hyperinsulinemia. Le nqubo ingadala i-hypoglycemia kosanda kuzalwa (ngoba ama-pancreas womama asetshenziselwa ukusebenza okubili), ukwehluleka ukuphefumula kanye ne-asphyxiation. Kokubili ushukela ophakeme noluphansi kuyingozi fetus.
Ukuphindaphinda okuvame kwe-hypoglycemia kungaphazamisa ukuthuthukiswa kwengane kwe-neuropsychiatric. Uma isifo sikashukela sohlobo loku-1 kwabesifazane abakhulelwe ku-trimester yesibili sinxephezelwe, lokhu kungadala ukuncipha kwamaseli e-fetus, i-hypoinsulinemia, futhi ngenxa yalokho, ukukhula kwe-intrauterine kwengane kuzovinjezelwa.
Uma kunoshukela omningi kakhulu emzimbeni wengane engakazalwa, khona-ke kancane kancane izogcina iba ngamafutha. Izingane ezinjalo ngesikhathi sokuzalwa zingaba nesisindo esingu-5-6 kg futhi lapho zihamba emhubheni wokuzala, ama-humerus azo angalimala, kanye nokunye ukulimala. Ngasikhathi sinye, ngaphandle kwesisindo nokuphakama okukhulu, izingane ezinjalo zilinganiswa nodokotela njengabangaphansi ngokuya kwezinye izinkomba.
Ukutholwa kwesifo sikashukela sokukhulelwa kwabesifazane abakhulelwe
Abesifazane abakhulelwe banomkhuba wokwandisa ushukela wegazi ngemuva kokudla. Lokhu kungenxa yokufakwa ngokushesha kwe-carbohydrate nokwandisa isikhathi sokutholwa kokudla. Isisekelo salezi zinqubo ngumsebenzi onciphile wohlelo lokugaya ukudla.
Ekuhambeleni kokuqala emtholampilo wabakhulelwe, udokotela unquma ukuthi ngabe owesifazane okhulelwe usengozini yokuthola isifo sikashukela sokukhulelwa. Owesifazane ngamunye onezici zobungozi uhlolwe ukuthi kubekezelelwa i-glucose Uma umphumela ungathandeki, khona-ke ukukhulelwa kugcinwa njengenjwayelo, futhi isiguli kufanele sihlolwe okwesibili emavikini angama-24-28.
Umphumela omuhle ucindezela udokotela ukuthi ahole owesifazane okhulelwe, enikezwe i-pathology ngesimo sikashukela sanoma yiluphi uhlobo. Uma kungekho zici zobungozi ezikhonjwe ekuhambeleni kokuqala, lapho-ke kuhlelwa isivivinyo sokubekezelela ukubekelwa phansi ushukela emasontweni angama-24 kuye kwangama-28. Lolu cwaningo luphethe imininingwane eminingi, noma ilula kakhulu. Ngobusuku bangaphambilini, owesifazane angadla ukudla okunokuqukethwe kwe-carbohydrate okungama-30-50 g. Ukuhlolwa kwenziwa ekuseni, lapho isikhathi sokuzila ebusuku sifinyelela amahora angama-8 kuya kwayi-14.
Ngalesi sikhathi, phuza kuphela amanzi. Ekuseni esiswini esingenalutho thatha igazi le-venous ukuze lihlaziywe futhi ngokushesha unqume izinga likashukela. Uma umphumela ubonakala ekutholakaleni kwesifo sikashukela sokukhulelwa, khona-ke isivivinyo siyamiswa. Uma i-glycemia ijwayelekile noma ikhubazekile esiswini esingenalutho, khona-ke owesifazane unikezwa isiphuzo esinegremu ezinhlanu kashukela no-250 ml wamanzi imizuzu emihlanu. Ukuphuza i-Liquid kungukuqala kokuhlolwa. Ngemuva kwamahora ama-2, ukuhlolwa kwegazi kwe-venous kuthathwa futhi, ngalesi sikhathi izinga le-glucose akufanele libe ngaphezulu kuka-7.8 mmol / lit.
Uma isampula yegazi inquma i-glycemia enkulu kune-11.1 mmol / ilitha emithanjeni ye-capillary (kusuka emunweni) noma egazini le-venous usuku lonke, lokhu kuyisisekelo sokuxilongwa kwesifo sikashukela sokukhulelwa futhi asidingi ukuqinisekiswa okwengeziwe. Kungashiwo okufanayo ngokuzila ukudla okusheshayo kwe-glycemia engaphezulu kuka-7 mmol / ilitha egazini le-venous kanye nama-6mmol / ilitha egazini atholakala emunweni.
Izindlela zokwelapha ushukela okhulelwe
Imvamisa, isinxephezelo sikashukela wokutholakala kwezamzimba sitholwa ngokulandela isidlo. Kepha ngasikhathi sinye, inani lamandla lemikhiqizo alikwazi ukwehliswa kakhulu. Uzodla ngendlela efanele kaningi nangezingxenyana ezincane, amahlandla ayisihlanu kuya kwayisithupha ngosuku, enza ukudla okulula phakathi kokudla kwasekuseni, kwasemini kanye nakusihlwa.
Ukudla akumele kube nama-carbohydrate agayekayo (amaswidi, namakhekhe), ngoba kuholela ekukhuphukeni okubukhali koshukela wegazi. Udinga futhi ukunciphisa ukusetshenziswa kokudla okunamafutha (ibhotela, ukhilimu, inyama enamafutha), ngoba ngokuntuleka kwe-insulin, amafutha aguqulwa abe yimizimba ye-ketone, okuholela ekunxilisweni komzimba. Qiniseka ukuthi ufaka ekudleni izithelo ezintsha (ngaphandle kukabhanana, amagilebhisi namakhabe), amakhambi nemifino.
Kuhle kakhulu uma owesifazane enayo i-glucometer ekhaya, futhi angakwazi ukukala naye ngokwakhe amazinga eglucose. Kulokhu, umthamo we-insulin ungashintshwa ngokuzimela ngokuya ngoshukela oshukela isikhathi esinikeziwe. Uma, kulandela ukudla, ukwehla koshukela wegazi kungenzeki, khona-ke odokotela banquma ukwelashwa kwe-insulin.
Amaphilisi okunciphisa ushukela ezimeni ezinjalo awasetshenziswa, ngoba anomthelela ongemuhle ku-fetus. Ukukhetha isilinganiso esifanele se-insulin, owesifazane kufanele alaliswe esibhedlela emnyangweni we-endocrinology. Futhi konke lokhu kungagwenywa uma kuthathwa izinyathelo ezifika ngesikhathi ukuvikela isifo sikashukela.
Ukuzalwa kwengane ngohlobo 1 sikashukela
Uma owesifazane etholakala enesifo sikashukela sokukhulelwa, lapho-ke kuzonconyelwa ukuzalwa okungokwemvelo ngaphandle kwamaviki angama-38. Into esemqoka ukubheka njalo isimo sowesifazane okhulelwe.
Ingane ekulesi simo futhi ikubekezelela kahle ukuzalwa kwengane ngokomzimba. Uma ngesikhathi sokukhulelwa owesifazane welashwa nge-insulin, khona-ke i-endocrinologist ngemuva kokubeletha iyonquma ukuthi iyaqhubeka yini ukusebenzisa le mithi noma cha. Ukulawulwa kwe-Glycemia kufanele kuqhubeke esikhathini sokubeletha.
Isigaba se-caesarean, esithatha isikhundla sokuzalwa kwengane, senziwa kuphela uma kunezinkomba zokubelethisa, ezinjenge-hypoxia kanye nokubambezeleka okuphawulwe ekukhuleni kwengane, kanye nosayizi omkhulu wengane, i-pelvis emincane kamama, noma enye inkinga.
Ingane yazalwa
Into emangalisa kakhulu umama angayenzela umntanakhe ngemuva kokubeletha isidlulile ukumncelisa. Ubisi lwebele luqukethe zonke izakhamzimba ezidingekayo ezisiza ingane ukuba ikhule futhi ikhule, yakhe ukungabikhona komzimba. Umama angasebenzisa futhi ukuncelisa ibele ukuxhumana okwengeziwe nengane. Ngakho-ke, udinga ukuzama ukugcina i-lactation futhi wondle ingane ngobisi lwebele isikhathi eside ngangokunokwenzeka.
Umthamo we-insulin, kanye nokudla kwesikhathi sokuncelisa ibele, kufanele kutuswe ngudokotela we-endocrinologist. Emsebenzini, kuye kwaqapheleka ukuthi ukuncelisa ibele kungaholela ekwehlekeni okukhulu kwamazinga kashukela (hypoglycemia). Ukuvimbela lokhu kungenzeki, ngaphambi kokondla, umama kufanele aphuze ingilazi yobisi.
Uma owesifazane enesifo sikashukela sokukhulelwa, khona-ke kungadluli amasonto ayi-6 emva kokubeletha, kuyadingeka ukuthi kuhlolisiswe futhi kutholakale izinga le-glucose esegazini esiswini esingenalutho, kanye nokwenza ukuhlolwa kokubekezelwa kwe-glucose (ukumelana). Lokhu kukuvumela ukuthi uhlole inkambo ye-carbohydrate metabolism futhi, uma kunesidingo, uchibiyela ukudla.
Njengoba kunobungozi bokuqhubeka kokukhula kwesifo sikashukela sohlobo 2, owesifazane ngemuva kokubeletha kudingeka ahlolwe iminyaka eminingana. Uma iminyaka emi-2 kuya kwemi-3, udinga ukwenza isivivinyo sokubekezelela futhi uhlaziye ushukela osheshayo. Uma kutholakala ukwephula ukubekezelelana, ukuhlolwa kufanele kwenziwe njalo ngonyaka. Ukukhulelwa okulandelayo kungahlelelwa ngemuva konyaka nesigamu futhi uqiniseke ukuthi ulungiselela ngokucophelela ukukhulelwa.
Izenzo Zokuvimbela Sikashukela Ukukhulelwa
Kuyadingeka ukuyeka ukusetshenziswa koshukela ocoliweyo, ukuze ungafaki ukudla okunosawoti kanye namafutha. Qiniseka ukuthi ufaka i-fiber ngesimo se-bran, i-microcellulose, i-pectin kwimenyu. Udinga ukuhamba kakhulu, nsuku zonke okungenani amahora ama-2 ukuhamba emoyeni omusha. Uma umuntu ovela ezihlotsheni eziseduze enesifo sikashukela noma uma owesifazane esondele eminyakeni engama-40, khona-ke kabili ngonyaka udinga ukukala glucose amahora ama-2 ngemuva kokudla.
Imikhuba yoshukela wegazi kwabesifazane abakhulelwe ethathwe emunweni (capillary) isukela ku-4 kuye ku-5.2 mmol / ilitha esiswini esingenalutho futhi ingabi ngaphezu kuka-6.7 mmol / ilitha amahora amabili ngemuva kokudla.
Izici zobungozi zesifo sikashukela sokukhulelwa:
- - Owesifazane okhulelwe oneminyaka engaphezu kwengu-40;
- - izihlobo ezisondelene zinesifo sikashukela. Uma omunye wabazali enesifo, khona-ke ingozi iphindwe kabili; uma bobabili begula, kathathu;
- - Owesifazane ungowomjaho ongewona omhlophe;
- - I-BMI (inkomba yesisindo somzimba) ngaphambi kokukhulelwa yayingaphezu kwama-25;
- - isisindo somzimba senyuka ngokubhekisele emuva ngemuva kokukhuluphala ngokweqile;
- - ukubhema;
- - isisindo sengane eyazalwa ngaphambili idlula i-4,5 kg;
- - Ukukhulelwa kwangaphambilini kwagcina ekufeni kwe-fetus ngezizathu ezingaziwa.
Ukudla kwesifo sikashukela sohlobo 2
Njengoba izitsha zokuqala, imifino, ubisi nezobho zezinhlanzi kufanelekile. Isobho seklabishi kanye ne-borsch kungadliwa kuphela imifino noma umhluzi obuthakathaka.
Izifundo zesibili - inkukhu, inhlanzi enamafutha amancane, iwundlu nenyama enamafutha amancane. Imifino ilungele noma yisiphi futhi kunoma yisiphi isamba.
Qiniseka ukuthi usebenzisa imikhiqizo yobisi ebilisiwe (i-kefir, ukhilimu omuncu, iyogathi, ushizi wekhokho).
Njengama-appetizer, ungasebenzisa inhlanzi ebilisiwe noma enamafutha, i-ham enamafutha amancane, unamathisela owenziwe ekhaya ngaphandle kokufakwa kawoyela, ushizi oluhlaza okwesibhakabhaka noma ushizi we-Adyghe.
Kweziphuzo, ungaphuza itiye ngobisi, amanzi amaminerali, ukumnika i-rosehip.
Isinkwa kufanele sibe sikashukela kusuka ku-rye kafulawa oxoshwe. Izithelo ezi-Sour kanye namajikijolo nejelly ku-saccharin zilungele amaswidi.
