Izimpawu eziphambili zesifo sikashukela sokukhulelwa kwabesifazane abakhulelwe, ubunzima obukhona nezindlela zokuzivikela

Enye yezinhlobo zesifo sikashukela esitholakala kubantu besifazane ngesikhathi sokukhulelwa ibizwa ngokuthi yi-gestationalabetes.

Imvamisa, lesi sifo sitholakala sisondele maphakathi nokukhulelwa kuwo wonke ama-5 abesifazane abakhulelwe. Isikhathi sokuthwala ingane umthwalo omkhulu emzimbeni wesifazane.

Ngalesi sikhathi, izifo ezahlukahlukene ziyabonakala, kubandakanya nesifo sikashukela sabesifazane abakhulelwe. Yiziphi izimbangela nezimpawu zesifo sikashukela sokukhulelwa? Kubayini avele?

Izithombe zomtholampilo zesifo sikashukela sokukhulelwa

Imvamisa, lesi sifo sinyamalala ngokuphelele ngemuva kokubeletha, futhi i-carbohydrate metabolism ibuyela kwesejwayelekile. Kodwa-ke, kusenokwenzeka amathuba okukhulisa ushukela ojwayelekile eminyakeni elandelayo.

Izimpawu eziphambili zesifo sikashukela esikhulelwe

Isibonakaliso esiyinhloko se-HD ushukela wegazi ophezulu. Lesi sifo ngokwaso sinenkambo engafundile.

Owesifazane angazizwa womile, ekhathele ngokushesha. Isifiso sokudla sizothuthuka, kepha ngasikhathi sinye siyokwehla isisindo.

Owesifazane akunakwenzeka ukuthi azinake lezi zimpawu, ekholelwa ukuthi lo ngumthelela wokukhulelwa. Futhi ngeze. Noma yikuphi ukubonakaliswa kokungakhululeki kufanele kuqwashise umama okhulelwe futhi kufanele azise udokotela ngabo.

Izimpawu zezindlela zokugcina zalesi sifo

Uma lesi sifo siqhubeka, izimpawu ezilandelayo kungenzeka:

• umlomo owomile njalo (naphezu kweqiniso lokuthi uketshezi oluningi seludakiwe);
• ukuchama njalo;
• ngokwengeziwe ngifuna ukuphumula;
• umbono unenkinga;
• isifiso sokudla siyakhula, kanye naso amakhilogremu wesisindo.

Ukomela kanye nokudla okuhle, kunzima ukubona izimpawu zesifo sikashukela, ngoba kowesifazane onempilo, ngenkathi elinde ingane, lezi zifiso ziyaqina. Ngakho-ke, ukucacisa lokhu kutholwa, udokotela uqondisa umama okhulelwe ocwaningweni olwengeziwe.

Ukuxilonga

Ukuthola lesi sifo, udokotela uqoka owesifazane obelethayo ukuhlolwa kwegazi nomchamo (okujwayelekile).

Izinkomba ezejwayelekile zingokulandelayo:

• esiswini esingenalutho - ukusuka ku-4.1 kuye ku-5.1 mmol / l;
• kanye namahora ama-2 ngemuva kokudla - kufika ku-7 Mmol / l.

Ucwaningo oluyisisekelo ekuboneni ushukela okhulelwe ukubalwa kwezinga le-glucose yeziguli.

Kwenziwa njalo kusuka ngeviki lama-20 lokukhulelwa. Uma imiphumela inamanani wokuncipha, owesifazane okhulelwe unikezwa ukuhlolwa kokubekezelela ushukela (i-GTT).

Ngaphezu kwalokho, lapho owesifazane obelethayo esengozini ye-HD, isifundo esifanayo senziwa ngokushesha, ekuhambeleni kokuqala kudokotela. Ngisho ne-glucose ejwayelekile yokuzila ukudla, i-GTT iyenziwa futhi emavikini wokukhulelwa angama-24-28

I-GTT inemininingwane yayo, futhi iyadingeka ukuyilungiselela.

Umphumela ofanele uzotholakala uma kugcinwa imithetho elandelayo:

• Izinsuku ezintathu zokugcina ngaphambi kokuhlaziywa, owesifazane okhulelwe kufanele achithe njengenjwayelo: adle ngendlela ayejwayele (ngaphandle kokudla okuvinjelwe) futhi hhayi ukuhlukunyezwa ngokomzimba;
• isidlo sokugcina ngaphambi kokufunda kufanele singabi nama-50 g wama-carbohydrate. Lokhu kubaluleke kakhulu. Njengoba i-GTT ithathwa kuphela esiswini esingenalutho, ngemuva kwamahora we-8-14 wokuzila;
• ngesikhathi sokuhlaziywa awukwazi ukubhema, udle noma yini noma uthathe umuthi. Ngisho nokuzivocavoca okuncane kakhulu (ukukhuphuka izitebhisi) kukhishwe ngaphandle.

Ngakho-ke, isampula legazi lokuqala lenziwa esiswini esingenalutho. Ngemuva kwemizuzu engu-5, isiguli siphuza isisombululo sokuhlola ushukela (1.5 tbsp wamanzi afafazwe nge-powder). Isampula eyengeziwe yegazi ithathwa ngemuva kwamahora ama-2. Uma konke kuhleliwe, khona-ke i-glycemia izoba ngu-7.8 mmol / l. Amanani aphezulu kusuka ku-7.9 kuya ku-10.9 mmol / L akhombisa ukubekezelela ushukela omncane.

Amanani we-11, 0 Mmol / L noma ngaphezulu akhombisa isifo sikashukela sokukhulelwa. Udokotela kuphela ongasithola lesi sifo, ngokususelwa kudatha evela ezifundweni ezikhethekile, nokuzixilonga ngalesi sifo sisebenzisa ama-glucometer akulungile, ngoba asilungile ngokwanele.

Ukwelashwa kokukhulelwa

Esikhathini esiningi samacala (aze afike ku-70%), lesi sifo silungiswa ngokudla. Owesifazane okhulelwe kufanele akwazi ukulawula ngokuzimela i-glycemia.

Ukwelashwa kokudla kwe-HD kususelwa kule migomo elandelayo:

• Ukudla kwansuku zonke kuhlelwa ngendlela yokuthi kufaka amaprotheni angama-40%, amafutha angama-40% kanye nama-20% ama-carbohydrate;
• funda ukudla ukudla okuncane: izikhathi ezingama-5-7 ngosuku ngokuphumula kwamahora ama-3;
• ngesisindo ngokweqile, kufanele futhi ubale okuqukethwe kwekhalori: hhayi ngaphezu kwama-25 kcal ngekhilogremu ngayinye. Uma owesifazane engenawo amakhilogremu angeziwe - ama-35 kcal ngekhilogremu. Ukunciphisa okuqukethwe kwekhalori kokudla kufanele kube ngokucophelela futhi kubushelelezi, ngaphandle kwezinyathelo ezinokhahlo;
• amaswidi, kanye namantongomane nembewu, kukhishwe ngokuphelele ekudleni. Futhi uma ufuna ngempela ukudla amaswidi - esikhundleni sawo nezithelo;
• Ungadli ukudla okwomile okomile (ama-noodle, iphalishi, amazambane abunjiwe);
• nikeza ukukhetha ezitsheni ezibilisiwe nezinomusi;
• phuza ngaphezulu - izingilazi ezingama-7-8 zetshezi ngosuku;
• thatha ama-vitamin complexes nodokotela wakho, ngoba le mishanguzo iqukethe i-glucose;
• zama ukunciphisa inani lamafutha ekudleni, futhi unciphise amaprotheni abe ngu-1.5 g ngekhilogremu. Thuthukisa ukudla kwakho ngemifino.

Uma ukudla kunganikanga umphumela olindelekile, futhi neglucose ligcinwa liphezulu, noma isiguli sinokuhlolwa okungalungile komchamo ngoshukela ojwayelekile, kunikezwa i-insulin.

Umthamo kanye nokulungiswa okungenzeka okulandelayo kunqunywa kudokotela kuphela ngokususelwa kwesisindo sowesifazane okhulelwe kanye nobudala bokuthinta.

Ukufakwa kungenziwa ngokuzimela, ngoba uqeqeshiwe yi-endocrinologist. Imvamisa, umthamo uhlukaniswe ngemithamo emibili: ekuseni (ngaphambi kokudla kwasekuseni) nakusihlwa (kuze kube isidlo sokugcina).

Ukwelashwa kwe-insulini akukhanseli indlela yokudla, kuyaphikelela kuso sonke isikhathi sokukhulelwa.

Izinkinga ezingaba khona

Ingozi yokuba nezinkinga ezahlukahlukene ku-fetus ikhulu ikakhulukazi ezigabeni zokuqala zokukhulelwa.

Isizathu salokhu ukuthi ingane idla ushukela kamama, kanti ne-insulin ayanele. Yena uqobo ngeke akhiqize i-hormone, ngoba i-pancreas ingakakhiwa.

Izokhula kuphela kwi-trimester yesibili bese iqala ukusetshenziswa kwe-glucose ku-fetus nakunina. Kulokhu, i-hyperinsulinemia iyakhula. Ingozi yakhe ukuthi kunokuphulwa komoya womntwana ongakazalwa. Ushukela ophansi awubi yingozi enganeni, ikhulisa ukuhamba kwegazi lokuqina futhi isongela ukugcwala ukukhula kwengqondo.

I-HD engaphendulwanga iqinisa kakhulu ukukhulelwa:

• owesifazane obelethayo angaba nokukhula kwe-gestosis ne-polyhydramnios;
• izifo ezithinta umchamo zingathela ingane;
• kuba khona njalo kwe-ketoacidosis, ebangela ukudakwa komzimba womama wonke;
• cishe zonke izitho zomzimba ziyahlupheka: amehlo, izinso, imithambo yegazi nenhliziyo;
• isibeletho sithola isisindo esikhulu kakhulu (i-macrosomia), bese ukuzalwa kwemvelo kuthathelwa indawo yisigaba se-caesarean;
• ukuthuthukiswa kwe-intrauterine kuvinjelwe.

Ukuqashelwa kwangemva kokubeletha

Uma owesifazane okhulelwe eba ne-HD, khona-ke amathuba okuthola isifo sikashukela esijwayelekile ukwanda kwakhe amahlandla ama-5.

Lokhu kuyingozi enkulu. Ngakho-ke, owesifazane ugcinwa njalo ngemuva kokubeletha. Ngakho-ke ngemuva kwezinyanga eziyi-1.5, kumele ahlole umzimba we-carbohydrate metabolism.

Uma umphumela uba muhle, okunye ukubheka kwenziwa njalo eminyakeni emithathu. Kodwa uma kwenzeka kutholakala ukwephula ukubekezelela ushukela

Konke ukukhulelwa okulandelayo kuleli cala kufanele kuhlelwe, ngoba isifo sikashukela (imvamisa izinhlobo ezi-2) singakhula eminyakeni eminingana emva kokuzalwa. Umsebenzi womzimba kufanele ukhushulwe.

Amavidiyo ahlobene

Mayelana nezimpawu zesifo sikashukela sokukhulelwa kwabesifazane abakhulelwe kule vidiyo:

Noma onesifo sikashukela esikhulelwe, owesifazane angazala izingane eziningi ezinempilo. Into esemqoka ukuthola i-pathology ngesikhathi esifanele futhi ngokushesha uqale ukwelashwa kwayo.