I-mestitus ye-Gestationalabetes mellitus ukuphula umthetho we-carbohydrate metabolism, ekhonjwe okokuqala ngesikhathi sokukhulelwa. Izimbangela zalesi sifo azikakaqondakali ngokuphelele. Isifo sikashukela i-mellitus ngesikhathi sokukhulelwa kungaholela kokuphuphuma kwezisu, ukuzalwa ngaphambi kwesikhathi, izifo zosana, nemiphumela emibi yesikhathi eside kumama.
Ukuhlaziywa kwe-mellitus yesifo sikashukela sokugcina ngesikhathi sokukhulelwa kuchazwe okokuqala lapho owesifazane evakashela udokotela. Ukuhlolwa okulandelayo kwenziwa ngesonto lama-24- 28. Uma kunesidingo, umama okhulelwe uhlolwa ngokungeziwe.
Izimbangela zesifo
Ngesikhathi sokukhulelwa, kuvela isitho se-endocrine emzimbeni - i-placenta. Ama-hormone ayo - i-prolactin, i-chonionic gonadotropin, i-progesterone, i-corticosteroids, i-estrogen - inciphisa ukuthikamezeka kwezicubu zomama ukungena kwe-insulin. Ama-antibodies kuma-insulin receptors akhiqizwa, ukwephulwa kwehomoni ku-placenta kuyabonakala. I-metabolism yemizimba ye-ketone iyathuthukiswa, futhi ushukela usetshenziselwa izidingo ze-fetus. Njengokunxephezela, ukwakhiwa kwe-insulin kuyathuthukiswa.
Ngokuvamile, ukuthuthukiswa kokumelana ne-insulin kuyimbangela yokwanda kwe-glucose yegazi ngemuva kokudla. Kepha ukusetshenziswa kwama-carbohydrate yi-fetus ngesikhathi sokufunda kwegazi elisheshayo kuholela ku-hypoglycemia encane. Njengoba kunesakhi sofuzo kusoshukela, izinto ezisetshenziswayo ezifakwayo aziwubekezeleli umthwalo ongezekile futhi i-pathology iba khona.
Isifo sikashukela ngesikhathi sokukhulelwa sithinta kabi impilo yomama nengane
Engcupheni yalesi sifo abesifazane:
- ukukhuluphala;
- ngaphezulu kweminyaka engama-30;
- sesindisiwe ifa;
- nomlando ongathandeki wokuvimbela inzalo;
- nezinkinga ze-carbohydrate metabolism ezitholwe ngaphambi kokukhulelwa.
Lesi sifo sikhula ezinyangeni ezingama-6-7 zokukhulelwa. Abesifazane abanesifo sikashukela sokukhulelwa banamathuba aphezulu okuthuthuka kwesimo somtholampilo walesi sifo ngemuva kweminyaka eyi-10-15.
Ukuxilongwa kwesifo sikashukela esenzeka kwabesifazane abakhulelwe ezimweni eziningi kuyinkimbinkimbi ngenkambo yaso ye-asymptomatic. Indlela enkulu yokuthola ukuphazamiseka kwe-metabolic izivivinyo zaselebhu.
Ukuhlolwa kwamabanga aphansi
Lapho owesifazane okhulelwe ebhalisiwe, izinga le-glucose ye-plasma inqunywa. Kuthathwa igazi le-venous ukuze kwenziwe ucwaningo. Akufanele udle okungenani amahora angama-8 ngaphambi kokuhlaziywa. Kwabesifazane abanempilo, inkomba ingu-3.26-4.24 mmol / L. Isifo sikashukela i-mellitus sitholakala ngamazinga okushukela asheshe abe ngaphezulu kwe-5.1 mmol / L.
Ukunqunywa kwe-glucose egazini lowesifazane okhulelwe - indlela yokucwaninga ayimfuneko
Ukuhlaziywa kwe-glycosylated hemoglobin kukuvumela ukuthi usungule isimo se-carbohydrate metabolism ezinyangeni ezi-2. Imvamisa, izinga le-glycosylated hemoglobin lingama-3-6%. Ukwanda kwesikhombisi ku-8% kukhombisa amathuba okuba nesifo sikashukela, nge-8-10% ingozi ilinganiselwe, nge-10% noma ngaphezulu - phezulu.
Qiniseka ukuthi uhlola umchamo we-glucose. I-10% yabesifazane abakhulelwe bahlushwa i-glucosuria, kepha kungenzeka ingahlotshaniswa nesimo se-hyperglycemic, kepha ngokwephulwa kwekhono lokuhlunga le-renal glomeruli noma i-pyelonephritis engapheli.
Ukuhlolwa emavikini angama-24-28 wokukhulelwa
Ukuhlolwa kweglucose yegazi ngesikhathi sokukhulelwaUma esivivinyweni sokuqala se-trimester standard singakhombisanga ama-pathologies we-carbohydrate metabolism, ukuhlolwa okulandelayo kwenziwa ekuqaleni kwenyanga ye-6. Ukunqunywa kokubekezelela i-glucose akudingi ukulungiswa okukhethekile futhi kwenziwa ekuseni. Ucwaningo lufaka ukunquma okuqukethwe kwe-carbohydrate okusheshayo, ihora elilodwa ngemuva kokuthatha u-75 g we-glucose, namanye ama-2 amahora. Isiguli akufanele sibheme, siqhubeke ngentshiseko, siphuze imishanguzo ethinta umphumela wokuhlaziywa.
Uma i-hyperglycemia itholwa ngesikhathi kuhlolwa isampula yokuqala, izinyathelo zokuhlola ezilandelayo azenziwanga.
Ukuzimisela kokubekezelela i-glucose kufakwe emacaleni:
- i-acidosis eyingozi;
- izifo ezithathelwanayo;
- ukwanda kwe-pancreatitis engapheli;
- isidingo sokuphumula kombhede.
Ushukela wegazi wokuqala wowesifazane okhulelwe uphansi kunowowesifazane ongakhulelwe. Ngemuva kwehora ukulayisha, izinga le-glycemia kowesifazane okhulelwe lingu-10-11 mmol / L, ngemuva kwamahora ama-2 - 8-10 mmol / L. Ukwehla kokubambezeleka kokuqunjelwa kwe-glucose egazini ngesikhathi sokukhulelwa kubangelwa ukuguquka kwesilinganiso sokufakwa emzimbeni wephephabhuku lesisu.
Uma kutholakala isifo sikashukela ngesikhathi sokuhlolwa, owesifazane ubhaliswa kudokotela obambelela endocrinologist.
Izinguquko ze-pathological metabolism ye-carbohydrate kwabesifazane abaningi ziyatholakala ngesikhathi sokukhulelwa. Ukuthuthukiswa kwalesi sifo kunqunywa ngofuzo. Isifo sikashukela i-mellitus siyingozi empilweni yomama nengane. Ukutholwa kusenesikhathi kokuphambuka kuyadingeka ekwelashweni kwesifo okufika ngesikhathi.
