Kuyo yonke inkathi yokukhulelwa, abesifazane kufanele baphumelele izivivinyo eziningi ezahlukahlukene. Enye yazo ifaka ukuhlolwa kokubekezelela i-glucose, okungasiza ekuboneni lokho okubizwa ngokuthi yi-gestational sikashukela futhi kuvikele ukukhula kwayo kube uhlobo olwaziwa kakhudlwana - isifo sikashukela seqembu lesibili.
Njengoba le nto ingenzeki kubo bonke abesifazane abakhulelwe - njengoba izibalo zibonisa, cishe ama-7% abo bonke banesifo, kubalulekile ukusungula ubukhona noma ukungabi bikho kwe-GDM ngendlela yesikhathi ukuze umama nengane ingahlupheki, futhi lesi simo singakhuli sibe yizifo eziyinkimbinkimbi kakhulu esikhathini esizayo esiseduze.
Abesifazane abakhulelwe kufanele banikele ngegazi nge-glucose ukuze bagweme ukuphazamiseka okubangelwa inguquko yemvelo ngemuva kwehomoni ehambisana nesikhathi sonke sokukhulelwa. Lokhu kuzokwenza ukuthi kubhekwe ukusebenza komzimba futhi, uma kunesidingo, ukukunikeze ngezinto ezingekho.
Kungani i-GTT ichazwa ngesikhathi sokukhulelwa?
Ukuhlolwa kwe-GTT kuvame ukubekelwa abesifazane abakhulelwe. Ngenxa yomthwalo omningi emzimbeni, kunethuba lokwanda kwezifo ezikhona, kanye nokuvuselela ezintsha, kufaka phakathi isifo sikashukela sokukhulelwa.
Enye yezimbangela ezinkulu zalesi sifo ingabizwa ngokuthi ukukhiqizwa okunganele kwe-insulin, lapho ikhiqizwa ngenani elincane kakhulu levolumu edingekayo, kuyilapho inesibopho sokulawula amazinga kashukela futhi yakha imithombo yokulondolozwa lapho kungekho ukuguqulwa kwamandla.
Ngokuntuleka kwe-insulin, ushukela awukwazi ukudonswa kahle, okuba imbangela yesifo sikashukela kwabesifazane abakhulelwe, abangakhula babe ezinye izinhlobo zalesi sifo.
Odokotela bathethelela isidingo sokuhlolwa ngale ndlela elandelayo:
- ukubona okungahambi kahle emzimbeni ngesikhathi sokukhulelwa;
- isifo sikashukela sokukhulelwa singenzeka ngesimo se-latent;
- ukuba khona kwesifo sikashukela kungaholela ekuphuthweni kwesisu;
- ingane ingazalwa inezinkinga zempilo.
Imvamisa, isifo sikashukela sokuthinta umzimba siphela lapho kuphela isikhathi sokukhulelwa, kepha umphumela ophephile uncike kakhulu ekuhlolweni okuyikho nasekuhlolweni kokulungiswa.
Ividiyo ngezimbangela zesifo sikashukela sokukhulelwa:
Izinkomba zokuhlaziywa okuphoqelekile
Lokhu kuhlolwa kunqunyelwe njengenyathelo lokuphoqelela kwabesifazane abanakho:
- ukuthathwa kwe-glucose engalungisiwe ngesikhathi sokukhulelwa kwangaphambilini;
- uma inkomba yesisindo somzimba isuka kuma-30 nangaphezulu, nokuthi owesifazane ngesikhathi sokuzalwa kwangaphambilini wayenamazinyane amakhulu ukusuka ku-4 kg noma ngaphezulu;
- uma owesifazane okhulelwe eba nezihlobo ezinesifo sikashukela.
Inkomba yokuhlolwa okunjalo ingakhishwa ngodokotela abanjengo-endocrinologist, udokotela wobudokotela, udokotela wezifo zabesifazane kanye nabanye, esimeni se:
- ukusolwa kwesifo sikashukela seqembu lokuqala noma lesibili;
- ukuthuthukiswa kwesimo esandulela ukukhula kwesifo sikashukela;
- isifo sikashukela sokukhulelwa
- ukwephulwa kwezinso, isibindi, amanyikwe;
- i-metabolic syndrome;
- izifo zesistimu ye-endocrine;
- Izinkinga ezinesisindo ngokweqile;
- uma i-urinalysis ikhombisa ushukela.
Uma kutholakala ama-pathologies anjalo, udokotela kufanele akhethe isethi eyodwa yezinqubo zesikhathi sonke sokukhulelwa, enze ukubhekwa ngezikhathi ezithile kwenkambo yokuthinta nezinguquko esimweni sowesifazane. Uma kutholakala izimpawu zesifo sikashukela, owesifazane okhulelwe kumele akhononde kudokotela ngoshintsho emzimbeni.
Ukuxhumanisa kuya ekuhlolweni
Akuwona wonke amacala avumela ukuhlolwa kwe-glucose.
Omama ababhekelele ukwephulwa okunjengokuthi:
- ukuba khona kwe-toxicosis,
ngenxa yokuthi kunethuba eliphezulu lokungaphuzi isixazululo esimnandi (ukuhlanza okungalindelekile), ngenxa yalokho i-glucose engeke idonswe; - ukuphazamiseka kwezifo kanye nezifo zomgudu wesisu;
- i-cholecystopancreatitis ye-acute;
- uma kunqunyelwe ukuphumula kombhede okuqinile;
- ukutheleleka ngegciwane;
- ukuba khona kokulimala (kuthinta ukusebenza kohlolo);
- Isifo sikaCrohn;
- izilonda ze-peptic;
- ukukhulelwa kade.
ngenxa yokuthi kunethuba eliphezulu lokungaphuzi isixazululo esimnandi (ukuhlanza okungalindelekile), ngenxa yalokho i-glucose engeke idonswe;Naphezu kokusebenza okuphezulu kokuhlolwa kokubekezelela kwe-glucose ekutholeni isifo sikashukela, kunezinye izindlela ezingasetshenziswa ukusithola.
Ukulungiselela nokuziphatha kohlolo
Ukuhlola kwenziwa ngokuthatha igazi emthanjeni. Ungadli ukudla ngaphambi kwale nqubo. Endabeni yezinkomba ezijwayelekile, isampula yegazi ephindaphindwe yenziwa ngemuva kwengxenye yehora noma ihora, uma umphumela wokuqala ukhombise idatha ngenhla kwesejwayelekile, isivivinyo siyama kanye nesifo sikashukela sokukhulelwa singasolwa.
Ngokusebenza okujwayelekile, okulandelayo kwenziwa:
- udinga ukuphuza isisombululo se-glucose;
- emva kwemizuzu engama-60, ukuhlolwa kwenziwa futhi;
- Phinda isivivinyo ufike ezikhathini ezi-4.
Ngaphambi kokunikezela, akunakuvumelekile ukuthi:
- udle ukudla (ungathela amanzi);
- utshwala
- ukubhema
- imithi kanye nemithi elwa namagciwane.
Zonke lezi zinto zingathinta ukuhlanekezela kwemiphumela. Kubalulekile ukulandela ukudla futhi udle okwejwayelekile ezinsukwini ezi-3 zokugcina ukuze ukudla kudle okungenani amagremu ayi-150 ama-carbohydrate nsuku zonke.
Kubalulekile futhi ukuthi uqinisekise ukuthi:
- yayinokuqukethwe okujwayelekile kwe-magnesium;
- kwakungekho zinkinga ze-endocrine;
- kwakungekho ukucindezela okungokomzwelo;
- kwakungekho imisebenzi yomzimba.
Ukuhambisana nazo zonke lezi zidingo kuzothinta imiphumela yokuhlolwa kwangempela. Odokotela kufanele bazise owesifazane okhulelwe ukuthi kumele athule ngaphambi kokuthi isivivinyo siphothulwe futhi bazame ukuphuza ikhambi le-glucose kungakapheli imizuzu eyi-5 ngemuva kokuhlolwa kwegazi kokuqala. Isixazululo uqobo sinokunambitheka okumnandi kakhulu futhi okunoshukela, ngakho-ke uma kukhona ukudakwa, akubona bonke abantu abangakwenza lokhu ngaphandle kokuhlanza.
Ukuhunyushwa kwemiphumela
Amanani alandelayo ku-mmol / l akufanele wedlule:
- esiswini esingenalutho - 5.1;
- Imizuzu engama-60 ngemuva kokulayisha ushukela - 10;
- emahoreni ambalwa ngemuva kokulayisha kwe-glucose - 8.6;
- Amahora ama-3 ngemuva kokulayisha ushukela - 7.8.
Uma okungenani 2 zalezi zinkomba zedlula lezi zilinganiso noma umngcele ngenani eliphakeme, udokotela angasola isifo sikashukela sokukhulelwa. Ukuhlolwa kwesisombululo esimnandi akwenziwa lapho imiphumela yokuzila idlula i-7 mmol / L.
Uma imiphumela ye-GTT ngesikhathi sokubeletha kwegazi le-venous esiswini esingenalutho idlula inani le-7 mmol / l, khona-ke owesifazane okhulelwe usolwa isifo sikashukela. Kulesi simo, ukulethwa kabusha kwemiphumela kuqokwa kungakapheli amasonto ama-2 ukukhipha izinkomba zamanga noma amaphutha ocwaningweni. Kepha, noma ngabe kunemiphumela emibi, ukuxilongwa akwenziwa. Kulokhu, umama okhulelwe angabhaliswa ku-endocrinologist.
Isiqinisekiso sokuxilongwa kanye namaqhinga wokwelashwa
Ukuhlaziywa okukodwa akwanele ukwenza ukuxilongwa. Lapho kuphinda kudluliswa ukuhlaziywa, uma izinkomba ziqinisekisiwe, udokotela uzokwazi ukuxilonga kuphela ngemuva kokubeletha. Futhi, ngemuva kokubeletha, kuphoqelekile ukuthi kube nokuhlolwa kwe-GTT ukwenza kucace ukuthi isifo sikashukela sasihambisana nokukhulelwa noma cha.
Abesifazane abakhulelwe abakhuphule izinga lokuhlolwa kwesibalo se-glucose kuzodingeka bahambisane nokudla okukhethekile kanye nohlobo. Ukudla kuphela okungajwayelekile isimo somzimba futhi kunciphise noshukela wegazi.
Okokuqala, kufanele unciphise ukusetshenziswa kwemikhiqizo equkethe ushukela, futhi ubuye usebenzise ukusetshenziswa kwama-carbohydrate alula nalawo anzima. Lokhu kuzovumela ngokushesha ngangokunokwenzeka ukuthuthukisa isimo sowesifazane okhulelwe.
Kufanele kulandelwe le mithetho elandelayo:
- ukuthathwa kwamanzi nsuku zonke - okungenani amalitha ayi-1.5 (kucatshangelwa kuphela amanzi ngaphandle kwegesi);
- qeda ngokuphelele othosiwe namafutha;
- ukondliwa kufanele kube ngokuxhamazanayo, kuyadingeka ukwahlukanisa ukudla kuma-5-6 receptions, udinga ukudla kancane njalo emahoreni angama-2-3;
- khipha ukudla okusheshayo nokudla okusheshayo;
- khipha i-ketchup, imayonnaise ekudleni (ingathathelwa indawo ukhilimu omuncu ophansi);
- ungadli ingulube;
- isinkwa esijwayelekile sibuyisela isinkwa sokusanhlamvu okuphelele.
Uncamela imikhiqizo elandelayo:
- inhlanzi enamafutha amancane (isb. hake, pollock);
- inyama yokudla (inkukhu, i-veal, iwundlu);
- okusanhlamvu;
- i-durum kakolweni pasta;
- imifino
- imikhiqizo yobisi enamafutha amancane.
Ngaphezu kokudla okunempilo, kufanelekile ukwenza imfundo yomzimba. Imidlalo ekhanyayo iyadingeka, ungahamba okuningi - konke lokhu kuzoba nomthelela ekuthuthukisweni. Zonke izenzo zakho kumele zihlangane nodokotela wakho ukuze zingalimazi ingane.
