Wonke umuntu wesifazane ophethwe yiluphi uhlobo lwesifo sikashukela futhi ofuna ukuba ngumama kufanele akhumbule ubungozi obukhulu bezinkinga zangemva kokubeletha nokuphambuka ekukhuleni kwengane engakazalwa. I-embryofetopathy kanye ne-diabetes ye-fetopathy yezingane ezisanda kuzalwa ibhekwa njengenye yale miphumela eyingozi yenkambo yesifo engabaliwe.
I-Fetal fetopathy yesifo sikashukela sokukhulelwa
Uhlobo lokuthokomala lwalesi sifo luba khona kubantu besifazane abaningi abakhulelwe futhi lubonakala ngoshintsho kumakhemikhali we-biochemical ejwayelekile sohlobo 2 sikashukela.
Ukuxilongwa kusenesikhathi kwenqubo enjalo ye-pathological kusiza ukuvikela inani elikhulu lezinkinga eziyingozi, kufaka phakathi i-fetopathy, okuyi-pathology ye-fetus eyenzeka ngemuva kwesizinda se-glucose ephezulu equkethe egazini lowesifazane okhulelwe.
Izinkinga zivame ukuhambisana nokusebenza kokuphazamiseka kwezinso, amanyikwe, kanye nokuphambuka ohlelweni lwe-vascular yengane. Naphezu kwempumelelo yemithi yesimanje ekwelashweni kwezifo eziningi, akunakwenzeka ukuvimba ngokuphelele ukuzalwa kwezingane ezinezinkinga ezinjalo.
Umphumela wokukhulelwa uncike ezicini eziningi:
- uhlobo lwesifo sikashukela;
- inkambo yesifo, kanye nokubuyelwa kwayo;
- ukuba khona kwe-gestosis, polyhydramnios nezinye izinkinga;
- ama-ejenti wezokwelapha asetshenziselwa ukwenza i-glycemia ibe ngejwayelekile.
I-Fetopathy ye-fetus ivame ukusebenza njengesithiyo ekuzalweni okungokwemvelo kwengane futhi iyisisekelo sesigaba se-cesarean.
Izimpawu ze-pathology
Izingane ezine-diopicathy yesifo sikashukela zivame ukuba ne-hypoxia engapheli esibelethweni.
Ngesikhathi sokubeletha, bangathola ukucindezelwa kokuphefumula noma i-asphyxiation.
Isici esiyingqayizivele sezingane ezinjalo sibhekwa njengomkhulu ngokweqile. Inani layo esibelethweni ngaphambi kwesikhathi empeleni lihlukile kwesisindo sengane ezelwe ngesikhathi.
Ngesikhathi samahora okuqala kusukela ngesikhathi sokuzalwa, lokhu kuphazamiseka okulandelayo kungabonakala enganeni:
- ukuncipha kwemisipha;
- ukucindezelwa kwe-Reflex yokuncela;
- ukushintshana komsebenzi okwehlisiwe nezikhathi ze-hyperacitivity.
Izimpawu ze-fetopathy:
- i-macrosomia - izingane ezizalwe omama abanesifo sikashukela zinesisindo esingaphezu kwama-4 kg;
- ukuvuvukala kwesikhumba nezicubu ezithambile;
- osayizi abahlukanisiwe, kuvezwe ekuqhubekiseni umthamo wesisu sosayizi wekhanda (cishe amasonto amabili), imilenze emifushane nezingalo;
- ukuba khona kokungalungi;
- ukugcwala ngokweqile kwamafutha;
- ingozi enkulu yokufa kwesibeletho (i-perinatal);
- ukubambezeleka kokukhula, okubonakaliswa esibelethweni;
- usizi lokuphefumula
- ukwehla komsebenzi;
- izikhathi ezimfushane zokulethwa;
- ukwanda kosayizi wesibindi, izindlala ze-adrenal nezinso;
- ukwedlula ukujikeleza kwamahlombe ngaphezu kosayizi wekhanda, okuvame ukudala ukulimala kwangemva kokubeletha;
- i-jaundice - ayihlotshaniswa nezimpawu zomzimba zezinsana futhi ayidlulanga phakathi neviki lokuqala lempilo. UJaundice, owavela ngemuva kwesizinda se-fetopathy, amasiginali ezinqubo zesibindi ezenzeka esibindini futhi adinga ukwelashwa okuphathelene nezidakamizwa.
I-pathogenesis yalezi zinkinga yisimo esivame kakhulu se-hypoglycemic kanye ne-hyperglycemic yowesifazane okhulelwe, esenzeka ezinyangeni zokuqala zesikhathi sokukhulelwa.
Ukuxilongwa kusenesikhathi
Abesifazane abanoma yiluphi uhlobo lwesifo sikashukela bayaziswa ngokuxilongwa lapho bekhulelwe.
Isidingo sokwenza isiphetho esinjengokuthi isifo sikashukela singaba amarekhodi esifo esiveziwe emlandweni wezokwelapha sikamama osakhulelwe.
Kwabesifazane abakhulelwe abanesifo sikashukela sokukhulelwa, ukutholwa kokubeletha kungatholakala kusetshenziswa:
- ukuxilongwa kwe-ultrasound (i-ultrasound), okukuvumela ukuthi ulandelele futhi ubone ngeso lengqondo inqubo yokukhula kwe-fetus esibelethweni;
- I-CTG (i-cardiotocography);
- izifundo zezinkomba zesimo se-biophysical sokukhula esibelethweni se-fetus, okubonisa ukwephulwa ekuthuthukiseni ubuchopho;
- dopplerometry;
- ukuhlolwa kwegazi kusuka kusampula lomchamo kuya kumamaki wesistimu ye-placental, enquma ubulukhuni be-fetopathy.
Yini engatholwa sibonga nge-Ultra:
- izimpawu ze-macrosomia;
- ukungalingani komzimba;
- izimpawu zokuvuvukala kwezicubu, kanye nokuqongelela ngokweqile kwamafutha angaphansi;
- indawo ye-echo-negative endaweni yamathambo ekhanda kanye nesikhumba sengane;
- ukuphindeka kabili kwekhanda;
- izimpawu ze-polyhydramnios.
I-CTG ikuvumela ukuthi uhlole imvamisa yezinkontileka zenhliziyo ngenkathi uphumule, ngesikhathi sokunyakaza, izinkontileka zesibeletho, futhi futhi nangaphansi kwethonya lemvelo.
Ukuqhathanisa imiphumela yalolu cwaningo kanye ne-ultrasound kwenza ukuthi sikwazi ukuhlola isimo se-biophysical ye-fetus futhi sikhombe ukuphazamiseka okungenzeka ekwakheni ubuchopho.
I-Dopplerometry inquma:
- izinkontileka ze-myocardial;
- ukugeleza kwegazi entanjeni yesambulela;
- ukusebenza kohlelo lwezinzwa lulonke.
Imvamisa yendlela ngayinye yokutholwa kusenesikhathi kwe-fetopathy inqunywa ngudokotela, ngokusekelwe ezimweni zenkambo yokukhulelwa, kanye nemiphumela yocwaningo lwangaphambilini.
Ukwelashwa kwabantu abakhulelwe
Ukwelashwa kwabesifazane abakhulelwe abanesifo sokuqina kwesifo sikashukela kuqala ngokushesha ngemuva kokuxilongwa.
Ukwelashwa ngesikhathi sokukhulelwa kufaka phakathi:
- ukuqapha kwe-glycemic
, kanye nenkomba yokucindezela kwegazi; - ukunamathela ekudleni okukhethekile okusekelwe ekuqukweni kokudla okunamafutha nokudla okuphezulu kakhulu (amakhalori aphelele ngosuku akufanele adlule ku-3000 kcal) ngaphambi kokuzalwa kwengane;
- ukuqokwa kwendawo eyengeziwe yamavithamini, esiza ekubuyiseleni ukushoda kwezinto zokulandela umkhondo lapho kungenakwenzeka ukuzithola ngokudla okuyisisekelo;
- Ukwelashwa kwe-insulin ukwenza amazinga e-glucose abe ngokwejwayelekile.
, kanye nenkomba yokucindezela kwegazi;Ukuqaliswa kwalezi zincomo kukuvumela ukuthi unciphise imiphumela elimazayo yalesi sifo ingane engakazalwa.
Ukuzalwa kwengane
Usuku lokuzalwa kwabesifazane abakhulelwe abanesifo sikashukela sokukhulelwa esihleliwe luvame ukuhlelwa kusengaphambili ngesisekelo se-ultrasound kanye nokuhlolwa okwengeziwe.
Isikhathi esifanele sokuzalwa kwengane enezibonakaliso ze-fetopathy sibhekwa njengamasonto angama-37, kepha uma kunezimo ezingalindelekile, singalungiswa.
Ngenqubo yezabasebenzi, odokotela bahlala beqapha izinga le-glycemia. Uma kungekho-glucose owanele egazini, lapho-ke izinkontileka zizoba buthaka. Ngaphezu kwalokho, owesifazane angahle aqaphele noma awele ekhefini ngenxa ye-hypoglycemia. Ukuzalwa kwengane akumele kudlule isikhathi eside, ngakho-ke, uma kungakapheli amahora ayi-10 ingane ingazalwanga, owesifazane unikezwa isigaba secesare.
Uma izimpawu ze-hypoglycemia zenzeka ngesikhathi sokubeletha, kufanele uphuze amanzi amnandi. Uma kungekho ngcono, owesifazane ujojwa ngesisombululo se-glucose esangaphakathi.
Ukukhwabanisa kwe-Postpartum
Ingane enezibonakaliso ze-fetopathy ifakwa ngesixazululo se-glucose (5%) ngemuva kokuzalwa ukuvimbela ukukhula kwe-hypoglycemia enezinkinga zesimo salesi simo.
Ukondla ingane ngobisi lwebele kwenziwa njalo emahoreni ama-2. Lokhu kuyadingeka ukuze kubuyiswe ukulingana phakathi kwe-insulin ekhiqizwa kuma-pancreas kanye nokuntuleka kweglucose.
Uma kungekho ukuphefumula, ingane ixhumeke kumakhenjini umoya omncane (umoya wokupholisa umoya) bese i-survivant ilawulwa ngokungeziwe. Ukuboniswa kwe-jaundice kumiswa ngaphansi kwethonya lemisebe ye-ultraviolet ngokuya ngemithamo esungulwe ngudokotela.
Owesifazane obelethayo ushintsha inani le-insulin ekhishwa izikhathi ezi-2 noma ezi-3. Lokhu kungenxa yokuthi inani le-glucose esegazini lehliswa kakhulu. Uma isifo sikashukela sokukhulelwa singaphethi, ke ukwelashwa kwe-insulin kukhanselwe ngokuphelele. Njengomthetho, izinsuku eziyi-10 ngemuva kokubeletha, izinga le-glycemia lifane futhi lithathe amanani abengaphambi kokukhulelwa.
Imiphumela nemiphumela yokwelashwa kwe-pathology engaziwa
I-Fetopathy osanda kuzalwa kungenzeka ukuthi ibange imiphumela engaphenduki, kuze kube ngomphumela obulalayo.
Izinkinga ezinkulu ezingakhula enganeni:
- isifo sikashukela se-neonatal;
- ukuntuleka komoya-mpilo ezicutshini nasegazini;
- ukubonakaliswa kwesifo sokuphefumula sokuphefumula (ukwehluleka ukuphefumula);
- i-hypoglycemia - uma kungekho zinyathelo ezifika ngesikhathi zokumisa izimpawu zayo kusanda kuzalwa, ukufa kungenzeka;
- ukwephulwa kwezinqubo ze-mineral metabolism ngenxa yokuntuleka kwe-calcium ne-magnesium, okungavusa ukubambezeleka kokuthuthuka;
- ukwehluleka kwenhliziyo;
- kusengaphambili ukuthayipha isifo sikashukela 2;
- ukukhuluphala
- i-polycythemia (ukwanda kwamangqamuzana abomvu egazi).
Izinto zevidiyo zesifo sikashukela sokukhulelwa kwabesifazane abakhulelwe nezincomo zokuvikelwa kwayo:
Kubalulekile ukuqonda ukuthi ukuvimbela izinkinga ze-fetopathy, kanye nokunikeza ingane usizo oludingekayo, abesifazane abakhulelwe abanesifo sikashukela sokukhulelwa badinga ukubonwa futhi bazalwe ezikhungweni zezempilo ezikhethekile.
Uma ingane izalwe ngaphandle kokuphazamiseka kwemvelo kokuzalwa kwayo, khona-ke ukwanda kwesifundo se-fetopathy kungaba nokuma okuhle. Ekupheleni kwezinyanga ezintathu zokuphila, ingane ivame ukululama ngokuphelele. Ingozi yesifo sikashukela kulezi zingane incane, kepha kunamathuba aphezulu okuthuthukisa ukukhuluphala kanye nomonakalo ohlelweni lwezinzwa ngokuzayo.
Ukugcwaliseka kowesifazane okhulelwe kukho konke ukunconywa kukadokotela nokulawulwa okuningilizayo kwesimo sakhe ngesikhathi sokubeletha kwengane kusivumela ukubikezela umphumela omuhle kubo bobabili umama okhulelwe nengane yakhe.
