Fetopathy matenda ashuga. Shuga pa mimba

Palibe ali mzimayi sangakhale otsimikiza kuti pathupi adzatuluka popanda mavuto, makamaka ngati akudwala matenda aliwonse. chikhalidwe yoopsa zingakhudze zosiyanasiyana ziti zimene zingam'pangitse zoipa. Choncho n'kofunika kuti aziona thanzi komanso amayesetsa kudziteteza ku zotsatira za zinthu chowawa. Makamaka mfundo zokhuza akazi amene ali matenda osiyanasiyana m'thupi.

Akazi ndi matenda "shuga" ndi maloto ndi mwana ayenera kudziwa kuti mu nkhani iyi paphewa udindo waukulu, chifukwa matenda kungachititse kuti mavuto osiyanasiyana mwanayo. Mmodzi wa iwo ndi fetopathy mwana wosabadwayo.

Features matendawa

Ashuga fetopathy ndi matenda a mwana wosabadwayo akuwuka pamaso pa chisanadze shuga kapena matenda a shuga mu amayi apakati, pamene shuga msinkhu ndi apamwamba kuposa milingo yachibadwa. Pakuti ichi kudwala khalidwe kusintha mkhalidwe wa mwana wosabadwayo ndi kukanika kwa kapamba, impso, macro- ndi microvascular dongosolo lake.

Ngati mbiri ya mkazi wapakati ali ndi matenda ngati "zipatso fetopathy", nthawi zambiri dokotala mukuganiza kuti agwire yobereka opaleshoni.

The yabwino Inde mimba mwa akazi ndi shuga amadalira zinthu zambiri. Zikuphatikizapo: mtundu wa matenda, mavuto amene amabwera, mankhwala wogwila yovomerezeka kuchiza matenda. Palibe kuopa zovuta zilizonse zoipa, ngati mu zimatiyika mimba magazi shuga anaimirira pamwamba pa mtengo yovuta.

Ngati mulibe zoperewerazo matenda, shuga, mimba zoipa zokhudza chitukuko cha mwana wosabadwayo ndi nthawi gestation. Madokotala zambiri patsogolo rodorazreshayut mkazi kupulumutsa moyo wake ndi mwana. Ndi matenda zimasiyanasiyana ultrastructure placental chotchinga, limene izo imaleka kugwira ntchito bwinobwino ndi kupulumutsa mwana wosabadwayo zonse zofunikira. Madokotala mu nkhani iyi, nthawi zambiri matenda a "hyperplasia wa capillaries lapansi." Mwanayo utero ayamba kwambiri kulemera, koma bwino anakamba.

umboni

Shuga pa mimba kumabweretsa mfundo yakuti mwana wabadwa ndi zizindikiro zakutsatapo matenda:

• Large kulemera (zambiri kuposa 4 kg);
• kuloza nuchoka pa khungu;
• kutupa kwa minofu zofewa ndi khungu;
• mimba zazikulu chifukwa cha kwambiri anayamba subcutaneous mafuta;
• miyendo yochepa;
• pabuka buluu khungu kamvekedwe;
• syrovidnoy yambiri ya khungu lubricant;
• yotakata mapewa.

zizindikiro

Newborn fetopathy limapezeka motere:

• kupuma mavuto, limafotokoza zimene kupanda kaphatikizidwe wa mankhwala achindunji m'mapapo (surfactant), kuwathandiza akulimbana mpweya koyamba;
• Nkosatheka kupuma movutikira ndipo ngakhale kupuma kumangidwa mwamsanga pambuyo pa kubadwa;
• zheltushka, amene amaona chizindikiro cha kusintha pathological mu chiwindi, chimene chimafuna chithandizo chokwanira;
• matenda a ubongo: utachepa minofu kamvekedwe, yimitsira wa woyamwa reflex, kusinthana kwa ntchito utachepa ndi hyperexcitability.

zifukwa

Fetopathy ashuga wosabadwa akufotokozera chifukwa njira akumane mimba imene anayambitsa uncompensated shuga mtundu 1 ndi 2. Komanso, chifukwa cha matenda ndi mayi a shuga gestational.

An kuchuluka owonjezera shuga m'magazi a mayi amachititsa yoopsa kapamba ayamba kupanga mankhwala kwambiri. Wotuluka mwa magazi a mayi ndi mwana shuga lalikulu zedi akuyamba mwakhama ntchito. Komabe, kutukula wa mwana wosabadwayo amafuna muyezo winawake, choncho owonjezera ali n'kukhala mafuta, imbaenda kuna lalikulu mwana kulemera.

Ngati mulibe kubweretsa glycemia linalake, izo angathandize kuti mphamvu amphamvu minofu adipose ndi mwana wosabadwayo woterewu zambiri kulola dongosolo lonse la ziwalo ndipo zimakhala mwana.

diagnostics

Kudziwa anomalies mu mwana wosabadwayo, dokotala n'kukulemberani njira zotsatirazi:

• ultrasound;
• kuphunzira chikhalidwe biophysical wa mwana wosabadwayo;
• Doppler;
• CTG;
• ziyenera a zolembera amuzolengedwa a dongosolo fetoplacental.

likhale ultrasound

The njira zofunika kudziŵa zakusokonenezedwa kwa mwana wosabadwayo ndi ultrasound. Analimbikitsa atagwira ultrasound mu mawu awa, ngati anandipeza ndi matenda a shuga pa mimba:

• Mu trimester - nthawi.
• Mu trimester chachiwiri - kamodzi monga pakati pa masabata 24 ndi 26. Izi ziri zofunika kuti tidziwe malformations zosiyanasiyana za chapakati mantha, mafupa ndi mafupa, genitourinary ndi mtima dongosolo, komanso dongosolo m'mimba.
• The awiri womwe lachitatu trimester ultrasound, ngakhalenso katatu. Pamene insulin amadalira shuga ndi kafukufuku ikuchitika pa sabata 30-32, ndiyeno kuchichita kamodzi pa sabata.

Zizindikiro za matenda ashuga fetopathy ndi ultrasound wa mwana wosabadwayo:

• mekeza kwambiri kwa nthawi yeniyeni ya nthawi;
• disproportion wa thupi;
• awiri mizere pa mutu;
• kochulukira kuchuluka kwa madzi;
• yoopsa wapawiri dera chifukwa wambirimbiri mafuta kapena minofu zofewa kutupa;
• mu mafupa a Chigaza pa amalembedwa zone ehonegativnoe, kusonyeza edema.

Biophysical Research yoopsa chikhalidwe

Kuphunzira kotereku angaulule kuphwanya mu chitukuko morphofunctional a ubongo zomwe amaona chiwonetsero chachikulu kwambiri embryopathy. Kuti tipeze yankho, dokotala ndi theka atakhazikitsa kupuma, kugunda kwa mtima ndi zochita locomotor wa mwana wosabadwayo.

Ngati pali kukayikitsa fetopathy, ndiye kugona mwanayo adzakhala yochepa ankakhala, ndipo nthawi zambiri amapanga kayendedwe yogwira. Short kugona nthawi ndi zosaposa 50 Mphindi, imene nthawi amalembedwa liwiro la mlingo mtima ndi kuchepa kugunda kwa mtima.

kunyamula Doppler

Mothandizidwa ndi phunziro ili kutsatira zizindikiro zotsatirazi:

• kufulumizitsa kuchepetsa ulusi m'mnyewa wamtima;
• mtima phindu linanena bungwe;
• ejection nthawi ya ventricle kumanzere;
• systolic ndi diastolic magazi mu mtsempha wamagazi chiŵerengero.

Doppler velocimetry anachita pa sabata 30 kuti aone mkhalidwe wa chapakati mantha dongosolo.

Kunyamula CTG ndi zochita za mayesero zinchito

njirayi amalola amayang'anitsitsa kugunda kwa mtima pa mpumulo, pa kayendedwe, uterine chidule. Madokotala ikuchitika mayesero panopa kutenga zitsanzo zochepa.

Kukhazikitsa aziona zolembera amuzolengedwa a dongosolo placental

Matenda placental insufficiency, ndi mkodzo ndi zitsanzo magazi atengedwa. Mu matenda amenewa mu trimester lachitatu fetopathy ashuga akuwonetseredwa kuwonjezeka kwambiri a Ace.

Chithandizo pa mimba

Kwa mimba, mkazi ayenera kukhala kudziletsa kuwunika magazi ndi shuga magazi. Ngati chofunika, ndi zina zotchulidwa insulin. Ngati muyeso njira ya shuga zofunikira kufufuza mawola 3-4 tsiku. Glycemia kudzudzulidwa shuga kapena insulin.

Fetopathy ashuga kumafuna kutenga mavitamini, kusunga ndi kudya zakudya zapadera malangizo ena a dokotala. Chakudya ayenera kukhala wolemera mu chakudya mosavuta zidyeke, ndi mafuta bwino kuchepetsa.

Chithandizo nthawi yobereka

Choyamba, mothandizidwa ndi ultrasound kudziwa tsiku mulingo woyenera kwambiri yobereka. Ngati mimba ndi wopepuka, ndi bwino rodorazreshat mkazi pa masabata 37. Ngati pali choopsa pa moyo wa mayi ndi mwana, zimatero mwa masabata 36. Medical mimba pa siteji yoyamba nthawi zonse umachitikira pokhapokha ngati pali zinthu zoopsa kunatsala pang'ono kuti moyo wa mayi, ndi mawu si kupulumutsa mwana.

Pa ntchito, madokotala akuyenera kuti aziona glycemia. Ngati kuchepa amphamvu madzi a shuga magazi mkazi alibe mphamvu zokwanira pa ntchito, monga kwambiri shuga yaikulu pa contractions uterine. Mu ndondomeko za pobereka kapena nthawi yomweyo pambuyo pawo, pali chiopsezo kuti wodwalayo itagwa chikomokere hypoglycemic.

Gestational shuga imapereka ntchito mwachidule. Ngati iwo mpaka maola oposa 10, mu nkhani iyi ikuchitika gawo la Kaisara, kenako chithandizo Kwalamulidwa mankhwala.

Chithandizo akabereka

Pofuna kupewa chitukuko cha hypoglycemia ndi mavuto zina, nthawi pambuyo pa kubadwa kwa mwana kutumikiridwa 5% shuga njira. Lililonse 2 chasa akhanda ayenera kupereka mkaka wa m'mawere, kuyambira madzimadzi izi mankhwala akhoza kusiya boma.

Kumayambiriro neonatal nyengo ayenera kutenga malo kuyang'aniridwa ndi madokotala amene ayenera kuwunika kupuma kwa mwana. Sanamwe kulumikiza othandizira. Pamaso pa matenda a ubongo kuthandiza kashiamu ndi magnesium njira. Ngati mwana ali ndi zizindikiro za matenda chiwindi, pamene azungu cha maso ndi khungu mwanayo amakhala jaundiced, dokotala n'kukulemberani magawo cheza ultraviolet mu mlingo mosamalitsa kumatanthauza.

akazi Postpartum 2-3 kuchepetsa insulin chifukwa mlingo shuga magazi kwambiri yafupika. Pa kumaliseche mlingo wa shuga wabwezeretsedwa ku misinkhu yachibadwa.

zosokonezeka

Ashuga fetopathy zotsatira neonatal mwina zotsatirazi:

• neonatal hypoxia;
• kuchepa lakuthwa madzi a shuga magazi mlingo yovuta;
• congestive mtima kulephera;
• shuga akhanda;
• kupanda magnesium ndi calcium, chimene zoipa zokhudza ntchito kwa chapakati mantha dongosolo;
• kunenepa.

Pomaliza

Fetopathy Shuga kuti akufotokozera mu wosabadwa pa zilili masiku ano a shuga amayi wake, zosasangalatsa kwambiri ndi matenda oopsa. Mkazi kwenikweni pa mimba potsatira malangizo onse dokotala ndi kulamulira misinkhu shuga magazi. Only mu nkhani iyi zotsatira mwana Sadzathandiza kwambiri chisoni.