FGR - ndichiyani? yoopsa kukula syndrome retardation

Matendawa "FGR" madokotala kuika ana onse amene amabadwa ndi akusowa thupi wachibale msinkhu wawo gestational. About matenda, akazi ambiri tikupeza pa mimba. Ku zipangizo za nkhaniyi mudzapeza zimene zizindikiro za matendawa limodzi ndi kuchedwa chitukuko yoopsa, chifukwa kumachitika.

FGR - ndichiyani?

Retardation syndrome chitukuko wosabadwa (IUGR) - ndi kudwala yodziwika ndi kwanthawi kuyenda kukula kwa mfundo pafupifupi ananena ponseponse kwa nthawi zina mimba. Mu Russia, kuchuluka kwa matenda Mitandadza 5 mpaka 18%. Miyeso ka mwana si nthawi zonse syndrome izi. 70% ya ana amene ndi matenda izi, ndi chikhalidwe chawo ndi yaing'ono kulemera anaikidwa. Iwo ndi mayi kapena bambo angakhale ang'ono mu msinkhu. Komanso, ayenera kukhala mwamuna kapena mkazi (wamkazi zambiri osachepera 5% ya anyamata pafupifupi 200 g) ndi mtundu.

Monga ulamuliro, boma kulipidwa mwana M'chaka choyamba cha moyo. Iye kunenepa ndipo kupeza msinkhu, mwatsala zizindikiro muyezo. Ngati zikutsimikiziridwa ndi matenda dokotala amakhala chifukwa chachikulu ndi kwanthawi mu kukula kwa mwanayo, sukhala thanzi ndi khalidwe la moyo imatengedwa wapadera zovuta chithandizo.

Kusiyanitsa mitundu iwiri FGR: ofananira ndi asymmetric. Aliyense mwina ali khalidwe yake mbali pathological. Pa iwo nkhani zotsatirazi m'nkhani ino.

Asymmetrical mawonekedwe FGR

Kudwala ambiri zidzachitika trimester wachiwiri ndipo amakhala ndi yoopsa kulemera chofunika pa kukula bwinobwino. The mwana zomwe zikutsalirazi kumbuyo mu Kukula kwa zimakhala wa pamimba ndi chifuwa. Asymmetric FGR zina yodziwika ndi musayambe m'goli mkati machitidwe limba. Popeza mankhwala yake amachepetsa kukula kwa mutu wa mwanayo ndi kwanthawi mu Kukula kwa ubongo zomwe zingachititse imfa yake.

The symmetrical mawonekedwe a FGR

kudwala The amakhala ndi kuchepa njila mu thupi la mwanayo kukula wachibale ndi mfundo pafupifupi kwa zaka makamaka gestational. Nthawi zambiri anapezeka ku trimester chachiwiri. The symmetrical mawonekedwe a matenda nthawi zambiri chifukwa matenda intrauterine wa mwana wosabadwayo, chromosomal kuvutika. Ana ndi matenda izi amabadwa ndi zosalongosoka chitukuko cha chapakati mantha dongosolo.

The chikuchititsa mavuto a matenda

Mwanayo akhoza amabadwa ochepa zifukwa zingapo. Sitiyenera kukusalani chakuti ndi mbali thupi. Kukula otsika mwana ndilandire kwa makolo awo. Komabe, ngakhale mu nkhani iyi dokotala wanena anapezeka "retardation syndrome mwana wosabadwayo." Ngati atabadwa thupi mwana mokwanira ntchito, ndipo bongo wake zizigwirizana malamulo, mankhwala enieni chofunika.

Madokotala kusiyanitsa zimayambitsa ena IUGR, tingayambe hypoxia ndipo ngakhale mimba anayamba kuchepa. Kuchedwa kakulidwe zimawonedwa mu mulanduwo, ngati mwanayo m'mimba ndi salandira mpweya ndi zakudya zofunikira. Popanda sikutheka kuti atchule chamoyo zonse kunachitika wa chamoyo.

Kuchepetsa kuchuluka kwa zipangizo ukubwera izo bwino zimayamba ndi zinthu zambiri:

1. mavuto Placental. Thupi ili ndi udindo yonyamula mpweya kwa mwana wosabadwayo m'mimba. Ngati nsengwa ndi olumala, mwina silingayende kwathunthu.
2. Kudwala mu machitidwe a ziwalo amayi tsogolo (kuthamanga kwa magazi, magazi, matenda a mtima ndi kapepala kupuma, matenda a shuga).
3. Kukula kwa mwana wosabadwayo udindo wapadera limabweretsa akonzedwa kuti asakhale ndi vutoli, amene iye amamulandira makolo ake.
4. Mankhwala osokoneza bongo. Ambiri a chilungamo utsi kugonana ndi kumwa mowa. zizolowezi zoipa, ngakhale mkaziyo anakana atatsala pang'ono lingaliro zikhoza IUGR pa mimba.
5. Madokotala zonse mwauzidwa kuti mkazi ali oyenera kukhala pamenepo basi awiri. Ndithu. Kudya pang'ono kapena kuchepa lakuthwa mu wambiri caloric akhoza kukhumudwa bwanji mwana. Ngati mwana wosabadwayo alibe zakudya zokwanira, iwo amayamba kuchotsapo thupi la mayi. Chakudya awiri sizikutanthauza kuti muyenera kudya zonse. The zakudya ayenera kukhala anzeru ndi zigwirizana yekha mankhwala abwino. Ali woyembekezera ayenera musaope bwino, kukhala pa zakudya okhwima ndi koletsedwa.
6. Mankhwala. Kuyambira mankhwala ponyamula mwana ayenera kuchotsedwa. Tengani mankhwala okha pa malangizo a dokotala, pamene china sizingathandizike.
7. Anasamutsa pa mimba, matenda chikhalidwe cha matenda (chikuku, toxoplasmosis, chindoko) Kodi suspend chitukuko cha mwana wosabadwayo. N'chifukwa chake madokotala mwamphamvu analangiza kuti katemera bwino pamaso pathupi mwana.
8. FGR 2 madigiri zambiri kuika akazi amene amakhala m'madera pa okwera mkulu. Kudera, kuthamanga ndi mkulu, ndipo kawirikawiri zimenezi zimathandiza kuti hypoxia mu mwana wosabadwayo ndi amachepetsa ake.

Panthawi yake chizindikiritso cha zimayambitsa vuto ndi kuwonongedwa ake wotsatira kulola dokotala kusankha mankhwala.

Kodi zizindikiro zikusonyeza retardation syndrome chitukuko yoopsa?

Chithunzi matenda a matenda zambiri zidzachotsedwa. Akuganiza chotero matenda nokha pakati n'zokayikitsa. zonse Only polojekiti ndi gynecologist a pa naini miyezi imasonyeza vuto m'nthawi yake.

Anthu ena amakhulupirira kuti ngati mkazi ali woyembekezera, pang'ono ayamba kulemera, osalephera, chipatso cha kukula ang'onoang'ono. Chifukwa china choona, koma kawirikawiri woona. Pamene woyembekezera latsopano mayi zimasokoneza zakudya tsiku la 1500 kcal zakudya ndi chidwi, Mwina zosayembekezereka wa IUGR mwana wosabadwayo ndi mkulu mokwanira. Mosiyana ndi zimenezi, matenda sayenera lilibe kwa akazi amene anali ndi kuwonjezeka akanagwiritsa kulemera.

A chizindikiro Mmenemo choonekera matendawa imatengedwa ochepa chabe waulesi kayendedwe yoopsa. Zizindikiro ayenera kuchenjeza ndi kukhala chifukwa kutumiza pangozi kwa katswiri.

Kudzifufuza ndi yoopsa kukula retardation

Ngati mukukayikira ndi pathological chitukuko cha dokotala wa mwana komanso kuchenjeza kutalika zikusiyana pakati pa mtengo wa uterine fundus zoyezera zolimbana, yeniyeni malo awa mimba. Matenda ambiri odalirika imodzi yoopsa ultrasound, imene akatswiri amanena kukula kwake ndi kulemera. Komanso, mothandizidwa ndi ultrasound angathe kudziwa udindo wa ziwalo za kachitidwe mwana.

Doppler komanso analamula kuti amaganiziridwa IUGR. Ndi chiyani icho? kafukufukuyu kuchitikira kuti aone nthenda yotaya magazi ziwiya mwanayo ndipo latuluka. Njira zofunika kwa Kupeza Vuto mwana wosabadwa imatengedwa cardiotocography (kafukufuku kugunda). Mu yachibadwa kugunda kwa mtima ranges kuchokera kumenyedwa pafupifupi 120 kuti 160 pa mphindi imodzi. Pamene mwana ali m'mimba adzasowe mpweya, mtima wake pang'onopang'ono pafupipafupi.

Yachokera pa zotsatira za kumupima, dokotalayo otsimikiza matenda ndi kudziwa kukula kwa matendawa.

• FGR digiri 1 akuti ndi zovuta, amakhala ndi kwanthawi mu Kukula kwa pafupifupi deta anthropometric kwa masabata awiri.
• FGR madigiri 2 kupatuka osiyana ndi zizindikiro muyezo mwa masabata awiri kapena anayi.
• Ovuta kwambiri ndi digiri wachitatu wa IUGR. Indicators cha kukula kwake ndi kulemera kwa mwana m'mimba si kukumana mfundo koposera masabata anayi. Nthawi zambiri 3 FGR kumabweretsa madigiri yoopsa kutha.

zochiritsira

Zochizira matenda ichi ntchito obstetrics nkhokwe yaikulu ya mankhwala akuuzidwa pa normalizing uteroplacental magazi.

1. Tokoliticheskogo kumasuka chiberekero ( "ginipral", "papaverine").
2. Yokonzekera normalization wa kagayidwe mu minofu ( "Curantil", "Aktovegin").
3. Kulowetsedwa mankhwala pogwiritsa ntchito njira shuga ndi mmalo magazi ,.
4. Vitamini mankhwala.

mankhwala onse Kwalamulidwa kwa nthawi yaitali ndi kuwunika zonse za chikhalidwe cha mwana wosabadwayo.

chidwi linaperekedwa kwa mankhwalawa FGR zakudya pa mimba. The zakudya ayenera moyenera ngati kuli kotheka. Iwo ali osavomerezeka kudalira mankhwala ena. Inu mukhoza kudya chirichonse. Sayenera kukusalani nyama ndi mkaka, popeza muli yambiri nyama mapuloteni. Apa ndi pamene mapeto a mimba kumawonjezera kufunika pafupifupi 50%. Nkofunika tisaiwale kuti cholinga chachikulu cha mankhwala - kuti kuzinenepetsa mwanayo ndi kum'patsa kukula yake ndi chitukuko ogwirizana.

Amayi apakati ndi analimbikitsanso koyenda tsiku, maganizo bata. Anatinso masana kugona opindulitsa zotsatira osati pa dziko la amayi m'tsogolo, komanso kwa mwana m'mimba pa.

kuchipatala kuti akalandire chithandizo ku FGR

Pambuyo chitsimikiziro, matenda yomaliza ya umayi tsogolo amafuna polojekiti zonse ndi akatswiri. Ultrasound anaika osachepera kawiri pa mwezi. kafukufuku mwatsatanetsatane chofunika kudziwa thunthu mwanayo ndi zilema structural zomwe zingachititse kuchedwa. Komanso tsogolo abereka anatumizidwa amniocentesis Ndondomeko ya ziyenera a kuvutika chromosomal, ngati matenda anali atazindikira pa ultrasound.

Kaya ziti mukopedwe pakutchulidwa wa IUGR, zotsatira zake mwanayo akhale sizingasinthe. Kupewa akazi awo ayenera kukayezetsa ultrasound Kupenda iwiri iliyonse. M'pofunika kuti aone kukula kwa mwana wosabadwayo ndi kukula kugunda ake.

Pamene mkazi ali mu sabata 37, madokotala zambiri kutenga lingaliro kupangira ntchito. Mpaka nthawi imeneyo, kasamalidwe ka mimba zimadalira boma la nyenyeswa mkati m'mimba. Ngati mkazi ali ndi zizindikiro preeclampsia, madokotala kusankha kubadwa msanga.

zosokonezeka zotheka ndi zotsatira

Ana ndi matenda kawirikawiri kukonza mavuto aakulu, osati pa moyo yoopsa, komanso pambuyo pa kubadwa. Mlingo wa chiopsezo zimadalira zimayambitsa ndondomeko pathological, ukulu wake ndi chiyambi cha nthawi. Malinga ndi kafukufuku, pamaso pa mavuto amapezeka ana miyeso yawo pa kubadwa zosakwana 1 kg.

Chifukwa chakuti mwana wosabadwayo ndi matenda mpweya ndi zakudya kubwera zedi osakwanira, anawo abadwe kale akufa. amachita sanathe kulimbana kuthamanga pa kubadwa zowawa, kotero madokotala zambiri kusankha gawo la Kaisara.

Ana amabadwa ndi IUGR zotsatira za matenda ichi chimakhudza ntchito kachitidwe yaikulu mkati limba. Iwo zambiri zimachitika hypoglycemia, kukana osauka matenda. Iwo sachedwa matenda a chikasu ndiyo ndipo meconium kukhumba, mwachitsanzo inhalation choyambirira ndowe.

Madokotala oterewa FGR madigiri 2, zotsatira za matenda kuli kovuta kulosera. khalidwe mwana wa moyo mu malo oyamba zimadalira chimayambitsa wa matendawa. Ena ana pang'onopang'ono afotokozerane ndi anzawo chitukuko. Ena matenda aakulu. matenda awo oyambirira kunenepa, amene kenako kumabweretsa kusokonezeka kwa mtima, matenda a shuga ndi matenda oopsa.

zodzitetezera

Usasiye popanda tcheru FGR. Kodi izo, ife kale anauza. Ndingatani kukuletsa zisachitike?

Kupewa yabwino FGR - kukonzekera mimba. Pamaso makamaka pathupi mwana makolo ndidzadutsa pa mndandanda wa mayesero kuchiza matenda aakulu. matenda maliseche ndi mano Tisanyalanyaze.

Abale kwa gynecologist pambuyo kulembetsa pa mimba mbali yofunika kupewa IUGR. The kale dokotala wapeza kuvutika, ndi apamwamba Mwina kuthetsa mavuto oopsa mu chitukuko cha mwana pa mimba ndi atabadwa.

Amayi oyembekezera ayenera kusamalira akafuna ntchito ndi zina. A kugona mokwanira sayenera maola 10 pa nthawi usiku ndi maola masana 2. Ngati inu kugona masana simungathe, mungakwanitse nthawi zina kugona mu malo yopingasa. Naps amathandiza matenda magazi pakati pa mwana ndi mayi, bwino michere zoyendera.

Kuyenda mu mpweya wabwino, chakudya chamagulu ndi kuchita masewera olimbitsa thupi - ndi kupewa lalikulu la IUGR. Kodi zikutanthauza chiyani? Mkazi ayenera kudya zakudya yekha wathanzi wolemera mu mavitamini ndi mme- zinthu. Madokotala ena amalangiza madona zakudya mkulu mu chakudya, monga zinthu zimenezi kusintha maganizo kukhala ndi pakati ndi mwana wosabadwayo mkati m'mimba. Pa nkhani ya masewera olimbitsa thupi, njira yangwiro anati yoga, kusambira mu dziwe.

retardation syndrome wosabadwa chitukuko - si aphedwa makolo amene lidzayambe maonekedwe a mwanayo. A mbali yaikulu mu mankhwala a matenda wa Timeliness matenda. Komabe, kuopsa kwake si chifukwa kusiya mwana. Palibe zotchinga zimenezi, kuti makolo achikondi sangathe kugonjetsa. Makamaka pankhani chimwemwe chenicheni akuchikazi.