Fetopathy shuga. Diabetes panguva pamuviri

Hapana ane mukadzi haagoni kuva nechokwadi chokuti akazvitakura achaita mberi pasina matambudziko, kunyanya kana ari kutambura chero chirwere. Fetus ezvinhu anogona kukanganisa zvakasiyana siyana zvinogona kumukuvadza. Saka zvinokosha kuti akuteerere utano hwavo uye edza kuti vazvidzivirire kubva zvinokonzerwa rwakashata ezvinhu. Kunyanya pfungwa dzine vakadzi vaya vane zvinetso zvakasiyana-siyana mumuviri.

Women pamwe nechirwere "chirwere cheshuga" uye kurota kuva mwana anofanira kuziva kuti kana iri pamapfudzi avo basa guru, nekuti chirwere ichi kunogona kukonzera matambudziko akasiyana-siyana mwana. Mumwe wavo ari fetopathy mudumbu.

Zvakakurukurwa chirwere

Chirwere cheshuga fetopathy chirwere chakakomba kubva mudumbu kunobva pamberi pre-chirwere cheshuga kana cheshuga vakadzi vane pamuviri, kana shuga pamwero wakakwirira kupfuura dzose siyana. Nokuti ichi zvokurwara mamirire kuchinja mamiriro ari mudumbu uye dysfunction kuti rwatata ake, itsvo, macro- uye microvascular gadziriro.

Kana nhoroondo mukadzi pamuviri ane chirwere se "zvibereko fetopathy", kazhinji chiremba anosarudza kuita kuvhiya pakusununguka.

The yakanaka nzira pamuviri vari vakadzi cheshuga runotsamira zvakawanda zvinokonzera pamusoro. Idzi dzinosanganisira: mhando chirwere, matambudziko anoitika yaivapo, akagamuchira mishonga yokurapa zvirwere. Hakuna kutya chero nemigumisiro, kana yose pamuviri ropa shuga yomuropa akamuka pamusoro dzinonetsa ukoshi.

Kana musingadi aripire chirwere ichi, chirwere cheshuga mellitus, pamuviri isakarurama zvarinoita kukura mudumbu uye nguva gestation. Doctors kazhinji mberi rodorazreshayut mukadzi kuponesa upenyu hwake uye mwana. With chirwere ichi dzinosiyana ultrastructure placental mhinganidzo, kwamakadarika wafa ishande kuitiswa uye kusunungura zvose zvaida mudumbu. Doctors muchiitiko ichi, kazhinji kuti chirwere che "hyperplasia isiri yekenza pakati capillaries." Mwana utero ari kuwana yakawanda uremu, asi havaratidzi yakatanga.

umboo

Chirwere cheshuga panguva pamuviri kunotungamirira ndechokuti mucheche akaberekwa aine zvinotevera zviratidzo chirwere:

• uremu Large (kazhinji kupfuura 4 kg);
• vanyatsoona minyato pamusoro ganda;
• kuzvimba nyoro zvinyama uye ganda;
• dumbu guru nokuda dzakabudirira zvakasimba subcutaneous mafuta;
• Mbabvu pfupi;
• yakatsvukuruka-mutema ganda rifanane;
• syrovidnoy kunyanya kuwanda ganda mafuta;
• yakafara pamapfudzi.

zviratidzo

Achangoberekwa fetopathy anooneka sezvinotevera:

• kufema kutambudzika, rinotsanangura kushaya kwetunhu nezvezuva fuma iri zvemapapu (surfactant), vachivabatsira cracking walnut kutanga mweya;
• fungidzira kupfupika mweya uye kunyange kufema kusungwa achangoberekwa;
• zheltushka, izvo vaiona chiratidzo Kumwe kuchinja kunotanga vari chiropa, chinoda zvakakwana kurapwa;
• chetsinga zvirwere: ungaderedza tsandanyama matauriro, kudzvinyirira kuti yakayamwa dzepanguva, ari alternation kuti yadzikira basa pamwe hyperexcitability.

zvikonzero

Fetopathy chirwere cheshuga mudumbu hwapedyo nokuda zvisingafadzi. nzira pamuviri panguva iyo yakatanga uncompensated chirwere cheshuga mellitus mhando 1 uye 2. Mukuwedzera, mhaka chirwere ndiye mai pakati gestational cheshuga.

An zvakawandisa yakawanda shuga muropa amai kunokonzera fetus rwatata anotanga insulin rakawandisa. Achipfuura raamai ropa kusvikira mwana shuga akawanda anotanga achishingaira aipedza. Zvisinei, nokuti kusimudzira zvakakwana mudumbu zvinoda mumwe mari nayo, saka zvakawandisa iri dzikwanise mafuta, iyo inotungamira anorema guru mwana.

Kana musingadi kuuya glycemia wokuyera, zvinogona kukonzera kuti simba inokwana adipose zvinyama uye mudumbu asingadi kukura anowanzoita kubvumira maitiro yose zvomukati uye nyama kwemwana.

Diagnostics

Kuziva anomalies ari mudumbu, chiremba prescribes maitiro anotevera:

• Ultrasound;
• kudzidza biophysical mamiriro ezvinhu mudumbu;
• Doppler;
• CTG;
• tinyatsonzwisisa nokukanganisika zvezvinangwa ose fetoplacental hurongwa.

Muchida Ultrasound

Nzira inokosha Pakusarudza chero kutyorwa azvarwa ndiyo Ultrasound. Varumbidzwa vakabata Ultrasound zvinotevera mashoko, kana nechirwere cheshuga panguva pamuviri:

• In wokutanga trimester - nguva.
• In yechipiri trimester - kamwe sezvo pakati 24 uye 26 mavhiki. Izvi zvinokosha kuti kuziva malformations siyana ari nechepakati huta, mapfupa uye mapfundo, genitourinary uye kumwoyo, uyewo zvomudumbu hurongwa.
• Vaviri anogona kuitwa wechitatu trimester Ultrasound, uye kunyange katatu. Kana jekiseni muyanzvi cheshuga mellitus iri kudzidza kuitwa pamusoro 30-32 vhiki, uye ipapo kuzviita kamwe pavhiki.

Zviratidzo chirwere cheshuga fetopathy kubudikidza Ultrasound ari mudumbu:

• yakawandisa uremu kwenguva chaiyo yenguva;
• disproportion muviri;
• gandiwa miviri musoro;
• yakawanda mvura;
• fetus Dual wedunhu nokuda yakawanda mafuta kana nyoro tishu kuzvimba;
• mune mapfupa dehenya muchimucherechedza ehonegativnoe vematunhu, zvichiratidza edema.

Biophysical Research fetus ezvinhu

Kuongorora kwakadaro kunoratidza kutyorwa iri morphofunctional kukura uropi, izvo vaiona wakakura zvikuru kuratidza embryopathy. Kuti uzive, chiremba uye maawa nehafu unocherekedza kufema, mwoyo mwero uye locomotor nebasa azvarwa.

Kana paine kunyumwira kuti fetopathy, ipapo mwana wacho hope ichava pfupi-akararama, uye vakawanda nguva anoita basa kufamba. Short hope nguva hapana anopfuura 50 maminitsi, panguva iyo nguva akacherekedza tava kuderera mwoyo mwero uye kuderera kwemwoyo.

akatakura Doppler

Achibatsirwa kudzidza ichi vanotevedzera zvinotevera zviratidzi:

• makarindira kuderedza myocardial fibers;
• cardiac goho mutengo;
• ejection nguva rworuboshwe ventricle;
• systolic uye diastolic ropa riyerere ari tsinga reshiyo.

Doppler velocimetry anoitwa musi vhiki 30 kuongorora mamiriro epfungwa.

Akatakura CTG chete tinyatsonzwisisa dzichipfekeka miedzo

nzira iyi kunoita kuti vaongorore mwoyo mwero pa zororo, panguva kufamba, uterine marwadzo. Doctors kunze miedzo uye panguva ino atore ivhu shoma.

Implementation kunyatsoongorora nokukanganisika zvezvinangwa ose placental hurongwa

Rokuongorora placental insufficiency, uye weti uye ropa ivhu nokubatwa. In chirwere chakadaro yechitatu trimester fetopathy shuga akaratidza kukosha zvibereko ACE.

Kurapa panguva pamuviri

Kubvira pamuviri, mumwe mukadzi anofanira kuitisa hwokuzvidzora richiona nezvezvabuda BP uye ropa shuga. Kana waida, chimwezve ndishandise jekiseni. Kuzvidzivirira kuyera shuga zvakafanira kuongorora ose maawa 3-4 daily. Glycemia akagadzirisa shuga kana jekiseni.

Fetopathy shuga kunosanganisira kutora mavhitamini, kuchengetwa chaiyo kudya nezvimwe vanorumbidza ari chiremba. Food vanofanira vakapfuma nyore digestible makabhohaidhiretsi, uye mafuta inokurudzirwa kuderedza.

Kurapa pakukurukura

Chokutanga, achibatsirwa Ultrasound kuona Zvakanyanya Kunaka Panguva Yepamuviri musi makurukuriro. Kana pamuviri zviri nyore, zvakanaka rodorazreshat mukadzi pa vhiki 37. Kana pane ngozi kuupenyu amai mwana, vanoita kudaro mavhiki 36. Medical pamuviri panguva imwe yapfuura chikuva kazhinji kuitwa chete kana paine chinhu nokukurumidza upenyu amai, uye matauriro haasi pamusoro kuponesa mwana.

Panguva basa, vanachiremba tinosungirwa akuteerere glycemia. Kana kuderera simba muropa shuga yomuropa mudzimai vasina simba zvakakwana panguva basa, sezvo vakawanda shuga iri kupedzerwa uterine sunga. Mukuita yokusununguka kana pakarepo pashure pavo, pane ngozi yokuti murwere rikawira hypoglycemic pakoma.

Gestational cheshuga mellitus inopa muchidimbu basa. Kana ivo haigari kwemaawa anopfuura 10, muchiitiko ichi kuitwa caesarean chikamu, pashure kurapwa iri ushandiswe inorwisa mabhakitiriya.

Kurapa pashure kuzvara

Kuti adzivise kukura yomuropa uye zvimwe matambudziko, zvimwe nguva pashure pokuberekwa kwomwana chinotarisirwa ane 5% shuga mhinduro. Ose 2 chasa achangoberekwa anofanira kupa mukaka, sezvo ichi Urume somushonga anokwanisa kumisa hurumende.

Early neonatal nguva vanofanira kutora nzvimbo pasi pokudzora vanachiremba vari kunodiwa kuongorora kufema mwana. In kwayo Kusavapo batanidza ventilator. In pamberi chetsinga zvirwere kubatsira calcium magnesium mhinduro. Kana mwana aine zviratidzo chiropa chirwere, kana nevachena kwemaziso uye ganda wemwana inova jaundiced, chiremba prescribes purogiramu ultraviolet mwaranzi ari dose zvachose kunorondedzerwa.

Vakadzi Postpartum 2-3 nguva kuderedza jekiseni nokuti ropa shuga pamwero iri yekudyidzana ipfupi. At kokuyerera yevanhu shuga anodzorerwa kwomuzvarirwo nhanho.

yematambudziko

Chirwere cheshuga fetopathy neonatal nemigumisiro vangava zvinotevera:

• neonatal hypoxia;
• rakapinza kuderera ropa shuga yomuropa kune yakaoma chechetere;
• congestive mwoyo kutadza;
• chirwere cheshuga vachangoberekwa;
• kushaya magnesium uye calcium, izvo isakarurama hunobata kushanda nechepakati tsinga;
• kufutisa.

mhedziso

Fetopathy Cheshuga kuti anova ari mudumbu panguva ino mamiriro ramai vake cheshuga, hazvifadzi chaizvo uye chirwere ngozi. Woman hazvo panguva yepamuviri kutevera zvose yachiremba vanorumbidza uye kudzora ropa shuga yomuropa. Chete iyi nemigumisiro nokuti mwana haangazorori wo kusuruvara.