I kēia mau lā, he maʻi maʻamau ka maʻi diabetes i nā wahine. I kēia hihia, hiki ke ʻokoʻa ke ʻano o ka maʻi: ke hilinaʻi ʻana o ka insulin, ʻaʻohe hilinaʻi-insulin, maʻi gestational. Akā hui pū ʻia kēlā me kēia ʻano like me kahi maʻi maʻamau - kiʻekiʻe koko koko.
E like me kāu i ʻike ai, ʻaʻole ia ka maʻi diabetes iho he mea weliweli, akā ʻo nā hoʻopiʻi e ala ana mai nā loko ʻole o ka pancreas. Eia kekahi, i nā makahiki i hala iho nei, ulu ka type 2 i ka wā ʻōpio, no laila, ʻo ka nui o nā wahine e makemake nei i ke keiki e māhuahua ana inā ʻo ke kau ʻana o ka maʻi hyperglycemia.
ʻO kaʻoiaʻiʻo, me ka maʻi diabetes, ʻo ka loaʻa ʻana o ke pēpē ʻaʻole maʻalahi. No laila, i nā wā he nui, koi nā kauka i ka hōʻeha. Eia kekahi, loaʻa i ka nui o ka hiki ke kuhi spontan.
I ka manawa hea e hoʻokuʻi ʻia ai ka haʻalele ʻana i ka maʻi diabetes?
Nui kekahi mau mea pono e pono ai ka noho ʻana o ka ʻōpiopio. Kuhi kēia mau contraindications i ka maʻi diabetes, no ka mea e hiki ke hōʻeha ʻia kāna papa inoa ʻaʻole wale no ka wahine, akā no kāna keiki hoʻi.
ʻO ka manawa pinepine, ua hānau nā keiki o nā makuahine me ka maʻi hānai me nā vascular, cardiac pathologies a me nā pale kīhai. Ua kapa ʻia kēia ʻōuli ka fetopathy.
I ka wā hoʻolālā, hiki ke noʻonoʻo i ke ʻano o ka maʻi i ka wahine a inā loaʻa paha ka makua kāne i kēlā maʻi. Hoʻokomo kēia mau mea i ka pae o ka predisposition hoʻoilina.
ʻO kahi laʻana, inā he makuahine ka maʻi o ka maʻi pānaʻi 1 a a i kona makuakāne ka olakino, a laila he hapa ka hopena o ka hoʻomohala ʻana i kahi maʻi i kahi keiki liʻiliʻi - aia wale nō 1%. I ka hōʻea o ka maʻi diabetes-hilinaʻi ma nā mākua ʻelua, ke loaʻa ka manawa i loaʻa i kā lākou keiki i ka 6%.
Inā loaʻa i ka wahine ka maʻi diabetes type 2 a ʻo kona makua kāne ke olakino, a laila no ka ola o ke keiki e kūleʻa mai 70 a 80%. Inā loaʻa i nā mākua ʻelua kahi ʻano hilinaʻi o ka insulin, a laila hiki i ka manawa e loaʻa ʻole ai kā kā lāua keiki ka mai like me kēia maʻi.
ʻO ka hōʻiliʻiliʻana no ka maʻi maʻi maʻi e hōʻike ʻia i loko o ia mau hihia:
- mau maka komo
- kūhā;
- makuahine o ko 40 makahiki;
- ka hele ʻana o ke kaua Rhesus;
- maʻi maʻi coronary;
- i ka wahine a me ke kāne he type 2;
- nephropathy a me ka hoʻomaʻamaʻa ʻole;
- pyelonephritis.
Hiki ke loaʻa i nā mea āpau i luna ke alakaʻi i ka hoʻopiʻi ʻana i ka maʻi fetal, e loaʻa iā ia kahi maikaʻiʻole i ke olakino wahine. Akā pinepine ka nīnau e pili ana i ke kōkō ʻana me ka maʻi maʻi maʻi kūʻokoʻa.
ʻOiai he nui nā wāhine e hoʻokokoke nei i kēia pilikia me ka mālama ʻole, ʻaʻole i kipa aku i nā kauka a ʻaʻole hoʻi e hele i nā hoʻokolohua kūpono. No laila, ʻo ka hiki ʻana o nā hana kolohe a me ka haʻalele ʻana i ka mea i hoʻohaʻahaʻa ʻia e hoʻonui i kēlā me kēia makahiki.
I mea e pale ai i kēia, pono e mālama pono nā wahine hāpai i ka maʻi maʻi i kā lākou hāpai ʻana ma o ka mālama pono ʻana i ke ʻano o ka pūpū. I kēia hihia, he mea nui ia e pili i kahi meaʻai kūikawā e koi ai i ka ʻike ʻana i ka glucose i nā kahe koko. Eia nō hoʻi, i ka wā o ka hānau ʻana o kahi keiki, pono ia e kipa aku i ka ophthalmologist, nā maʻi gynecologist a me ka endocrinologist.
Pehea e hōʻino ai kahi mea hoʻoweliweli i ka wahine me ka maʻi maʻi maʻi? Ma hope o kēia kaʻina hana, hoʻomohala paha ka mea maʻi i nā hōʻeha like i nā wahine olakino. Hoʻopili kēia ma ka hoʻonui ʻia o ka maʻi a me nā pilikia o ka hormonal.
No ka paleʻana i ka hapai, hoʻohana kekahi mau maʻi maʻi i kahi hana intrauterine (me ka antennae, me antiseptics, ʻo ka puni), akā hoʻomaikaʻi lākou i ka hoʻolaha ʻana o ka maʻi. Hiki ke hoʻohana ʻia nā kīpoki mana hānau i ka hopena ʻaʻole i pili i ka metabolism. Akā hoʻohālikelike ʻia kēlā mau lāʻau i nā maʻi vascular.
Hōʻike ʻia nā wahine me ka mōʻaukala o ke kanulau maʻi gestational i nā lāʻau lapaʻau e loaʻa ana ʻo Progestin. Akā ʻo ka ʻoi aku ka palekana a me ka palekana i ka mālama ʻana i ka hapai. Akā, hoʻohana wale ʻia kēia ala ʻo ka pale ʻana i nā wahine i loaʻa iā ia nā keiki.
Akā he aha e pili ana i nā wahine me ka maʻi maʻi i makemake maoli i ka hoʻomanawanui a hānau i kahi keiki olakino?
Pono e hoʻomākaukau e mākaukau no kēlā hanana, a, inā pono, hiki ke hoʻokō ʻia nā ʻano lāʻau lapaʻau ʻē aʻe.
Hoʻolālā Hoʻolālā
ʻO ka mea mua, pono ke hoʻomaopopo ʻia i ke ʻano o ka wahine i loaʻa ka huehue i ka metabolism momona i ka lilo ʻana o ka wahine i ka makahiki 20-25 mau makahiki. Inā he makua ʻo ia, a laila e hoʻonui ʻia ka nui o nā ʻōpiopio.
ʻAʻole nui ka poʻe e ʻike, akā ka malformations (anocephaly, microcephaly, maʻi ʻōpū) o ka hoʻomohala ʻana i ka maʻi hānau ma ke hoʻomaka o ka hāpai ʻana (a hiki i 7 mau pule). A me nā maʻi me ka maʻi decompensated e loaʻa pinepine i nā maʻi i loko o nā ovaries, no laila ʻaʻole hiki iā lākou ke hoʻoholo maʻamau no ka loaʻa ʻana o nā menstruation a me ke ʻano ka hapai ʻana.
I kēia manawa, hiki i kahi pūpū i hoʻomaka mua i ke kūkulu. I mea e pale ai i kēia, pono ke hoʻokaʻawale ʻia ka maʻi diabetes i ka wahi mua, i pale ʻia ai ke ʻano o nā hemahema.
No laila, inā ʻo ka pae o ka hemoglobin glycated ma mua o 10%, a laila ʻo ka hopena o ke ʻano o nā ʻano pilikia o nā pilikia i ke keiki he 25%. No ka ulu ʻana o ka pēpē i ulu maʻamau a mau loa, ʻaʻole pono nā hōʻailona ma mua o 6%.
No laila, me ka maʻi diabetes, he mea nui loa e hoʻolālā i kahi hapai. Eia kekahi, hiki i kēia lā ke ʻimi i ka mea a ka makuahine i kahi predisposition genetic i nā hoʻopiʻi vascular. Mālama kēia iā ʻoe e hoʻohālikelike i nā loaʻa o ka maʻi maʻi a me ka pale ʻana o ka hoʻopiʻi.
Eia kekahi, me ke kōkua o nā ʻano genetic, hiki iā ʻoe ke loiloi i ka hopena o ka maʻi diabetes i kahi keiki. Eia naʻe, i kekahi hihia, pono e hoʻolālā ʻia ka hāpai ʻana, no ka mea ʻo ia wale nō ke ala i ka hoʻomohala ʻana i ka hōʻeha ʻana o nā hihia ʻino.
I kēia hopena, ma kahi o 2-3 mau mahina ma mua o ka ʻae ʻana, pono e uku ʻia ka maʻi diabetes a me ka pae o ka hemoglobin glycated. I kēia hihia, pono kahi wahine e ʻike ma ka wā hāpai, ʻo ka wikiwiki o ke kō koko koko mai ka 3.3 a 6.7.
Eia kekahi, pono kahi wahine e hopu i ka maʻi piha o ke kino. Inā ma ke ʻano o ka noiʻi ua ʻike ʻia nā maʻi a me nā maʻi paha, a laila pono e hoʻokō i kā lākou mālama holoʻokoʻa. Ma hope o ka hāpai ʻana me ka maʻi diabetes ma nā hoʻomaka mua, pono ke halihali i ka haukapila, kahi e ʻae ʻia nā kauka e nānā pono i kona olakino.
ʻO ka ʻōpū i loko o ka maʻi maʻi maʻi pinepine he papa like me ka nalu. I ka first trimester, ke hoʻemi ʻia nei ke kiʻekiʻe o ka glycemia a me ka pono o ka insulin, e hoʻonui ana i ka hopena o ka hypoglycemia. ʻO kēia ma muli o nā loli o ka hormonal, e hopena i ka hoʻomaikaʻi ʻana i ka glucose o peripheral glucose.
Eia nō naʻe, ma ka hapalua o 2 a me 3 o ka hapē o ka hapai, ua loli nui ka mea a pau. Hoʻohui nui ʻia ka pēpē me ka plenta, he mau mea kuea. No laila, i nā hola 24-26, hiki ke loli koʻikoʻi ke ʻano o ka maʻi diabetes. I loko o kēia manawa, ʻike pinepine ka glucose, a me ka pono o ka insulin e hoʻonui, me ka acetone e loaʻa pinepine i ke koko. Hōʻike pinepine nā ea i ka hanu maʻi.
I ke kolu o ka mahina o ka hapai, ua ulu ka placenta, ma muli o ke ʻano o ka counterinsular i hoʻāla ʻia a ʻike hou ʻia ka pono o ka insulin. Akā ma nā hoʻomaka mua o ka hāpai ʻana i ka maʻi maʻi maʻi maʻi, ʻaʻole ia he ʻokoʻa i ka maʻamau, ʻoiai ke kuhi hewa ʻole nā maʻi hyperglycemia pinepine pinepine.
A ma ka lua a me ke kolu ʻo ka mea hoʻomaʻamaʻa iki ʻole i ukali ʻia e nā hoʻopiʻi like ʻole. Ua kapa ʻia kēia ʻano hana i ka pōkole, kahi i kūʻe ai ka huhu a piʻi ke koko. Ma ka hana pilikino, hele ka pathology ma 50-80% o nā hihia.
Akā i mua o nā hoʻopiʻi vascular, hiki i ka gestosis ke ulu i 18-20 pule. He hōʻailona kēia no ka maleʻana. Eia kekahi, hiki i ka wahine ke kūkulu i ka hypoxia a me ka polyhydramnios.
Hoʻomaʻa pinepine, nā mea maʻi me ka maʻi maʻi e hāpai ana i kahi keiki e hoʻomohala i nā maʻi maʻi urinary. Hoʻokomo ʻia ka pale ʻole a me ka maʻi hānai ʻole i hoʻopuka ʻia me kēia.
Eia kekahi, e kū i ke kiʻi o nā kiʻekiʻe o ka glucose, hiki ke hana hewa i ka laha o ka uteroplacental, a ua nele i ka pūpū a me ka oxygen.
He aha nā pilikia e hiki mai ai i ka wā hānau.
ʻO ka hoʻopiʻi pinepine ʻana o ka hānau keiki ʻana ʻo ka nāwaliwali o ka hana. I nā maʻi maʻi, ʻo ka hoʻemi ka nui o ka ikehu kaila, hilinaʻi i ka papa o nā kaʻina o ka anabolic.
I ka manawa like, e hoʻohaʻ pinepine pinepine ke kō o ke kōʻai koko, no ka mea ua nui ka nui o ka glucose i ka wā hana. No laila, hāʻawi ʻia nā wahine i nā ʻāpana me ka insulin, e hoʻohālikelike ʻia ka hōʻailona a me nā hōʻailona glycemia i kēlā me kēia hola. Hoʻololi ʻia nā hanana like i ka wā o ka hoʻokō ʻana, no ka mea, ma 60-80% o nā hihia, hāʻawi ʻia ka maʻi diabetes i kahi ʻaoʻao cesarean, ʻo ka mea nui o lākou ka maʻi vascular.
Akā ʻoiai ke ʻano o nā wāhine me ka maʻi diabetes i ka hapanui o nā hihia he contraindicated i nā hānau kūlohelohe me ka maʻi diabetes, ʻoi aku ka nui o ka hānau ʻana iā lākou iho. Eia naʻe, hiki wale kēia me nā hoʻolālā hāpai a me ka uku uku no ka maʻi māʻalo, e pale i ka make i ka perinatal.
ʻOiaʻiʻo, i ka hoʻohālikelike ʻana me nā 80s, i ka wā i ʻike ʻole ʻia ai nā hopena momona, i kēia lā ke mālama pono ʻia nei ka papa o ka hāpai ʻana me ka maʻi diabetes. Mai kēia manawa ua hoʻohana ʻia nā peni syringe hou, a ua ʻano ʻia nā ʻano lāʻau lapaʻau ʻē aʻe e hiki ai iā ʻoe ke hānau keiki me kahi fetopathy a ma ke manawa. ʻO ke wikiō i kēia ʻatikala e haʻi aku iā ʻoe i ka mea e hana ai me ka maʻi diabetes.
