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ʻO kekahi ʻano like o nā maʻi o ke kō i ʻike ʻia i loko o nā wahine i ka wā antenatal ka mea i kapa ʻia ʻo ka maʻi gestational.
ʻO ka maʻamau, ʻike ka maʻi kokoke i ka waena o ka hapai i kēlā me kēia wahine i ka hana 5. ʻO ka manawa lawe i kahi pēpē he kaumaha nui loa ia ma ke kino wahine.
I loko o kēia manawa, hōʻike ʻia nā ʻano like ʻole, me ke ʻano o ka maʻi maʻi o nā wahine hāpai. He aha nā kumu a me nā hōʻailonaʻeha o ka maʻi gestational? No ke aha ia e ʻike ai?
ʻO ke kiʻi haukapila o ka maʻi maʻi gestational
I ka manawa pinepine, ua nalowale ka maʻi ma hope o ka hānau ʻana, a me ka hoʻoneʻe ʻana o ka metabolate i ke ʻano maʻamau. Eia naʻe, ʻo ka hiki ke hoʻomohala i ka maʻi maʻamau i nā makahiki ma hope.
ʻO nā hōʻailona nui ka maʻi hānai
ʻO ka hōʻailona nui o ka HD koko kiʻekiʻe. ^ E Ha yM. ʻO ka maʻi āpau kekahi ala ʻaʻole unuhi.
Hiki i ka wahine ke make wai, wikiwiki a luhi. E holomua ka momona, akā i ka manawa like ia e lilo ai ke kaumaha.
ʻAʻole hiki i ka wahine ke mālama i kēlā mau hōʻailona, me ka manaʻoʻiʻo o ka hopena kēia o ka hapai. A makehewa ole. ʻO kahi mea e ʻike ai ka ʻoluʻolu ʻole e hoʻoweliweli i ka makuahine e manaʻo ai a ʻike ʻo ia i ke kauka e pili ana iā lākou.
Nā hōʻailona o ka latent o ka maʻi
Inā hele ka maʻi, hiki i kēia mau hōʻailona:
- ka waha maloʻo maloʻo (ʻoiai ʻo ka nui o nā wai inu);
- nā manawa pinepine;
- nui a makemake wau e hoʻomaha;
- impa ka hihio;
- ulu ka momona, a me nā paona o ia paona.
I ka makewai a me ka makemake maikaʻi, paʻakikī ke hoʻomaopopo i nā hōʻailona o ka maʻi lolo, no ka mea, i kahi wahine olakino, ke kali nei no kahi keiki, hoʻonui nui kēia mau makemake. No laila, e wehewehe i ka hoʻomālamalama ʻana, kuhikuhi ʻo ke kauka i ka makuahine ʻāpono i kahi noiʻi hou.
Naʻi hoʻolika
I mea e hoʻoholo ai i ka maʻi maʻi, ua kau ke kauka i kahi wahine i hana i ke koko a me ka hoʻāʻo urine (ka maʻamau)
I nā ʻōlelo maʻamau:
- ma kahi ʻōpū ʻole - mai 4.1 a i 5.1 mmol / l;
- a me 2 mau hola ma hope o ka ʻai - a hiki i ka 7 Mmol / l.
ʻO kahi noiʻi kumu ma ka hoʻomaopopo ʻana i ka maʻi hānai hoʻohālikelike o ka pae ʻana o ke koena o ke koko o ka mea maʻi.
Lawe ʻia mau ia ma ka 20th wiki of gestation. Inā loaʻa nā hopena i ka hopena, ʻo ka wahine hāpai e kuhikuhi ana i kahi hōʻike no ka hoʻomanawanui i ka glucose (GTT).
Eia kekahi, ʻo ka wahine i loko o ka hana e hōʻeha ʻia no ka HD, e lawe ʻia ana kahi ʻano like like, i ka mua o ka hele ʻana i ke kauka. ʻOiai me ka hoʻoliʻu nohona maʻamau, hana hou ʻia ʻo GTT ma 24-28 mau pule gestational.
Loaʻa iā GTT ona mau hiʻohiʻona pono, a pono e hoʻomākaukau no ia.
E loaʻa ka hopena kūpono inā ʻike ʻia nā lula ma lalo nei:
- ʻO ka 3 mau lā i hala ma mua o ka nānāʻana, pono ka wahine hāpai e hoʻolilo maʻa e like me ka mea maʻamau: ʻai e like me ka mea maʻamau (me ka ʻōlelo paʻa ʻole) ʻaʻole kino kino;
- i ka mea ʻaina hope ma mua o ke aʻo ʻana pono e loaʻa nā mea hou aku i ka 50 g o nā kaʻe. He mea koʻikoʻi loa kēia. Mai ka lawe wale ʻia ʻo GTT ma kahi ʻōpū ʻole, ma hope o ka hola 8-14 o ka wikiwiki;
- i ka wā o ka hoʻoili ʻana ʻaʻole hiki iā ʻoe ke ulaula, ʻai i kekahi mea a loaʻa ʻole ka lāʻau lapaʻau. ʻOiai ka hoʻonaninino kino (ke piʻi ʻana o nā ʻenekeneke) i ka haʻalele.
No laila, ua hana ʻia ka pauku mua he koko ma ka ʻōpū ʻole. Ma hope o 5 mau minuke, inu ka mea maʻi i kahi hopena hoʻāʻo no ka glucose (1.5 tbsp o ka wai me kahi pauka i hoʻoheheʻe ʻia i loko). Holo hou kekahi koko koko ma hope o 2 mau hola. Inā hoʻonohonoho nā mea āpau, a laila, ʻo ka glycemia ka 7,8 mmol / l. ^ E Ha yM. ʻO nā waiwai kiʻekiʻe mai 7.9 a 10.9 mmol / L hōʻike i kahi hoʻohaʻahaʻa haʻahaʻa haʻahaʻa.
ʻO nā waiwai o 11, 0 Mmol / L a i ʻole he mea hōʻike i ka maʻi maʻi gestational. Hiki wale i ke kauka ke hoʻoponopono i ka maʻi, e hilinaʻi nei i ka ʻikepili mai nā noiʻi loiloi, a me ka ʻike pono ʻole i ka maʻi e hoʻohana ana i nā glucometer he pololei ʻole, no ka mea ʻaʻole pololei.
Hoʻohana ʻia i ka wā maʻi
I ka nui o nā hihia (he 70%), hoʻololi ʻia ka maʻi e ka meaʻai. Pono kekahi wahine hāpai i hiki ke mālama kūʻokoʻa i ka glycemia.
Hoʻokumu ʻia ka lāʻau mālamaola no HD i nā ʻōkuhi i lalo:
- Hoʻolālā ʻia ka meaʻai ʻai i kēlā me kēia lā ke loaʻa iā ia ka 40% protein, 40% momona a me 20% mau mea momona;
- e aʻo i ka ʻai ʻokoʻa: 5-7 mau lā i ka lā me ke anuanu o 3 mau hola;
- me ka nui o ke kaumaha, pono nō ʻoe e helu i ka ʻike calorie: ʻaʻole iʻoi aku ma mua o 25 kcal i ka kg o ke kaumaha Inā ʻaʻohe wahine ʻē aʻe i ka wahine - 35 kcal i ka kilokilo. E hōʻemi i nā haʻahaʻa o ka calorie o ka meaʻai e makaʻala a mālie, me ke ʻano ʻole;
- ʻO nā ʻōmaʻomaʻo, a me nā nati a me nā huaʻai, ʻaʻole i haʻalele ʻia mai ka meaʻai. A inā makemake maoli ʻoe e ʻai i nā lepoki - kāpili iā ia i nā hua;
- Maiʻai i nā meaʻai maloʻo maloʻo (nā mio, pākui, nā ʻuala pauna);
- hāʻawi i nā makemake i nā pā kuke a me ka ʻaihue;
- inu hou - 7-8 mau aniani o ka wai i kēlā me kēia lā;
- e lawe i nā mea paʻakikī i ke kauka, no ka mea, aia i kēia mau lāʻau ka glucose;
- e hoʻāʻo e hōʻemi i ka nui o ka momona i ka meaʻai, a e hōʻemi i ka protein i 1,5 g no ka kg. Hoʻonui i kāu meaʻai me nā meaʻai.
Inā hāʻawi ʻole ka meaʻai i ka hopena i manaʻo ʻia, a mālama ʻia ke kiʻekiʻe o ka glucose, a i ʻole ka mea maʻi i ka hoʻāʻo ʻia i ka urine me ka kō maʻamau, ua ʻōlelo ʻia ka therapy insulin.
ʻO ka hala a me ke hoʻoponopono ʻia a i ʻole ka hoʻoholo ʻana ma hope o ke kauka e kau ʻia ana ma ke kaumaha o ka wahine hāpai a me nā makahiki gestational.
Hiki ke hoʻokō ʻia nā ʻōlelo hoʻohālikelike, hōʻike ʻia e kekahi endocrinologist. ʻO ka maʻamau, ua mahele ʻia ke kauā i ʻelua mau wai: i ke kakahiaka (ma mua o ke kakahiaka) a i ke ahiahi (a hiki i ka pāʻina hope).
Insulin therapy ma ke ala ʻaʻole hiki i ka mea pale ke kaʻai, ke hoʻomau i ka holo ʻana o ke ao holoʻokoʻa.
ʻO nā ʻōhua hiki
Nui ka hoʻonāukiuki ʻana o nā ʻano hemahema i ka ʻōpū o ka wā nui.
ʻO ke kumu o kēia e ʻai ana ka pēpē i ka glucose maternal, a ʻaʻole i lawa ka insulin. ʻAʻole ʻo ia i hiki ke hana i ka hormone, no ka mea, ʻaʻole i hana hou ka pancreas.
E kūkulu wale ia i ka trimester lua a hoʻomaka e hoʻohana i kaʻili o ka glucose i ka ʻōpū a me ka makuahine. I kēia hihia, ulu nā hyperinsulinemia. ʻO kona pilikia ʻo ia ka mea hoʻonāukiuki i ka hanu o ke keiki hānau ʻole. ʻAʻole emi ka haʻahaʻa haʻahaʻa no ka pēpē, hoʻopilikia i ke kahe koko a hoʻoweliweli a e pōʻino i ka ulu ʻana o ka noʻonoʻo.
Ua hoʻohui piha ʻia ʻo Untreated HD i ka hapai:
- he wahine i ka hana hana e ulu i ka gestosis a me polyhydramnios;
- hiki ke hōʻeha ka pā o ka maʻi paʻakai i kahi pēpē;
- aia nā hihia pinepine o ka ketoacidosis, kahi e hoʻoiho ai i ka hoʻonāukiuki o ke kino o ka makuahine;
- aneane paha nā ʻāpana a pau: nā maka, nā ʻōpū, nā ipu koko a me ka puʻuwai;
- Ka nui loa ka momona o ke pēpē (macrosomia), a ua loli ke ʻano maoli i kahi ʻāpana caesarean;
- hoʻopololei ka ulu ʻana.
Hoʻomaopopo postpartum
ʻO ka maʻi diabetes gestational kekahi hiʻohiʻona: ʻaʻole nalo ke neʻe ma hope o ka lawe ʻana.Inā loaʻa he wahine hāpai i ka HD, a laila ʻoi aku ka hopena o ka ʻohi ʻana i ka maʻi maʻamau no ka nui o nā manawa he 5.
He hanana koʻikoʻi nui kēia. No laila, nānā mau ka wahine i hope o ka hānau ʻana. No laila ma hope o 1.5 mau mahina, pono ʻo ia e nānā i ka hoʻoliʻiliʻi o ka ʻaiā.
Inā maikaʻi ka hopena, e mālama ʻia ka nānā ʻana i kēlā me kēia mau makahiki ʻekolu. Akā inā ʻike ʻia kahi kipi o ka pale ʻana i ka glucose, hoʻomohala ʻia kahi meaʻai kūikawā, a hoʻonui ka ʻike i 1 manawa i kēlā me kēia makahiki.
E pono ke hoʻolālā ʻia nā hāpai ʻia a pau ma hope o kēia hihia, no ka mea, ʻo ka maʻi diabetes (ʻo ka maʻamau 2 mau ʻano) hiki ke hoʻomohala i mau makahiki ma hope o ka hānau ʻana. E hoʻonui ʻia ka hoʻoikaika kino.
Nā wikiō pili
E pili ana i nā hōʻailona o ka maʻi maʻi gestational i nā wahine hāpai i ka wikiō:
ʻOiai me ka maʻi hānau wahine, hiki i ka wahine ke hānau i nā pēpē olakino he nui. ʻO ka mea nui ka hakakā i ka wā kūpono me ka hoʻomaka koke o kāna hoʻomanawanui.