Sikashukela Fetopathy. Isifo sikashukela ngesikhathi sokukhulelwa

Akekho owesifazane akakwazi qiniseka ukuthi ukukhulelwa kwakhe kuyoba ukuqhubeka ngaphandle yezinkinga, ikakhulukazi uma uhlushwa isifo yimuphi. isimo kwengane kungathinta ezihlukahlukene izici ezingase zibangele kuye umonakalo. Ngakho-ke kubalulekile ukuze kuqashwe impilo zabo futhi bazama ukuba bazivikele imithelela yezimo ezimbi. Ikakhulukazi labo amaphuzu eziphathelene labo besifazane babe kwempilo emzimbeni.

Abesifazane kanye uphethwe "isifo sikashukela" futhi iphupho ukuba babe nomntwana kufanele uqaphele ukuthi kuleli cala emahlombe abo wemfanelo omkhulu, ngoba lesi sifo kungaholela yezinkinga ezihlukahlukene ingane. Omunye wabo umbungu fetopathy.

Izici lesi sifo

fetopathy Diabetic isifo esiyingozi umbungu ezivela khona zangaphambi sikashukela noma isifo sikashukela kwabesifazane abakhulelwe, lapho izinga glucose ingaphezu kwe amazinga evamile. Ngenxa yalesi zokugula ushintsho sici isimo fetus ukungasebenzi kwekhono amanyikwe, inso, macro- futhi microvascular isimiso sakhe.

Uma umlando owesifazane okhulelwe has a uphethwe ngokuthi "izithelo fetopathy", avame udokotela enquma ukuba afeze ukulethwa kuhlinzwa.

I evumayo Yiqiniso yokukhulelwa e abesifazane sikashukela kuncike ezicini eziningi. Lezi zihlanganisa: uhlobo lwesifo, yezinkinga, izidakamizwa ekhona wamukela ekwelapheni izifo. Akukho ukwesaba kwanoma iyiphi ngemiphumela emibi, uma lonke amazinga sokukhulelwa igazi glucose esasivele phezu ukubaluleka esibucayi.

Uma ungenalo nxephezela lesi sifo, ngifundise ngesifo sikashukela, ukukhulelwa Uphatha kabi ukuthuthukiswa umbungu kanye inkathi sokukhulelwa. Odokotela bavame kuthuthukiswe rodorazreshayut owesifazane ukuze asindise ukuphila kwakhe futhi ingane. Nalesi sifo kuyahlukahluka ultrastructure esinomhlapho isithiyo, lapho kokuba uyeke ukusebenza ngokujwayelekile futhi akhulule bonke umbungu edingekayo. Odokotela kuleli cala, ngokuvamile ukwenza sitholakele "Hyperplasia ka-capillary." Ingane e utero buthola eziningi isisindo, kodwa ayiqondakali athuthukile.

ubufakazi

Isifo sikashukela ngesikhathi sokukhulelwa kuholela yokuthi usana sizalwa izimpawu ezilandelayo zokugula:

• isisindo omkhulu (ngokuvamile ezingaphezu kuka-4 kg);
• ukukhomba ukulimaza esikhumbeni;
• ukuvuvukala izicubu zomzimba ezithambile kanye isikhumba;
• isisu esikhulu ngenxa kakhulu athuthukile amafutha ongama;
• nemilenze iDemo;
• ngokubomvu blue isikhumba ithoni;
• syrovidnoy isamba ngokweqile isikhumba igrisi;
• emahlombe ezibanzi.

izimpawu

fetopathy Newborn livela ngale ndlela:

• ukucindezeleka zokuphefumula, echaza ukuntuleka zamagama into ethile kule wamaphaphu (surfactant), babasize ngokuhlaziya umoya lokuqala;
• kufushane cishe umoya ngisho ukuboshwa zokuphefumula ngokushesha nje ngemva kokuzalwa;
• zheltushka, okuyinto kubhekwa uphawu izinguquko sokugembula esibindini, okudinga ukwelashwa okufanele;
• iziyaluyalu zezinzwa: kwehle imisipha ithoni, ukucindezelwa of abancela reflex, alternation umsebenzi kwehle nge hyperexcitability.

izizathu

Fetopathy umbungu sikashukela eba ngenxa Yiqiniso okungekuhle yokukhulelwa ngesikhathi lapho kwakuvela uncompensated ngifundise ngesifo sikashukela uhlobo 1 no-2. Ngaphezu kwalokho, imbangela isifo ungunina of sikashukela sokukhulelwa.

Kuvele inani eleqile glucose egazini unina kubangela amanyikwe fetus iqala ukukhiqiza insulini eningi kakhulu. Kokuqhubeka ngegazi likamama ingane glucose in inqwaba iqala ngenkuthalo wachitha. Nokho, i-ekuthuthukiseni umbungu kudinga ethile, ngakho ngokweqile is ibe namafutha, okuyizinto kuholela ingane isisindo esikhulu.

Uma ungenalo zilethe glycemia kuyinsakavukela, kungaba nomthelela namandla eqinile kwezicubu adipose futhi ingane akusho ngendlela evamile avumele sonke isimiso yezitho zangaphakathi nezicubu of a baby.

ukuhlola

Ukukhomba anomalies ku-fetus, udokotela sinquma le nqubo elandelayo:

• ultrasound;
• ukufunda isimo biophysical umbungu;
• Doppler;
• CTG;
• ukuhlolwa izimpawu kwamakhemikhali uhlelo fetoplacental.

eliyifa ultrasound

Indlela eyisisekelo sokunquma yimuphi ukwephulwa fetus ultrasound. Kunconywe ebambe ultrasound ngalamagama lalandzelako, uma unesifo sikashukela ngesikhathi sokukhulelwa:

• Ngo senyanga yokuqala - isikhathi.
• Ngo senyanga yesibili - kanye phakathi amasonto 24 no-26. Lokhu kuyadingeka ukuze ukuhlonza kombungu ezihlukahlukene sezinzwa, amathambo kanye namalunga, uhlelo genitourinary futhi senhliziyo, kanye isimiso sokugaya ukudla bungene.
• Laba ababili bangase ozoba eyesithathu senyanga ultrasound, ngisho kathathu. Lapho insulini sikashukela engaphansi mellitus kuyinto ucwaningo olwenziwe ku ngesonto 30-32, bese ukukwenza kanye ngesonto.

Izimpawu fetopathy sikashukela by ultrasound umbungu:

• ezisinda kakhulu isikhathi othize yesikhathi;
• disproportion lomzimba;
• ukunquma nentaba double ikhanda;
• isamba anda amanzi;
• fetus wesifunda ezimbili ngenxa semali fat noma soft izicubu ukuvuvukala;
• emathanjeni Yekhanda imakwe ehonegativnoe zone, okubonisa edema.

Biophysical Ucwaningo isimo fetus

Ukuzihlola okunjalo kungembula ukuhlukumeza ekuthuthukiseni morphofunctional zobuchopho, okuyinto kubhekwa ukubonakaliswa olunzima kunalo lonke ake embryopathy. Ukuze sithole izimpendulo, udokotela nesigamu elungisa ukuphefumula, nokushaya kwenhliziyo kanye locomotor umsebenzi we-fetus.

Uma kukhona izinsolo fetopathy ke ubuthongo womntwana ngeke kube okwesikhashana, futhi esikhathini esiningi wenza ukunyakaza asebenzayo. Dlala ubuthongo Ubude besikhathi imizuzu akukho ngaphezu kuka-50, futhi phakathi naleso sikhathi imakwe okwehlisa of ukushaya kwenhliziyo ukwehla kwenhliziyo.

Ethwele Doppler

Ngosizo yalolu cwaningo ulandele izinkomba ezilandelayo:

• usheshise ekunciphiseni Imicu yotshani esivimba amanzi;
• inhliziyo okukhipha value;
• ejection nesikhathi ventricle engakwesobunxele;
• systolic futhi diastolic blood flow isilinganiso Umthambo.

Doppler velocimetry ukwenziwa ngesonto 30 ukuhlola isimo isimiso sezinzwa esiyinhloko.

Ukuthwala CTG nge ukuhlolwa ukuhlolwa obusebenzayo

Le nqubo ivumela ukuhlola ukushaya kwenhliziyo lapho esephumule, ngesikhatsi ukunyakaza, lesizalo ukusikwa. Odokotela kwenziwe ukuhlolwa futhi okwamanje ukuthatha amasampula ezimbalwa.

Implementation kokuhlaziywa izimpawu kwamakhemikhali uhlelo esinomhlapho

Ukuxilonga esingamahlalakhona esinomhlapho, futhi umchamo kanye amasampula egazi losana. Ngo leso sifo e yokuthathu yesithathu sikashukela fetopathy wabonakaliswa nokwanda okuphawulekayo we-ACE.

Ukwelashwa ngesikhathi sokukhulelwa

Phakathi nenkathi yokukhulelwa, owesifazane kufanele ukuqhuba self-ukuqapha of wegazi kanye igazi glucose. Uma kudingeka, i-insulin eyengeziwe ebekiwe. Njengoba isilinganiso izifo ushukela oludingekayo ukuze siphenye zonke 3-4 amahora nsuku zonke. Glycemia ukulungiswa glucose noma nge-insulini.

sikashukela Fetopathy kuhilela amavithamini ukuthatha, ukugcinwa olukhethekile lokudla nezinye izincomo udokotela. Ukudla kufanele kube ocebile carbohydrate kalula digestible, namafutha Kunconywa ukwehlisa.

Ukwelashwa ngesikhathi sokubeletha

Okokuqala, ngosizo ultrasound ukunquma usuku kahle ukulethwa. Uma ekhulelwe ayinzima, kungcono rodorazreshat owesifazane uma sebehlanganisa amasonto angu-37. Uma kukhona usongo ekuphileni kukamama kanye nengane, benza kanjalo lange -36. isisu Medical olukhona kusenesikhathi ngokuvamile eyenziwa kuphela uma kukhona usongo okuseduze kokuphila kukanina, futhi inkulumo akukho mayelana kulondolozwa ingane.

Nalapho esesikwa, odokotela aphoqelelwe ukuqapha glycemia. Uma ukwehla oqinile amazinga kashukela egazini lowesifazane ngeke uyoba nawo amandla anele nalapho esesikwa, njengoba eziningi glucose ichithwa lesizalo Kufinyeta. Ngo inqubo bebeletha noma ngokushesha ngemva kwabo, kukhona ingozi ukuthi isiguli iwela equlekile hypoglycemic.

Sokukhulelwa ngifundise ngesifo sikashukela ihlinzeka zabasebenzi emfushane. Uma sithatha amahora angaphezu kuka-10, futhi kule ndaba eyenziwa Ukubeletha, ngemva kwalokho ukwelashwa ezinqunyiwe antibiotic.

Ukwelashwa ngemuva kokubeletha

Ukuvimbela ukuthuthukiswa kahle kungakhuphula izinga likashukela kanye nezinkinga okwengeziwe, isikhathi esithile ngemva kokuzalwa kwengane iqondiswa 5% isixazululo glucose. Njalo osanda kuzalwa 2 chasa kumelwe yinike ubisi lwebele, ngoba lolu ketshezi okwelapha uyakwazi ukumisa isimo.

Early isikhathi nezinsana okufanele kwenzeke ngaphansi kokuqondisa odokotela ngubani kudingeka ukuqapha ukuphefumula ingane. Ngo ukungezwakali kwawo ukuxhuma womoya-mpilo. Ephambi kwezinduna iziyaluyalu zezinzwa ukusiza calcium ne-magnesium izixazululo. Uma ingane has izimpawu isifo sesibindi, lapho abamhlophe samehlo isikhumba sengane kuba jaundice, udokotela ekunika umhlangano emisebeni ultraviolet in umthamo ngokuqinile echaziwe.

abesifazane Kwangemva Kokubeletha izikhathi 2-3 ukunciphisa insulini ngoba ezingeni igazi glucose is kakhulu ziyancipha. Ngezinye osenyameni izinga glucose ubuyiselwa amazinga evamile.

yezinkinga

Diabetic nemiphumela fetopathy ezisanda kubelethwa bangase babe naloku lokulandzelako:

• hypoxia ezisanda kubelethwa;
• ukwehla elibukhali amazinga igazi glucose ezingeni esibucayi;
• congestive ukuhluleka kwenhliziyo;
• sikashukela izinsana;
• kuntuleka i-magnesium ne-calcium, okuyinto Uphatha kabi ukusebenza kwesimiso semizwa esiyinhloko;
• ukukhuluphala.

isiphetho

Isifo sikashukela Fetopathy esakheka ku-fetus ngesikhathi samanje sikashukela sikanina, kubuhlungu kakhulu futhi isifo esiyingozi. Owesifazane ngempela ngesikhathi sokukhulelwa ulandele izincomo zonke kadokotela futhi ukulawula amazinga igazi glucose. Kuphela kulesi simo imiphumela leyo ngane ngeke kube buhlungu kakhulu.