ʻO ka maʻi maʻi gestational

ʻO ka maʻi maʻi gestational - He ʻano kūikawā o ke maʻi maʻi e hoʻomohala ai i nā wahine i ka wā hāpai a ma muli o kahi hoʻomaʻamaʻa hormonal. ʻO ka hōʻailona nui o kēia maʻi ka piʻi ʻana o ka glucose koko ma hope o ka ʻai ʻana a mālama i ka maʻi maʻamau ma luna o ka ʻōpū ʻole. Hoʻopilikia ka maʻi maʻi gestational i kahi hoʻoweliweli i ka hānau ʻana o ka pūpū, me ka mea hiki ke hoʻoulu i ka hoʻomohala ʻana o nā malenation congenital o ka puʻuwai a me ka lolo. No ke kumu o ka ʻike mua ʻana i ka pathology, nā wāhine i ka manawa o 24-28 mau wiki e hōʻike ʻia ana he hoʻokolohua hoʻomanawanui glucose. ʻO ka mālama ʻana i ka maʻi maʻi gestational pili i kaʻai ʻana, kahi hoʻoponopono o ka hana a me ka hoʻomaha, ma nā hihia koʻikoʻi, ua hoʻonoho ʻia nā maʻi insulin.

Hoike ʻike

ʻO kahi maʻi gestational a ʻoi paha kahi maʻi e hoʻomohala ma muli o ka hoʻonāukiuki i ka metabolism kalepa i ka puʻuwai o kahi wahine ma ke ʻano o ke kūleʻa o ka insulin (ka hapa o nā hoʻēmi a i ka insulin). I loko o kahi hikiwau, hōʻike ka maʻi āpau ma kahi o ka 3-4% o nā wahine hāpai a pau. ʻO ka pinepine, ʻo ka hoʻonui mua o ka glucose koko i hoʻoholo ʻia i nā poʻe maʻi e hōʻemi ana i nā makahiki he 18 a ʻoi aku paha i 30 mau makahiki. Hōʻike pinepine nā hōʻailona mua o ka maʻi gestational ma 2-3 trimester a nalowale ma a me ka nui ma hope o ka hānau ʻana o ka pēpē.

I kekahi manawa maʻi diabetes gestational i kekahi manawa ke kumu no ka maʻi maʻamau i ka wahine ma hope o ka hānau keiki. Hoʻomaopopo ka like i ka like me 10-15% o nā maʻi me kēia maʻi. Wahi a nā kānaka ʻepekema, ʻike pinepine ʻia ka maʻi gestational i nā wahine ʻeleʻele. ʻO ka pōʻino o ka maʻi i ka kōpū ma muli o ka piʻi nui o ka glucose i ka koko o ka makuahine, hoʻomaka ka ʻōpū o ke pēpē e hana ikaika i ka insulin. No laila, ma hope o ka hānau ʻana, paʻapū nā keiki i ka hoʻohaʻahaʻa i ke kō koko. Eia kekahi, hāʻawi ka maʻi maʻi gestational i ka hoʻonui wikiwiki i ka paona o ka maʻi fetal i ka wā o ka hoʻomohala ʻana i ka wahine.

Nā kumu o ke maʻi maʻi gestational

ʻO ka etiopathogenesis o ke ōlaʻi gestational ʻaʻole i hilinaʻi maikaʻi ʻia elucidated. Hōʻike nā ʻepekema ʻepekema i ka ulu ʻana o ka maʻi ma muli o ka hoʻopaʻa ʻana i ka hana o kahi nui o nā insulin i nā hormones e kuleana ana i ka ulu kūpono a me ka hoʻomohala ʻana o ka pūpū. I ka wā hāpai, pono ka paona o ka wahine i nā glucose hou, e koi ʻia no ka makuahine wale nō, akā no ke pēpē hoʻi. Aia ka hoʻonui hoʻopiʻi i ka hana o insulin. Ua lilo kēia mau kumu nui i ka maʻi diabetes gestational. E pale aku i ke kua o ka pancreatic β-cell dysfunction, ua hoʻonui ʻia kahi hoʻonui o ka proinsulin.

ʻO ke kumu o ka maʻi diabetes gestational hiki i nā maʻi autoimmune e hoʻopuka i ka luku ʻana i nā pancreas a, ma muli o ka hōʻemi ʻana i ka hana o ka insulin. I ka poʻe maʻi e loaʻa ai i ko lākou mau hoahānau nā ʻano maʻi like ʻole, ua hoʻonui ʻia ka piʻi ʻana o kēia pathology ma 2 mau manawa. ʻO kekahi kumu maʻamau maʻamau o ka maʻi ka hiʻona, no ka mea ke hoʻopili nei kekahi i ke kaʻina hana i ka metabolic i loko o ke kino o ka makuakāne. Hiki i ke maʻi maʻi maʻi inā ua loaʻa ka maʻi maʻi o ka wahine i ka wā mua o ka wā hāpai i hāpai i nā maʻi pancreatic.

ʻO ka wahine me ka maʻi polycystic ovary syndrome, kokoke i ka hana ʻino - ka uahi, inu i ka wai a me ka lāʻau lapaʻau, ʻokoʻa lākou no ka hoʻomohala ʻana i ka maʻi gestational. ʻO nā mea e hoʻohālikelike ana i ka hānau ʻana o kahi fetus nui, stillbirth, he mōʻaukala polyhydramnios, gestational diabetes ma mua o nā wā hānau. Loaʻa ka pilikia nui o ka patology ma nā poʻe maʻi i ʻoi aku a ʻoi aku ka 18 a ʻoi aku i ko 30 mau makahiki. Eia kekahi, ʻo kahiʻai palaka ʻole, ʻo ia ka mea e hoʻohana ai i kahi nui o nā meaʻai e waiwai nui ana i nā polokalamu kalakika wikiwiki, hiki ke hoʻonāukiuki i ka hoʻomohala ʻana.

Nā hōʻailona āpau a me ke nānā ʻana i ka maʻi gestational

ʻAʻole loaʻa i nā maʻi maʻamau ke ʻano maʻi. ʻO kahi hōʻailona nui o ka pathology he hoʻonui i ka hoʻoliʻiliʻi o ke koko, ʻaʻole i ʻike ʻia i ka wahine ma mua o ka wā hapai. Hoʻomaʻi pinepine ʻia kēia maʻi i ka poʻe maʻi ma hope o nā hebedoma 20 o ka hōʻeha ʻana. Hoʻopili ia, me ka maʻi maʻi gestational, ka nui o ka hoʻonui ʻana i ke kaumaha o ke kino o ka mea maʻi (ʻoi aku ma mua o 300 g i kēlā me kēia pule), ke ʻano ikaika o ka makewai, a me ka hoʻonui ʻana i ka hopena i nā lā i ka lā. Pēlā hoʻi, e hoʻopiʻi nā mea maʻi i ka hoʻohaʻahaʻa ʻana i ka momona, nā wikiwiki wikiwiki. Ma ka ʻaoʻao o ka ʻōpū, ʻo kahi hōʻailona o ka hoʻomohala ʻana i ka maʻi gestational hiki ke ulu wikiwiki i ka nui, nā pae ʻana ʻole o nā ʻāpana o ke kino, ka nui o ka hoʻoneʻe ʻana i nā momona momona.

ʻO ke ala nui no ka hoʻopaʻa ʻana i ke ʻano maʻi gestational he hōʻike koko e hoʻoholo ai i nā pae glucose. I ka wā e kākau inoa ai no ka hapai, hea nā wāhine āpau e ka obstetrician-gynecologist no kēia loiloi. ʻO ka hui pilikia no ka hoʻomohala ʻana i ka maʻi gestational ka mea maʻi i ka wā, a ke nānā ʻana i ke koko i lawe ʻia mai loko mai o ka manamana lima, he glucose i ka pae o 4.8-6.0 mmol / L, a mai kahi vein - 5.3 a 6.9 mmol / L. Inā hele ʻia kēlā mau ʻōmole, hoʻohālikelike ʻia ka wahine i ka lāʻau me ka ukana o ka glucose, kahi e hiki ai iā ʻoe ke hoʻomaopopo i ka maʻi o ka pakanihua o nā hāmeʻe o ka lua i nā papa mua.

Eia kekahi, no ka hoʻoholo ʻana i ka hana o ke pancreas a me ka ʻoi ʻana o ka maʻi gestational, kahi hoʻomaʻamaʻa maʻamau no ka hoʻohaʻahaʻa glucose e kuhikuhi i ka hana maʻamau no nā wahine hāpai no ka manawa o 24-28 mau pule. ʻO ka mua, lawe ʻia kahi hōʻike koko mai kahi vein ma kahi ʻōpū ʻole, a ma hope iho e inu ai ka wahine i ka 75 g o ka glucose i hoʻoheheʻe ʻia i ka 300 ml o ka wai. Ma hope o 2 mau hola, ua ʻōlelo hou ʻia ka hoʻonaninani koko. Ua hoʻokumu ʻia ka hōʻike ʻana o ka maʻi gestational inā he hōʻailona mua o ka glucose ma mua o 7 mmol / l, ka lua - ʻoi aku ma mua o 7.8 mmol / l. ke hōʻoia ia, e kuhikuhi ʻia ka wahine hāpai i kekahi ʻano loiloi hou i ka lā hoʻokahi ma hope o kekahi mau hola.

Hana no ka maʻi maʻi maʻi gestational

No ka maʻi maʻi gestational, hana ʻia ka hana ma ka papa outpatient. ʻO ka mea mua, ua hāʻawi ʻia ka mea maʻi e nānā i nā meaʻai. Kuhi ʻia ka meaʻai i ka hoʻohaʻahaʻa i nā pae glucose koko, no laila pono ka wahine e haʻalele i nā huahana e loaʻa ana i nā polokalamu kālaiʻu wikiwiki mai kāna papa: confectionery, starchy vegetables. Pono nā huaʻai i ka loli ʻana a ʻaʻole hoʻi momona loa. ʻO ka momona momona a me ka palaoa, ka meaʻai wikiwiki, ka hale ʻai, a me nā muffins ua pāpā ʻia no ka maʻi maʻi gestational. Hiki iā ʻoe ke hoʻololi i kēia mau huahana me ka kāpeti, nā ʻōpū, nā zucchini, nā manamana, nā mea kanu. Eia kekahi, me ka maʻi maʻi gestational, pono pono e hoʻopili i ka iʻa momona haʻahaʻa a me ka iʻa, cereals, cereal cereal, pasta o nā ʻano paʻakikī, nā mea kanu i ka papa. Hoʻokahi manawa i ka hebedoma, hiki iā ʻoe ke ʻae i ka iʻa i ʻāpana ʻulaʻula i ka ʻai.

I ka hoʻohui ʻana i kahi meaʻai no ka wahine hāpai i ka maʻi maʻi gestational, pono ia e hōʻoia i ka lawa o ka nui o nā kō a me nā minamina e pono ai no ka ulu a me ka hoʻomohala ʻana o ka pūpū. Pono nā kāloli i ka 45% o ka waiwai o ka meaʻai, nā momona - 30%, nā protein - 25%. Me ka maʻi maʻi gestational, pono nā wahine hāpai i ka ʻai liʻiliʻi, akā maʻamau - 3 mau kīʻai nui a me 2-3 mau kīlani. Pono e hoʻomākaukau i ka kīʻaha hoʻokaʻawale, nā koho maikaʻi loa ʻo nā huahana i hoʻolapalapa, ka aʻa palaoa, kāʻai ʻia. ʻO ka hoʻoponopono inu ka mea e hoʻohana ai i ka liʻiliʻi o ka 1.5 lita o ka wai i kēlā me kēia lā.

Ke kono ʻia nei ka hana maʻalahi no nā maʻi me ka maʻi maʻi gestational. Hāʻawi lākou iā ʻoe e mālama i ke kino i ke ʻano maikaʻi, pale i ka momona kaumaha. Eia kekahi, hoʻonui ka hana i ka hana o ka insulin, he mea nui ia no ka maʻi maʻi gestational. Hoʻopilikia ka hana kino pilikino i ke ʻano hele kino, ka hele ʻana, ka ʻauʻau. ʻO ka neʻe o ka neʻe, ka hoʻomaʻamaʻa e kuhikuhi ana i ka hana o nā ʻōpū o kaʻili e pono ke pale ʻia. Hoʻoholo ʻia ka pae o ka ukana e ka hoʻomanawanui o ka wahine a hoʻonohonoho ʻia e ke kauka.

ʻO ka wahine me ka maʻi maʻi maʻi e nānā pono i kona kaila koko i kēlā me kēia lā; kau ʻia ka nui ma luna o kahi ʻōpū ʻole a 60 mau minuke ma hope o kēlā me kēia pāʻina. Inā hāʻawi ʻia ka lāʻauʻai me ka hoʻoikaika ʻana i ka hoʻomaʻamaʻa maikaʻi, i ʻōlelo ʻia ai nā inikua insulin no ka mea maʻi me ka maʻi maʻi gestational. Hoʻoholo ʻia ka nui o ka lāʻau lapaʻau e kekahi loea. E hoʻomau ka mālama ʻana i ka wā maʻi me kēia maʻi a hiki i ka 38-40 mau pule. ʻO ka hoʻoili pinepine ʻia e ka ʻāpana cesarean, ʻoiai ʻo ka mea nui a ka mea hānau, a hoʻoweliweli ʻia i ka hoʻomohala ʻana o nā ʻōhumu i ka wā kūlohelohe o ke kaʻina hānau.

Me ka maʻi maʻi gestational, hānau kahi pēpē me kahi haʻahaʻa o ka glucose i ke koko, eia naʻe, hoʻi ka mākaukau e hana maʻamau me nā umauma maʻamau a i ʻole hoʻi i hui ʻia nā ʻano hui like ʻole. E hoʻokaʻawale i ka lawe ʻana i ke kō i loko o ke koko o ka makuahine a me ke keiki. Ma hope o ka hānau ʻana, ʻo kahi wahine me ka maʻi maʻi gestational e pono i ka papa ʻaina i ʻōlelo ʻia ma ka wā hāpai a anaʻi i nā pae glucose e pale ai i ka hoʻomohala ʻana i ka maʻi type 2. Ma ke ʻano he kānāwai, e hoʻi nā hōʻailona i ka maʻamau i nā mahina mua ma hope o ka hānau ʻana o ke pēpē.

Ka wānana a me ka pale ʻana i ka maʻi gestational

Ma keʻano holoʻokoʻa, me ka maʻi maʻi gestational, makemake nui ka prognosis no ka makuahine a me ke keiki. Me kēlā maʻi, loaʻa kahi pilikia o ka hoʻomohala ʻana i ka macrosomia - ka nui o ka ulu ʻana o ka pūpū, a me ka hoʻonui ʻana o ka paona o ka wahine. Me ka macrosomia, mālama ka lolo o ke keiki i kona nui maoli, a hoʻonui ka ʻili o ka poʻohiwi. ʻO kēia mau hopena o ka maʻi maʻi gestational hiki ke hōʻeha i ka wā o ka hānau ʻana. Inā hōʻike ka ultrasound i kahi fetus nui, hiki paha i ke kauka ke hōʻike i ka hāʻawi mua ʻana, no ka mea, ʻoiai kekahi i kahi pōpilikia, ʻoiai, ʻoiai ka nui o ka nui o ka pēpē, ʻaʻole nui ka makua.

ʻO ka pale ʻana i ka maʻi maʻi gestational ma ka hoʻolālā ʻana i ka hānau ʻana a me ka mālama ʻana i ke kaumaha o ke kino. Pono ka wahine e ʻai kūpono, a haʻalele i nā hana ʻino. Hōʻoiaʻiʻo i ka pili ʻana i ke ola ʻano ikaika, no ka mea, ʻo ka hoʻohaʻahaʻa kino i hiki ke hoʻemi i ka hiki ke hoʻomohala ʻana i ka maʻi gestational. He mea nui ia e hana mau nā hoʻomaʻamaʻa ʻole a hāʻawi ʻole i ka wahine hānai i kahi pilikia ʻole.

ʻO nā hui pilikia no ka hoʻomohala ʻana i ka maʻi gestational

Ua hōʻike ka World Health Organization (WHO) i kēia e like me nā mea koʻikoʻi koʻikoʻi no ka hoʻomohala ʻana i ka maʻi gestational:

• ʻoi aku ke kaumaha (BMI ma mua o 25) a i ʻole ka momona (BMI 30).
• maʻi ma ka ʻohana kokoke,
• ka loaʻa ʻana o nā maʻi maʻi gestational ma nā wā hāpai
• nā mea lae hōʻahewa o ke kāohiʻana ma waho o ka wā hapai,
• macrosomia (hānau i ka wā ma mua o ke keiki e kau ana ma mua o 4000 g),
• polyhydramnios, pathological lilo nui i loaʻa i ka hapai i hāʻawi ʻia, gestosis,
• ʻoi aku ka nui o nā makahiki o kahi wahine hāpai.

ʻO ka liʻiliʻi loa o kēia mau hōʻailona i lawa.

Diagnostics o ka maʻi gestational maʻi

Hoʻomaʻi pinepine ʻia ka maʻi diabetes gestational i ka wā o ka nānā ʻana o ka prenatal, a ʻaʻole i hoʻokumu ʻia i nā hōʻailona i hōʻike ʻia.

I ka manawa ke kipa mua ai kahi wahine hāpai i kahi kauka a hiki i 24 mau pule, ʻo kekahi o kēia mau noiʻi i kauoha ʻia no nā wahine a pau:

• ka hoʻolaʻa glucose venous plasma (Hoʻoholo ʻia ka manaʻo gula ma hope o ka hoʻokeo mua ma mua o 8 mau hola a ʻaʻole iʻoi aku ma mua o 14 mau hola), hiki ke hoʻokau ʻia kēia noiʻi i ka hana mua koko biochemical mua. ʻAʻole hoʻohana ʻia ke koko capillary (ke koko mai ka manamana lima) no ka maʻi maʻi. Me ka nui o ke kō anuo plasma gula ma kahi ʻōpū ≥ 5.1 mmol / L akā akā ma lalo o 7.0 mmol / L hōʻike koke ʻia me ka maʻi maʻi gestational.
• ka loiloi o ka pae o HbA1c (glycated hemoglobin). Ke hele nei ʻoe i kahi hoʻokolokolo hāpai, ʻaʻole hiki iā ʻoe ke ʻai i ka ʻai no nā hola 2-3 ma mua o ka hāʻawi ʻana i ke koko, hiki iā ʻoe ke inu i ka wai maʻemaʻe. Inā ʻo ka pae pae 02/08/2019

Kēia koko i nā wahine hāpai

Hōʻike ka pae o ke kō i loko o ke koko capillary āpau (hoʻāʻo ʻia ke koko mai ka manamana lima e hoʻohana ana i ka ʻoihana kāpili a i ʻole ka calibrated glucometer)?

Inā makemake nā kāne a me nā wahine hāpai ʻole i ka kōʻai momona (ʻo ka ʻai o ka manawa hope loa ma kahi o 8 mau hola aku) 3.3 - 5.5 mmol / L, a me 2 mau hola ma hope o ka ʻai (ka mea e kapa ʻia nei ʻo ka glycemia postprandial) a hiki i ka 7.8 mmol / l, no laila ʻoi aku ka wahine hāpai i ka liʻiliʻi loa - ma ka ʻōpū piha 4-5.1 mmol / l, a me 2 mau hola ma hope o ka ʻai ʻana a hiki i 6.7 mmol / l.

ʻO ka hemoglobin Glycated (HbA1c): i nā kāne a me nā wahine ʻaʻole wahine hāpai, ʻo ka maʻamau ka 5.7 - 6.0%, i nā wahine hāpai a hiki i ka 5.8%.

Nā hōʻailona o ka maʻi gestational

ʻAʻole like me nā ʻano maʻi ʻē aʻe, ʻaʻole paha he mau hōʻailona. Hiki ke hoʻoluhi ʻia nā hōʻailona ʻole: ka luhi, nā nāwaliwali o ka naʻau, ka nui ʻana i ka make wai, ka waha maloʻo nui, ka nui o ka urination, nānaki a me ka maloʻo ʻana i ka pūpū, ka maʻi mau ʻana o ka maʻi vulvovaginal (ʻoiai ka hoʻomau ʻana i ka hopena o nā wahine hāpai).

Kūkā ʻia ka hopena ʻoi loa ma ka maʻi gestational.

Naʻi hoʻolika

1. huka koko.
2. Hemoglobin Glycated.
3. Urinalysis + gula a me nā kino ketone (acetone).
4. Pākuʻikahi Glycemic.
5. Ka hoʻāʻo ʻana hōʻaiha.
6. ʻO nā hōʻike ʻē aʻe mai ka papa hana loiloi maʻamau (UAC, ka hōʻike koko hoʻāno biochemical).
7. Wahi a nā ʻōkuhi: ka nānā ʻana i ka urine e like me Nechiporenko, ka moʻomeheu bacteriological o ka urine a me nā mea ʻē aʻe.
8. ʻO nā kūkākūkā ʻana o nā loea lapaʻau (optometrist, kauka laulā, a laila endocrinologist).

ʻO ke kōpaʻa o ke koko ma luna o 5.1 mmol / L ka mua o ka hoʻomaʻamaʻa mua ʻana no ka ʻaila metabolika. Ma ka hihia o ka nānā ʻana o nā uku he nui e hoʻomaka i kahi noiʻi hohonu e noʻonoʻo nei i ka ʻike ʻana i ka maʻi maʻi gestational. ʻO nā data lōʻihi i ka hānau ʻana o nā keiki nui i ke koʻikoʻi o ke olakino mai nā makuahine me ka nui o ke kō he nui ma mua o 5.1 mmol / l, akā naʻe i loko o nā ʻano maʻamau i hana ʻia, ka mea i hāpai i ka hoʻoponopono hou ʻana i ke kōpaʻa koko koko no nā wahine hāpai. Hōʻike ka ʻike i kēia mau keiki i ka pale ʻana i ka pale ʻana, pinepine (hoʻohālikelike ʻia me ka lehulehu o nā mea) i nā hana hoʻopiʻi a me ka hopena kiʻekiʻe o ka hoʻomohala ʻana i ka maʻi maʻamau i loko o kahi keiki.

Hōʻike ʻia ka glycated hemoglobin ma luna o 5.8% e like me ke kū ʻana o ke kō koko i ka manawa like. ʻO kēia ka mea i loaʻa ka manawa hyperglycemia i ka liʻiliʻi he 3 mau mahina.

Hoʻomaka ka puna i loko o ka urine i ka wā e kolo ai ke kō koko koko ma kahi o 8 mmol / L. Ua kapa ʻia kēia paepae mōʻauwila. He emi ka pae i ka glucose o 8 mmol / l; ʻaʻole ia e pili i ka urine.

Akā hiki i nā kino ketone (acetone) i loko o ka urine ke kūʻokoʻa kūʻokoʻa i ke pae o ke kō koko. Akā ʻo kekahi mau kino ketone i loko o ka urine (ketonuria) ʻaʻole ia e hōʻike i ka hoʻomohala nui ʻana o ka maʻi gestational diabetes mellitus, hiki iā lākou ke kūʻē i ke ʻano o ke ʻano o ka maʻi o ka wahine hāpai me ka hoʻomau ʻana a me ka nele o kaʻai maʻamau a me ka makemake, ma ke ʻano o preeclampsia me ka edema, ʻoi aku ka maʻi o ka maʻi ʻeha a me nā maʻi ʻehaʻeha me ke kiʻekiʻe o ka maʻi. (nā toxicoinfection ka lawena a me nā mea ʻē aʻe) hiki ke hoʻonāuki i ka ketonuria.

ʻO ka ʻōlelo glycemic kahi helu ʻana o ke kō koko koko i loko o ka dinamics no ka lā 1 i kēlā me nā manawa like ʻole (ma kahi ʻōpū ʻole, ma hope o ka ʻai ʻana, i ka pō) i mea e maopopo ai nā pihi glycemic (he mea pilikino lākou no kēlā me kēia kanaka) a me ke koho o ka lapaʻau.

- I ke kakahiaka ma kahi ʻōpū ʻole
- Ma mua o kou hoʻomaka ʻana i ka ʻai
- ʻElua mau hola ma hope o kēlā me kēia pāʻina
- Ma mua o ka hele ʻana e moena
- I 24 mau hola
- I 3 mau hola 30 mau minuke.

ʻO ke ʻano kāhea o Glucose ke ʻano he hana noiʻi ma ka endocrinology, kahi e noʻonoʻo ai i ka nānā ʻana i nā huna huna o ka metabolism.

ʻO ka hoʻomākaukau no ka laʻana o ke kūpaʻa glucose: i ka 3 mau lā ma mua o ke aʻo ʻana, pono ʻoe e pili i ka ʻai maʻamau, ma ka pōpilikia ʻaʻole ʻoe e hoʻohaumia i ke kino a me ke kaumaha, overcooling a overeating, pono ʻia e haʻalele i ka moekolohe, ʻaʻole pono e ulaula ma mua o ke aʻo ʻana (e like me ka wā maʻamau i ka wā hāpai, ʻoiaʻiʻo hoʻi).

Wehe ʻia ka ʻaila koko ka momona, kahi momona o 75 mau glucose i 300 ml o ka wai mahana i lawe ʻia i loko o 5 mau minuke, e ana ʻia ke kōpaʻa koko ma kēlā me kēia hapalua no nā hola 2, a laila e kālai ʻia kahi kukū kōpī mai nā hōʻailona. ʻO ka hoʻohālikelike o nā hualoaʻa o ka hoʻokolohua hoʻoliʻi glucose e hana ʻia e ke kauka - he endocrinologist.

Pono ke kūkākūkā oculist e nānā i ke kālā. ʻO ka hōʻeha o ka maʻi maʻi i ka retina hiki ke ʻano o ka hoʻoweliweli ʻē aʻe, a pono hoʻi i kahi ala like ʻole, mai ke ʻano mālama i ka ʻeha a me ka puʻuwai ʻana (laser coagulation of foci of proliferation ma ka retina, ka mea, e like me nā hōʻike ʻana, hiki ke hoʻokau ʻia a hiki i ka wā o ka ʻōpū).

ʻO nā hopena o ka maʻi maʻi gestational

ʻO nā hopena no ka fetus me ka maʻi mellitus maʻi gestational e like me nā mea e hoʻomohala nei me nā maʻi mellitus maʻi 1 a me 2. ʻO ka mea nui ke hoʻopiʻi i nā ʻōkuhi koko he nui, ʻaʻohe o ke ʻano o ka maʻi maʻi.

ʻO nā ʻōmole o ka maʻi maʻi no ka makuahine ʻaʻole i ʻike maoli ʻia e like me ka maʻi type kīkē 1, ʻoiai, ua ʻokoʻa ka lōʻihi o ka maʻi. Akā ʻo gellational diabetes mellitus ka lawelawe ʻana i ke "alarm bell" no ka wā e hiki mai ana, ʻoi aku ka nui o ka nui o ka mau makuahine i ka hoʻomake ʻana i nā maʻi maʻi type 2 ma mua o ka heluna kanaka.

ʻO ka maile me ka maʻi gestational ke ʻano lapuwale loa. Hiki i nā kūlana hypoglycemic ma ka lua o ka hapalua o ka hāpai ʻana, i ka wā e pono ai ka mālama maoli ʻana o ke kino no ka insulin i ka emi ʻana, no ka mea, hoʻomaka ka pancreas o ka pūpū.

Ke lawe nei i ka mālama ʻana i ka maʻi diabetes gestational me kahi obstetrician - gynecologist a me ka endcrinologist. ʻO ka hoʻoholo mua no ka koho ʻana o nā loea lapaʻau e hana ʻia e ka endocrinologist, a laila lawe ʻia ka mana e ke kauka i hele mai i ka hauka antenatal. Inā kūpono, hoʻouna ʻia ka mea maʻi no ka kūkākūkā hou me ka endocrinologist.

ʻO ka ʻai no ka maʻi maʻi maʻi gestational e like me ka lolo 1 ʻano (e ʻike i ka ʻatikala "Type 1 diabetes"). Pono ʻoe e aʻo pehea e helu ai i nā pūʻulu berena (XE) i mea e koho ai i nā meaʻai kūpono no ka meaʻai. Me ka papaʻai ʻana, hiki pinepine iā ia ke hoʻokō i ka uku uku no ka hoʻonaninani kalima, a me ka hōʻemi ʻana o ka paona. No laila, ʻo nā hopena āpau i hiki aku i ka makuahine a me ka fetus a hōʻemi nui loa.

Inine hoʻōla

I ka hōʻike ʻana o nā maʻi mestitus maʻi gestational, ua hui ʻia ka hui ʻana o nā mea like (ka mōʻaukala olakino, ka nui ʻana o ke kino, ke kō a me ka pae hemoglobin glycated, ke ʻano o nā hoʻopiʻi a me nā maʻi concomitant) e pili ana i ka helu helu, koho ʻia ka nui o ka nui o ka nui o ka insulin.

Hoʻohana ʻia nā ʻāpana like ʻole o ka insulin e like me ke ʻano type mellitus type 1, akā, ma ke ʻano he ʻano ʻokoʻa, ka ʻokoʻa o ka dosie. ʻO kekahi manawa lawa kahi hoʻokahi a i ʻole ʻelua e hoʻokele i ka insulin o ka lā i kēlā me kēia lāʻai ʻai.

I ka manawa lawe o ka lawe ʻana, mālama ʻia kahi loiloi o ka nui o ka insulin i mea e pale ai i ka hypoglycemia i ka wā hānau.

Ka Hoʻouna

ʻO ka maʻi diabetes gestational ʻaʻole nā ​​contraindication i ka hāʻawi ʻana ma o ke kanawai maoli.

Nā hōʻailona no ka hoʻolauna hana:

- Nā hua nui (ʻoi aku ma mua o 4 kg) a ʻo ka hua he moa (ʻoi aku ma mua o 5 kg). Hōʻike ʻo Karinka i nā pēpē, ma ka hema ma ke kaupaona kino, a ma ka ʻaoʻao ʻākau ka lōlū.

- Ke pohō nei ʻo Perinatal i ka mōʻaukala (make o kahi keiki i ka wā mai ka 22 mau pule o ka wahine a 7 mau lā o ka pēpē no nā kumu e pili ana i ka lawe ʻana a me ka anomalies congenital).

- He moʻolelo o ka trauma makuahine a me / a me ka trauma o ka fetal (ka mōʻaukala o nā waimaka o ka perineal o ko III a me ka IV degere i ka makuahine, ka hōʻeha poʻo, ka pōkole o ka collarbone, hōʻino ʻia i nā plexuses i hoʻopā ai ka brachial i ka pūpū).

- He moʻolelo paʻakikī o ka wā postoperative / postpartum i loko o kahi anamnesis (suppuration of sutures, hoʻokumu i nā fistulas, hernias, a me nā hoʻopiʻi'ē aʻe).

- E hōʻino ana i ka lā ocular, ka mea e koi ai i ka wehe ʻana i kahi manawa paʻakikī (priniferative retinopathy me kahi hopena kiʻekiʻe o ka hana retinal detachment i ka wā e ho'āʻo ai).

I kēia manawa, ʻo ka pilikia o ka maʻi mellitus maʻi gestational ke kāʻili nei i ka nānāʻana ʻaʻole wale o ka obstetricians - nā poʻe gynecologists, akā nā poʻe loea. Inā ʻoe i hoʻopaʻa inoa ʻia ma ka haukapila antenatal ma ke manawa, a laila e ʻike ʻoe i kāu pae ʻai koko i ka manawa kūpono. Inā kānalua ʻoe ua loaʻa iā ʻoe ka maʻi gestational, e nānā hou aku ʻoe a e hāʻawi ʻia ka ʻai. Kuhi i nā ʻōlelo a pau o ka obstetrician - gynecologist a me ka endocrinologist, he hoʻomaikaʻi ʻia ka prognosis no ka makuahine a me ka maʻi fetus.

Kāohi

ʻO ka hemahema ʻana o kēia maʻi, ʻo ia ke kāpae ʻana i nā mea pono mua predisposing i hōʻike ʻia i loko o ka pauku e pili ana i nā pūʻulu pōpilikia. Ua akaka hiki ke hiki ke hoʻoponopono ʻia i ka makahiki a me ka anamnesis, akā hiki i ka nui ke kaumaha. Ke lawe mai nei i ke kaupaona ʻana ma ke kino e pale i ka nui o nā pilikia, a ʻaʻole wale kēia maʻi maʻi maʻi gestational, akā he ʻano maʻi hypertension gestational, preeclampsia, edema o ka wahine hāpai a me nā mea'ē aʻe.

Eia nō naʻe, i ka wā e hoʻolālā nei i ka hāpai ʻana, ʻaʻole loa ia e ʻike i nā maʻi e pili ana i nā maʻi pili koko, nā hōʻeha o ka hapai i nā hoahānau mua. Hiki ke kōkua i kēia i ka wānana i ka pilikia a pale iā lākou.

Loaʻa kāu "ʻelua" i kou mau lima, pono ʻoe e ʻike i ke ʻano o ke kuleana a hāʻawi i ke ʻano liʻiliʻi. Mālama iā ʻoe iho a me ka paʻa ʻana i nā ʻōlelo ʻana e kōkua iā ʻoe e waiho i kahi kumu maikaʻi no ke olakino o kāu pēpē. E mālama pono iā ʻoe iho a ola.

Hoʻomaʻamaʻa

Wahi a nā ʻōnaʻi o WHO, ua hoʻokaʻawale ʻia nā ʻano maʻi like ʻole o ka wahine hāpai.

1. Pākuʻi aku i ka maʻi diabetes mellitus 1 ma mua o ka wā hapai.
2. Pākuʻi ʻia ke ʻano maʻi type 2 ma mua o ka wā hapai.
3. ʻO ka mellitus maʻi hānai hamela - ʻo kēia huaʻōlelo ke hoʻohui pū i kekahi maʻi me ka hoʻomanawanui i ka glucose i loaʻa i ka wā hāpai.

Naʻi hoʻolika

No nā wahine hāpai nā mea ʻaʻole i hōʻike ʻole i nā hilahahi metabolic i ka wā mua, ma waena o 24 a 28 mau pule, ʻo PGTT me 75 g o ka glucose ka mea e hoʻomaʻamaʻa ʻia.

ʻO kēia manawa, e like me nā poʻe loea, ʻo ka mea maikaʻi loa loa no ka hōʻike, ma nā hihia kūʻokoʻa loa, no nā mea āpau (ʻoi ke kiʻekiʻe o ka GDF, ka nui o ka pēpē e like me nā papa pākēneka o ka ulu ulu intrauterine> 75 pālua, nā hōʻailona ultrasound o ka maʻi fetopathy maʻi), ʻo PHTT me 75 g Hoʻolaha ʻia ka glucose i nā wai 32 o ka hāpai ʻana.

Eia kekahi, mai poina e pili ana i nā contraindications no ke alakaʻi ʻana iā PHTT:

• intolerance glucose
• maʻi maʻi gastrointestinal, hele pū ʻia me ka hoʻopili o ka glucose i hoʻopalapiha.

Hoʻomaʻamaʻa

• Hoʻohana ʻia me ka papa o ka hoʻokeʻokeʻa maʻalahi me nā pēpē a me ka pau ʻana o ka momona, ʻo ka mākaʻi like ʻole o ka pāʻai o kēlā me kēia lā no nā lā he 4-6.
• Hoʻopau i kahi hana holomua
• Ka mālama pono ʻana i ka glycemia, ke koko, ke kaumaha o ke kino.

Inā hiki ʻole ke hoʻokō i nā pae glycemia i kaupaʻa ʻia i nā hebedoma 1-2 o ka kaohi o ke ake iho - kahi hōʻike hoʻomohala no ka hoʻomaka ʻana o ka maʻi insulin.