ʻO ka maʻi maʻi i ka Wahine Hānau

ʻO kahi maʻi diabetes mellitus he maʻi ka mea e pae ai ka nui o ka glucose i ka serum o ke koko, i kapa ʻia kekahi ʻano kiʻekiʻe o ke kō. ʻO ka Diabetes mellitus i loko o nā wahine hāpai ua kaʻawale i kahi ʻokoʻa o kēia maʻi. Hoʻopili i luna o ke ola o nā kānaka o nā kāne like ʻole, akā ʻoi aku ka maikaʻi no nā wahine i ka wā hāpai. I ka manawa like, ʻeha ka makuahine a me ke keiki.

ʻO ka maʻi diabetes mellitus i kū mai i ka wā hāpai a kapa ʻia he gestational. Inā paʻa kahi mea maʻi maʻamau me ka maʻi mellitus e hoʻomaʻamaʻa ʻia a hiki i ka hopena o kona ola, a laila ʻo kāna ʻano gestational ma 90-95% o nā hihia e hala ma hope o ka hānau ʻana o ka pēpē. Akā no kēia, pono ia e mālama i ka maʻi a mai haʻalele i ka mālama ʻana a hiki i nā hōʻailona a pau a ʻike ʻia ke ʻano o ke kōʻai koko - a hiki i 5.1 mmol / l.

Ka hōʻike ʻana o ka maʻi gestational

I ka wā hāpai, loaʻa ka hānai koko kiʻekiʻe nā makuahine āpau. ʻO ka maʻi maʻamau ka manawa maʻamau a ʻike ʻia i ka hapalua o ka hapalua. Inā ua ʻike ʻia ka maʻi maʻi ma ka kahi pōkole pōkole, a laila ua ola ʻia ʻo ia ma mua.

ʻO nā kumu nui o ka maʻi diabetes i nā wahine hāpai ka loaʻa ʻana o ka momona a me ke hoʻoponopono ʻana i ka hormonal. Hoʻomaka ka hana o nā sela o ke kino e hoʻohana i ka insulin hormone i hana ʻia e ka pancreas ma kahi like ʻole, e pane iki i ka liʻiliʻi, a me ka nui o ka insulin i loaʻa he nui e hoʻoponopono i ka glucose koko. Hoʻonohonoho ʻia ka Insulin, akā hele maʻa ʻole ʻia

  • ka kō i loaʻa i ka urine
  • makewai maoli
  • nā hoʻomaʻa pinepine ʻana
  • nāwaliwali
  • ninini
  • pinepine ke kino, genitourinary a me nā maʻi ʻeha,
  • he ʻike hoʻopuka.

ʻO wai ka mea nui aʻe i ka maʻi gestational?

Pono nā wahine hāpai a pau e nānā inā ua hoʻonui lākou i ka glucose koko. Hoʻokumu ka maʻi maʻi gestational i kahi kokoke o 2-5% o nā wahine hāpai. Loaʻa nā maʻi i ka maʻi: 7–9%.

Pili kēia i nā wahine hāpai i nā hiʻohiʻona:

  • ʻoi aku i nā makahiki 35
  • momona momona
  • maʻi kanulau gestational ma kahi hāpai ʻana ma mua,
  • kekahi keiki nui ma ka hanau mua ana mai,
  • ma ka maʻi maʻamau
  • ʻO nā maʻi ovary polycystic i ka wā ma mua.

Ia mau ʻānō e noʻonoʻo pinepine ʻia i kēlā mau wahine hāpai. ʻO ka paʻakikī ke hāpai i nā wahine me ka maʻi maʻi maʻi.

Ma muli o ke kaupaona ʻana o kekahi o nā kumu o ka maʻi diabetes i ka wahine hāpai, pono ʻoe e lilo i ka momona aʻo ke hoʻolālā ʻana i kahi wā hāpai a laila hoʻomau ka hana ʻana i nā hana kino. Ma laila wale nō e hoʻohana pololei ai ke kino i ka insulin a e hoʻomau ka glucose i mea maʻamau.

I ka manawa hea e nānā ai ʻoe i kāu kaila koko?

ʻO ka maʻamau, ʻike ʻia kēlā mau hoʻokolohua ma kahi makahiki gestational o 24-28 pule. I kēia manawa, hana ka plasenta i nā hāmeʻa hou aku, a hiki mai paha ka pale ʻana i ka insulin. Inā hōʻike ka loiloi ma mua o ka honu o ke koko ma mua o ka maʻamau, ke kauka nei ke kauka i nā hoʻokolohua ʻē aʻe e hōʻoiaʻiʻo ana ka maʻi maʻi gestational type mellitus i ka wā hāpai.

I ka manawa pinepine, ua hāʻawi ʻia ka wahine i kahi hopena ʻono momona maikaʻi loa e inu ai a hiki i kahi hola ke ʻike ʻia pehea ke ʻano o ke ʻano o ke kō i loko o kēia manawa. Inā ʻaʻole i hālei ka hilahila koko ma kahi pākuʻi. Ma hope o ka haʻalele ʻana i ka 8 mau hola mai ka meaʻai, ua nānā ʻia ke kiʻekiʻe o ke kōʻai wikiwiki, ma hope o ka mea maʻi e inu ai i kahi hopena glucose. Ma hope o 1, 2 a me 3 mau hola, ʻike hou ʻia ke kiʻekiʻe o ke kō. Hoʻokumu ʻia kēia mau ho'āʻo, ua hoʻoholo ʻia inā loaʻa kekahi maʻi.

ʻO ka pahuhopu nui i ka mālamaʻana i ka maʻi hānai o kēlā me kēia ʻano maʻamau ka maʻamau o nā pae gula.

ʻAʻole pono nā wahine momona i ke wā o ka hāpai ʻana i ka ʻai. ʻO ka hoʻopiʻi ʻana me ka paona i kēia manawa he pilikia, ʻo ka pahuhopu nui ka hōʻoia ʻana i ke ola o ke keiki. Akā ʻoi aku ka nui o ka paona wikiwiki e hiki ke loaʻa i ka maʻi diabetes.

Inā he wahine maʻi ka maʻi hāpai, e wehewehe ke kauka i ke ʻano kūʻokoʻa i ka pae o ka glucose, kahi eʻai ai ke ʻano a me nā mea e pono ai ke ʻano o ke kō. Inā pono, ua kuhikuhi ʻia nā ʻōlelo inikini. ʻAʻole hopohopo nā wahine hāpai: ʻaʻole i hōʻeha ka insulin i ke olakino o ka embryo.

Diet a hoʻomaʻamaʻa no nā wahine hāpai

I kēia manawa ke kūʻai aku nei nā ʻōhua like ʻole. Hiki paha i kāu kauka ke ana ʻoe i kāu kōʻai ʻai ʻahaʻaina ma mua o ka papaʻaina, 2-2.5 mau hola ma hope o ka ʻai ʻana. A laila e hōʻike ʻia nā ʻike a pau i ke kauka.

Ma waho o nā koi meaʻaiʻai, ʻaʻohe lāʻau lapaʻau e hiki ke kōkua. E wehewehe aku ke kauka iā ʻoe i nā meaʻai e koho ai, pehea ka nui e ʻai ai, pehea kaʻai. ʻO ke koho o nā huahana, ka nui a me ka manawa o ka ʻahaʻaina ka mea nui e pono ai ʻoe e lawelawe pono i ka mea e mālama i ka mea e loaʻa ana iā ʻoe me ke kōkua o injections.

E kōkua ka hana pilikino i nā maʻi maʻi ʻaʻole e maʻi. Hoʻomaʻamaʻa ka hoʻokalakupua i ka loaʻa ʻana o ka wahine nona ka maʻi diabetes type 2 ma hope o ka hānau ʻana.

  • hoʻomaʻamaʻa i ka liʻiliʻi o ka hapalua hola i kēlā lā
  • Hana i nā hana aerobic
  • e nīnau aku me kāu kauka inā paha e hoʻomau i ka hana ʻana e hoʻoikaika i nā iwi a i ʻole ka hana ʻana inā he wahine kēia i hana ma mua o ka hāpai ʻana,
  • haʻalele i nā hana pilikino i hiki ai ke ʻeha ʻia i loko o ka ʻōpū a hāʻule paha,
  • pale i nā hana hoʻihoʻi ma ka hoʻomaka ʻana o ka wā hāpai.

No ke aha e mālama ʻia ai ka maʻi maʻi gestational

Inā hana ʻia ka hoʻokalakia ʻana a lawe ʻia ka lāʻau lapaʻau, liʻiliʻi ka hopena o nā hoʻopiʻi ʻana.

Hānau nā wahine i nā keiki olakino, a nalowale ke maʻi diabetes ma hope o ka wā hapai. Akā inā haʻalele ʻoe i ka maʻi me ka ʻole o ka mālama ʻana, he mea weliweli ia i ka makuahine a me ke keiki.

Pono e hoʻomaopopo ʻia inā inā he koko koko ka nui o ka wahine hāpai, ua kiʻekiʻe ke kō o ke koko a ka embryo. Paʻa ʻia kāna pancreas e hana i ka nui o ka insulin i mea e hōʻemi ai i ka nui o ke kō i loko o ke koko, a waiho mau nō ia i loko o kona kino i ke ʻano o ka momona.

Inā lawe maʻalahi ka makuahine i ka hakahaka, ʻaʻole i hahai i nā ʻōlelo a ke kauka, hiki i nā hoʻopiʻi i lalo:

  • koko kiʻekiʻe a me ke protein i loko o ka urine o kahi wahine hāpai,
  • manaʻo ʻino
  • kaupaona nui o ke keiki i ka hanau ana, he mea weliweli no ka wahine hanau ana, a no ke keiki,
  • hānau hānau
  • ka manawa kūpono e hele i ke kahua cesarean,
  • jaundice i ka hanau
  • hoonui ka nui o ka make o ka embryo or keiki hānau,
  • aia ka pilikia nui o kahi keiki i loaʻa i ka maʻi diabetes type 2 i nā makahiki o kona ola makua.

Ma hope o ka hānau keiki ʻana

Ke lilo nei i makuahine, kahi wahine i loaʻa i ka maʻi maʻi gestational i ka wā hāpai a hoʻomau i ka nānā ʻana i kona koko koko, ka u me ka wai a me ka makewai a nalowale nā ​​hōʻailona. Kuhi pinepine nā kauka i kahi loiloi i 6 a me 12 mau pule ma hope o ka lawe ʻana. I kēia manawa, hana ka lehulehu i nā pae o ke kō, akā ʻaʻole kēia i ka 5-10% o nā wahine. Pono ʻoe e ʻimi i ke kōkua o ke kauka, inā ʻaʻole i loaʻa kahi maʻi maʻi maʻamau ʻole e hoʻomake ʻia i loko o kahi maʻi koko koko mau.

ʻOiai inā ua lilo ka pae o ke koko i ka maʻamau, ua hoʻomau ka hoʻoweliweli a ʻoi i ka maʻi diabetes type 2. Hōʻike ʻia kēlā mau wahine e nānā hou aku i kekahi mau makahiki 3 e ʻike inā he nui ka nui o ka glucose i ke koko.

ʻO ka mālama ʻana i ka maʻi gestational ka mālama ʻana i kou makuahine a me kāu pēpē.

ʻO nā kumu o ka maʻi maʻi i ka wahine hāpai

ʻO ka maʻi diabetes mellitus i loko o nā wahine hāpai (gestational) kahi maʻi pathological kahi i hopohopo ʻia ke kino i ka glucose i hiki ke hoʻololi i ka hoʻololi ʻana o ka physiology o ka wahine i ka wā o ka gestation.

Ka hoʻokele i ka hormone ka nui o ka glucose i ke koko e ʻai ʻia ana me ka meaʻai. ʻO ka hana ʻana o ka insulin e hoʻokaʻawale i nā glucose a e kahele i ia i nā ʻāpana a me nā kino o ko mākou kino, e hoʻemi ana i kona neʻe i nā waiwai maʻamau.

ʻO ke hoʻonuiʻana o ka glucose i ka maʻi diabetes i kahi wahine hāpai i hiki mai ma muli o ka hana o nā hormone plentental ma lalo o ka hana o nā hormones i hana ʻia e ka placenta. Ke alakaʻi nei kēia i kahi kaumaha nui ma ka pancreas, no laila i kekahi mau kūlana i hiki ʻole ke hoʻokō i kāna mau hana. Ma muli o ke ala, ua piʻi ka pae o ke kō a alakaʻi i kahi maʻi metabola ma o ka makuahine a me ke keiki. Ma o ka mea huna transplacental, komo ka glucose i ke kahe o ke keiki, e hāʻawi ana i ka hoʻonui i ka ukana ma kāna pancreas. Hoʻomaka ka kino e huna i kahi nui o ka insulin, e koi ana iā ia iho e hana me kahi ukana pālua. Hoʻopili pinepine ka hana ʻana i ka insulin i ka loaʻa ʻana o ke kō, hoʻohuli iā ia me ka momona momona, hoʻonāukiuki i ka mea hāpai i ka momona nui.

Kahi papa o nā mahele o ka hopena paha

ʻO nā mea nui e hoʻonāukiuki i ka hoʻonāukiuki o ka metabolism hoʻonā i ka wā hāpai.

  • Predisposition genetic. ʻO ka hoʻonui ʻia o ka hoʻonui ʻana i nā pae o ka glucose i nui mau manawa inā loaʻa he hihia o ka maʻi gestational i ka mōʻaukala ʻohana.
  • ʻOi momona. ʻO ka hoʻonāukiuki o ka kalaiwa a me ka lipid metabolism he ʻoi aku ʻo ka mea kiʻekiʻe ʻoi ka nui.
  • Nā maʻi ʻōnaehana. ʻOiai kueʻole paha i ka hiki ke hana o ka pancreas, kahi e hoʻonāukiuki i ka hana o ka insulin.
  • He 35 makahiki. Inā he koʻikoʻi o ka moʻolelo o ka lāʻau o ka wahine, a laila piʻi ka nui o ka ulu ʻana o ka maʻi diabetes.
  • Kāhea i loko o ka urine. ʻO ka hoʻonuiʻana i ke synthesis glucose i loko o ke kino o kahi wahine e hoʻopilikia i ka hana filtration o nā keiki.

Loaʻa i kahi koʻikoʻi o ka hoʻouluʻana i ka maʻi diabetes i nā wahine i loaʻa i hoʻokahi a ʻelua paha o nā ʻōlelo pae i luna.

ʻO nā hōʻailona o ka hoʻonui glucose

I ka hoʻomaka mua o ka maʻi diabetes i ka wā hāpai, ʻaʻole hiki i ka wahine ke kānalua, no ka mea, ʻaʻohe ʻano lapaʻau e haʻi ʻia nei o ka maʻi. ʻO ia ke kumu e kākau ai i nā gynecologists i kēlā me kēia mahina i kahi hōʻike diagnostic i ke koko a me ka urine no ka glucose. ʻO ka pae glucose maʻamau ma ke koko o ka capillary he 5.5 mmol / L, a ma ke koko venous - a hiki i ka 6.5 mmol / L.

ʻO nā hōʻailona nui i ka maʻi maʻi:

  • hoʻonui i ke kōpaʻa koko ma mua o 9-14 mmol / l,
  • hookeau pinepine,
  • huehue
  • hoʻonui nui momona
  • mau ka makewai mau
  • ka malo maloʻo.

He paʻakikī i ka ʻike ʻana i kekahi mau hōʻailona o ka maʻi maʻi, ʻoiai hiki iā lākou ke loaʻa ma nā wahine hāpai wahine.

Nā hōʻailona hōʻailona

I ka wā hapai, ʻike ka nui o ke kino o ka wahine i nā mea āpau a me nā ʻōnaehana, no laila e holomua nā kūlana pathological me ka ikaika pālua. Hoʻohālikelike ke kiʻi olakino ma waena o ka maʻi gestational a me gestational, nā hōʻailona i pili i ke ʻano a me ka lōʻihi o ka hyperglycemia.

Hōʻike ʻia nā ʻeha mai ka ʻōnaehana cardiovascular e nā loli i ka waihona, nā hāʻule nui i loko o ke koko, a me ke ʻano ikaika ʻo DIC pū kekahi.

Ma muli o nā hoʻololi o ka ʻōnaehana urinary i loko o kahi wahine, ua mau ʻia nā kaʻe ʻana i ke kolo i ke aʻalolo i nā pōpoki, ma muli o ka hopena o ka hana filtration. ʻO ka hōʻiliʻili nui o nā kahe i loko o ke kōpana e hōʻike ʻia e ka popo nui o ka maka a me nā haʻahaʻa haʻahaʻa. Ke hoʻopili ʻia kahi maʻi maʻi lua, paʻakikī ka loaʻa ʻana o ka maʻi e ka hoʻomohala ʻana o ka pyelonephritis a me ka bacteriuria.

ʻO kahi hōʻike maʻamau o ka maʻi gestational ka tuai nephropathy.

ʻO nā mea nui ka maʻi maʻi i ka wahine hāpai.

  • lawa pono,
  • ka makewai
  • huki ka wai i ka 3 lita i kēlā me kēia lā,
  • ʻeha ka ʻāʻā pohā,
  • fluctuations i ke kaupaona o ke kino
  • maualoko mau
  • maʻi hoʻokūkū
  • wahī ʻaʻe
  • ua hoemi i ka hihio
  • ʻili kino ʻōlaʻi,
  • ke ʻano o ke ʻano heʻe.

ʻO ka pōʻino o ka maʻi maʻi ma ka maʻi gestational pū kekahi me ka gestosis koʻikoʻi, hiki ke hōʻeha ʻia e ka hoʻouka ʻana o ka eclampsia.

ʻO nā ʻōhua hiki

Ma ka maʻi mellitus, hōʻike ʻia nā maʻi vascular koʻikoʻi i ka manawa o ka gestation, ka mea e pili ana i ke kūlana o ka hoʻomohala ʻana. I ka wā mua o ka waiho ʻana i nā ʻōpū a me nā ʻōnaehana o ka embryo, hiki ke hoʻololi ʻia nā genetic, a laila hiki ke hoʻopiʻi ʻia i ka maʻi maʻi i ka pēpē. ʻO ka hoʻonui o ke kaila glucose i ka makuahine e hoʻonāukiuki i ka metabolism i loko o ke pēpē a alakaʻi i ka ketoacidosis.

Nā hopena o ka hāpai ʻana me ka maʻi diabetes:

  • I ka wā mua, hiki mai paha ka kuhi hewa.
  • Malformations o ka pēpē.
  • ʻO Ketoacidotic ka pīhoihoi i ka wahine.
  • Polyhydramnios.
  • ʻO nā hewaʻole o ka hoʻokumuʻana o ka plasenta.
  • He maʻi hypoxia ohoʻi ʻana.
  • ʻO ke ʻano o kahi kuʻuna nui.
  • ʻO ka hoʻoweliweli o ka hānau mua.
  • Hana ikaika.

ʻO ka hōʻeha nui o nā hoʻopiʻi ma ka manawa o ka hānau ʻana i kahi keiki e hilinaʻi ana i ke ʻano o ke maʻi maʻi a me nā hiʻohiʻona pilikino o ke kino o ka wahine.

Nā hana hoʻohālikelike

Pono ka mālama ʻana i nā wahine me ka maʻi diabetes i ka wā hāpai a lawe ʻia i ka ʻōlelo kūkākūkā a me ka hale hoʻokipa maternity, kahi kahi mau ʻoihana kūikawā. Pono ke gynecologist e haʻi i ka wahine i ke kūkākūkā me ka endocrinologist, nāna e kuhikuhi ʻia e hana i nā ʻimi noiʻi kūikawā e hoʻoholo ai i ke ʻano a me ke ʻano o ka maʻi maʻi.

ʻO ka hoʻomālikelike ʻana o ke ʻano ka ʻike ʻana i nā ʻōnaehana penei:

  • ʻO ka loiloi o ka hana hoʻoikaika o nā keiki i ka hana. Urinalysis no ke kō, nā huina, nā pā koko keʻokeʻo. ʻO ka nānāʻana biochemical o ka serum koko no ka ʻike o ka urea a me ka mea hana.
  • ʻO ka loiloi o nā maʻi vascular. ʻO ke nānāʻana o ke koko a me ka hoʻoholo ʻana i ke ʻano o ka waihona kālā.
  • ʻO ke aʻo ʻana o ka hana pancreatic. Ka hoʻoholoʻana i ka hoʻokahe o ke koko, nā antibodies insulin serum. ʻO ka diagnostics ultrasound a me ka hōʻike hōʻike screening no ka hoʻomanawanui i ka glucose.

Ke hoʻomaopopo nei a me ka nānā ʻana i ka maʻi gestational latest gestational, hōʻike ʻia ka hoʻāʻo ʻana me ka glucose.

Nā kuʻina mālama

I nā hōʻailona mua o ka maʻi maʻi, pono ka wahine hāpai i ka haukapila e mālama koke i ka hoʻomohala ʻana o nā hoʻopiʻi.

ʻO nā hana nui no ka maʻi maʻi gestational:

  • Hoʻokomo ʻia ka Insulin therapy e hoʻohaʻahaʻa i nā pae haʻahaʻa i lalo o ka pae maʻamau.
  • ʻO kaʻaiʻai kūpono me nā helu liʻiliʻi o ka meli, nā momona momona a me nā hoʻemi wai kōo liʻiliʻi.
  • E kōkua ka hana kino kino e hoʻihoʻi i ka hana kaʻina metabolic a hoʻonui i ka hana insulin.

I ka wā hāpai, he mea nui loa no ka wahine ke kiaʻi i kona olakino, no laila, ma nā hōʻailona mua o ke kō o ke koko kiʻekiʻe, pono ia e ʻōlelo i kahi loea.

Waiho I Kou ManaʻO HoʻOpuka