ʻO ka maʻi gestational a iʻole gestational i ka wā hāpai

ʻO ke ʻano maʻi o ka maʻi gestational ke ʻano o nā maʻi i hiki wale i nā wahine hāpai. Ua wehewehe ʻia kona helehelena e ka mea o ke kino o ka makuahine i ka wā e hiki mai ana ke kalepa i ka hana o nā ʻaina. Hoʻokomo pinepine ʻia nā Patology i ka hapa lua o ka huaʻōlelo.

Pehea a pehea no ke maʻi maʻi gestational i ka wā o ka wā hāpai

Hoʻomilikia ka maʻi ma muli o ka loaʻa ʻana o ka wahine wahine i ka ʻike ʻana i nā ʻopa a me nā ʻona i kona insulin ponoʻī.

ʻO ke kumu o kēia hanana i kapa ʻia he piʻi ʻana ma ka pae o nā hormona i ke koko i hoʻolālā ʻia i ka wā hāpai.

I loko o kēia manawa, hoʻemi ʻia ke kō ma muli o ka mea i pono ai ka pēpē a me ka plasenta.

Hoʻomaka ka pancreas e hana i ka nui o ka insulin. Inā ʻaʻole lawa no ke kino, a laila hoʻomohala ka maʻi gestational i ka wā hāpai.

I ka nui o nā manawa, ma hope o ka hānau ʻana o ke pēpē, hoʻi ka pae kōlaʻa koko o ka wahine i ke ʻano.

Ke hōʻike nei i nā haʻawina ma United States, hoʻomohala kēia maʻi i ka 4% o nā wahine hāpai.

I Europa, kēia hōʻailona kuhikuhi mai ka 1% a 14%.

He mea kūpono ia ma ka 10% o nā hihia ma hope o ka hānau ʻana o kahi pēpē, nā hōʻailona o ka pathology i hele i ka type 2 diabetes mellitus.

Nā hopena o GDM i ka wā hāpai

ʻO kahi koʻikoʻi nui o ka maʻi nui loa i kahi kuʻi. Hiki mai i ka 4.5 a hiki i 6 kilograms.

Hiki i kēia ke alakaʻi i nā hānau hānau paʻakikī i kahi e koi ʻia ai kahi mahele cesarean. Hoʻonui hou nā keiki nui i ka hopena o ka momona.

ʻO kahi hopenaʻoi aʻe o ka hopena o ka maʻi maʻi i nā wahine hāpai, ʻo ia ka hoʻonui nui o ka preeclampsia.

Hōʻike kēia hoʻonāukiuki e ke koko kiʻekiʻe, ke kī nui i ka nui o ka protein i ka urine, ʻūlū.

Hoʻopilikia kēia mau mea i ka ola o ka makuahine a me ke keiki. I kekahi manawa pono e hoʻolilo nā kauka i ka hānau mua.

Me ka nui o ke kaumaha o ke kino, hiki i ka pūpū ke hoʻomohala i ka hāʻule ʻana o ka hanu, ua ʻokiʻoki i ke kani kino. Ke wehe nei hoʻi nā mea hoʻohālikelike i ʻōlohelohe, e kū like ana, huehue, jaundice.

Ua kapa ʻia kēia kūlana ʻo ka maʻi hānau maʻi diabetes. Hiki iā ia ke alakaʻi i ka wā e hiki mai ai i ka hoʻopiʻi ʻana i ka puʻuwai, kahi mau i ka noʻonoʻo a me ka hoʻomohala kino.

He aha ka mea e hoʻohālikelike ai i ka maʻi maʻi gestational

ʻO kahi hopena kiʻekiʻe aʻe o ka nānā ʻana o kēia maʻi i ka wahine me:

• mau pauna hou
• metabolism kalima
• nā maʻi o ka ʻōnaehana cardiovascular,
• maʻi hoʻopilikia piha loa
• lawe ʻia he māhoe a he triplets paha,
• ʻO GDM i nā hāpai wahine ma mua.

Eia kekahi, ʻo ka hoʻomohala ʻia o ka maʻi ke pā ʻia e ka makahiki o ka makuakāne me ka makuahine e kali nei. ʻO ka pinepine, ʻo ka mea i loko o nā wahine i loko o ka hana ma mua o 30 mau makahiki. Hiki i ke kumu o ke kanu ʻana i nā maʻi no ka maʻi maʻi ma kahi o nā mākua.

Hiki i ka hānau ʻana o ke keiki ma mua ke hoʻopilikia i ke ʻano o ka pathology. ʻOi paha ka hapanō i kauka, hānau ʻia.

Ma muli o ka hiki ke hoʻohālikelike ʻia o nā hāpai ʻana ma mua.

ʻO ka maʻi hoʻoliʻi o ka maʻi

ʻO kahi hōʻike ʻana o ka maʻi mellitus maʻi gestational i ka wā hapai e hōʻike ana he pae koko glucose i mua o ka ʻāʻī ʻana.

ʻAʻohe hōʻailona nui loa o ka maʻi gestational i ka wā hāpai.

ʻIke pinepine ʻia ia ma hope o ka nānā ʻana i ka ultrasound i ka wā e hōʻike ai i ka fetus oversized. I kēia manawa, hoʻomaka ʻia ka mālama ʻana, akā ʻoi aku ka maikaʻi o ka lawe ʻana i nā mea e pono ai. No kēia kumu, hana ʻia kahi hōʻike hoʻoliʻi glucose.

Eia kekahi, inā loaʻa ka nui o ka makuahine i ka paona nui, hiki iā ia ke kamaʻilio e pili ana i ka nui o ke kō koko.

Hiki nō hoʻi i ka maʻi me ka urination pinepine. Akā ke hilinaʻi i kēia mau hōʻailona ʻaʻole pono.

Hōʻike lima hana

Lawe ʻia kekahi hōʻike he koko i kekahi mau hola ma luna o nā hola he nui e hoʻāʻo ai no ka hoʻohaʻahaʻa glucose. Huli ʻia ka noiʻi hou ʻana me ka hoʻohana ʻana i kahi hopena o 50, 75 a i ʻole 100 mauʻaina o ka glucose.

Ke lawe nei i kahi keiki, ʻo kahi wahine ma luna o kahi ʻōpū ʻole ʻo ka 5.1 mmol / l. ʻO hoʻokahi hola ma hope o ka ʻai - 10 mmol / L. A ma hope o ʻelua - 8.5 mmol / L.

Inā kiʻekiʻe ke kuhikuhi, a laila hana kekahi maʻi - gestational diabetes i ka wā hāpai.

Ma hope o ka nānā ʻana i ka maʻi, pono ʻoe e nānā i ke kaomi a me nā hana o nā keiki.

E nānā no nā mau hōʻino, e kuhikuhi i nā hoʻāʻo i ke koko a me nā wai hoʻi.

Hiki i kāu kauka ke ʻōlelo aku iā ʻoe e kūʻai i ke kaʻi koko koko e hoʻopaʻa i ke koko i ka home.

ʻO ke kānāwai o ka mālamaʻana i ka GDM i nā wahine hāpai

I nā hōʻailona mua o ka maʻi maʻi gestational i ka wā o ka hapai, ke kuhikuhi ʻia ke mālama koʻikoʻi - he meaʻai.

Inā aia kekahi, a laila hoʻohui ʻia me ka hoʻonāʻau ʻia me ka insulin. Hoʻopili ʻia ka ʻā hoʻokahi.

Me kēia maʻi, ʻo nā kauka nui ke kaukau ʻana i nā meaʻai meaʻai 9.

Hoʻoikaika pū ʻia ka hana maʻalahi. Loaʻa lākou i ka hopena maikaʻi ma ka hana insulin a pale i ka hōʻemi ʻana o ka glucose i nā paona hou.

Inā ʻike ʻia kahi maʻi, pono e nānā ka mea maʻi e kahi endocrinologist a me kahi mea hānaiʻai. Inā loaʻa iā ia kahi puʻukū, he kūkākūkā me nā psychologist e pili ʻole ia.

He mea nui hoʻi e hoʻomanaʻo e hiki ke lawe ʻia nā lāʻau e hoʻokaʻawale ʻia ke kō.

ʻO kaʻai ʻana a me ka hana maʻamau i kēlā me kēia lā i ka wā hāpai me ka GDM

I ka wā o kaʻai, hiki i ka emiʻana o ke kaila o ka caloric.

Eʻai i nā manawa 5-6 i loko o nā wahi liʻiliʻi a ʻai ʻole i nā lawelawe nui 3 mau manawa i ka lā, e hana ana i nā kīmaha 3-4 mau manawa ma waena o lākou.

ʻO nā kīʻaha nui ka haki, ka ʻū, nā iʻa, ka ʻiʻo, nā cereals, a me nā mea i hoʻolapalapa ʻia nā mea kanu, nā hua ʻai, nā ʻano ʻono a me nā huahana momona haʻahaʻa.

Ke koho nei i nā huahana meaʻai, pono ka makuahine e pono ai i ka loaʻa o kāna pēpē i nā huaora a me nā minamina i pono no kona hoʻomohala ʻana. No laila, inā ua hoʻoholo ka wahine hāpai i hana e papaʻa, a laila pono ʻo ia e aʻo i ka ʻike e pili ana i ka poʻe me ka type 1 a me ka type.

I ka manawa o ka papaʻai, pono e hoʻokaʻawale i nā pale me nā momona a me nā momona.

No ka manawa holoʻokoʻa o ka hānai ʻana i kahi pēpē, nā kīʻaha, kaona, nā lālā, ka pasta a me nā ʻuala e haʻalele i ka meaʻai. Pono e kiola ʻia ka ʻanoʻu a me kekahi mau ʻano hua.

Pono nā maʻalahi i ka lau. E kōkua kēia i ka pale ʻana i ka hana nui a ka pancreatic.

E hoʻāʻo e like me ka mea liʻiliʻi e ʻai i nā meaʻai i nā meaʻai a pau, nā mōloli wikiwiki a aloha. Pono ia e hāʻawi i nā huahana semi-oti.

Kālā i kēlā me kēia lā

E hāʻawi ʻia nā ʻōleloʻike e pili ana i ka helu ʻai o kēlā me kēia lā e nā mea mālama olakino a me ka endocrinologist.

ʻO ka maʻamau ma kahi o 35-40 mau pākēneka o ke kaumaha o ka wahine. No ka laʻana, inā ʻo ka paona he 70 kg, a laila ma ke ʻano he 2450-2800 kcal.

Kūpono ʻia ʻoe e mālama i kahi palapala ʻoihanaʻai i nā manawa holoʻokoʻa holoʻokoʻa. Hiki i kēia ke mele i ka hopena o ka lā inā ua hoʻonui ʻia ke ʻano maʻamau.

Inā ʻike ʻia ka manaʻo o ka pōloli ma waena o nā meaʻai, a laila e kūpono ʻia ka inu ʻana i ka wai ma nā sips liʻiliʻi. Pono ka inu ʻana i kēlā me kēia lā ma kahi o 2 lita o ka wai maʻamau.

ʻO ke papa o ka hānau keiki ʻana a me ka mana o ka postpartum ma GDM

ʻO nā hoʻohālikelike i ka hana ʻaʻole nā ​​ʻano 1 a me ke ʻano type type 2, no laila, me GDM, maʻalahi ka hoʻopuka ʻana.

Hoʻokomo wale ka pilikia i kahi fetus nui loa, e koi ʻia kahi ʻāpana cesarean ma aneʻi.

ʻAi ʻia ka hānau kūʻokoʻa ʻana inā ʻaʻole i pōʻino ka kūlana i ka lā i hala.

Paipai ʻia nā hoʻohālikelike inā ʻaʻohe ʻenehana kūlohelohe a i ʻole ka neʻe ka wahine hāpai i ka manawa i kuhikuhi ʻia.

Ma hope o ka hānau ʻana, loaʻa paha ka pēpē koko haʻahaʻa. Hoʻohā wale ʻia ia e ka meaʻai.

ʻAʻole koi ʻia ka lāʻau lapaʻau.

ʻO kekahi manawa aia ka pēpē ma lalo o ka mālama ʻana o nā kauka. Pono kēia e hoʻoholo inā he hewa paha ma muli o kahi kuhi hewa i ka glucose i ka makuahine.

ʻO ka maʻamau ma hope o ka hoʻokuʻu o ka plasenta, i ke ʻano o ka wahine i ke ʻano maʻamau. ʻAʻohe mea lele i ka glucose koko. Akā naʻe, i ka malama mua, pono ʻoe e pili i kahi papaʻai ma mua o ka hānau ʻana o ka pēpē.

ʻO ka pēpē ka hope e hoʻolālā ʻia wale nō ma hope o kekahi mau makahiki. E kōkua kēia i ka hoʻōla o ke kino, a pale i ka hōʻea ʻana o nā pilikia nui.

Ma mua o ka hoʻoluhi ʻana, pono ia e hoʻomaʻamaʻa i ka hōʻike a haʻi i ka maʻi gynecologist e pili ana iā GDM i ka wā hānau mua.

ʻO ke ʻano o kēia maʻi i ka wā o ke kau ʻana o kahi keiki e hōʻike nei no ka ʻilihune o ka wahine i ka insulin. Hoʻonui kēia i ka loaʻaʻana o ka hoʻomohala ʻana i ka maʻi diabetes a me nā vascular pathologies ma hope o ka hānau keiki ʻana. No laila, he mea koʻikoʻi ke pale i nā maʻi.

Ma hope o ka hānau ʻana no 6-12 mau pule, pono ʻoe e hōʻoia hou i ka hoʻoneʻe o ke kō. ʻOiai inā he mea maʻamau, a i ka wā e hiki mai ana e nānā pono ʻia i kēlā me kēia 3 mau makahiki.

ʻO ka maʻi diabetes mellitus (GDM): kahi pōpilikia o kahi hāpai "momona". Nā ʻokoʻa no ke keiki, nā meaʻai, nā hōʻailona

Wahi a ka World Health Organization, aia ma mua o 422 miliona mau kānaka me ka maʻi maʻi o ka honua. Ke ulu nei kā lākou helu i kēlā me kēia makahiki. Ke hoʻonui nei, pili ka maʻi i nā poʻe ʻōpio.

ʻO nā hoʻopiʻi o ka maʻi hānai e alakaʻi i nā maʻi vascular koʻikoʻi, nā pēpē, ua pā ka retina, a paʻa ka make ʻana o ka ʻōnaehana. Akā hiki ke mālama ʻia kēia maʻi. Me ka hoʻouka kūpono, hoʻopau ʻia nā hopena koʻikoʻi i ka manawa. ʻAʻohe mea ʻē a ma hapai maʻii hoʻomohala ʻia i ka wā o ka hōʻea. Ua kapa ʻia kēia maʻi maʻi maʻi maʻi gestational.

• Hiki ke hoʻonāukiuki i ka maʻi diabetes
• He aha nā ʻano maʻi maʻi i ka wā e hāpai ana
• ʻO kahi hui
• He aha nā maʻi maʻi gestational i ka wā hāpai?
• Nā hopena no ke keiki
• He aha ka pilikia o nā wahine
• Nā hōʻailona a me nā hōʻailona o ke maʻi gestational i nā wahine hāpai
• ʻO nā hōʻike a me nā manawa maʻamau
• Hoʻomaʻamaʻa
• Insulin therapy: nā mea i hōʻike ʻia a me ke lawe ʻia ʻana
• Diet: ʻae ʻia a papa ʻia nā meaʻai, nā loina maʻamau o ka hānai no nā wahine hāpai me GDM
• Hōʻikeʻike menu no ka pule
• ʻO ka lāʻau lapaʻau
• Pehea e hānau ai: hānau kūlohelohe a ʻāpana cesarean?
• Kāohi i ka maʻi maʻi gestational i nā wahine hāpai

Ke hōʻike nei ka American Diabetes Association i nā hōʻike e 7% o nā wahine hāpai i ka hoʻomohala maʻi. I kekahi o lākou, ma hope o ka laweʻana, ua hoʻi ka glucose i ka maʻamau. Akā ma 60% ma hope o 10-15 mau makahiki, ua hōʻike ʻia ka maʻi diabetes type 2 (T2DM).

Hoʻohana ka gestation i kahi mea hoʻonāukiuki i ka hopena hoʻokūkū o ka glucose o ka maʻi. ʻO ka hoʻolālā o ka hoʻomohalaʻana o ka maʻi gestational e kokoke loa i T2DM. Hoʻokumu ka wahine hāpai i ka pale ʻana i ka insulin ma lalo o ka mana o nā ʻano o kēia ʻano:

• ka synthesis o nā hormone hāmeʻa i ka plenta: estrogen, progesterone, lactogen pl pae,
• ka hoʻonui ʻana o ka hana o ka cortisol i ka cortex adrenal,
• hōʻino i ka insulin metabolism a me kahi hoʻohaʻahaʻa i kona mau hopena i nā kiko,
• hoʻonui i ka hoʻonui ʻia o ka insulin ma o nā keiki,
• hoʻōla o ka insulinase i ka plasenta (kahi enzyme e wāwahi i ka hormone).

Pilikia ke kūlana i kēlā mau wāhine i loaʻa ka pale kino physiological (makeʻe) i ka insulin, ʻaʻole i hōʻike ʻia i ke ʻano maʻi. Hoʻonui kēia mau mea i ka pono o kahi hormone, beta cell o ka pancreas synthesize iā ia i kahi nui. Hoʻolaha, hele kēia i ka hōʻemi a me ka hyperglycemia i hoʻomau - e hoʻonui i nā pae o ka glucose koko.

Hiki i nā ʻano maʻi maʻi like me ka hānau ʻana. ʻO ke ʻano o ka palaka ʻana i ka manawa o ka hanana he ʻano ʻelua.

1. ma mua o ka maʻi i loaʻa ai ma mua o ka hāpai ʻana (ʻo ka maʻi type a me ke ʻano type type 2) he pre-gestational,
2. maʻi gestational diabetes (GDM) i nā wahine hāpai.

Wahi a ka mālama pono ʻana no GDM, aia:

• offset e ka ai
• hoihoi ʻia e ka lāʻauʻai a me ka insulin.

Aia paha ka maʻi maʻi ma ke kahua o ka uku a me ka hoʻokaʻawale. ʻO ka hōʻeha o ka maʻi maʻamau gestational e pili ana i ka pono e hoʻopili i nā ʻano ʻano like ʻole o ka mālama ʻana a me ka paʻakikī o nā hōʻahewa.

ʻO ka Hyperglycemia, i ulu i ka wā o ka hapai, ʻaʻole mau ke ʻano maʻi gestational mau. I kekahi mau hihia, hiki ke hōʻike i kahi mea maʻi type 2.

ʻO wai ka mea weliweli no ka hoʻomohala ʻana i ka maʻi maʻi i ka wā hāpai?

ʻO nā loli o ka hormonal e hiki ke hoʻonāukiuki i ka metabolism o ka insulin a me ka glucose e kū i nā wahine hāpai. Akā ke hoʻololi nei ka poʻe a pau i ka maʻi diabetes. Pono kēia i nā mea predisposing:

• nā kau momona a i ʻole ke kala ʻana,
• ke kō ʻole ke ahonui glucose
• piʻi kaomi gula i ka wā o ka hāpai ʻana,
• Pākuʻi helu 2 ma nā mākua hāpai
• ʻoi aku i nā makahiki 35
• polycystic ovary syndrome,
• ka mōʻaukala kolohe
• hanau ma ka mua o na keiki e kaupaona ana ma mua o 4 kg, a me nā malformations.

Akā ʻo ia mau kumu ke hoʻopilikia nei i ka hoʻomohala ʻana o ka pathology ma kahi ākea ʻē aʻe.

Ua manaʻo ʻia ʻo GDM i ka palola i kūkulu ʻia ma hope o nā 15-16 mau pule o ka hānau ʻana i kahi keiki. Inā hōʻike mua ʻia ka hyperglycemia ma mua, a laila aia i ka latine mellitus diabetes, i noho ʻia ma mua o ka wā hapai. Akā ʻike ʻia ka piʻi poʻokela kiʻekiʻe i ka lā 3ri. ʻO kahi hōʻailona like o kēia ʻano no ka maʻi maʻi gestational.

Ka maʻi kūlohelohe ma ka wā hānai ʻokoʻa mai ka maʻi maʻi gestational ma hope o hoʻokahi manawa o ka hyperglycemia, piʻi nui ke kōhula a ʻaʻole hoʻi e kulu. ʻO kēia ʻano o ka maʻi me ka hopena kiʻekiʻe e hiki ke hele i ka type 1 a i ʻole type 2 paha ma hope o ka hānau ʻana.

No ka hoʻoholo ʻana i nā loiloi o ka wā e hiki mai ana, aia nā makuahine postpartum a me GDM i ka manawa postpartum i loaʻa i kahi pae glucose. Inā ʻaʻole ia e hoʻohuli maoli, a laila hiki iā mākou ke manaʻo i ke ʻano o ka maʻi diabetes type 1 a i ʻole ua make.

ʻO ka pilikia o ka hiki ʻana o ke keiki e hilinaʻi ana i ka kiʻekiʻe o ka uku o nā pathology. ʻO nā hopena koʻikoʻi nui loa e nānā me kahi palapala uncompensated. Hōʻike ʻia ka hopena ma ka ʻōpiopio:

Eia nō hoʻi, nā keiki i hānau ʻia i nā makuahine me ka maʻi maʻi gestational i ka nui o ka hōʻeha o ka hōʻeha keiki, ka make o perinatal, nā maʻi cardiovascular, nā ala āpau o nā ʻōpū, nā calcium a me nā maʻi pālua o ka magnesium, a me nā pilikia neurological.

Hoʻonui ka GDM a i ʻole ka maʻi āpau i mua i ka hiki ke hiki i ka maʻi maʻi (gestosis), hōʻike nō ia iā ia iho i nā ʻano like ʻole.

• kōkuhi o nā wahine hāpai
• nephropathy 1-3 degere,
• preeclampsia,
• eclampsia.

ʻO nā kūlana hope loa e pono ai ka hoʻokipa ma ka waihona mālama mālama kino, hōʻino, a me ka lawe mua.

ʻO ka maʻi i pale ʻia me ka maʻi hānai i alakaʻi i nā maʻi o ka ʻōnaehana genitourinary - cystitis, pyelonephritis, a me ka recurrent vulvovaginal candidiasis. Hiki i nā maʻi āpau ke alakaʻi i ka maʻi o ka pēpē a i ka wā hānau.

ʻO nā hōʻailona nui o ka maʻi maʻi gestational i ka wā hāpai

ʻAʻole haʻi ʻia nā hōʻailona o ke maʻi gestational, ulu aʻe ka maʻi i kahi palau. Lawe ʻia kekahi mau hōʻailona o ka wahine no nā loli ʻano maʻamau i ka wā hāpai:

• luhi, nāwaliwali,
• makewai
• nā hoʻomaʻa pinepine ʻana
• lawa ka nui o ka momona me ka makemake nui.

Loaʻa pinepine ka hyperglycemia i ka loaʻa ʻana o ka hoʻokaʻawale ʻana o ke kaila glucose koko. Hoʻohana ʻia kēia ma kahi ʻano loiloi hou aʻe.

Ua hoʻonohonoho ke Kuhina o ke ola i kahi manawa no ka hoʻāʻo ʻana i ka hoʻokaʻa kō koko koko:

Inā hele i nā mea pili i ka hopena, e hoʻomaʻamaʻa ʻia ka hoʻokaʻawale glucose. Inā hōʻike ʻia nā hōʻailona o ke maʻi ma ka wā hāpai, hōʻike ʻia ka hoʻāʻo glucose.

ʻO kahi hōʻike hoʻokahi e hōʻike ana i ka hyperglycemia ʻaʻole lawa ia e hana i kahi maʻi maʻi. Pono ke kiaʻi ʻana ma hope o kekahi mau lā. Eia kekahi, me ka hyperglycemia hoʻolaha pinepine, ua kau ʻia ke kūkākūkā o ka endocrinologist. Hoʻoholo ke kauka i ka pono a me ka manawa o ka hoʻokaʻawale ʻaʻa glucose. ʻO ka maʻamau ka liʻiliʻi o 1 ma hope o ka maʻi ma hope o ka hyperglycemia paʻa. Hoʻomaopopo hou ka hōʻike hōʻike e hōʻoia i ka maʻi maʻi.

ʻO nā hopena hōʻike i hōʻike ʻia e pili ana i ka GDM:

• ka wikiwiki o ka wikiwiki ma mua o 5.8 mmol / l,
• hoʻokahi hola ma hope o ka hoʻokomoʻana i ka glucose - ma luna o 10 mmol / l,
• ʻelua hola ma hope, ma luna o 8 mmol / l.

ʻO ka manawa, e like me nā hōʻike ʻana, ke lawe ʻia nei nā haʻawina:

• kekipukapuka hemoglobin,
• hōʻike hoʻāʻo i ka kō
• kolamu a me ka ʻōlelo lipid,
• hōʻikeʻike koko ololi,
• coagulogram
• nā mekameka koko: progesterone, estrogen, plent lactogen, cortisol, alpha-fetoprotein,
• noiʻi ʻana i ka urine e like me Nechiporenko, Zimnitsky, ʻo Reberg hōʻike.

ʻO nā wahine hāpai i ka diabetes g pre-gestational a me gestational he ultrasound o ka pēpē mai ka 2nd trimester, dopplerometry o nā ipu o ka plasenta a me ke kaula umbilical, CTG maʻamau.

ʻO ke ʻano o ka hāpai ʻana me ka maʻi maʻi maʻi e pili ana i ka pae o ke kāohi ponoʻī o ka wahine a me ke hoʻoponopono ʻana o ka hyperglycemia. ʻO ka poʻe i loaʻa i ka maʻi diabetes ma mua o ka ʻāhaʻi, pono lākou e hele ma ke kula Diabetes, nā papa kūikawā e aʻo ai iā lākou pehea e ʻai ai i kaʻai, pehea e kūʻokoʻa ai i kā lākou kaohi i ka glucose.

ʻO ke ʻano o ke ʻano o ke kuʻuna, pono nā wahine hāpai i ka nānā ʻana:

• kahi kipa i ka gynecologist i kēlā me kēia 2 hebedoma ma ka hoʻomaka ʻana o ka maʻi gestation, hebedoma - mai ka lua aʻe,
• ʻO nā kūkākūkā endocrinologist i hoʻokahi manawa i kēlā me kēia 2 hebedoma, me ke kūlana decompensated - hoʻokahi manawa i hoʻokahi pule,
• ka nānā ʻana o ka mea lapaʻau - ʻo kēlā me kēia trimester, a me ka ʻikeʻana o ka pathology extragenital
• ophthalmologist - hoʻokahi manawa a pau a ma hope o ka hānau keiki ʻana,
• neʻe neurologia - ʻelua mau manawa no ka ʻōpū.

Hāʻawi ʻia ʻo ia i ka hoʻolaʻa ʻana no ka nānā ʻana a me ka hoʻoponopono ʻana i ka lāʻau lapaʻau no ka wahine hāpai me ka GDM:

• Ka manawa 1 - i ka mea i hoʻomaʻamaʻa mua a i ʻole ke kaohi ʻana i nā maʻi patolo,
• 2 mau manawa - i 19-20 mau wiki e hoʻoponopono i ke ʻano, hoʻoholo i ka pono e hoʻololi i ka regimen mālama,
• 3 mau manawa - me ke ʻano type type 1 a me ke ʻano type 2 - ma 35 mau hebedoma, GDM - i nā wiki 36 e mākaukau no ka hānau keiki ʻana a koho i ke ala o ka hānau ʻana.

Ma kahi hale haukapila, ʻo ka pinepine o nā haʻawina, ka papa inoa o nā hoʻokolohua a me ka pinepine o ka hoʻopaʻa ʻana i hoʻopaʻa ʻokoʻa. Pono ka nānā ʻana i kēlā me kēia lā i kahi hōʻike mimi no ka kō, ke koko, a me ke kaomi koko.

Hoʻoholo kū hoʻokahi ka pono o nā inikini insulin. ʻAʻole kēlā me nā hihia āpau o GDM e koi i kēia ala; no kekahi, ua lawa kahi ʻano lāʻau lapaʻau.

Nā hōʻailona no ka hoʻomaka ʻana i ka ineminika i nā hōʻailona ma lalo o nā hilo koko.

• ka hookeai ana i ke koko glucose me ka papa ʻaina ma mua o 5.0 mmol / l,
• hoʻokahi hola ma hope o ka ʻai ʻana ma luna o 7.8 mmol / l,
• 2 mau hola ma hope o ka nānā ʻana, glycemia ma luna o 6.7 mmol / L.

Hoʻolohe Hoʻopili ʻia nā wahine hāpai a me nā lactating e hoʻohana i nā lāʻau lapaʻau i nāʻaila, koe wale nō ka insulin. ʻAʻole hoʻohana ʻia ka insulins lōʻihi.

ʻO ke kumu o ka mālamaʻana i ka insulin e hoʻomākaukau ai i ka hana pōkole a me ka ultrashort. Ma ke ʻano maʻi maʻi 1, he ʻola bolus maʻamau e hoʻokō ʻia. No ka maʻi maʻamau a me ke GDM, hiki nō ke hoʻohana i ka kuʻuna kuʻuna, akā me kekahi o nā hoʻoponopono pilikino e hoʻoholo ana ka endocrinologist.

I ka poʻe hāpai wahine me ka mālama hewa o ka hypoglycemia, hiki ke hoʻohana ʻia nā pā o insulin, e hoʻomaʻamaʻa i ka hoʻokele ʻana o ka hormone.

Meaʻai no ka maʻi gestational i ka wā hāpai

ʻO ka mālama ponoʻana i kahi wahine hāpai i ka GDM pono e kūlike i nā ʻōlelo aneʻaneʻi:

• ʻAi a liʻiliʻi i ka liʻiliʻi. ʻOi aku ka maikaʻi ma ka hana 3 mau kīʻaha nui a me nā kīʻī liʻiliʻi 2-3.
• ʻO ka nui o nā haʻalulu paʻakikī o kahi 40%, protein - 30-60%, momona a 30%.
• E inu liʻiliʻi ma kahi o 1.5 mau punawai o ka wai.
• E hoʻonui i ka nui o ka fiber - hiki iā ia ke adsorb glucose mai ka ʻōpū a lawe aku.

ʻO nā huaʻōlelo maʻalahi e pili ana i ka maʻi ʻaʻai o ka maʻi gestational i ka wā hāpai

ʻO ka maʻi diabetes mellitus i ka wā hāpai (HD) - Ke ʻano o kahi maʻi maʻi e kū mai ana i nā wahine e pili pū ana me nā pilikia o ka hormonal ma ke kolu ʻoi ʻekolu. ʻO ke hopena, ala mai ke kōpaʻa koko ma hope o ka ʻai ʻana a hōʻemi ma luna o ka ʻōpū ʻole.

He mea hoʻoweliweli ka pathology i ke keiki, ʻoiai hiki ke hoʻonāukiuki i ka hopena o nā maʻi congenital.

Ke pale nei i kēia hana, ma nā hola 24-28 ua noi ʻia kahi wahine e hana i kahi loiloi no ka maʻi gestational, a me ia ke ʻano ke ʻano o ka maʻi maʻi, e pili ana i kekahi mau lula o ke kōʻaiʻai a me ke ʻano hana. I kekahi mau hihia, koi ʻia ka lāʻau lapaʻau, hiki ke kuhikuhi ʻia e ke kauka wale nō.

Koho ʻia ka maʻi maʻi gestational he code ICD o 10 - O 24.

ʻAʻole paʻa i nā kumu o ke maʻi gestational i nā wahine hāpai. Eia nō naʻe, ʻike i kahi poʻe loea i ka lula e hoʻomaka ana ka pathology e pili ana i ke kua o ka hana o ka hormonal. A ʻo kahi hopena, poloka i ka hana ʻana o ka insulin. Eia naʻe, ʻaʻole hiki i ke kino ke ʻae i ia ʻano, no ka mea, pono ka makuahine a me ka pēpē i ka glucose no ka hana maʻamau o nā maʻi a me nā ʻōnaehana. I ka hopena, he pono compensatory e hoʻonui i ka synthesis synt. ʻO kēia ka ulu ʻana o ka maʻi maʻi gestational.

ʻO nā pathologies Autoimmune kekahi o nā kumu kūpono e hiki ai HD. ʻO kēlā mau maʻi e hoʻopilikia kino i ka mokuʻāina o ka pancreas. ʻO ka hopena ka hoʻoemi ma nā synt synthesis.

Aia kekahi mau mea e hoʻonui i ka hopena o ka HD:

• Nā ʻilima
• ʻAleʻāina Ua hōʻike ʻia e nā kānaka ʻepekema ʻo kekahi mau ʻōiwi e loaʻa pinepine i ka maʻi gestational ma mua o nā mea ʻē aʻe. ʻO kēia mau ʻāpanaʻeleʻele, nā ʻAsia, nā Hispanics, a me nā ʻAmelika Hui Pū ʻIa.
• Hoʻonui ka piʻiʻana o ka glucose i ka urine.
• Hoʻoikaika glucose hoʻohaʻahaʻa.
• Hoʻolaha genetic. Inā hele kekahi ma ka ʻohana mai kēia ala kuʻuna, a laila e pili ana ka maʻi like me ka wahine.
• ʻO ka hānau ma mua, inā ʻoi ka nui o ke kaumaha o ka pēpē 4 kg.
• ʻO ka wā hapai ma mua ua hele pū ʻia me ka maʻi maʻi gestational.
• ʻO kahi nui o ka waiʻani amniotic.

Aia kekahi mau hōʻailona e hōʻike pololei ʻole i ka hiki ʻana o nā maʻi gestational: