Isifo Sikashukela Emikhawulweni Yokukhulelwa: Okudlule
Isifo sikashukela esandulele esikhukhuleni sokukhulelwa esikhathini esidlule sasikhathazeka kakhulu. Kwaba nzima ukuthi omama abanesifo sikashukela bakhulelwe futhi baphathe abantwana abaphilile abaphila kahle. Ngaphambi kokufika kweziglucometers ezithwala ngesandla ezihlinzeka ngemiphumela esheshayo, izilonda ezilahlayo, imishanguzo engcono nemikhombandlela yokunakekelwa, kwakunzima uma kungenakwenzeka ukufeza nokugcina ukulawula okuhle kwe-glycemic ngesikhathi sokukhulelwa-kungabi yilapho ukulawulwa kwe-glycemic okudingekayo kunciphise izingozi .
Emuva ngawo-1950, kwakungavamile abantu abanesifo sikashukela abafaka i-insulin ukuba babe nezinto ezibukeka njenge-laboratory encane ephelele ngezingilazi zilazi ezidingekayo ukuba ziboshwe ngokuphuza utshwala nezinaliti ezikhaliwe ngogesi. Ngenxa yokuthi ama-glucometers ayengatholakali, amazinga kashukela egazi ayengeke afinyelelwe kalula noma ngokushesha.
Ngaleso sikhathi, kwakucatshangwa ukuthi abesifazane abanesifo sikashukela babengeke bakwazi futhi bangenabantwana. Amantombazane amaningi abelethwe ngoba ingozi ephezulu yokudilizwa kokuqala kwe-placenta yayingaqondakali. Ukungahambi kahle , ukukhubazeka kokuzalwa kanye ne-macrosomia esongela ukuphila (isisindo sokuzalwa esiphakeme) sasivamile. Ukuphila komama nomntwana kwakusengozini.
Isifo Sikashukela Emikhawulweni Yokukhulelwa: Namuhla
Ukulawulwa kwe-glycemic kanye nokunciphisa ingozi kulula ukuthola ulwazi lwanamuhla, imihlahlandlela yokuphatha namathuluzi. Ngokuhlelwa kahle, ukunakekelwa kwezinambuzane nokulawulwa okuqinile kwamazinga kashukela egazi, owesifazane onesifo sikashukela ekukhulelwe angaba nethuba elifanayo lomntwana onempilo njengowesifazane onesifo sikashukela.
Ukuhlolwa kwe-A1c laboratory kusetshenziselwa ukuhlola amazinga okudla kashukela egazi ezinyangeni ezingu-2-3 ezedlule. I-A1c ejwayelekile yowesifazane ongenayo isifo sikashukela ngesikhathi sokukhulelwa ngu-6.3%. Ukuphakama kwezinga le-A1c ngaphambi nangesikhathi sokukhulelwa, ukuphakama kwezingozi kuyabonakala. Ngokuvamile, kunconywa ukugcina ama-A1c ngaphansi kuka-6.0%, kodwa hhayi phansi kakhulu ukugwema ingozi enkulu ye-hypoglycemia (izinga eliphansi lokushukela kwegazi) noma imikhawulo yokukhula komntwana.
Khuluma nodokotela wakho mayelana nemigomo yakho ye-A1c.
Ukulawulwa okunamandla kwamazinga kashukela egazini kunciphisa ingozi yokuhlukunyezwa kokubeletha, kokubeletha nokubeletha. Amazinga kashukela e-emva kokudla kwegazi ahlobene kakhulu nesisindo sokuzalwa esiphakeme noma i-macrosomia, eyaziwa nangokuthi i-baby syndrome enkulu.
Isifo sikashukela ekukhulelweni kokukhulelwa kwandiswe ngenxa yokulawulwa kwegazi elimpofu
Ngaphambi nangesikhathi sokukhulelwa kokuqala : Ukungahambi kahle kanye nokuhlukumezeka okukhulu kokuzalwa.
Ngemuva kwamaviki ayishumi nambili ama-Gestation : Amazinga aphezulu e-insulini nama-glucose ebusweni, okungabangela ukukhula okusheshayo namafutha amaningi. I-Macrosomia ihlotshaniswa nesidingo esikhulayo sezingxenye eziphuthumayo ze-cearean, ukuhlukunyezwa kokubeletha , ukufa komntwana, kanye nezinkinga ze-neonatal.
Ngesikhathi sokukhulelwa kweLate : Izinga eliphakeme likashukela e-fetus lingabangela i-hypoxia (ukunganele oksijini okwanele) kanye ne-acidosis emntwaneni, okungenzeka ukuthi iyimbangela yokuzala okuphezulu kwabesifazane abanamazinga ashukela egazi alawulwa kahle. Kukhona ingozi ephakeme ye-preeclampsia, i-polyhydramnios (kakhulu kakhulu i-amniotic fluid) kanye nokusebenza ngaphambi kwesikhathi.
Ngemuva kokuzalwa : Izinsana ezine-macrosomia ngenxa yezinga eliphezulu likashukela egazini labesifazane lisesengozini enkulu yokuthuthukisa ukukhuluphala ngokweqile nokubekezelelana kwe-glucose ukubekezelelana. Ukulawulwa okubi ngesikhathi sokukhulelwa kungathinta nokuthuthukiswa kwengqondo nokuzikhandla kwengqondo.
Izingozi kumama : Ukuphakama kwamazinga kashukela egazini ekukhulelwe kungabuye kube nemiphumela yesikhathi eside, kuhlanganise nokuwohloka kwe-retinopathy ne-nephropathy.
Funda kabanzi mayelana nesifo sikashukela ekukhulelweni .
Imithombo
UKitzmiller, MD, MS, uJohn L; Vimba, BS, RN, CDE, Jennifer M; Brown, MD, Florence M; I-Catalano, MD, uPatrick M; Conway, MD, uDeborah L; I-Coustan, MD, uDonald R; Gunderson, RD, PHD, Erica P; Herman, MD, MPH, uWilliam H; Hoffman, MSW, LCSW, Lisa D; Inturrisi, RN, MS, CNS, CDE, Maribeth; Jovanovic, MD, uLouis B; Kjos, MD, uSiri I; Knopp, MD, uRobert H; UMontoro, MD, uMartin N; Ogata, MD, Edward S; Paramsothy, MD, MS, Pathmaja; Umfundi, RD, CDE, Diane M; Rosenn, MD, uBarak M; Thomas, RD, Alyce M; no-Kirkman, MD, M Sue. Ukuphatha Isifo Sesifo Sikashukela Sokukhulelwa: Ukufingqa Ubufakazi Nezincomo Zokubambisana Zokunakekelwa. Ukunakekelwa yisifo sikashukela ngo- May 2008 31 (5): 1060-1079.