Mukati
Fetal macrosomia: paunenge uchitarisira mwana mukuru
Kare, kubereka "mwana akanaka" kwakakurumbira. Nhasi, vanachiremba vanocherechedza kukura kwe "fetus" panguva yose yekuzvitakura. Fetal macrosomia, kureva uremu hwekuzvarwa hunodarika 4 kg, hunogona kunetsa kuzvara.
Chii chinonzi fetal macrosomia?
Fetal macrosomia inowanzotsanangurwa nehuremu hwekuzvarwa hunodarika 4000g. Inobata 5% yevachangozvarwa. Vacheche vane macrosome havangove vane matambudziko akawanda ehuremu kupfuura vamwe vacheche sezvavanokura. Izvo zvese zvinoenderana nekwakabva iwo mashoma mazana magiramu mamwe. Chiremba wevana anongove akanyanya kutarisisa kushanduka kwehuremu hwavo uye urefu hwemacurves.
chirwere
Pasinei nekufambira mberi kwehunyanzvi, kufanotaura fetal macrosomia hakusi nyore. Kupuruzira dumbu nekuyera kureba kwechibereko panguva yekuongororwa nanyamukuta kana gynecologist zvinopa chiratidzo chekukura kwe "fetus". Ngozi ye fetal macrosomia inogonawo kuonekwa panguva yeultrasound asi nzira dzekuverenga dzekufungidzira huremu hwe "fetus" dzakawanda uye hadzina kupusa.
Zvinokonzera
Chirwere cheshuga chemadzimai, chingave chiripo kana kuti chiri kukura panguva yekuzvitakura (gestational diabetes), ndicho chikonzero chikuru che fetal macrosomia. Isu tinoziva zvakare kuti kufutisa kwaamai kunowedzera ne 4 njodzi ye fetal macrosomia. Zvimwe zvinokonzerwa nengozi zvakaonekwawo: uremu hwekuberekwa kwaamai hwakakura, makore ekuberekwa kwemadzimai anopfuura makumi matatu nemashanu, nhoroondo ye fetal macrosomia mumimba yapfuura, kuwedzera kuwanda kwehuremu panguva yekuzvitakura, nguva yechinyakare.
Nzira yekudzikisa sei njodzi?
Gestational chirwere cheshuga chiri chinhu chikuru chengozi ye fetal macrosomia, vanaamai vane pamuviri vanofarirwa nayo (vanopfuura makore makumi matatu nemashanu, BMI inopfuura makumi maviri nemashanu, nhoroondo yemhuri yerudzi rwechipiri chirwere cheshuga, gestational diabetes, macrosomia) inotarwa pakati pemavhiki makumi maviri nemana kusvika makumi maviri nemasere eamenorrhea. "Oral hyperglycemia". Muedzo uyu unoitwa padumbu risina chinhu kutarisa kuti muviri unogadzirisa sei kutenderera kweshuga muropa. Iine matanho akati wandei: kuongororwa ropa pakusvika murabhoritari, kutorwa kwe35g yeglucose yemvura, kuchiteverwa nekuongororwa ropa kweawa imwe, kozoita maawa maviri gare gare.
Kana chirwere cheshuga che gestational chikaonekwa, vanaamai venguva yemberi vanobatsirwa nerutsigiro rwakakosha kuchirapa (chikafu chekudya, kuita mabasa emuviri akachinjika, nguva zhinji maultrasound ekutarisa kukura kwe fetal) uye nokudaro kuderedza kurema kwe fetal. Vakadzi vakanga vakafuta vasati vava nepamuviri kana kuwana mapaundi akawanda panguva yekuzvitakura vanoongororwawo zvakanyanya.
Kuzvara kana uchitarisira mwana mukuru
Fetal macrosomia inogona kutungamirira kumatambudziko panguva yekusununguka. Kudivi raamai, inokurudzira kubuda ropa panguva yekusununguka, zvirwere zvepamuviri, cervico-vaginal maronda, kuputika kwechibereko. Kudivi remwana, dambudziko rinowanzoitika uye rinotyiwa ishoulder dystocia: panguva yekudzingwa, mapendekete emwana anoramba akavharika muchiuno chaamai asi musoro wake watobuda. Chimbichimbi chakakosha chinoda kunyatsoita nzira yekubvisa mwana achangozvarwa pasina njodzi.
Tichifunga nezvenjodzi idzi, National College yeFrench Gynecologists uye Obstetricians yakapa mazano akati wandei:
- Kana huremu hwe "fetus" hunofungidzirwa hwakakura kupfuura kana kuenzana ne 4500 g, chikamu chekutanga chekubara chinoratidzwa;
- Kufungidzira kwe macrosomia kunogona kururamisa kuiswa kwekuberekwa mukati mevhiki ye39 yeamenorrhea;
- Sarudzo yechikamu checesarean kana nzira yemukadzi inofanira kuitwa pane imwe nyaya-ne-nyaya. Asi kana pane kuberekwa kwemukadzi, zvinokurudzirwa kudzidzira epidural analgesia uye kuve nechokwadi chekuvapo kwakakwana kweboka rekudzivirira (nyamukuta, chiremba wezvidziviriro, anesthesiologist uye chiremba wevana).