Kuva nemwana kugadzirira. Asati aita mwana, zvinokurudzirwa kuita preconceptional kushanya kuitira kuti aise mikana yese parutivi rwake kuti ave nepamuviri uye ave nepamuviri pasina matambudziko. Tarisa pane kukosha uye zviri mukati meiyi yakakosha kuongororwa hutano hwaamai.

Kuve nekuongororwa kwehutano pamberi pechirongwa chekuzvitakura kunokubvumira kufumura zvinhu zvinogona kukanganisa kubereka, kutanga nhumbu ine hutano uye kuona dambudziko ringaite iro nhumbu inogona kuwedzera. Muchidimbu, ndezvekuunza pamwe chete mamiriro ezvinhu ekuita pamuviri uye kuti mimba iyi iende zvakanaka sezvinobvira.

Kuongororwa kwepakutanga kunokurudzirwa neHaute Autorité de Santé (1) kune vese vakadzi vanoronga kuita mwana. Izvo zvakakosha muchiitiko chekunetseka kwakakomba kwekudzivirira panguva yekuzvitakura yapfuura kana yemwana anotambura nechirwere chakakomba. Kubvunzurudza uku kunogona kuitwa nachiremba ari kuenda, gynecologist kana nyamukuta, uye inofanira kuitika isati yatanga "bvunzo dzemwana", zvakanaka pamberi pebaba venguva yemberi.

Uku kushanya kwekutanga kunosanganisira zvikamu zvakasiyana:

• Un general examination (urefu, uremu, BP, zera).

Kunyanya kutariswa kunobhadharwa kuhuremu nekuti kuwandisa kunogona kuderedza kubereka uye kuwedzera njodzi yematambudziko panguva yekuzvitakura. Saizvozvowo, kuonda kwakanyanya kunogona kukanganisa kubereka. Kunyange vasati vafunga nezvekuita pamuviri, rubatsiro rwezvokudya zvinovaka muviri runogona naizvozvo kukurudzirwa.

• kuongorora gynecological

Kuti utarise kana chibereko uye maovari zviri zvakajairika, palpation yemazamu. Kana pasina smear isingasviki makore matatu, smear inoitwa sechikamu chekuongororwa gomarara rechibereko (3).

• kudzidza nezveobstetric history

Muchiitiko chekunetseka panguva yekuzvitakura yapfuura (hypertension, gestational diabetes, kusununguka nguva isati yakwana, kukura kunonoka mu utero, fetal malformation, kufa mu utero, nezvimwewo), matanho anogoneka anogona kuitwa kuti adzivise kudzokazve panguva yekuzvitakura kweramangwana.

• kuvandudzwa kwenhoroondo yezvokurapa

Muchiitiko chekurwara kana nhoroondo yekurwara (chirwere chemoyo, pfari, chirwere cheshuga, hypertension, kuora mwoyo, kenza mukuregererwa, nezvimwewo), zvakakosha kuongorora migumisiro yechirwere pakubereka uye pamuviri asiwo kune avo. wepamuviri pachirwere, pamwe chete nekurapa uye kugadzirisa sezvinodiwa.

• chidzidzo chenhoroondo yemhuri

Kuti utsvage chirwere chenhaka (cystic fibrosis, myopathies, hemophilia…). Mune zvimwe zviitiko, kubvunzurudzwa kwemajini kuchakurudzirwa kuitira kuti uongorore njodzi kune angangoita mwana asati aberekwa, mikana yekuongororwa uye kurapwa.

• kuongororwa ropa

Kugadzira boka reropa uye rhesus.

• kudzokorora kwe vaccinations

Kuburikidza nerekodhi yekudzivirira kana rekodhi yehutano. Kuongororwa kweropa kunotorwawo kuti kutariswe majekiseni ezvirwere zvakasiyana-siyana zvinotapukira: rubella, hepatitis B uye C, toxoplasmosis, syphilis, HIV, chickenpox. Muchiitiko chekusadzivirira kurwisa rubella, zvinokurudzirwa kubayiwa pamberi pemimba yakarongwa (3). Kune vanhu vanopfuura makore makumi maviri nemashanu vasina kugamuchira pertussis vaccine booster, kubata-up kunogona kuitwa kusvika kumakore makumi matatu nemapfumbamwe; inokurudzirwa zvakasimba kune vakaroorana vane chirongwa chevabereki vasati vatanga pamuviri (25).

• un kutariswa kwemazino anorairwawo asati abata pamuviri.

Panguva yekushanya kusati kwaitwa pamuviri, murapi anozotarisawo pakuongorora mararamiro evaviri ava kuitira kuti aone zvingangokonzeresa mbereko nemimba, uye kuvapa mazano ekuti vadzikise. . Zvakanyanya:

• kurambidza kunwa doro kubva panguva yekubata pamuviri
• rega kushandisa fodya kana zvinodhaka
• dzivisa kuzvirapa
• kuderedza kuratidzwa kune mamwe makemikari

Muchiitiko chekusadzivirira toxoplasmosis, mukadzi anofanira kutora matanho ekuzvidzivirira kubva panguva yekubata pamuviri: kunyatsobika nyama yake, kudzivisa kudya michero yakagadzirwa nezai, mishonga yakagadzirwa nemukaka (chizi kunyanya), mbishi, yakakangwa munyu kana kuputa nyama inotonhora, geza michero nemiriwo inoda kudyiwa isina kubikwa, geza maoko ako zvakanaka mushure mekurima gadheni, ipa shanduko yemarara ekatsi kune mumwe wako.

Uku kushanya kusati kwave nefungidziro kunopedzisira kwave mukana wekuti chiremba anyore folate supplementation (kana folic acids kana vhitamini B9) nekuti kuperevedza kwakabatana mu "fetus" nenjodzi yakawedzera yeneural tube closure abnormalities (AFTN). Kudzivirira kukanganisa kwakakomba uku, kuwedzera kunokurudzirwa pamwero we0,4 mg / zuva. Kunwa uku kunofanira kutangwa mukadzi achangoda kubata pamuviri uye kuenderera mberi kusvika mavhiki gumi nemaviri ekuzvitakura. Kune vakadzi vane nhoroondo yevachangobva kuberekwa kana vachangozvarwa vane AFTN kana avo vanorapwa nemimwe mishonga yeantiepileptic (iyo inogona kukonzera kushomeka kwefolate), kuwedzerwa kwe12 mg / zuva kunokurudzirwa (5).