Isifo Sikashukela Gestational (GDM): Izimbangela, Izimpawu, Izingozi Nokulashwa

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Ukukhulelwa kudinga ukunakekelwa okwengeziwe nokukhathazeka. Uma ungowesifazane okhulelwe onesifo sikashukela, kufanele uqaphele kakhulu. Isifo sikashukela esitholakala ngesikhathi sokukhulelwa sibizwa ngokuthi yisifo sikashukela sokukhulelwa. Lokhu kuzobeka ukukhulelwa kwakho esigabeni esinobungozi ngenxa yamathuba okuphuphuma kwesisu, ukukhubazeka kokuzalwa, ukuzala usana, ukuzalwa ngaphambi kwesikhathi kanye nengane enkulu ^[1] . Isifo sikashukela somzimba sihlukaniswe izigaba ezimbili, iClass A1 (engalawulwa ngokudla kuphela) kanye neClass A2 (idinga i-insulin noma imithi yomlomo ukulawula isimo).

Lapho owesifazane ekhulelwa, umzimba wakhe uhlangabezana nezinguquko eziningi futhi, angahle athambekele ezinkingeni ezithile eziqondene nabesifazane abakhulelwe. Lapho owesifazane enesifo sikashukela sokukhulelwa, amazinga kashukela egazini angakhuphuka kakhulu futhi lokhu kungadala ezinye izinkinga zombili ezinganeni nakunina ^[okubili] .

Ngenxa yalokho, enye yezinkinga ezizwakale kakhulu ngalezi zinsuku ngenkathi ukhulelwe ukwenzeka kwesifo sikashukela sokukhulelwa. Amazinga ama-hormone angenza izinga likashukela egazini likhuphuke lapho ukhulelwe, kukhuphule izingqinamba zokukhulelwa okuyinkimbinkimbi nobungozi obukhulu. Kodwa-ke, umuntu uhlale elulekwa ukuthi ahlale ethembekile noma ngabe kutholakala ukuthi unesifo sikashukela sokukhulelwa ^{[3] [4]} .

Isifo sikashukela sokukhulelwa senzeka kuphela ngesikhathi sokukhulelwa. Kukhombisa amazinga aphezulu kashukela ngesikhathi sokukhulelwa obejwayelekile ngaphambi kokukhulelwa. Isimo ngokuvamile siyelapheka uma usubeletha umntwana. Ngezinye izikhathi, kwandisa amathuba okuthi uthuthukise uhlobo lwesifo sikashukela sohlobo lwesibili, yize kungavamile ^[3] .

Izimbangela Zesifo Sikashukela Sokukhulelwa

Imbangela ngqo yokuthuthukiswa kwalesi simo ayikaziwa. Kodwa-ke, kuye kwaqinisekiswa ukuthi ama-hormone adlala indima enkulu ekwakhiweni kwalesi simo.

Ngesikhathi sokukhulelwa, amahomoni akhiqizwa yi-placenta abangela ukwakheka kwe-glucose egazini lakho, okuholela kusifo sikashukela sokukhulelwa ^[5] . Ngokufanelekile, amanyikwe akho angakhiqiza i-insulin eyanele yokusingatha lokhu. Kodwa-ke, kwezinye izimo, uma kungenjalo, amazinga eglucose egazi akhuphuka aholele kwisifo sikashukela sokukhulelwa.

Ziyini izimbangela zesifo sikashukela sokukhulelwa?

Izimpawu Zesifo Sikashukela Sokukhulelwa

Imvamisa, isimo asibangeli zimpawu noma zimpawu. Izimpawu ezibangelwe zingaba mnene futhi zimi ngale ndlela elandelayo ^[6] .

• Ukubona okufiphele
• Ukukhathala
• Kuhoshozela
• Ukoma ngokweqile
• Isidingo eseqile sokuchama

Kodwa-ke, kufanele kuqashelwe ukuthi iningi lezimpawu ezihambisana nesifo sikashukela sokukhulelwa zivame kakhulu futhi ziyabonakala kwabesifazane abaningi abakhulelwe. Lokhu kufaka phakathi izimpawu ezinjengokukhathala, ukoma okwandayo, isicanucanu nokuhlanza. Ngenxa yobuningi bezimpawu, zingase zinganakwa, zibeke bobabili umama nengane engcupheni ^[7] .

Izingozi Zesifo Sikashukela Sokukhulelwa

Kungenzeka ukuthi ube nesifo sikashukela sokukhulelwa uma

• unomlando wesifo sikashukela
• ube nesifo sikashukela sokukhulelwa ngesikhathi ukhulelwe ngaphambi kwesikhathi
• babekhuluphele ngaphambi kokukhulelwa
• wayenamazinga aphezulu kashukela egazini
• ube nomfutho wegazi ophakeme
• bake bazala ingane enkulu phambilini
• yazuza isisindo esiningi ngesikhathi sokukhulelwa
• bangaphezu kweminyaka engama-25
• balindele izingane eziningi
• waphuphunyelwa yisisu noma wazala ingane ishonile
• une-polycystic ovary syndrome (i-PCOS), i-acanthosis nigricans, noma ezinye izimo ezihlotshaniswa nokuphikiswa kwe-insulin ^{[8] [9]}

Izinkinga Zesifo Sikashukela Sokukhulelwa

Uma kwenzeka ukunganakwa nokunakekelwa, isimo singaba sibi kakhulu futhi siholele ezinkingeni ezingathinta impilo yengane nomama ^[9] .

Izinkinga eziphathelene nalesi simo zimi kanje:

• Ubunzima bokuphefumula
• Isisindo sokuzalwa esiphakeme
• I-dystocia ehlombe (ibangela ihlombe lengane ukuthi linamathele emgodini wokuzalwa ngesikhathi sokubeletha)
• Ushukela wegazi ophansi
• Ukulethwa ngaphambi kwesikhathi
• Ukwanda kwamathuba okulethwa kwabeletha
• Ukufa kwe-Neonatal
• Macrosomia

Ukuxilongwa Kwesifo Sikashukela Sokukhulelwa

Ngokuvamile kwenzeka phakathi nengxenye yesibili yokukhulelwa kwakho. Izimpawu zalokhu kungaba yisidingo sokuchama kaningi, uzizwe womile kakhulu kunokujwayelekile, uzizwa ulambile futhi uthambekele ekudleni ngokweqile. Yize lezi zimpawu zingahlotshaniswa nezimpawu zokukhulelwa zodwa, imvamisa ukutholakala kwesifo sikashukela sokukhulelwa kuhilela ukuhlolwa okwenziwe ngesikhathi sokuhlolwa kwakho kokukhulelwa okujwayelekile ^[10] .

Imvamisa, phakathi kwamasonto angama-24 kuya kwangama-28, udokotela wakho angakunika isivivinyo sokuhlola isifo sikashukela sokukhulelwa.

Ukwelashwa Kwesifo Sikashukela Sokukhulelwa

Uma kwenzeka kutholakala ukuthi unalesi sifo, uhlelo lokwelashwa luzoya ngamazinga kashukela nsuku zonke egazini.

Kuzodingeka ukuthi uvivinye ushukela wegazi ngaphambi nangemva kokudla.

Kwezinye izimo, imijovo ye-insulin izokwaziswa ukuthi isize ukulawula amazinga kashukela egazini ^{[ishumi nanye]} .

Umthelela Wesifo Sikashukela Sokukhulelwa Enganeni

Njengoba ingane yakho ithola izakhamzimba egazini lakho, ukuba nesifo sikashukela sokukhulelwa nakho kungayithinta ingane. Ingane igcina ushukela owengeziwe ngohlobo lwamafutha okwenza ikhule ibe nkulu kunokujwayelekile. Kungaba nezinkinga ezithile zokukhulelwa ezifana nokulandelayo ^[12] :

• Kungahle kube nokulimala kwengane ngesikhathi sokubeletha ngenxa yokukhula kosayizi wengane.
• Ingane ingazalwa inamazinga aphansi kashukela namaminerali egazini.
• Kungaba nokuzalwa kwangaphambi kwesikhathi.
• Ingane ingazalwa ine-jaundice.
• Kungaba nezinkinga zokuphefumula okwesikhashana.

Ngaphandle kwalokhu, ingane ingaba nethuba elikhulayo lokukhula ukukhuluphala nesifo sikashukela ezigabeni zakamuva zokuphila kwayo. Izingane ezinjalo kufanele zikhuthazwe ukuthi zigcine indlela yokuphila enempilo zisuka nje ^[13] .

Ukuphatha isifo sikashukela sokukhulelwa

Uma utholwe unesifo sikashukela sokukhulelwa, udokotela wakho uzokuqapha eduze. Uzocelwa nokuthi uvakashele udokotela wakho ukuyohlolwa njalo futhi kuzodingeka ukuthi wenze okulandelayo ^{[14] [ishumi nanhlanu]}

• Hlola amazinga kashukela egazini lakho okungenani izikhathi ezine ngosuku. Gcina umshini wokuqapha i-glucose egazini ngokuzenzakalela ekhaya.
• Yenza ukuhlolwa komchamo kwenziwa njalo ukubheka ukuba khona kwama-ketone. Lokhu kwenzelwa ukubheka ukuthi isifo sikashukela siyalawulwa yini.
• Ukuvivinya umzimba njalo. Ungafinyelela kubaqeqeshi abazokwazi ukukuqondisa kangcono mayelana nokuzivocavoca umzimba okufanelekile futhi okunempilo ukukwenza ngesikhathi sokukhulelwa.
• Funa izincomo zikadokotela wakho noma ze-dietician ukuze wakhe ishadi lokudla okunempilo. Ukudla kwakho kufanele kube njalo ukuze kunganyusi amazinga kashukela egazini.

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2. [okubili]I-American Diabetes Association. (2004). Ukunakekelwa kwesifo sikashukela, 27 (suppl 1), s88-s90.
3. [3]Umbazi, M. W., & Coustan, D. R. (1982). Imigomo yokuhlolwa kokuhlolwa kwesifo sikashukela sokukhulelwa.Iphephabhuku laseMelika lezokubelethisa kanye nezifo zabesifazane, i-144 (7), i-768-773.
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7. [7]UBuchanan, T. A., & Xiang, A. H. (2005). I-Gestational diabetes mellitus.I-Journal yophenyo lomtholampilo, i-115 (3), i-485-491.
8. [8]UBoney, C. M., Verma, A., Tucker, R., & Vohr, B. R. (2005). I-Metabolic syndrome ebuntwaneni: ukuzihlanganisa nesisindo sokuzalwa, ukukhuluphala komama kanye nesifo sikashukela sokukhulelwa. I-Pediatrics, i-115 (3), i-e290-e296.
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11. [ishumi nanye]Kamana, K. C., Shakya, S., & Zhang, H. (2015). I-Gestational diabetes mellitus kanye ne-macrosomia: ukubuyekezwa kwezincwadi.I-Annal of Nutrition and Metabolism, 66 (Suppl. 2), 14-20.
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