Chifukwa chakuti mphumu imakhala yodziwika kwambiri ndi matenda, sizodabwitsa kuti 3 mpaka 8 peresenti ya mimba yonse imakhala ndi matenda a mphumu.
Mosiyana ndi zinthu zina zomwe mungaleke kumwa mankhwala panthawi yomwe ali ndi mimba kapena gawo loyambirira la mimba panthawi yomwe imakhala yovuta kwambiri chifukwa cha kutentha kwa thupi, asthmatics amafunika kumwa mankhwala kuti azikhala ndi mphamvu yabwino.
Izi zimabweretsa mafunso angapo okhudzana ndi chitetezo cha mankhwala a mphumu pa nthawi ya mimba, zomwe zimakhudza mimba ya mphumu yanu ya mphumu, ndipo kodi mphumu ingapangitse mimba kukhala pangozi yaikulu kapena kuvulaza mwana kapena ayi?
Kudzetsa Kudzala Pakati pa Mimba
Kugonana ndi mphumu kumatha kuganiziridwa ndi lamulo la magawo atatu - gawo limodzi mwa magawo atatu aliwonse a atsikana omwe ali ndi pakati ali ndi mphamvu zowonongeka, gawo lachitatu silinasinthidwe, ndipo gawo lomaliza lachitatu limakhala ndi zizindikiro zowonjezereka. Kawirikawiri, kupweteka kwanu kwa mphumu musanakwatire kumakhudzana ndi kuuma kwa mphumu pa nthawi ya mimba.
Ngakhale wina angaganize kuti pamene chiberekero chanu cha m'mimba chimawonjezeka kuti mphamvu ya mphumu ikhale yoipitsitsa, koma zimakhala zosiyana kwambiri ndi masabata omaliza a mimba. Pamene chifuwa cha mphumu chimawoneka bwino chinkawoneka kuti chimachita pang'onopang'ono pa nthawi ya mimba. Amayi omwe chifuwa cha mphumu chinafalikira, kuwonjezeka kunkapezeka pakati pa masabata 29-36 a mimba.
Zizindikiro zofunikira kwambiri za mphumu sizodziwika panthawi yopuma ndi kubereka. Zikuoneka kuti masewera a chifuwa amayamba kupezeka nthawi yachiwiri ndi yachitatu. Pomaliza, maphunziro a mphumu pa nthawi yomwe ali ndi mimba nthawi zambiri amatha kubwereza mimba yotsatira. Ngati mphumu yanu ikamakula panthawi yomwe mayi ali ndi mimba imayamba kusintha ndi mtsogolo mimba komanso mosiyana.
Zotsatira za Phumu pa Mimba
Kupweteka kwa mphumu yosautsa kungayambitse mavuto onsewa:
- Imfa ya mwana
- Kutumiza kwapakati
- Kulemera kochepa
- Kutuluka kunja
- Kutseketsa pamaso ndi pambuyo pa kubala
- Kusokonezeka maganizo
- Preeclampsia kapena kutenga mimba-kumayambitsa matenda oopsa
- Magazi amawombera kapena mapulmasi
- Ziphuphu zolakwika
- Hyperemesis, matenda osanza
- Ntchito yovuta
Zovuta izi zingakhale chifukwa cha kuchepa kwa mpweya wa oxygen. Kuchepetsa mpweya wa mpweya mumayi kungachititse kuchepa kwa mpweya wa mwana wanu komanso kuchepa kwa magazi ku pulasitiki. Palinso mavuto otheka kuchokera ku mankhwala a asthma.
Zonsezi sizinagwirizane ndi kusintha kwa mphumu kapena zotsatira za mphumu pa nthawi yomwe mayi ali ndi pakati ayenera kutanthauza kuti asthmatics sayenera kutenga mimba. Chithandizo chabwino ndi kuchepetsa kuchepetsa kuchepetsa mavutowa.
Pamene mphumu yanu imakhala yovuta kwambiri, mumakhala ndi mavuto aakulu a mphumu.
Kuchiza Kachifuwa Pakulera
Mankhwala anu a mphumu pa mimba si onse osiyana ndi mankhwala anu m'thupi losakhala ndi pakati. Mukusowa ndondomeko yochita masewera a mphumu , muyenera kuyang'anitsitsa zizindikiro zanu za mphumu nthawi zonse , ndikuyesera kupewa zokopa. Chimodzi mwa zinthu zomwe zimapangitsa kuyang'anitsitsa kukhala kovuta kwambiri pathupi ndikumverera kwafupipafupi odwala ambiri omwe ali ndi pakati amapezeka, makamaka pakapita mimba.
Kugwedeza ndi kuwomba, komabe sizimakhala zachilendo za mimba ndipo zingakhale chizindikiro cha kuchepa kwa mphumu. Zotsatira zake, kufufuza mphumu ndi chiwongoladzanja chachikulu kapena FEV1 ikhoza kukhala yodalirika kwambiri kwa wodwala wodwala. Kuchepa kwa zina mwa izi kungatanthauze kuphulika kwa mphumu.
Mofanana ndi wodwala wosakhala ndi pakati, kusiya kusuta n'kofunika kwa asthmatic yokhala ndi pakati. Kusuta fodya kumawonjezera chiopsezo cha kuwonjezereka kwa mphumu , koma kungachititse kuti mpweya wotsika kwambiri uwonjezeke ndipo zingathe kuwonjezera chiopsezo chokumana ndi mavuto ena omwe tatchulidwa kale. Mofananamo, kupeŵa zokhumudwitsa zina monga fumbi, dander , ndi fodya ndi gawo lofunika pa ndondomeko yanu.
Mankhwala Pa Mimba
Zokhudzana ndi chithandizo cha mphumu pa mimba, mafunso awiri kawirikawiri amayamba okhudzana ndi mankhwala.
1. Kodi kumwa mankhwala a mphumu kumakhudza mwana wakhanda?
2. Kodi mimba imasintha mphamvu ya mankhwala ena poyerekeza ndi mphamvu yake kudziko losakhala ndi pakati?
Mankhwala a mphumu pa nthawi yomwe ali ndi pakati adakhudzidwa ndi zotsatira zovuta zambiri monga:
- Kutuluka kunja
- Imfa
- Ziphuphu zolakwika
- Kuchepetsa kukula mu utero
- Kukula kosauka
- Kuchetsa magazi kutsika ku placenta
- Kuwonjezeka kwa chiopsezo chobwezeretseratu
Komabe, wina ayenera kudziwa kuti zotsatira zake zonse zimakhala zovuta mimba, ngakhale amayi omwe ali ndi pakati omwe alibe mphumu. Mwachitsanzo, congenital anomalies amapezeka 3% mwa kubadwa kwa amayi ndi amayi osauka 10-15% pa mimba. Mankhwala osokoneza bongo omwe alipo pakalipano amadziwika kuti A A ndi United States Food and Drug Administration. Izi zikanakhala mankhwala omwe amayendetsa maphunziro ofufuza azimayi oyembekezera sanathe kuwonetsa chiopsezo kwa mwana wakhanda pamene ali ndi mimba yoyambirira komanso palibe umboni wa chiopsezo pakapita mimba. Mankhwala ambiri a mphumu ndi alasi B kapena a Kalasi. Mankhwala a m'kalasi B amatanthauza kuti maphunziro a zinyama sanawonetseke kuti ali ndi chiopsezo cha mwana, koma palibe maphunziro ophunzitsidwa kwa amayi apakati. Zingathenso kutanthauza kuti panali zoopsa zina zomwe zimapezeka mu maphunziro a zinyama zomwe sizinavomerezedwe kafukufuku wa amayi m'zaka zitatu zoyambirira za mimba ndipo palibe umboni wa chiopsezo panthawi yomwe ali ndi mimba. Mu chiopsezo cha m'kalasi C sangathe kuchitidwa ndipo kugwiritsidwa ntchito kuyenera kuganiziridwa kokha ngati ubwino wa fetus ndi woopsa kwambiri. Mu kalasi D pali umboni wowopsa wa chiopsezo, koma kugwiritsa ntchito mankhwala kungakhale kovomerezeka ngakhale pangozi.
Kawirikawiri, amamva kuti mankhwala othandiza kuti akhale ndi vuto labwino la mphumu komanso kupewa zoopsa kuposa zoopsa zomwe zimagwiritsidwa ntchito nthawi zambiri pochiza mphumu. Albuterol, beclomethasone, ndi budesonide zonse zakhala zikugwiritsidwa ntchito pa maphunziro a asthmatics omwe ali ndi pakati ndipo maphunziro onse anali ndi zotsatira zolimbikitsa. Komabe, maphunzirowa ndi mouth prednisone sanakhale otonthoza. Palinso mankhwala ambiri omwe ali ndi vuto laling'ono pakati pa odwala omwe ali ndi pakati.
SABAs . Agonists ochita maseŵera afupipafupi amapereka chithandizo msanga kwa zizindikiro za mphumu monga:
Ngakhale kuchuluka kwakukulu kwa SABAs kwawonetsa zotsatira zowopsa kwa zinyama, palibe deta yomwe ikuwonetsa bwino zomwe zimachitika mthupi mwa anthu. Zofufuza zasonyeza kuti zasonyeza pang'ono ngati zili ndi vuto la albuterol. Komabe, maphunziro angapo ochepa kwambiri amasonyeza gastroschisis kapena vuto lobadwa kumene mwana wakhanda ali ndi zina kapena matumbo ake kunja kwa mimba chifukwa cha kutsekula kosavuta kumimba kwa mimba. Vuto lina ndi maphunziro ena omaliza omwe amasonyeza kuti zingakhale zovulaza ndizakuti ntchito ya SABA ikugwirizanitsidwa ndi mphumu yosatetezedwa yomwe ingabweretse mavuto ambiri omwe anawotchulidwa kale.
Nthawi zina amagwiritsidwa ntchito popewera antchito oyambirira. M'malo molemetsa mankhwalawa amaperekedwa kudzera mu IV. Zotsatira zoyipa zomwe zimawonedwa ndi njira iyi ya kayendedwe ndi hyperglycemia kapena shuga wambiri wa magazi. Pamene ana amabadwira nthawi zina amakhala ndi mtima wapamwamba, kutenthedwa, komanso kutsika kwa shuga chifukwa cha chithandizo cha amayi. Zotsatira zake zonse mwa khanda zimachiritsidwa ndipo kawirikawiri, zimasintha mofulumira kwambiri kotero sizili kutsutsana.
LABAs . Zochitika ndi a LABA ndi mimba ndi zochepa kwambiri kuposa a SABAs. Malinga ndi zomwe zilipo panopa zomwe zimaphatikizapo maphunziro a anthu ndi zinyama, sizikuwoneka kuti salmeterol kapena formoterol imachulukitsa chiopsezo cha kubereka kosabadwa. Pali zowona zaumunthu zowonjezereka ndi salmeterol. Chotsatira chake, ndi zomveka ngati mayi atenga mimba kuti apitirize LABA yomwe imafunika kuti athetse mphumu muyambeyo. Vuto lopwetekedwa mwadzidzidzi ndi mlingo wapang'ono kuphatikiza LABA / kutchulidwa steroid kumawoneka ngati ofanana ndi mlingo wapamwamba kwambiri wa ICS monotherapy.
Epinephrine. Chifukwa cha chiopsezo cha kuchepa kwa magazi kupita ku placenta, Gulu logwira ntchito pa umimba ndi mphumu limalimbikitsa mankhwalawa kuti agwiritsidwe ntchito pokhazikitsa anaphylaxis.
Oral steroids. Mankhwalawa amagwiritsidwa ntchito kawirikawiri poyembekezera mimba zosiyanasiyana kusiyana ndi mphumu. Zina mwazokhudzana ndi ntchito zawo zimaphatikizapo chiopsezo choyambitsa chithunzithunzi, matenda osokoneza bongo (makamaka a cleft palate), kutenga mimba, kutengeka kwa shuga, kuchepetsa kuchepa, ndi kulephera kubereka. Pali mayankho ochepa chabe. Mwachitsanzo, kafukufuku wina wasonyeza chiopsezo chowonjezeka cha palate ndi ena sanatero. Umboni umene umasonyeza kuti usanabadwe msanga pakati pa amayi omwe akulandira steroid pa nthawi yomwe ali ndi pakati ndi wolimba kwambiri. Potsirizira pake, kuthamanga kwambiri kwa magazi ndi mitsempha yapamwamba ya shuga kumadziwika bwino ndipo kotero, sizodabwitsa. Choncho zimakhala zovuta kwambiri. Pali chiopsezo chachikulu kwa amayi ndi fetus zokhudzana ndi kuchepa kwa mphumu. Kuopsa kwa mphumu yosalamulirika kungawonekere kuti pangakhale zoopsa za steroids kwa odwala ambiri.
Shalaids yosakaniza. Deta ya chitetezo cha mankhwala otsekemera a steroids pa nthawi ya mimba, monga choncho kwa odwala omwe alibe, ndizolimbikitsa kwambiri. Phunziro la registry la inhaled steroid budesonide ku Sweden amayi sanasonyeze chiopsezo choopsa cha malformations poyerekeza ndi anthu ambiri. Phunziroli silinasonyeze kuti pali mavuto omwe amabwera chifukwa cha kukula kwa fetus, kufa, kapena kutentha. Malingana ndi zomwe zapezazi ndizozimene zimaphatikizapo mankhwala otchedwa steroids omwe ali ndi chigawo cha B. M'mabuku ena monga kuwerenga, fluticasone sizinayambe kuchuluka kwa maubwenzi opatsirana pogonana poyerekezera ndi steroids ena opunditsidwa. Mayesero awiri omwe amachititsa kuti azitha kuyendetsa bwino amachititsa kuti mapapu apangidwe komanso kuchepa kwa chiwerengero.
Leukotriene amasintha. Monga mabungwe a LABA, gululi la mankhwala ali ndi zochitika zazing'ono zamakono mpaka lero, koma deta ndi montelukast ikukula. Deta yosindikizidwa kuchokera ku Registry Pregnancy Registry ndipo mayesero omwe akuyembekezera, akuyesedwa amasonyeza kuti chiwerengero cha zoberekera zosawonetsa sizikusiyana ndi anthu ambiri. Chotsatira chake, odwala omwe akufunikira leukotriene modifier angapangidwe bwino ndi montelukast mpaka deta yambiri ikupezeka kwa othandizira ena.
Anti-immunoglobulin E antioconal anti-immunoglobulin E antibody kapena omalizumab imavomerezedwa kwa odwala omwe ali ndi mphumu yosasamalidwa bwino yomwe ili ndi zigawo zapamwamba za IgE ngakhale kugwiritsa ntchito mankhwala osokoneza bongo. Ngakhale kuti simunayesedwe mozama mu maphunziro a zachipatala, chiwerengero cha mavuto monga kuperewera kwa amayi, kubadwa asanamwalire, ana aang'ono omwe ali ndi zaka zakubadwa, komanso congenital anomalies zimafanana ndi maphunziro ena a asthmatics omwe ali ndi pakati. Panopa palibe deta yokwanira yopangira malingaliro oti agwiritsidwe ntchito pathupi.
Methylxanthini. Pali chithandizo chachikulu cha zachipatala ndi theophylline ndi aminophylline pamene ali ndi mimba. Ngakhale mankhwalawa ali otetezeka kuchipatala, thupi lawo limasinthika kwambiri pamene ali ndi pakati komanso maulendo ayenera kuyang'anitsitsa. Njira zochepetsera zochepetsetsa ndizochepa kwambiri zomwe zimapangitsa kuti odwala omwe ali ndi pakati asakhale ovuta. Komanso, monga odwala omwe sali oyembekezera, steroid yosakaniza ndi yothandiza kwambiri kuti athetse mphumu. Chotsatira chake, mankhwalawa amalingaliridwa ngati othandizira ngati mankhwala sangathe kuperekedwa ndi steroid yosakanizidwa.
Immunotherapy. Ngakhale kuti sikoyenera kuyambitsa immunotherapy pa nthawi ya mimba, sizikuwoneka kuti mankhwalawa amachititsa kuti amayi kapena fetus awonongeke kwambiri kuti athe kupitilira pa nthawi ya mimba.
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