Zosintha Zosamba Zingakhale Zofunikira Kuti Zitsimikizire Matenda a Fetal
Matenda anu a chithokomiro ndi ofunika panthawi yomwe ali ndi pakati pamene imayambitsa kupanga mahomoni otchedwa triiodothyronine (T3) ndi thyroxine (T4), yomwe imathandiza kwambiri kuti ubongo wa mwana ndi ubongo wake ukhale wolimba.
Pa trimester yoyamba, mwanayo amadalira ma mayi omwe amachititsa mahomoni a chithokomiro, omwe amaperekedwa kudzera mu pulasitiki.
Pofuna kuthana ndi chosowachi, chithokomiro cha amayi chidzapitirira kuwonjezereka, zomwe zimapangitsa kuti chidziwitso chiwonjezeke. Izi kawirikawiri sizikudziwika ndipo sizidzasokoneza mimba mwa njira iliyonse.
Komabe, nthawi zina kukulitsa kumawoneka pa kafukufuku wa kuchipatala ndikumuuza mayiyo kuti ali ndi hypothyroidism , momwe matenda a chithokomiro sakuwombera timadzi timene timatulutsa chithokomiro chokwanira.
Kusintha kwa Ntchito ya Chithokomiro Pakati pa Mimba
Ngakhalenso pazochitika zachilendo, mimba imayambitsa nkhawa pa chithokomiro. Kufunika koonjezera kutulutsa kwa hormone ndi 50 peresenti kudzapangitsa kufalikira kwa dzikolo palokha. Azimayi okhala ndi chithokomiro choyenera, chikhochi chikhoza kuwonjezeka ndi 10 peresenti. Kwa amayi omwe ali ndi hypothyroidism, amatha kuwonjezeka paliponse kuyambira 20 mpaka 40 peresenti.
Pambuyo pa kukulitsa kwa geni palokha, pali kusintha kwa kupanga mahomoni komwe madokotala amatha kuwunika pogwiritsa ntchito mayeso a magazi.
Mmodzi mwa iwo ndi mayeso a TSH , omwe amayeza kuchuluka kwa homoni (stimulating hormone) (TSH) m'magazi. TSH ndi hormone yomwe imapangidwa ndi chida cha pituitary chomwe chimayambitsa kupanga T3 ndi T4.
Chifukwa chakuti chithokomiro chopezeka nthawi zonse chimakhala chosiyana pa nthawi yomwe ali ndi pakati, machitidwe a TSH adzasintha pamene amayi akuyenda kuyambira pa 1 mpaka 3 trimester.
Muzochitika zachilendo, mtengo wodalirika wa TSH ungakhale wochokera ku 0.2 mpaka 4.0 mlU / L.
Ngati chifukwa cha chithokomiro sichitha kupitirira pamene ali ndi pakati, phindu lidzagwa, kusonyeza dziko la hypothyroid. Zikatero, mankhwala opangidwa ndi chithokomiro adzatumizidwa kuti asinthe mahomoni a chithokomiro. Amayi amatha kuyang'aniridwa kuti aone ngati ali ndi kachilombo ka HIV.
Kuwunika TSH Pakati pa Mimba
Ma laboratories ambiri amapanga zigawo zawo zokwanira zitatu za TSH zomwe zikuwunikira zomwe akuganiza kuti ndizo "zachibadwa" pa nthawi iliyonse ya mimba. Ngati sichoncho, American Thyroid Association (ATA) imalimbikitsa kugwiritsa ntchito mizere yotsatirayi:
- Yoyamba katatu: 0.1-2.5 mIU / L
- Chachiwiri chachitatu: 0.2-3.0 mIU / L
- Chachitatu cha trimester: 0.3-3.0 mIU / L
Ngati muli ndi matenda a chithokomiro, muyenera kuyang'anitsitsa nthawi zonse mukakhala ndi pakati . Ngati matenda a chithokomiro akuthamangira m'banja lanu kapena muli ndi zizindikiro za matendawa, ndizofunika kudziwitsa dokotala wanu kuti muthe kuyang'anitsitsa ndi kuchiritsidwa.
Hypothyroidism
Ngati muli hypothyroid, nkofunika kwambiri kuti muzitha kuchiritsidwa musanafike komanso panthawi yomwe muli ndi mimba. Ngati mankhwala osasamalidwa kapena osatetezedwa akuchitidwa, hypothyroidism yanu ingayambitse mwana wanu mavuto.
Ngati mukupatsidwa mankhwala a hypothyroidism musaganize kuti mukhoza kupitiriza kuyendetsa matenda anu mofanana. Mukhozadi kuonjezera mlingo wanu wa mankhwala osokoneza bongo amodzi a 50% pokhapokha pamene mimba imatsimikiziridwa. Ndipotu kafukufuku akusonyeza kuti pakati pa 50 ndi 80 peresenti ya amayi a hypothyroid ayenera kuchita izi.
Malinga ndi malangizo a ATA, kuwonjezeka kumeneku kuyenera kuyamba kumayambiriro kwa masabata 4 mpaka 6 ndikupitilira mpaka masabata 16 mpaka 20 (pambuyo pake ntchito yanu ya chithokomiro idzaperekedwa mpaka nthawi yobereka).
Pankhani yowunika, kuyesedwa kwa chithokomiro kudzafunika kuthamanga milungu iwiri iliyonse pa theka loyamba la mimba komanso kachiwiri pakati pa milungu 26 ndi 32.
Pambuyo pa kubereka, mlingo wa mankhwala uyenera kuchepetsedwa kuti usanakhale ndi mimba ndi kuyang'anitsitsa pakapita masabata asanu pambuyo pa tsiku loperekera.
Matenda a Hashimoto
Matenda a Hashimoto , omwe amadziwikanso kuti Hashimoto's thyroiditis, ndi matenda omwe amachititsa kuti pang'onopang'ono athane ndi chithokomiro. Mankhwala a hyperothyroidism amayamba chifukwa cha matendawa ndipo amachiritsidwa mofanana pogwiritsa ntchito mankhwala omwe amachititsa kuti asinthe.
Chithandizo cha matenda a Hashimoto panthawi yoyembekezera kumaphatikizapo kuchiza hypothyroidism, ngakhale kuti tcheru iyenera kukhala yowonjezereka kuti tizisunga TSH pansi pa 2.5 mlU / L, ngati miyezo yapamwamba imakhudzidwa ndi kuwonjezeka kawiri pa chiopsezo chotenga padera.
Matenda a Manda
Nthawi zina, mayi amatha kugwira ntchito mopitirira muyeso osati chithokomiro chopanda mphamvu. Izi zimatchedwa hyperthyroidism, yomwe imayambitsidwa ndi matenda a Manda .
Ngati sichikutsatiridwa, hyperthyroidism ikhoza kubereka msanga kapena preeclampsia (kutenga mimba kumayambitsanso kuthamanga kwa magazi ndi kuwonongeka kwa thupi). Zowopsa kwa mwana zimaphatikizapo kulemera kochepa, kubadwa kwa mtima, zofooka zapachiyambi, ndi mavuto ena. Pa milandu yowopsya kwambiri, chiberekero chikhoza kuchitika.
Kuonjezera apo, ngati muli ndi pakati ndipo muli ndi matenda a Graves, muli pangozi yowonjezereka yakukhala ndi mawonekedwe aakulu a hyperthyroidism otchedwa chithunzithunzi cha chithokomiro . Amatchedwanso matenda a thyrotoxic, amachititsa kuti mahomoni a chithokomiro atulutse kwambiri omwe amachititsa kuti kuwonjezeka kwa magazi kuwonjezeke, kutentha kwa thupi, ndi kuthamanga kwa mtima.
Pakati pa mimba, Matenda a Graves amachiritsidwa ndi mankhwala otchedwa antityroid mankhwala otchedwa propylthiouracil m'kati mwa trimester yoyamba ndi wina wotchedwa methimazole kwa mimba yotsalayo.
Mawu Ochokera
Chinthu chofunika kukumbukira ndi chakuti ngati muli ndi hypothyroid ndipo mukukonzekera kuti mukhale ndi pakati, muyenera kulankhula ndi dokotala wanu za kusintha kwa mlingo wanu wa mankhwala a chithokomiro kuti mukhale ndi chonde. Cholinga ndicho kusunga mlingo wanu TSH pansi pa 2.5 mIU / L.
Muyeneranso kugwira ntchito ndi dokotala wanu kuti mutsimikizire kutenga mimba mwamsanga, ndipo pangani ndondomeko yanu kuti muwonjezere mlingo wanu wa mankhwala ndi ndalama zomwe mwakonzeratu mwamsanga mutangomaliza kutenga mimba yanu.
> Chitsime:
> Alexander, E ,; Pearce, E .; Brent, G ;; ndi. al. "2017 Malangizo a bungwe la American Thyroid Association la Kuzindikira ndi Kusamalira Matenda a Chithokomiro pa Mimba ndi Postpartum." Chithokomiro. 2017; 27 (3): 315-389.