Pakati pa mimba , chithokomiro chachikazi cha mkazi chiyenera kuwonjezera kuchuluka kwa mahomoni ake, kuti akwaniritse zosowa za amayi ndi kubereka mwana.
Malingana ndi malangizo a 2011 a American Thyroid Association kuti apeze matenda ndi chithokomiro cha matenda a chithokomiro Panthawi yoyembekezera ndi Postpartum, zina mwa kusintha kumeneku zikuphatikizapo zotsatirazi:
- Azimayi omwe alibe ayodini amalephereka, chithokomiro chimamera pafupifupi 10 peresenti pa kukula pakati pa mimba.
- Azimayi omwe ali ndi ayodini amalephera, chiberekero chimakula kuchokera pa 20 mpaka 40 peresenti pa kukula pakati pa mimba.
- Kawirikawiri, kupanga mai wa thyroxine (T4) ndi triiodothyronine (T3) kumawonjezeka ndi 50% panthawi ya mimba.
- Mayi wodwala ali ndi kuchuluka kwa peresenti ya 50 peresenti muyeso wake wa tsiku ndi tsiku.
Malingana ndi kafukufuku amene analembedwa m'magazini ya Journal of Clinical Endocrinology ndi Metabolism , pamene mayi akuchitidwa chithandizo cha hypothyroidism amakhala ndi pakati, ayenera kuwonjezerapo mlingo wake wa levothyroxine mlingo ndi mapiritsi awiri pa sabata, kuti asunge chithokomiro mwachibadwa (" euthyroid ").
Zotsatira Zophunzira
Malingana ndi kafukufukuwo, Kuwonjezera kwa mlingo wina wa mlingo pa sabata kungathe kuchepetsa kwambiri chiopsezo cha hypothyroidism mwa mayi ndikukumana ndi zofuna kuti mimba yoyamba imayika chithokomiro cha mayi.
Kusamalidwa ndi amayi omwe ali ndi mimba kumayambiriro kwa mimba kumakhala ndi chiopsezo chowonjezereka chopita padera, ndipo ngati mimba ikupitirira, imapanganso chiopsezo cha kubereka, kusanabadwe msanga, ndi kuchepa kwachinsinsi ndi kuchepa kwa ana pambuyo pobadwa.
Phunziro ili, amayi omwe anali hypothyroid adatsimikizira kuti ali ndi mimba ndipo anayamba kuchulukitsa mlingo wawo wa mankhwala a levothyroxine pakatha masabata asanu ndi awiri kapena asanu akuyembekezera - kapena masiku makumi anayi asanakwane.
N'zochititsa chidwi kuti pachiyambi pomwe, ophunzira 27 pa 100 alionse anali ndi chiwerengero cha TSH chapamwamba kuposa 5.0 , chomwe chimasonyeza hypothyroidism ndipo ndi chiwerengero chokhudzana ndi zotsatira zoipa zomwe zimakhudza mimba komanso chitsimikizo cha thanzi la mwana ndi chitukuko, ngati anabadwa.
Azimayi omwe adagonjetsa mankhwalawa adatha kumangomva mankhwalawa ndipo adatenga mankhwala ambiri a chithokomiro komanso amafunika kusintha mlingo wambiri. Ofufuzawa amati anthu omwe amatha kutsirizira pang'ono ndi awa:
- akazi opanda chithokomiro cha chithokomiro
- Azimayi omwe chiwerengero chawo cha TSH musanayambe mimba anali osachepera 1.5
- Azimayi amene amatenga 100 mcg / tsiku la levothyroxine asanakhale ndi mimba.
Phunziroli linagogomezera kufunika kozindikira kwa odwala mimba yoyamba ndi kuchitapo kanthu kwa odwala, kulembera kuti: "Pochita zamankhwala, amayi samakonda kupeza chithandizo chamankhwala asanakwane masabata 8 mpaka 12. Choncho, odwala okhawo ayenera kumvetsetsa kufunikira koyambirira ( levothyroxine) kusinthika nthawi yomweyo pamene akusowa msambo komanso kuyerekezera kwabwino kwa mimba. "
Malingana ndi ochita kafukufukuwo, kuchulukitsa mlingo wa levothyroxine ndi pafupifupi 30% -kuwonjezera mlingo uliwonse mlungu uliwonse -pamene mimba itatsimikiziridwa "imachepetsa kwambiri chiopsezo cha amayi omwe ali ndi zaka zitatu zoyambirira.
Kuwunika chithokomiro kumagwira ntchito kamodzi pamwezi kupyolera pakati pa mimba chifukwa ochepa mwa odwala angafunike kusintha kwa mlingo wa L-T4 kuti asunge ma oyenera a TSH. "
Kafukufuku wasonyeza kuti amayi ambiri omwe ali ndi kachilombo koyambitsa mahomoni amafunika kuchuluka kwa 50 peresenti pa nthawi yoyamba ya mimba pamene mwanayo akudalira amayi omwe amapanga-kapena mankhwala-chifukwa cha hormone yofunika kwambiri ya chithokomiro. Mahomoni a chithokomiro ndi ofunikira kuti mwana asamalidwe bwino, makamaka m'zaka zitatu zoyambirira. Pambuyo pa trimestre yoyamba, chithokomiro cha mwana chimatha kupanga mahomoni a chithokomiro, ndipo kudalira mahomoni a ma chithokomiro amachepetsa.
> Chitsime:
> Leila Yassa, Ellen Marqusee, Rachael Fawcett, ndi Erik K. Alexander. "Kutentha kwa Hormone Kwambiri Kumayambiriro kwa Mimba (THERAPY)." Journal of Clinical Endocrinology & Metabolism . Lofalitsidwa May 12, 2010.