Azimayi okhala ndi matenda a nyamakazi ndi matenda ena a rheumatic angadandaule chifukwa chokhala ndi pakati kapena kukhala ndi nkhawa ngakhale atatenga mimba. Azimayi ena omwe ali ndi matenda a rheumatic angalangizedwe kuti asakhale ndi pakati.
Azimayi Oyembekezera Amene Ali Ndi Matenda a Matenda a Matenda Odwala Matenda Aakulu
Chodetsa nkhaŵa chimabwera chifukwa chosadziŵa momwe mchitidwe wa chifuwa cha mayi udzakhudzire mimba komanso momwe mimba idzakhudzire vuto lake la nthendayi.
Ngati muli ndi nyamakazi ndipo muli ndi pakati kapena ngati mutenga pakati, pali zinthu zina zofunika kuzidziwa.
1. Poganizira mwatsatanetsatane ndi chithandizo chamankhwala choyenera, amayi omwe ali ndi nyamakazi kapena zizindikiro zina zimatha kukhala ndi mimba yabwino.
Ndikofunika kwa amayi apakati omwe ali ndi nyamakazi kuti azisamaliridwa ndi odwala matendawa kuti athe kusamalira mimba yawo komanso kuti adziwe kuti ali ndi kachilombo ka HIV . Mimba yabwino imatheka ndi njira ya timu, koma sikuti mimba iliyonse idzakhala yopanda mavuto.
2. Zotsatira za mimba pa matenda a rheumatic zimasiyana malinga ndi chikhalidwe.
Mimba yothandizidwa ndi matenda a nyamakazi , lupus , antiphospholipid , ndi zizindikiro zina zimakhala ndi maonekedwe osiyanasiyana komanso zosokoneza.
- Azimayi omwe ali ndi nyamakazi yamthempha amakhala ndi zizindikiro zomwe zimakula pakapita mimba koma zimayambanso kubereka mwanayo. Pa nthawi ya kusintha, zingakhale zotheka kuchepetsa kapena kusiya mankhwala a nyamakazi.
- Ndi lupus, kawirikawiri pali moto wofewa kwambiri umene umachitika panthawi ya mimba, komanso pambuyo pobadwa.
- Matenda a Antiphospholipid ndi matenda omwe amachititsa kuti thupi likhale ndi phospholipids kapena mapuloteni a plasma. Matendawa amatha kukhala ndi systemic lupus erythematosus kapena matenda ena a rheumatic disorder. Ndili ndi vutoli, pangakhale chiopsezo chowonjezereka chokhalira magazi, kuperewera kwa amayi, kapena kuthamanga kwa magazi pa nthawi ya mimba. Nthaŵi yozungulira yobereka ndi yovuta kwambiri.
- Kuchulukanso kwa magazi kumene nthawi zina kumayanjanitsidwa ndi scleroderma , Sjogren's syndrome , lupus, ndi antiphospholipid matenda angadwale kwambiri ndi mimba; Ndi chifukwa chake mimba sichilangizidwa ndi chikhalidwe ichi.
- Zina zowonongeka, kuphatikizapo scleroderma popanda pulmonary hypertension, polymyositis, dermatomyositis, ndi vasculitis , kawirikawiri sizimakhudzidwa ndi mimba ngati matendawa akuyendetsedwa.
3. Amayi omwe ali ndi matenda a impso okhudzana ndi vasculitis, scleroderma, kapena lupus ali ndi chiopsezo chowonjezereka cha matenda oopsa kwambiri komanso preeclampsia.
Mkwatibwi wokhala ndi mimba yabwino ndi wathanzi ndi wapamwamba kwambiri ngati impso ikugwira ntchito ndi kuthamanga kwa magazi ndizochilendo ndipo matenda a chifuwa sagwira ntchito kapena pakhululukidwa kwa miyezi isanu ndi umodzi asanatenge mimba. Izi ndi zofunika kwambiri kwa amayi omwe ali ndi lupus. Mosiyana ndi zimenezi, amayi omwe ali ndi ntchito zapsososale, kuthamanga kwa magazi osasinthasintha, ndi matenda opatsirana omwe amachititsa kuti asatenge mimba.
4. Khungu la mtima la Congenital lingathe kuchitika peresenti yochepa ya ana obadwa ndi amayi omwe ali ndi anti-Ro.
Mankhwala oletsa anti-Ro amapezeka kwambiri kwa odwala matenda a lupus ndi Sjogren. Mankhwalawa amayamba kufalikira kwa mwana ndipo amawononga mtima wa mwanayo, zomwe zimachititsa kuti mtima wake ukhale wochepa kwambiri.
Nthawi zina, mwanayo amatha kukhala ndi pacemaker. Azimayi omwe ali ndi anti anti-Ro ayenera kuyang'anitsitsa ndi kuyang'anitsitsa. Mankhwala a anti-La angakhalenso ovuta panthawi ya mimba.
5. Kutupa, komwe kumakhala kovuta pa matenda a rheumatic, ndipo mankhwala ena omwe amachiza kutupa akhoza kukhala ovuta panthawi ya mimba.
Zingakhale zabwino kuti amayi asamamwe mankhwala alionse mpaka atatha kumimba ndi kuyamwitsa. Sizomwe zili bwino ngakhale kuti ali ndi mimba ndipo ali ndi matenda a rheumatic, kotero kuti ayenera kuganiziridwa. Ngati mankhwala omwe akufunikira kuti matenda a mkazi asatengedwe amachotsedwa, chiopsezo cha matenda osadzitetezera chiyenera kuyeneredwa ndi zoopsa zomwe zingakhalepo kwa mwana wosabadwa.
6. Pali mgwirizano wokhudza mankhwala omwe amatsutsana ndi nthendayi ndi otetezeka kapena osagwiritsidwe ntchito pa nthawi ya mimba ndi lactation (kupanga mkaka).
Gulu la azimayi odwala matendawa, omwe ali ndi vuto la matendawa, amavomereza kuti mankhwala osokoneza bongo amavomereza kuti agwiritse ntchito panthawi ya mimba ndi lactation.
Mankhwala ovomerezeka kuti agwiritsidwe ntchito pa nthawi ya mimba ndi lactation ndi awa:
- NSAIDs (mankhwala osagwiritsa ntchito mankhwala opweteka) mpaka sabata 32
- Azulfidine (sulfasalazine)
- Plaquenil (hydroxychloroquine)
- Corticosteroids (pansi pa 10 mg ngati n'kotheka)
Mankhwala ovomerezeka kuti agwiritsidwe ntchito pa nthawi ya mimba koma akukambiranabe pa nthawi ya mimbayi ndi awa:
- Cyclosporine A
- Imuran (azathioprin)
Mankhwala omwe sali ovomerezeka pa nthawi ya mimba ndi lactation ndi awa:
- Methotrexate
- Arava (kumbuyo)
- CellCept (mycophenolate)
- Cytoxan (cyclophosphamide)
- Mankhwala oletsa anti-TNF
- Rituxan (rituximab)
(Zindikirani: Mankhwala oteteza anti-TNF amavomerezedwa kuti ndi otetezeka panthawi yomwe ali ndi mimba komanso mwina lactation.)
7. Akazi omwe akuganiza kuti ali ndi mimba ayenera kukhala ndi chifuwa chachikulu kwa miyezi itatu kapena 6 asanayambe kutenga mimba.
Ndikoyenera kuti amayi onse omwe ali ndi matenda a rheumatic athe kulangizidwa ndi rheumatologist ndi katswiri wa tizilombo asanayambe kutenga mimba. Momwemonso chiopsezo chawo chokhala ndi mavuto chingayesedwe ndi ndondomeko yothetsera matenda a chifuwa chachikulu komanso mimba ikhoza kukhazikitsidwa bwino.
8. Amayi omwe ali pa chiopsezo chachikulu chotengera vutoli ayenera kuwona kuti a rheumatologist awo amatha miyezi itatu kuti akhalebe oyenera ndi kuyang'anira matenda.
Azimayi amene amaonedwa kuti ali ndi chiopsezo chachikulu chotenga vutoli ayenera kukhala ndi timu yotetezeka yomwe imakhala ndi mimba yoopsa kwambiri. Maulendo obwereza komanso kuwunika kawirikawiri kudzafunika pamene mimba ikupita. Zinthu zomwe zimapangitsa kuti mimba ikhale yoopsa kwambiri ndi:
- Kuwonongeka kwa impso
- Mkhalidwe wa mtima
- Kupweteka kwambiri kwa magazi
- Matenda a m'mapapo opatsirana
- matenda ovuta kwambiri
- In vitro fetereza
- Zobadwa zambiri
- Vuto loyambitsa vutoli
Zotsatira:
Mimba ndi Rheumatic Disease. American College of Rheumatology. March 2014.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Pregnancy-Rheumatic-Disease
Kelley's Textbook ya Rheumatology. Kusindikiza kwachisanu ndi chinayi. Elsevier. Mimba mu Rheumatic Diseases. Mutu 39.
Zomwe Zimapangidwira Zokha. Chikhalidwe cha zojambula: Kubalana ndi mimba mu matenda a rheumatic. May 2015.
http://www.ncbi.nlm.nih.gov/pubmed/25555818