Mimba ndi Kutupa kwa Matenda

by Amber J. Tresca

Mimba ndi Zotsatirapo Mankhwala a IBD Ali ndi Mimba Ndi Mwana

Kodi Akazi Okhala ndi IBD Angakhale ndi Ana?

Inde, amayi omwe ali ndi matenda opatsirana kwambiri (IBD) akhoza kukhala ndi ana. M'mbuyomu, amayi omwe ali ndi IBD adalangizidwa kuti asamakhale ndi mimba. Koma njira zamakono zogwirira ntchito za IBD zakhala zikupanga kukhala ndi mwana wotetezeka kwa amayi ndi mwana. Kukhala ndi matenda aakulu pamene ali ndi pakati kumafuna kuyang'anila mosamala ndi madokotala oyenerera, koma mimba yabwino ndi mwanayo zonse zingatheke.

Kodi Amuna ndi Akazi Omwe Ali ndi IBD Akuchepetsa Ndalama?

Chiwerengero cha amayi omwe ali ndi IBD n'chofanana ndi amayi omwe ali ndi thanzi labwino. Azimayi omwe ali ndi matenda a Crohn amatha kuchepa. Kukonzekera za kulera ndi nkhani yofunika kwa mkazi aliyense, makamaka kwa omwe ali ndi IBD. Pali nthawi zina pamene mimba silingathenso kulangizidwa, monga nthawi yowonongeka kapena kumwa mankhwala ena.

Zakhala zikudziwika kwa zaka zambiri kuti sulfasalazine (Azulfadine), mankhwala omwe amagwiritsidwa ntchito kuti athetse vutoli, angapangitse kuti anthu osachepera 60 peresenti akhale opanda mphamvu. Chidutswa cha sulfa cha mankhwala chingasinthe umuna, koma zotsatirazi zimasinthidwa mkati mwa miyezi iwiri yosasiya ntchito yake. Kuchita opaleshoni ya Proctocolectomy mwa amuna kungayambitse vutoli, ngakhale izi sizikusowa.

Malinga ndi kafukufuku wina wa mabukuwa, kusabereka kumachitika mwa amayi makumi asanu ndi anayi (48%) omwe amachitidwa opaleshoni kuti athe kuchiza matenda a zilonda zam'mimba. Izi zikutheka chifukwa cha kupweteka mu mazira omwe amatha kuchitika pambuyo pa opaleshoni yaikulu.

Vuto la kusabereka pambuyo pa colectomy lakhala likufunsidwa kwa zaka zingapo chifukwa maphunziro ambiri adawonetsa mitundu yosiyanasiyana ya infertility. Palinso malipoti ofanana a kusabereka kwa odwala a Crohn's disease.

Kodi Mankhwala Amakhala Bwanji Pa Mimba?

Amayi ambiri amakhulupirira kuti ayenera kusiya mankhwala pamene ali ndi mimba, komabe kupitiriza kumwa mankhwala a IBD kumapereka mpata wabwino wopewera.

Mankhwala ambiri a IBD asonyezedwa kuti ali otetezeka kuti apitirize pa nthawi yomwe ali ndi mimba, ndipo ambiri akhala ndi mbiri yakale ya ntchito yoyenera ndi odwala. Dongosolo la Chakudya ndi Mankhwala (FDA) lakonza dongosolo la kugwiritsa ntchito mankhwala pa nthawi ya mimba (onani Table 1 m'munsimu).

Kafukufuku wasonyeza kuti mankhwala ambiri omwe amagwiritsidwa ntchito nthawi zonse pa chithandizo chokonzekera ndi maulendo apamwamba a IBD ali otetezeka kuti amayi apakati azigwiritsa ntchito. Izi ndi:

Sulfasalazine (Azulfidine [Mimba ya Bathupi B])
Mitundu ya mesalamine (Asacol, Pentasa, Rowasa [Bungwe la Mimba B])
Corticosteroids (prednisone [Mimba Yachikhalidwe B]
Zamoyo ( Remicade , Humira , Vedolizumab , Stelara , Cimzia )

Pamene Zofunikira Zothandizira Amankhwala Zizikhala Padera payekha

Mankhwala ambiri a IBD adzakhala otetezeka kuti apitirize panthawi yomwe ali ndi mimba ndipo sayenera kuthetsedwa popanda kulangizidwa mwachindunji ndi gastroenterologist ndi OB / GYN akudziwa bwino nkhani ya mkazi wa IBD. Palinso mankhwala ena omwe angafunikire kusintha pa nthawi ya mimba.

Immunosuppressants. Mankhwala osokoneza bongo azathioprine (Imuran [Gulu la Mimba D]) ndi 6-mercaptopurine (Purinethol kapena 6-MP [Mimba ya Mimba D] amawoloka pamtunda ndipo amatha kupezeka mu mitsempha ya magazi.

Komabe, akhoza kulangizidwa mosamala panthawi yomwe amayi ena ali ndi mimba kuti athetse vuto lalikulu. Mankhwalawa samapanga chiopsezo cha zilema zobereka.

Methotrexate ndi thalidomide. Methotrexate (Mimba Yoyembekezera Mayi X) ndi thalidomide (Mimba ya Pathupi X) ndi mankhwala awiri osamalidwa bwino omwe sayenera kugwiritsidwa ntchito panthawi yomwe ali ndi mimba monga momwe zimakhudzira mwana wosabadwa. Methotrexate imatha kuchotsa mimba ndi ziphuphu zosawonongeka, ndipo ziyenera kuthetsedwa miyezi itatu isanakwane, ngati zingatheke. Thalidomide amadziwika bwino chifukwa chosowa zofooka za thupi komanso ziwalo zina zikuluzikulu za thupi m'thupi.

Kugwiritsira ntchito kumaloledwa kokha ndi kulamulira kovuta kwa kubadwa komanso kuyesedwa kwa mimba mobwerezabwereza.

Metronidazole. Metronidazole ( Flagyl [ Bathupi B B]), antibiotic yomwe nthawi zina imagwiritsidwa ntchito pofuna kuthana ndi mavuto omwe amabwera ndi IBD, sizingakhale zotetezeka kwa mwanayo pambuyo pa trimester yoyamba. Kafukufuku wina adawonetsa kuti metronidazole sizinayambitse zolepheretsa kubereka m'miyezi itatu yoyamba, koma palibe maphunziro a nthawi yayitali omwe achitidwa. Mphindi za mankhwalawa zimagwiritsidwa ntchito panthawi yomwe ali ndi mimba, ngakhale kuti nthawi zambiri maphunzirowo akutsutsanabe.

Kodi Mimba imakhudza bwanji njira ya IBD?

Maphunziro a IBD pa nthawi yomwe ali ndi mimba amatha kukhalabe ofanana ndi momwe amachitira panthawi yomwe ali ndi pakati. Pa chifukwa ichi, ndikofunika kwa amayi omwe akulingalira kutenga mimba kuti azisunga kachitidwe ka mankhwala ndikugwira ntchito kuti abweretse, kapena kusunga, matenda awo mu chikhululuko.

Pakati pa amayi omwe ali ndi pakati pamene IBD yawo ikulephera kugwira ntchito, gawo limodzi mwa magawo atatu aliwonse amatha kusintha, gawo limodzi mwa magawo atatu likuwonjezereka, ndipo gawo limodzi mwa magawo atatu aliwonse sichikusintha mu matenda awo. Pakati pa amayi omwe ali ndi pakati pamene chiwindi chawo chikufalikira, awiri mwa atatu aliwonse adzapitirizabe kukhala ndi matenda opatsirana.

Madokotala akhoza kuthana ndi vuto lalikulu la IBD limene limapezeka pa mimba yosakonzekera kwambiri mwaukali. Kupeza chikhululukiro ndikofunikira kuti zitsimikizire kuti mimba ili ndi thanzi labwino.

Mphindi 1 - Zotsatira za mankhwala a FDA

Gulu	Kufotokozera
A	Maphunziro oyenerera, amayi omwe ali ndi pakati sanawonetseke chiopsezo chowonjezereka cha zovuta za fetus.
B	Maphunziro a zinyama samapereka umboni wosonyeza kuti mwanayo ali ndi vuto, komabe palibe maphunziro okwanira, okonzedwa bwino kwa amayi apakati. KODI maphunziro a zinyama amasonyeza zotsatira zovulaza, koma maphunziro okwanira, okonzedwa bwino mwa amayi apakati alephera kusonyeza chiopsezo kwa mwana wakhanda.
C	Kafukufuku wa zinyama asonyeza zotsatira zovulaza ndipo palibe maphunziro okwanira, okonzedwa bwino mwa amayi apakati. KAPENA Palibe maphunziro a zinyama omwe adachitidwa, palibe maphunziro okwanira, omwe amawongolera bwino amayi oyembekezera.
D	Zofukufuku, zokwanira, zoyendetsedwa bwino kapena zosamalidwa, mwa amayi omwe ali ndi pakati zakhala zikuwonetsa chiopsezo kwa mwana wakhanda. Komabe, kupindula kwa mankhwala kungapangitse kuti pakhale ngozi.
X	Zofukufuku, zowonongeka bwino kapena zowonongeka, zinyama kapena amayi apakati zasonyeza umboni wabwino wosonyeza kuti mwana ali ndi vuto lobadwa ndi mwana. Mtengo umatsutsana ndi amayi omwe ali kapena omwe angakhale ndi pakati.

Kodi Pali Vuto Lililonse Ndi Mimba Ndi IBD?

Kwa amayi omwe ali ndi matenda a zilonda zam'mimba ndi matenda a Crohn kukhululukidwa, kuopsa kwa kuperewera kwa amayi, kubereka komanso kubereka kwachilendo ndi zofanana ndi za amayi abwino. Matenda a Crohn pa nthawi yomwe ali ndi mimba kapena panthawi yomwe ali ndi mimba imakhudzidwa ndi chiopsezo chachikulu cha kuperewera kwa amayi ndi kubereka msanga.

Mafupa ndi vuto lalikulu kwa amayi apakati, ndi makumi asanu pa 50 aliwonse a amayi omwe akuvutika nawo. Zizindikiro za IBD, monga kutsegula m'mimba kapena kudzimbidwa, zingathe kuwonjezera chiopsezo cha ziwalo za m'mimba. Pali mankhwala angapo omwe angachepetse magazi monga Kegel, kuteteza malo oyeretsa, kutsalira kukhala ndi kuima kwa nthawi yayitali ndi kukweza katundu wolemera kapena mopitirira malire, pogwiritsa ntchito mafuta odzola kuti azizizira pang'onopang'ono ndikuchepetsanso mafupa, phukusi lachitsulo kuti athandizidwe kumoto, atakhala m'madzi otentha okwanira kuti aphimbe mafinya, ndi kugwiritsa ntchito suppositories kapena creams.

Kodi IBD Yambani Kupita Kwa Ana?

Anthu ena omwe ali ndi IBD akhoza kukhalabe opanda ana chifukwa chodera nkhaŵa kuti ana angalandire matenda awo. Zaka zaposachedwapa, pakhala malingaliro pa lingaliro lakuti IBD ikuyenda m'mabanja ndipo ingakhale yokhudzana ndi majini ena. Ochita kafukufuku alibe mayankho omveka bwino pankhani ya momwe IBD yapitilira pakati pa mibadwo, koma palinso kafukufuku wokhudzana ndi mwayi wa ana omwe adzalandira matenda awo.

Zikuwoneka kuti ali ndi chiopsezo chochulukira cha Crohn's disease kusiyana ndi zilonda zam'mimba, makamaka m'mabanja achiyuda. Komabe, ana omwe ali ndi kholo limodzi ndi Crohn's disease ali ndi chiwopsezo cha moyo wa 7 mpaka 9% wokhala ndi moyo, ndipo ndi 10% pangozi yokhala ndi mtundu wina wa IBD. Ngati onse awiri ali ndi IBD, vutoli liwonjezeka kufika pafupifupi 35%.

Kodi N'chiyani Chingakuthandizeni Musanalowe Mimba Kapena Pakati pa Mimba?

Akazi tsopano akulimbikitsidwa kuti matupi awo akonzekere kutenga mimba mwa kuwonjezera kudya kwa folic acid, kusiya kusuta, kuchita masewera olimbitsa thupi komanso kudya thanzi. Kwa amayi omwe ali ndi IBD, chinthu chachikulu chomwe chimakhudza nthawi ya mimba ndi thanzi la mwana ndizochitika za matenda. Kusiyiratu mankhwala alionse omwe angakhale ovulaza kwa mwana amene akukula akuthandizanso. Mimba idakonzekera kuti IBD ikhululukidwe imakhala ndi mwayi waukulu kwambiri wa zotsatira zabwino.

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