Izwi rokuti "kuberekwa kwakanyanyisa" muchivande chinowanzoshandiswa kureva kunzwisisana kwegadziriro yekuita muviri, umo rufu rwekuberekwa runoitika. Pathology inokura mangwanani, kusvika masvondo makumi maviri, asi mune dzimwe nguva, chirwere ichi chinogona kuitika mukati mechipiri uye chechitatu. Chinhu chisingadziviriki chinogadziriswa chechirwere ndechokubvisa pamuviri kamwechete.
Nei kutora mimba kuchimisa?
Vanachiremba havagoni kupa mhinduro isina kufanirwa kumubvunzo, nei fetus inomira. Ikoko kunogona kuva nezvinhu zvakawanda zvinogona kukonzera chirwere ichi. Kazhinji, vanachiremba vanotaura panguva imwechete pamusoro pezvikonzero zvakasiyana siyana zvakakonzera kupera kwekuita pamuviri, nokuti hazvibviri kuziva kuti chii chakakonzera kukurudzira. Pakati pezvikonzero zvinowanzokonzera chirwere, vanachiremba vanosiyanisa:
- utachiona uye hutachiona huri mumuviri;
- kusawirirana kweR Rh chinokwana fetus uye amai;
- kukanganisa kwehutano hwekuvhara ropa mumutumbi wamai anouya;
- kuvapo kwechirwere chechibereko;
- kuvapo muna anamnesis kubvisa pamuviri;
- miitiro yakaipa (doro, nicotine);
- zvinowanzotambudza mamiriro;
- kuita IVF .
Kubata pamuviri pamuviri pakutanga-zvikonzero
Muzviitiko zvakawanda, hutachiona hunokura mumatanho ekutanga ekutambisa intrauterine embryo. Muchiitiko ichi, chinonyanya kukonzera chiremba vanachiremba vanoti zvirwere zvinotapukira zveamai:
- furuwenza;
- herpes;
- chlamydia;
- mycoplasmosis;
- toxoplasmosis;
- ureaplasmosis.
Kutsanangura chikonzero nei fetus inopera mumatangiro ekutanga ekudzivirira, vanachiremba pane imwe yenzvimbo dzekutanga vanoisa mberi uye zvirwere zvepabonde mumucheche. Kakawanda zvinoshandisa maitiro ekugadzirisa intrauterine yenhengo nemaitiro. Somugumisiro, huipi hwemwoyo nemagadziriro ehutano hunobudirira, izvo zvisingawirirani nehupenyu. Mwana anofa, uye pamuviri unomira.
Kubata pamuviri muchechi chechipiri - zvikonzero
Kuberekwa kwakakonzerwa nehupiri katatu kwakanyanya. Kufambira mberi kwake kunowanzobatanidzwa nemafambiro evakadzi vane pamuviri pachavo. Kusapindirana nehurumende yakagadziriswa, kusaregererwa kwekugadzwa kwechiremba, zviitiko zvinowanzoitika uye kushungurudzika kunokanganisa hupenyu hwakanaka hwomukadzi uye nzira yekuzvitakura. Somugumisiro wemamiriro ezvinhu akadaro, kazhinji kuwedzera kwezvirwere zvisingaperi zvinowanikwa. Pakati pezvipupuriro zvinogona kukonzera kupera kwekuita pamuviri:
- kushungurudza kwemwoyo yematambudziko;
- kidyo chirwere;
- kukanganisa mune endocrine system;
- chirwere cheshuga.
Kubata pamuviri pamuviri wechitatu - zvikonzero
Apo kubata kwechando kunowedzera mumutatu wechitatu, zvinokonzera zvinowanzobatanidzwa nekuchinja kamwe kamwe mune hutano hweamai. Kazhinji, hutachiona hunoitika kune vakadzi vane zvirwere zvisingaperi zvekuvhiringidza mumuviri. Kutungamirira pakuguma kwekuita pamuviri pane imwe nguva inotevera, kuvhiringidzika kune endocrine system zvinogonawo kuitika: chirwere cheshuga mellitus, kusagadzikana kwehutachiona hwetachiona - kunowanzoonekwa sechikonzero chinokonzera chirwere. Zvisinei, hatigoni kuisa zvachose zvikonzero zvisingaoneki zvekufambisa:
- dambudziko remuviri;
- kudhakwa;
- kushungurudzika kukuru;
- zvinodhaka zvinodhaka.
Nzira yekunzwisisa sei kuti fetus ichandowa?
Chimwe chinhu chehutachiona ndechokushayikwa kwezviratidzo mumavambo ekutanga. Zviratidzo zvekutanga zvekudzivirira kwechando zvinogona kuonekwa mumazuva mashomanana, uye shure kwevhiki mbiri. Kuti uone kuti kupopotedzana kwenguva yakareba, mukadzi ane pamuviri anofanira kunyatsoteerera hutano hwake, kuziva zviratidzo zvekudzivirira kwechando. Pakutanga, kunyange kunyunyuta kwakakwana kunokosha kutaurira chiremba anoenda.
Kuberekwa kwakanyanya - zviratidzo mumutatu wekutanga
Muzviitiko zvakawanda, pamuviri wakanyanyisa unofambidzana nekuonekwa kwezviratidzo zvakananga zvinobatsira kufungidzira kuti zvakaipa. Zviratidzo zvehutano hwakanyanyisa mumatangiro ekutanga hauna humwe hunokosha, saka vanaamai vanogona kuzvitora kuti zviitike kwenguva pfupi. Zviratidzo zvekutanga zvekuzvitakura zvakanyanya munguva pfupi zvinoratidzika sezvizvi:
- Kupera kwekurumidza kwe toxicosis - kuramba kusingagumi uye kusuruvara, kwakashungurudza vakaroorana vane pamuviri kwemazuva mazhinji, vakarasika.
- Kuonekwa kwepakakoromora kunorwadza mumimba pasi, izvo zvisingachinji, ndezvishoma uye zvinogona kuwedzera.
- Kunyangarika kwekudzivirira kwezvinyoro zvinyuchi uye kuderera kwehuwandu hwavo - bvudzi rinova kukura kwakafanana, kunzwisiswa kweikopi kunoderera.
- Kubuda ropa kunobva kumudzimai - kunobatanidza nekurambwa kwei fetal egg.
- Kupera zvishoma kuderera kwekushisa kwebasal - nekutanga kwekuita pamuviri, chiratidzo ichi chinotarirwa pamadrigiri 37, asi nekupera kwakaderera kusvika 36.7-36.8.
- Kuwedzera kwekushisa kwemuviri, chills, kushaya simba kunokonzerwa nokuparadzwa kwemuviri we fetus.
Kuberekwa kwakakosha mune yechipiri trimester - zviratidzo
Kana iyo fetus yakafa mu-trimester yechipiri, zviratidzo zvemukadzi zvakangofanana nezvakanyorwa pamusoro apa. Panguva imwecheteyo, zviratidzo zvakadai sekumiswa kwechimbichimbi chekufamba kwe fetus kuwedzerwa kwavari. Kana pakutanga amai vakatarisira vachinge vaona kudengenyeka kwemazuva ose uye fetal flips mudumbu, zvino mukurudzirwa kwehutano ivo vasipo. Kuti uongorore kudarika kwekanguva uye kutora matanho, vanachiremba vanokurudzira kuti vauye nesangano rezvehutano kana fetus isingazviiti yakanzwika kwemaawa anopfuura gumi mushure.
Kuberekwa kwakakonzerwa nechitatu chetatu
Kuti urege kunetseka, amai vese vekupedzisira vanofanira kufungidzira kuti hutachiona hunozviratidza sei mumagariro akazotevera uye chii chinoratidza kana fetus iri yakaoma. Penguva refu, mwana haasisiri kushingaira, anoita zvishomanana kufamba, saka kubata pamuviri kwevakadzi kunogona kukanganisa nokuda kwechiitiko chepanyama chinowanzoitika. Zvisinei, muzviitiko zvizhinji, kusina kufamba kunobatanidzwa ne:
- spotting;
- kuponda marwadzo mumimba pasi;
- kurutsa kukuru;
- kuwedzera kwekushisa kwemuviri;
- kuora kwehupenyu hwakanaka;
- kuderedza ropa;
- kuwedzera kwenhamba yemwoyo;
- kuora mwoyo (uye kubuda ropa kwakanyanya).
Kuberekwa kwakanyanya - kuongororwa
Muzviitiko zvakawanda, zviri kumudzimai kuti aone kana mwana wacho anenge akaoma, mukadzi haagoni. Mukadzi ane pamuviri anogona kungofungidzira kukura kwehutachiona, nokuda kwekuziva kuti zvakakosha kuti uone chiremba. Apo kuberekwa kwechando kunowedzera pane imwe nguva, gare gare gynecologist yake inogonawo kugadzirisa panguva yekuongorora nguva dzose. Kuti asimbise kufunga kwake, chiremba anopa zvinotevera zvinongororwa:
- kuongororwa ropa nekuda kweHCG - ne fetal fading, kukanganiswa kwehomoni iyi muropa remukadzi ane pamuviri yakaderera pane mitemo inogadziriswa neshoko rekuita pamuviri;
- kusawirirana kwehukuru hwechibereko kwekanguva;
- kusabatwa kwepalpitation ye fetus panguva yekugadziriswa kuburikidza nekunze kwemuviri pamadziro.
Kuberekwa kwakanyanya - ultrasound
Iyi nyanzvi yekuongorora inokubvumira kuti uongorore hutachiona pakutanga kwekuita gestation. Kubata nguva isati yasvika pamatambo ekutanga kunogona kuonekwa kare mavhiki 6-7 ekudzivirira. Munguva yekuongororwa kwechibereko chechibereko, chiremba anoita kugadziriswa kwekupedzisira pamusana pekutsva kwe ultrasound. Kuberekwa kwechando kunonzi kana:
- iyo fetal egg inorema 20 mm kana kupfuura, asi hapana embryo (anembrionia) mairi;
- hapana maitiro ekushaya mwoyo mukati memubhesi yakakura kupfuura 5 mm (transvaginal ultrasound) kana 9 mm (pamwe nekuongorora kwechirwere chepabonde).
Kuberekwa kwakanyanya - miedzo
Chidzidzo chikuru chema laboratori nokuda kwekudzivirirwa kwakanyanyisa kuongororwa ropa kweHCG. Kufungisisa kwaro pamashoko maduku kunoramba kuchikura. Zvisinei, hCG muhutano hwakafa huri kuderera, uye mune dzimwe nguva, simba rekuwedzera kwaro muropa haringarangarirwi. Kuti pakupedzisira zviongorore, mukadzi ane pamuviri anopiwa kuverengerwa kuongororwa kakawanda, neawa rimwe zuva, uye ultrasound inoitwa.
Kuongorora kwefa yakafa
Histology yemucheche mushure mekuberekwa kwechando kunosanganisira microscopy yemuenzaniso wezvinyama zve fetal membranes ye embryo. Ichi chidzidzo chinangwa chekusimbisa chikonzero chakakonzera chirwere. Kubva pamigumisiro yekuongororwa, mukadzi anogona kugoverwa zvimwe zvidzidzo kuti avasimbise. Pakati pavo:
- kuongororwa kweTORCH utachiona - kunoitwa mazuva mashomanana mushure mekuchera;
- kutsunga kwehutano hwemakemoni evanhukadzi - progesterone, estradiol, thyroxine;
- an immunogram;
- smear on the microflora;
- kutsunga kwezviratidzo zvikuru zveropa coagulation system - fibrinogen, prothrombin , antithrombin.
Kucheneswa kwemimba yakaoma
Kupindira kwekuvhipisa hakusi iyo chete nzira yekurapa pamuviri wakaneta. Penguva pfupi kwazvo, kubviswa kwemufi fetal egg inogona kuitwa nekushandisa mishonga inodzinga. Kuchenesa mushure mokunge pamuviri wakanyanyisa kunoratidzwa kana chirwere chinowanika panguva yevhiki 7 kana gare gare. Uku kupindira kwekuvhiya kunoitwa muchipatara uchishandisa sarudzo yakawanda kana yekunze.
Munguva yekushanda, chiremba anobvisa fetus yakasviba, panguva imwe chete achichera uterine endometrium. Izvo zvikamu zvinyorwa zvemu embryo zvinowanikwa muchitoro chisina kuyerwa uye chinotumirwa ku laboratory ye histology. Pamagumo ekunyora, mukadzi anoshandiswa oxytocin, inokonzera uterine contractions. Munguva yekudzorera nguva, murwere anotora mishonga inorwisa mabhakitiriya kuti arege kuisa njodzi yezvinetso zvinotapukira.
Zvakakosha kuziva kuti mushure mekuchera vakadzi vose vanogadzirisa kubuda kwepabonde. Kazhinji ivo vanofanira kunge vari zvekuzvipira uye vanopedzisira vasati vhiki imwe chete. Kuonekwa kweropa, kunyange chidiki chekubuda ropa, iyo inogona kuendeswa nemarwadzo ari mudumbu rezasi nguva zhinji, inofanira kuva chikonzero chekuenda kuna chiremba. Izvi zviratidzo zvinowanzoita kuti uterine kubuda ropa, kunoda kurapwa kwakakurumidza.
Kuberekwa mushure mekudzivirirwa kwakaoma
Zvinotora nguva yekudzorera utano hwomuviri, saka vanachiremba havasi kukurudzira kuronga pamuviri kwemwedzi 6. Iyo hormonal system munguva ino zvishoma nezvishoma inodzokera kune yaimbova iyo nyika. Ovulation haisi nguva dzose inoitika, naizvozvo, uye mwedzi mushure mekunge pamuviri wakanyarara hauna kugara. Zvose izvi zvinomanikidza nzira yekugadzirira pamuviri, saka vanachiremba vanokurudzira kutanga chirongwa chekurapa isati yatanga, iyo inosanganisira:
- Kusarudzwa kwechikonzero chakakonzera kupera kwekuita pamuviri ;
- kushandisa zvinodhaka zvinotarisirwa kubvisa zvirwere zvisingagumi zvekuberekwa;
- maitiro e vitamin therapy uye physiotherapy.