Masiku angapo apitawo, dokotala yemwe ali ndi mbiri ya Instagram ya chimodzi mwa zipatala adafalitsa zolowera zotsutsana. M'menemo, adapempha amayi apakati kuti atseke firiji ndi "kukhala ngati Ewa" - katswiri wa neonatologist yemwe adakali wochepa kwambiri pa masabata 30 a mimba. Kusala kudya kunkawoneka ngati kuukira kwa amayi apakati onenepa kwambiri. Kodi mimba ndi kunenepa kwambiri ndi kuphatikiza koyipa? Timalankhula ndi katswiri wazachipatala Rafał Baran wochokera ku Superior Medical Center ku Krakow za kunenepa kwambiri pamimba.
- «Tsekani firiji ndi kudya awiri, osati awiri. Mupangitsa moyo kukhala wosavuta kwa ife komanso inu nokha »- chiganizo ichi chinayambitsa chipwirikiti m'ma TV. Zinkawoneka ngati kuukira kwa amayi omwe akulimbana ndi kunenepa kwambiri
- Mimba, pamene BMI ya amayi ili pamwamba pa 30, imakhala yowopsa kwambiri. Lingaliro lenileni la mwana lingakhale vuto
- Mavuto angabwerenso panthawi yoyembekezera, yobereka, ndi puerperium.
- Zambiri zitha kupezeka patsamba lofikira la Onet.
Anamaliza maphunziro awo ku Medical University of Silesia ku Katowice, ndipo panopa akugwira ntchito ku Gynecological Endocrinology and Gynecology Clinic ya University Hospital ku Krakow. Tsiku ndi tsiku, amachita makalasi ndi ophunzira akunja azachipatala ku Clinic, monga gawo la Sukulu ya Akunja a Collegium Medicum ya Jagiellonian University. Amagwiranso ntchito pofufuza.
Zokonda zake zazikulu ndi kupewa ndi kuchiza matenda a chiberekero, kusabereka ndi ultrasound diagnostics.
Agnieszka Mazur-Puchała, Medonet: Ali ndi pakati “tseka furiji ndi kudya awiri, osati awiri. Pangani moyo kukhala wosavuta kwa ife komanso inu nokha ”- tidawerenga m'nkhani yomwe ili ndi mbiri ya County Hospital Complex ku Oleśnica. Kodi mayi wonenepa ndi wolemetsa kwenikweni kwa ogwira ntchito zachipatala?
Kugwada. Rafał Baran, gynecologist: Izi zinali zatsoka pang'ono. Ndikukhulupirira ndi mtima wonse kuti dokotala amene anafalitsa nkhaniyi sanalingalire kuti azisala anthu onenepa kwambiri. Zikatero, chiopsezo cha zovuta pa nthawi ya mimba, kubadwa ndi puerperium kumawonjezeka. Kunenepa kwambiri kungapangitsenso kukhala kovuta kutenga mimba. Komabe, ntchito yathu, monga madokotala, ndiyo, koposa zonse, kulabadira vuto ili ndi kusamalira wodwala onenepa m'njira yabwino kwambiri, komanso kuti tisamamuchititse manyazi.
Tiyeni tizigawule mu zinthu zofunika kwambiri. Kodi kunenepa kwambiri komanso kunenepa kwambiri kumapangitsa bwanji kukhala kovuta kutenga mimba?
Choyamba, tiyenera kumvetsetsa kuti kunenepa kwambiri ndi chiyani komanso kunenepa kwambiri. Kuwonongeka uku kumachokera ku BMI, yomwe ndi chiŵerengero cha kulemera kwa msinkhu. Pankhani ya BMI yoposa 25, tikukamba za kunenepa kwambiri. BMI pamlingo wa 30 - 35 ndi kunenepa kwambiri kwa digiri ya 35, pakati pa 40 ndi 40 kunenepa kwambiri pa digiri ya 35, ndipo kupitirira XNUMX ndiko kunenepa kwambiri kwa digiri ya XNUMX. Ngati wodwala akukonzekera kutenga pakati ali ndi matenda monga kunenepa kwambiri, tiyenera kumusamalira mwapadera ndikufotokozera kuti mavuto omwe ali ndi pakati angabwere. Iwo akhoza kukhala osiyana. Kunenepa kwambiri komwe kumakhala ndi BMI pamwamba pa XNUMX ndizowopsa, komanso matenda omwe nthawi zambiri amatsagana nawo, monga matenda a polycystic ovary kapena hypothyroidism, omwe angayambitse vuto la ovulation, ndipo zikatero zimakhala zovuta kutenga pakati. Kumbali ina, kunenepa kwambiri sikumakhudza kwambiri chonde.
Ndi zovuta zotani za mimba zomwe zingachitike kwa wodwala kunenepa kwambiri?
Choyamba, pali chiopsezo chachikulu cha matenda a shuga kapena kuthamanga kwa magazi, kuphatikizapo pre-eclampsia. Kachiwiri, pangakhalenso thromboembolic mavuto, ndipo mwatsoka kwambiri Vuto, mwachitsanzo, mwadzidzidzi intrauterine imfa ya mwana wosabadwayo.
Chifukwa cha zovuta izi, timalimbikitsa amayi onenepa omwe akukonzekera kutenga pakati kuti alankhule ndi katswiri poyamba. Wodwalayo ayenera kukhala ndi mbiri yodziwika bwino ya lipid, matenda a shuga ndi insulini kukana, kuwunika kwa chithokomiro ndi kayendedwe ka magazi, kuyeza kuthamanga kwa magazi ndi ECG. Kudya koyenera moyang'aniridwa ndi katswiri wazakudya komanso kuchita masewera olimbitsa thupi kumalimbikitsidwanso.
Bwanji ngati mkazi wonenepa ali kale ndi pakati? Kodi kuchepetsa thupi ndi njira yokhayo?
Inde, koma moyang'aniridwa ndi katswiri wa zakudya. Sizingakhale zakudya zoletsa kapena zochotseratu. Iyenera kukhala yolinganizidwa bwino. Malangizowo ndi kuchepetsa mphamvu ya mphamvu ya zakudya zomwe zimadyedwa ku 2. kcal patsiku. Komabe, ngati kumwa uku mimba isanakwane kwambiri, kuchepetsa kuyenera kuchitidwa pang'onopang'ono - osapitirira 30%. Zakudya za mayi woyembekezera ziyenera kukhala ndi zakudya zazikulu zitatu ndi zitatu zazing'ono, zokhala ndi chakudya chokhala ndi index yotsika kwambiri ya glycemic kuti mupewe kuchuluka kwa insulin. Kuphatikiza apo, timalimbikitsanso kuchita masewera olimbitsa thupi - osachepera katatu pa sabata kwa mphindi 15, zomwe zimathandizira kagayidwe kanu ndikuchepetsa thupi.
Ndizovuta zotani pobereka mkazi wonenepa?
Kubereka kwa wodwala wonenepa kumakhala kovuta kwambiri ndipo kumaphatikizapo chiopsezo chachikulu. Muyenera kukonzekera bwino. Chinsinsi ndicho, choyamba, kuyesa kolondola kwa kulemera kwa mwana kuti athetse macrosomia, zomwe mwatsoka zimakhala zovuta chifukwa chakuti minofu ya adipose ilibe kuwonekera bwino kwa mafunde a ultrasound. Ndiponso, kuyang’anira mmene mwana alili bwino pogwiritsa ntchito CTG n’kovuta mwaukadaulo ndipo kumaphatikizapo kulakwa kwakukulu. Odwala omwe ali ndi kunenepa kwambiri, fetal macrosomia amapezeka nthawi zambiri - ndiye kuti mwana amakhala wamkulu kwambiri pazaka zake zoyembekezera. Ndipo ngati ndi yayikulu kwambiri, kubereka kwa nyini kumatha kulumikizidwa ndi zovuta monga phewa la dystocia, mitundu yosiyanasiyana ya kuvulala kwapakhosi mwa mwana ndi mayi, kapena kusayenda bwino pakubala, zomwe zikuwonetsa kuti gawo la opaleshoni yofulumira kapena yadzidzidzi.
Ndiye kunenepa kwambiri kwa amayi sichizindikiro chachindunji cha kubereka kwa Kaisareya?
Sichoncho. Ndipo ndibwino kuti mayi woyembekezera yemwe ali ndi kunenepa kwambiri abereke kudzera m'chilengedwe. Opaleshoni yochiza ndi yofunika kwambiri paokha, ndipo wodwala onenepa kwambiri timakhalanso pachiwopsezo cha thromboembolic complication. Komanso, kudutsa khoma la m'mimba kupita ku chiberekero kumakhala kovuta. Pambuyo pake, chilonda chodulidwacho chimachira kwambiri.
Kodi pali matenda ena aliwonse, kupatula macrosomia, a mkazi onenepa?
Kunenepa kwambiri kwapakati kumawonjezera chiopsezo cha meconium aspiration syndrome. Ndizothekanso hypoglycemia, hyperbilirubinemia kapena kupuma kwa mwana wakhanda. Makamaka ngati kuchitidwa opaleshoni ndikofunikira. Dziwani kuti pankhani ya amayi apakati onenepa, mosiyana ndi macrosomia, fetal hypotrophy imathanso kukula, makamaka pamene mimba imakhala yovuta chifukwa cha matenda oopsa.
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