Madokotala ambiri oyembekezera kutenga mimba amaonedwa kuti ndi ofunika kwambiri. Mfundo yakuti thupi lachikazi limapangidwa mwachibadwa kuti likhale labwino kwa mwana mmodzi yekha pa mimba imodzi, kotero kuti ana awiri sangakhale okwanira mpweya ndi zakudya zokwanira, zimakhala pamodzi, ndipo izi zimapangitsa kuti zikhale zovuta zosiyanasiyana.
Awiri kapena amodzi?
Kuzindikira kwa intrauterine kukula kwa mimba zambiri kumatheka kale kale. Ultrasound ikhoza kuzindikira kuti kukhalapo kwa dzira lachiwiri la fetus mu nthawi ya masabata 8-12, koma zotsatira za kafukufuku woyamba silingathenso kuganiziridwa kukhala otsiriza. Pali nthawi pamene zipatso zimakonzedwa kotero kuti wina abise chachiwiri kumbuyo kwawo, ndipo kupezeka kwa mazira awiri a fetus sikukutanthawuza chitukuko chawo chonse. Mu 1 trimester, pafupifupi 15-20% ya multiple pregnancy amakhala kholo limodzi - chifukwa cha imfa ya mazira - imasiya kukula ndikukhalabe m'chiberekero mpaka kubadwa.
Yoyang'aniridwa
Ngati kafukufuku akuwonetsa kuti palibe mwana mmodzi yemwe wayamba kukula, mayi wamtsogolo adzayendera ma consultation a amayi nthawi zambiri kuposa ena. Mu 2 trimester - masiku khumi, ndipo 3 - sabata iliyonse. Kuonjezera apo, mkaziyo nayenso ayenera kusamala kwambiri za thanzi lake ndikutsatira chikhalidwe chake, kuyambira kulemera (chifukwa chokhala ndi mimba zambiri, ayenera kukula kwambiri kuposa nthawi zonse - kuwonjezeka kwa miyezi 9 kumatha kufika makilogalamu 18-20) ndikutha zizindikiro za toxicosis, kuchepa magazi m'thupi, kuphwanya kwa impso, mtima.
Matenda a m'thupi ndi chimodzi mwa mavuto omwe amanyamula mapasa. Ndi "kuchepa kwa magazi", chiwerengero cha maselo ofiira a m'magazi (maselo ofiira a magazi) ndi hemoglobin (oxygen transfring substance) m'magazi amachepetsedwa ngati magazi a magazi, motero, mkazi amatha kutopa, nthawi zonse amamva wofooka, mutu wake umatembenuka ndipo khungu lake limatuluka, Dyspnea, matenda otsekedwa mtima, odwala kwambiri, amatha kutaya chidziwitso pambuyo pa katundu wang'ono. Matenda ambiri omwe amapezeka m'thupi amapezeka ndi kusowa kwachitsulo, komanso vitamini B 9 (folic acid), zonsezi ndizofunika kuti chitukuko ndi kukula koma makamaka placenta.Ngati mimba yoyenera, chiopsezo cha kuchepa kwa magazi ndi chochepa (makamaka ngati mutenga mankhwala apadera - chakudya chokhazikika sichitha nthawi zonse kuti chikhale chofunika chachitsulo), ndiye pamaso mwa mapasa amakula kwambiri, ndipo katatu popanda kupewa magazi ndi zovuta zedi.Zowopsa ndi ziti? Nthaŵi imodzi ndi hafu imawonekera ku toxicosis, chiopsezo chotenga padera chimadza kufika 40%, mavuto amapezeka nthawi zambiri pamene akubereka, pangakhale vuto la kuyamwitsa. Ana omwe amabadwa ndi amayi ovutika ndi kuchepa kwa magazi amayamba kudwala (ali ndi chitetezo chochepa), amakhala odwala matenda opatsirana.
Kodi mungapewe bwanji mavuto?
- Pitirizani kufufuza za matenda anu, m'kupita kwa nthawi, funsani dokotala wanu.
- Tengani mayesero - kuchepa magazi m'thupi kumatsimikiziridwa ndi kuyesa magazi nthawi zonse.
- Tengani mankhwala oyenera. Ndasankhidwa! Osati zomwe ena adazilembapo, zomwe munaziwona pamalonda ... Choyamba, kukonzekera zachitsulo kwa amayi apakati ali ndi zenizeni, ndipo kachiwiri, mlingo wa amayi amtsogolo umasankhidwa payekha, malinga ndi zotsatira za kusanthula ndi boma. Musadzipangitse kuchepetsa mlingo wa mankhwala: ngati mankhwala amachititsa khunyu (makamaka nthawi zambiri zimakhala ndi toxicoses), muyenera kuwona dokotala ndikukupemphani kuti mutenge mankhwala ena. Ngati simungathe kumeza mapiritsi, muyenera kuchita jekeseni. Ndipo ndithudi munthu sayenera kuyembekezera kuchepa magazi m'thupi mwa "zakudya zowonjezera" zipatso. Zipatso ndi ndiwo zamasamba, zomwe zimakhalapo "kulamula" anthu ambiri ofunira zabwino, zimathandiza, kuti apereke chitsulo ndi folic acid muzambiri, zomwe zimafunika kuti pakhale mimba yambiri, amafunika kudyedwa kuposa munthu wathanzi komanso wamphamvu kwambiri.
Late toxicosis
Mimba mwa amayi omwe ali ndi intrauterine kukula kwa mimba zambiri zimapezeka kawiri kawiri kuposa nthawi zonse. Kuyambira kawirikawiri mpaka toxicosis ambiri kumayambiriro, zimasiyana, koposa zonse, kuti zingayambitse mavuto ambiri kwa ana kusiyana ndi amayi. Ndi gestosis, nseru ndi kusanza sizichitika nthawi zonse, koma pali kutupa kobisala, mapuloteni amapezeka mumtsinje, kuthamanga kwa magazi kumatuluka, ndipo chofunika kwambiri - toxicosis zimakhudza placenta, kusokoneza zomwe mwanayo (kapena ana) amapereka ndi mpweya ndi zakudya. N'zoona kuti iyi si njira yabwino yosinthira chitukuko, makamaka (kuganizira mawu) - pa dongosolo la manjenje. Ndipo kubadwa kwa amayi omwe ali ndi gestosis nthawi zambiri kumakhala kovuta ...
Kuwonetsera kwa pochedwa toxicosis kungatengedwe, koma amayi onse omwe amabereka mofulumira kwambiri (zaka zoposa 18) kapena kenako (pambuyo pa zaka 35), nthawi zambiri (pakati pa kubadwa kwa ana osakwana zaka ziwiri), amayi omwe ali ndi ana ambiri ndi angapo, komanso ndi amayi omwe ali ndi pakati-omwe ali ndi pakati - ndi mwana aliyense chiopsezo chikuwonjezeka). Mavuto olimbitsa thupi a amayi amtsogolo, a Rh-conflict, a hypertension ndi matenda ena ndi zovuta kwambiri.
Kodi zikuwonetseredwa bwanji? Chimodzi mwa zizindikiro zoyambirira za gestosis chikhoza kukhala ludzu lamphamvu, ndipo wodwala amamwa madzi ambiri (ndipo amadzimadzi ambiri - powerengera, muyenera kuganizira zonse zakumwa zamadzi ndi zakumwa zonse), koma mkodzo ndi wotsika kwambiri. Izi zikutanthauza kuswa kwa mchere wa madzi: madzi ambiri samachotsedwa ndi thupi, koma amakhalabe m'matumbo ndipo amachititsa kuti chisamaliro chikhale chosasinthika. Ngati choletsedwa chakumwa ndi mchere mu zakudya sizithandiza, ngati pali kunyowa, kumutu, chizungulire, kuthamanga kwa magazi, nthawi yomweyo muyenera kufunsa dokotala ndikutsatira malamulo ake onse. Kupita kuchipatala chomwe chingatheke - pokhala ndi mimba yambiri, muyenera kukhala wokonzeka kuti mwayambe kutero chifukwa cha mavuto osiyanasiyana, ngakhale ngati zilizonse zachilendo, patatha milungu iwiri isanathe nthawi yobereka, madokotala angatenge mkazi woyembekezera pansi kuyang'anira kwake nthawi zonse ndikuyamba kukonzekera kubereka.
Kupewa gestosis
Pa nthawi ya 2 trimester (ndipo ndithudi - mu theka lachiwiri la mimba), m'pofunika kukana mbale yokazinga ndi zokometsera, kuchokera ku zokometsera zokometsera zokometsera, kusuta ndi mchere. Chikhalidwe chakumapeto nthawi zina chimakhala chovuta kwa amayi oyembekezera, koma, tsoka, ayi, ayi, zingakhale zovuta kupeŵa edema. Chokoleti iyenso idzasinthidwa ndi maswiti ena - chifukwa cha mphamvu pamtima. Idyani bwino, yendani mumlengalenga mobwerezabwereza ndikupewa nkhawa monga momwe mungathere - amayi akuyembekeza mapasa, muyenera kudziyang'anitsitsa kwambiri kuposa ena.
Wofatsa
Kuyambira ndi 2 trimester, vuto lina limodzi lalikulu liyenera kuganiziridwa: kuthekera kwa kuperewera kwa amayi komanso kuthetsa mimba. Malingana ndi chiwerengero, pafupifupi 50% ya amayi omwe ali ndi pakati ambiri amakhala ndi vuto la kubwezeredwa kumbuyo pa siteji imodzi kapena ina ya kugonana. Zimakhulupirira kuti izi zimachokera ku kutambasula kwa minofu ya uterine yomwe imayambitsa mavoti ake ambiri. Choncho, ndi ululu uliwonse m'munsi kumbuyo ndi m'munsi pamimba, kumverera kwa chifuwa mu chiberekero, mwamsanga mwadzidzidzi, muyenera nthawi yomweyo kupeza thandizo lachipatala ndipo, ngati kuli kotheka, pitani ku chipatala kuti mutetezedwe: ndizotheka kuti madokotala azitenga zoyenera kuti athetse nthawi yoberekera ndikupereka mwayi woti ana akule bwino. Kodi mungapewe bwanji mavuto?
Kuyambira pa masabata makumi awiri, muyenera kusiya kusewera masewera (makamaka mitundu yogwira ntchito). Mwina dokotala angakulimbikitseni kuchepetsa moyo wa kugonana (zimakhudza kwambiri chiberekero), ngati n'kotheka - musagwire ntchito (makamaka musayambe kubwerera kwa amayi oyembekezera, zomwe zingakhale ngati mimba imaperekedwa kuchokera pa sabata la 28) koma kupatula kugona kwa usiku wonse maola osachepera 4-6, ndi kumapeto kwa nthawi - mpaka maola 8. Musaphonye maulendo okaonana ndi amayi. Nthawi imodzi kamodzi pa milungu iwiri iliyonse, dokotala wa matenda a amayi ayenera kudziwa momwe chiberekero chimakhalira, makamaka chiberekero: ngati chiyamba kufikitsa msanga kuposa sabata la 23, chomwe chimatchedwa kuti chiberekero cha khola lachiberekero chimagwiritsidwa ntchito - zimagwiritsidwa ntchito zomwe zingachepetse chiopsezo cha kubadwa msanga. Patsiku lomaliza, mankhwalawa amagwiritsidwa ntchito mofanana - makonzedwe apadera a mankhwala.
Ndi nthawi yobereka
Pakati pa mimba zambiri, ntchito zingapo zapitazo ndizofunikira - izi ziyenera kukumbukiridwa osati zofanana ndi zolinga zathu zowerengera. Ndipotu, mapeto a mimba, makanda m'mimba mwa amayi amangokhala opanda malo, mpweya, kapena zakudya, ndipo ali kale mokwanira kuti apitirize kukhala ndi moyo mosiyana ndi thupi la mayi. Chilengedwe chatsamalira ana otere mwamsanga momwe angathere: ngati pangakhale mimba yambiri yomwe imachitika nthawi zambiri, ana ambiri amakula panthawi imodzimodzi - kale "zaka" zawo zam'mimba ndipo chiwalo chonse chazimayi chimakonzekera kubereka.
Kwa katatu, nthawi yeniyeni yobadwa ndi masabata 34-36 a mimba, mapasa amakhala ndi nthawi yochuluka - mpaka masabata 36-38. Pafupifupi 50% amapasa amabadwa ndi zolemera zochepa (mwazizolowezi) - mpaka makilogalamu 2.5, pomwe pakati pa ana apo pangakhale kusiyana kwa kulemera kwa magalamu 200-300. Ngati zambiri (mpaka 1 makilogalamu), izi zikuwonetsa kale mavuto ndi chitukuko Mmodzi mwa iwo, koma m'mudzi wamakono wamakono ndipo vutoli limathetsedwa: kusiyana kwa kukula kumawoneka bwino ndi ultrasound, ndipo neonatologist idzakonzekera zonse zofunika kuti zithandize mwana wakhanda msanga. Tiyeni tizindikire kuti mavuto ambiri amabweretsa ana akuluakulu - nthawi zina zimakhala zolemera makilogalamu 5-6, ndipo zimakhala zovuta kwambiri (kuti sizodabwitsa - chiberekero chofunika kwambiri), komanso kubereka popanda kuthandizidwa ndi opaleshoni nthawi zambiri sizingatheke.
Kawirikawiri, njira yoberekera si imodzi, koma ana angapo, ndithudi, ndi ovuta kwambiri kuposa nthawi zonse. Choncho, pokonzekera phwando la katatu (osatchula kuwonjezeranso kwa mabanja ambiri) madokotala nthawi zambiri amalimbikitsa gawo lopuma. Mapasa nthawi zambiri amabereka mofanana ndi wina aliyense, ngakhale pangakhale mavuto. Ndibwino kuti musataye mwana ngati madokotala amapereka mankhwala oopsa: ngati pangakhale mavuto osayembekezereka, izi zidzasunga nthawi.