Uxinzelelo lwengcinezelo lunye lweengxaki eziqhelekileyo kunye nezona zinzulu kakhulu ngexesha lokukhulelwa. Ngenye yeembonakaliso zangaphambi kwe-eclampsia - imeko apho ifomu elibi lingaholela ekufeni komama, kwakunye nokuphulwa kophuhliso lomntwana kunye nokuzalwa kwangaphambi kokuzalwa. Ukuchonga iimpawu zokuqala ze-preeclampsia kunokugcina ubomi bomfazi.
Iintlobo zengcinezelo yokhuseleko xa ukhulelwe
I-pre-eclampsia kunye nezinye iimeko, ezihamba kunye nokwanda kwexinzelelo lwegazi, zifunyenwe malunga ne-10% ye-primipara. Nangona kunjalo, kubafazi abaninzi abakhulelweyo, umfutho wegazi ophezulu unganangazi kakuhle, ngaphandle kokuba kufuneka bafumane uviwo lwezonyango ekupheleni kokukhulelwa.
Kukho iintlobo ezintathu eziphambili zexinzelelo lwengqondo kwiimalikazi ezikhulelweyo:
- i-hypertension esele ikhona ngaphambili-inzima ukukhulelwa okuqhelekileyo; maxa wambi ukwanda kwexinzelelo lwegazi kuqala ukuxilongwa ngexesha lokukhulelwa;
- Ukuxinzeleleka kweengxaki zomzimba - kuvela kwimvelaphi yokukhulelwa. Kule meko, akukho protein kumchamo, kwaye uxinzelelo lwegazi lubuyela ngokuqhelekileyo kwiintsuku ezintandathu emva kokunikezelwa;
- i-pre-eclampsia - ukunyuswa kwengcinezelo yegazi kunempembelelo enkulu kwizinye iinkqubo zomzimba; Ngokuqhelekileyo ihamba kunye nokubonakala kweprotheni kumchamo.
I-Preeclampsia ingaba nemiphumo emibi engozini yobomi bobabili umama kunye nomntwana. Ngokunyuka kwengcinezelo yegazi, owesifazane okhulelweyo ufuna unyango lwengxamiseko ukuze athinte ukuphuhliswa kwe-eclampsia, ehambelana nokuxubusha kunye ne-coma. Ukufumanisa kwangaphambili iimpawu kwaye unyango olusesikweni lunokuthintela uphuhliso lwe-eclampsia. Ngokuqhelekileyo ihamba kunye neempawu ezilandelayo:
- ukubonakala kwezikhanyiso zokukhanya, imivimbo, "izimpukane" phambi kwamehlo, ziphazamisa emehlweni;
- photophobia;
- intloko;
- intlungu kwisisu esiphezulu okanye kwi-quadrant ephezulu;
- ukuhlanza;
- malaise jikelele.
Ngokunyuka kwexinzelelo lwegazi, kubalulekile ukucacisa isizathu kunye nokuhlola ubunzima bexinzelelo. Isibhedlele ngenxa yale nto ayidingekanga, kodwa ngamanye amaxesha kukho imfuneko yophando olongezelelweyo. Kukho izinto ezinobungozi bokuphuhliswa kwe-preeclampsia:
- ukukhulelwa kokuqala;
- ubukho be-pre-eclampsia ekukhulelweni kwangaphambili;
- abaneminyaka engama-20 okanye ngaphezulu kweminyaka engama-35;
- ukukhula okuphantsi;
- migraine;
- Iimeko ze-preeclampsia okanye i-eclampsia kwabasetyhini kwintsapho;
- ophezulu wexinzelelo lwengqondo;
- ukungabikho komzimba;
- ukukhulelwa okubanzi;
- Ubukho bezifo ezidibeneyo, njenge-systemic lupus, isifo sikashukela kunye nesifo sikaRaynaud.
Kwabesetyhini abathile abakhulelweyo, iimpawu zexinzelelo zengcinezelo azikho, kwaye ukwanda kwexinzelelo lwegazi kufunyanwe kuqala ngolu vavanyo olulandelayo kwintetho yabesifazane. Emva kwexeshana, ukulinganisa ngokuphindaphindiweyo koxinzelelo lwegazi kuqhutyelwa. Ngokuqhelekileyo amanqaku angadluli kuma-140/90 mm Hg. umz., kwaye ukwanda okuzinzile kuthathwa njenge-pathology. I-Urine iphinde ihlaziywe ngenxa yobuninzi beeprotheni ngoncedo lweziganeko ezikhethekileyo. Umgangatho wayo unokuthiwa ngu "0", "umkhondo", "+", "+" "okanye" + + + ". Isalathisi "+" okanye ngaphezulu sichazwa ngokuphawulekayo kwaye sidinga uviwo olongezelelweyo.
Bhedlele
Ukuba uxinzelelo lwegazi luhlala luphezulu, uvavanyo olongezelelweyo lwesibhedlele lwenziwa ukwenzela ukucacisa ubunzima besifo. Ukuxilongwa ngokuchanekileyo, isampuli yeeyure ezingama-24 kunye nomlinganiselo weprotheni wenqanaba lwenziwa. Ukugqithisa kumchamo we-300 mg weprotheni ngosuku kukuqinisekisa ukuxilongwa kwe-pre-eclampsia. Uvavanyo lwegazi luyenziwa ukuze kugqitywe ukubunjwa kwamaselula kunye nomsebenzi we-renal kunye ne-hepatic function. Isimo se-fetal sijongwa ngokubeka esweni intlawulo yenhliziyo ngexesha le-cardiotocography (CTG) kunye nokwenza i-ultrasound scanning ukuvavanya ukuphuhliswa kwayo, umthamo we-amniotic fluid kunye nokuhamba kwegazi kwi-cord (soppler study). Kwababhinqa abathile, ukuqwalaselwa ngokugqithiseleyo kunokuhlelwa ngaphandle kokulaliswa esibhedlele, umzekelo, ukutyelela kwisibhedlele sosuku lwesigqeba sokubeletha, amaxesha amaninzi ngeveki. Iziganeko ezinzima kakhulu zifuna ukunakekelwa esibhedlele ukubeka iliso kwizinga lexinzelelo legazi emva kweeyure ezine, kwakunye nokucwangcisa ixesha lokuhambisa. Uxinzelelo lwengqondo, olungabandakanywa ne-preeclampsia, lunokumiswa kunye ne-labetalol, i-methyldopa kunye ne-nifedipine. Ukuba kuyimfuneko, unyango olusakhulayo lunokuqaliswa nanini na ixesha lokukhulelwa. Ngako oko, kunokwenzeka ukukhusela iingxaki ezinzima zokukhulelwa. Ngokuphuhliswa kwe-pre-eclampsia, ikhosi emfutshane ye-anti-intrasive treatment ingenziwa, kodwa kuzo zonke iimeko, ngaphandle kweefom ezithobekileyo, uhlobo oluphambili lwonyango lubonelelo lweenkonzo. Ngethamsanqa, kwiimeko ezininzi, i-preeclampsia ikhula ngokukhulelwa kokukhawuleza. Kwiifom ezinzima, ukuhanjiswa kwangaphambi kwexesha (ngokuqhelekileyo kwinqanaba le-caesarean) lingaqhutywa kwinqanaba lokuqala. Emva kweveki yama-34 yokukhulelwa, umsebenzi wokuzalwa uvame ukuvuselelwa. I-preeclampsia ekhuselekileyo inokuqhubeka, iphendukele ekuhlaselweni kwe-eclampsia. Nangona kunjalo, azinqabile kakhulu, njengokuba abaninzi abafazi bafumana ukuhanjiswa kwezinto zangaphambili kwizigaba zangaphambili.
Ukubuyiselwa komfutho wexinzelelo kwimeko yokukhulelwa okuphindaphindiweyo
I-Preeclampsia ijwayele ukubuyela emva kokukhulelwa okulandelayo. Iifom ezintle zesifo ziphindaphinda kangangoko (kwi-5-10% yamatyala). Izinga eliphindaphindiweyo le-preeclampsia liyi-20-25%. Emva kwe-eclampsia, malunga nekota yesithandathu sokukhulelwa ngokuphindaphindiweyo kunzima ngama-preeclampsia, kodwa i-2% kuphela yamatyala iphinda ihlakulele i-eclampsia. Emva kokuqala kwe-eclampsia, malunga ne-15% yenze ingozi engapheliyo kwiminyaka emibini emva kokubeleka. Emva kwe-éclampsia okanye i-preeclampsia enzima, i-frequency yayo i-30-50%.