txheem
Fetal macrosomia: thaum koj tab tom yuav xeeb tub
Yav dhau los, kev yug me nyuam "tus menyuam zoo nkauj" tau nrov. Niaj hnub no, cov kws kho mob saib xyuas qhov loj ntawm tus menyuam hauv plab thaum cev xeeb tub. Fetal macrosomia, uas yog hais tias yug hnyav dua 4 kg, tuaj yeem ua rau muaj kev nyuaj rau kev yug menyuam.
Dab tsi yog fetal macrosomia?
Fetal macrosomia feem ntau txhais los ntawm qhov hnyav yug ntau dua 4000g. Nws txhawj xeeb txog 5% ntawm cov menyuam yug tshiab. Cov menyuam mos macrosome tsis tas yuav muaj teeb meem ntau dua li qhov hnyav dua li lwm tus menyuam mos thaum lawv loj hlob tuaj. Nws tag nrho yog nyob ntawm keeb kwm ntawm ob peb puas grams ntxiv. Tus kws kho mob yuav tsuas yog me ntsis ntxiv rau qhov kev hloov pauv ntawm lawv qhov hnyav thiab qhov siab nkhaus.
diagnostic
Txawm tias muaj kev vam meej, kev kwv yees tus me nyuam hauv plab macrosomia tsis yooj yim li. Lub plab palpation thiab ntsuas qhov siab ntawm lub tsev menyuam thaum lub sij hawm kuaj xyuas txhua hli nrog tus kws yug menyuam lossis tus kws kho menyuam yaus muab qhov qhia txog qhov loj ntawm tus menyuam hauv plab. Qhov kev pheej hmoo ntawm tus menyuam hauv plab macrosomia kuj tuaj yeem kuaj pom thaum lub sijhawm ultrasound tab sis cov txheej txheem suav los kwv yees qhov hnyav ntawm tus menyuam hauv plab muaj ntau heev thiab lawv tsis yog ruam.
Cov ua
Niam txiv mob ntshav qab zib, txawm tias ua ntej los yog kev loj hlob thaum cev xeeb tub (mob ntshav qab zib gestational), yog qhov ua rau fetal macrosomia. Peb kuj paub tias leej niam rog rog ntau ntxiv los ntawm 4 qhov kev pheej hmoo ntawm fetal macrosomia. Lwm yam kev pheej hmoo tseem raug txheeb xyuas: qhov hnyav ntawm leej niam yug me nyuam, leej niam hnub nyoog tshaj 35 xyoos, keeb kwm ntawm fetal macrosomia hauv kev xeeb tub yav dhau los, hnyav hnyav thaum cev xeeb tub, lub sij hawm dhau los.
Yuav txo cov kev pheej hmoo li cas?
Gestational diabetes yog qhov tseem ceeb ntawm kev pheej hmoo rau fetal macrosomia, cov niam uas muaj kev cia siab rau nws (tshaj 35 xyoo, BMI tshaj 25, tsev neeg keeb kwm ntawm hom 2 mob ntshav qab zib, ntshav qab zib gestational, macrosomia) tau sau tseg ntawm 24 thiab 28 lub lis piam ntawm amenorrhea. "qhov ncauj hyperglycemia". Qhov kev sim no yog ua tiav ntawm lub plab khoob los xyuas seb lub cev tswj hwm cov piam thaj hauv cov ntshav li cas. Nws muaj ntau theem: kev kuaj ntshav thaum tuaj txog ntawm lub chaw kuaj mob, qhov nqus ntawm 75g ntawm cov kua qabzib, tom qab ntawd kuaj ntshav 1 teev, tom qab ntawd 2 teev tom qab.
Thaum gestational ntshav qab zib tau raug txheeb xyuas, cov niam yav tom ntej tau txais txiaj ntsig los ntawm kev txhawb nqa tshwj xeeb los kho nws (kev noj haus, ua kom lub cev ua haujlwm zoo, ntau zaus ultrasounds saib xyuas kev loj hlob ntawm fetus) thiab yog li txwv qhov hnyav ntawm fetus. Cov poj niam uas rog dhau ua ntej cev xeeb tub lossis nce phaus ntau thaum cev xeeb tub kuj tau saib xyuas zoo dua.
Kev yug menyuam thaum xav tau tus menyuam loj
Fetal macrosomia tuaj yeem ua rau muaj teeb meem thaum yug menyuam. Nyob rau ntawm leej niam, nws txhawb los ntshav thaum lub sij hawm yug me nyuam, kab mob tom qab yug me nyuam, cervico-vaginal lesions, uterine ruptures. Ntawm tus me nyuam, qhov teeb meem uas nquag thiab ntshai tshaj plaws yog lub xub pwg dystocia: thaum lub sij hawm tshem tawm, tus me nyuam lub xub pwg nyom tseem thaiv hauv niam lub plab thaum nws lub taub hau twb tawm lawm. Nws yog ib qho tseem ceeb thaum muaj xwm txheej ceev uas yuav tsum tau ua kom tiav obstetric maneuver kom tshem tawm cov me nyuam mos uas tsis muaj kev pheej hmoo.
Raws li cov kev pheej hmoo no, National College of French Gynecologists thiab Obstetricians tau tshaj tawm ntau cov lus pom zoo:
- Yog tias kwv yees qhov hnyav ntawm tus menyuam hauv plab yog ntau dua lossis sib npaug li 4500 g, ib qho kev phais phais yog qhia;
- Kev tsis txaus siab ntawm macrosomia tuaj yeem ua pov thawj tias kev yug menyuam hauv lub limtiam thib 39 ntawm amenorrhea;
- Kev xaiv ntawm txoj kev phais los yog qhov chaw mos yuav tsum tau ua raws li qhov xwm txheej. Tab sis nyob rau hauv cov ntaub ntawv ntawm qhov chaw mos yug, nws raug pom zoo kom xyaum epidural analgesia thiab xyuas kom meej lub xub ntiag ntawm obstetric pab neeg (pob niam mis, obstetrician, anesthesiologist thiab pediatrician).