Zvimwe zvinhu zvakasikwa uye genetics zvinogona kuva nemhosva yekuremara kwekuberekwa
Kukanganisa kuberekwa kunogona kukanganisa kutarisa kwemachecheche, kushanda, kana zvose. MuUnited States, mumwe wevana makumi matatu nematatu anoberekwa ane chirwere chekuzvarwa. Zvimwe zvirema zvinoberekwa zvinonzwisisika, zvakadai sekukamwa kana muromo. Zvimwe kukanganisa kuberekwa zvinoda kuongororwa mumiedzo yekuona, zvakadai sepfemital heart defects.
Kukanganisa kwekuzvarwa kunoitika apo mwana ari kukura mudumbu.
Zvimwe makemikari, mishonga, uye zvinodhaka-zvinonzi teratogens-zvinogona kuwedzera njodzi yekuremara kwekuzvarwa. Mumazuva 14 ekutanga ekudzivirira, tatatogen dzinokonzera kusakanganiswa kana kuunza kupererwa kwepamuviri . Pakati pemakore gumi nemashanu nemakumi matanhatu ekuberekwa (panguva yekutanga kwetatu) fetus inonyanya kunetseka nemigumisiro yeatatogens uye kukanganisa kwakanyanya kunogona kuitika. Kunyanya kunyanya, nhengo dzakakura dzinokura panguva iyi. Izvo zvinofanira kuonekwa kuti matatogeni haisi iyo chete inokonzera kukanganisa kuberekwa. Genetics inobatsirawo. Uyezve, zvose zvinokanganisa uye zvizvarwa zvinogona kukanganisa pamwe.
Hapana nzira chaiyo-moto yekudzivirira matambudziko ekuberekwa, zvisinei. Pakupedzisira, zvakatipoteredza uye zvizvarwa zvinokonzera kuti zvive nematambudziko aya. Kuchengetedza mararamiro ane hutano uye misangano yenguva dzose neA-OB-GYN kare uye panguva yepamuviri inogona kukubatsira kuti uve nehutano hwakanaka. Kunyange zvakadaro, kune matanho aunogona kutora kuti udzikise njodzi yako yekuva nemwana ane urema hunoberekwa.
# 1: Kwete Doro Panguva Yechirwere
Kushandisa doro ndicho chinokonzera kukanganisa kuberekwa panguva yekuzvitakura.
Maererano neCDC:
Hapana chakazivikanwa chakawanda chekushandisa doro panguva yekudzivirira kana kuti uchiedza kutora pamuviri. Panewo nguva yakachengeteka panguva yekuzvitakura kunwa. Zvose zvinodhaka zvinokanganisa zvakafanana, zvinosanganisira mazambiringa ose newaini. Apo mukadzi ane pamuviri anonwa doro, ndizvo zvakaita mwana wake.
Uyezve, hafu yematambudziko ose muUnited States haagadzirwi. Inogona kutora pakati pemavhiki mana nematanhatu mukadzi asati aziva kana ane pamuviri. Munguva iyi, doro rinogona kukanganisa kukura kwe fetus.
Kushandisa doro munguva yekuzvitakura kunogona kutungamirira ku fetal alcohol syndrome (FAS). Kuipa kwezvinhu kwakaitwa neFAS kunosanganisira zvinotevera:
- intrauterine kukura kwemiganhu (kureva, kuwedzera kukura kwecheche ari mudumbu)
- microcephaly (kureva., utsi hudiki uye hutano husina kunaka)
- flattened face secondary kusvika middeveloped midface
- joint anomalies
- kusawirirana kwakashata
- congenital heart defects
- kuremara kwepfungwa
Nzira chaiyo iyo doro inokonzera FAS isingazikamwi. Isu tinoziva kuti doro rinodarika nyore kusvika pamucheto kusvika mumucheche. Muropa risina kuberekwa, doro rinosvika pakuonekwa kwakafanana neaakaonekwa mumayese ekuparadzirwa kwaamai.
Zvisinei, kuberekwa kunonyanya kushaya enzyme doro dehydrogenase, iyo inobudiswa nechiropa uye inoda kubvisa doro. Pane kudaro, vacheche vanovimba nemakemikari emukadzi uye vanaamai kuti vabvise doro. Izvozvo zvinokonzerwa nehutano dehydrogenase pakugadzirisa doro; saka, doro rakawanda rinoramba riri mumusana wekukura.
Doro inokonzera kukanganisa kwakanyanya kurongeka kwemwana. Haisi kungovhiringidza kukura kwemasero emishonga asiwo anovauraya (inonzi anopoptosis).
# 2: Hapana Kusvuta Panguva Yokudzivirira
Zvakanakisisa kurega kusvuta vasati vatora pamuviri; zvisinei, kune amai vakamirira vachiri kusvuta, hazvisati zvanyanyisa kurega. Uyezve, vakadzi vane pamuviri vanofanira kugara kure neutsi hwechipiri.
Heano zvimwe zvipingamupinyi zvinokuvadza izvo mwana akaberekwa naamai vanoputa panguva yekuzvitakura vanogona kuwana:
- intrauterine kukura kwemiganhu
- cleft lip
- cleft palate
- SIDS
- preterm labor
- kuwedzerwa kuwedzera (hyperexcitability)
- kutsamwa
- kuwedzera kwematomu tone (hypertonicity)
- kudengenyeka
Nicotine inowedzera zvikamu zana nemashanu kubva muropa re fetus kupfuura iyo yeamai. Kunyanyisa kuti amai vanoputa, kuwedzera kwekuda kwekukura kwemukati kwekemikirini. Uyezve, kunyange avo vanosvuta fodya 10 kana kuti vashoma pazuva (vasvuta vatsva), vanoisa vana vavo kaviri pangozi yepamusoro yekuberekwa.
# 3: Hapana Marijuana kana imwe "Migwagwa" Zvinodhaka panguva yekuzvitakura
Marijuana ndiyo inowanzoshandiswa nemishonga mumugwagwa. Iko ikozvino inotongwa mune dzimwe nyika, iyo ine zvakawanda zvekudzivirira nyanzvi dzinofungidzirwa.
Dzimwe nyanzvi dzinofunga kuti mbanje haisi yepamusoro uye haina kukonzera kukanganisa kuberekwa. Zvisinei, CDC inokurudzira pamusoro pemudzimai ane pamuviri kusvuta kana kushandisa zvimwe zvinodhaka zvinodhaka nekuti mishonga iyi inogona kutungamirira kutanga kutanga, kuberekwa kwemaviri, nekuremara kwekuberekwa.
Uyezve, kune humwe hutsigiro hwekubatana kwekushandisa mbanje panguva yekuzvitakura uye nekupedzisira neurodevelopmental zvinetso mumwana, zvakadai sokusava nehanya uye kusagadzikana pamwe chete nezvinetso nekunzwisisa uye kufunga.
Hapana nhamba yakachengeteka yembanje yakagadzirirwa vakadzi vari kuronga kuva nepamuviri kana kuti vane pamuviri. Nokudaro, zvakanakisisa kuti vakadzi vasasvuta kana kuti zvimwe vashandise mishonga pakuberekwa kana pamuviri. Kana uchida mbanje nekuda kwechiremba, zvakanaka kuti ukurukure kushandiswa kwakadaro neB OB-GYN yako.
# 4: Kudzivirira Utachiwana
Zvimwe zvirwere panguva yekuzvitakura zvinogona kutungamirira kuzvitadzo zvakaberekwa. Zvirwere zvinogona kudzivirirwa nokutora matanho, kusanganisira kurega kure nevanhu vane zvirwere, kushamba maoko kwemaoko, uye kunyatsobika nyama. Uyezve, zvimwe zvirwere zvinodzivirira mukadzi kubva kune hutachiona izvo zvinogona kutungamirira kuzvitadzo zvekuzvarwa.
Chazhinji munguva pfupi yapfuura, Zika chirwere ichi chave chichitsvaga mishonga yakawanda ichikonzera kukanganisa kuberekwa mucheche akaberekwa navanaamai vane utachiona. Izvi zvinokonzerwa nekuremara zvinosanganisira microcephaly (musoro muduku) uye uropi husina kunaka. Zvisinei, kutapurirwa kweZika utachiona munyika yeUnited States ichiri kushoma, uye hutachiona nemamwe maitiro ehutatogenic yakawanda kwazvo.
Cytomegalovirus (CMV) ndiyo inonyanya kukonzera utachiona muzvitsva. Chizhinji chevakadzi vane CMV antibodies. Kazhinji kacho, hutachiwana hutachiona ne CMV (utachiona hwekutanga) hunoisa pangozi ye CMV muchechecheche (kureva, congenital CMV). Kunyange zvakadaro, kugadziriswa kwe CMV kana kutapukirwa kweamai vane dambudziko rakasiyana kunogonawo kutungamirira ku congenital CMV.
Vanhu vakawanda vane chirwere che CMV havaratidzi zviratidzo zvehutachiona uye ruzivo hapana zviratidzo. Munhu ane immune system yakasimba anogona kuchengetedza utachiona ne CMV mukutarisa. Zvisinei, CMV inogona kukonzera utachiona hwakakomba kune avo vane simba rekudzivirira zvirwere. Uyezve, CMV inogona kukanganisa fetus uye inogona kukonzera kukanganisa kuberekwa.
Vakawanda vacheche vanoberekwa ne CMV chirwere vane utano. Panenge imwe yevana vashanu vanoberekwa ne CMV zvirwere vanorwara pavanenge vaberekwa kana kuti vanoenda kukura matambudziko ehutano kwenguva refu. Vamwe vana vanoratidza zviratidzo zveHIVV kutapuka pakuberekwa. Vana vashomanana vanoratidzika kunge vane utano pakuberekwa asi vanoramba vachiwedzera zviratidzo zvehutachiona, zvakadai sekurasikirwa.
Heano mamwe emigumisiro inogona kuitika ye CMV chirwere muchechecheche:
- petechiae (kureva, duku tsvuku kana kuti ruvara rwepepuru paganda rinokonzerwa ne-capillaries)
- kuwedzera kwechiropa uye spleen
- chiropa, mapapu, uye spleen zvinetso
- jaundice
- microcephaly
- hepatitis
- seizures
- hukuru hushoma pakuberekwa
- hemolytic anemia (an autoimmune blood disorder)
- kushandiswa mahesabu
- chorioretinitis (kureva, kuvhiringidzwa kwechoroid uye retina) uye mamwe matambudziko eziso
- matambudziko emeno
- zvinetso zvekunzwa
- psychomotor issues
- kuremara kwepfungwa
Zvakaoma kufanotaura kuti vana vacharamba vaine hutachiwana hweHIV, uye hapana kurapwa kwe CMV chirwere panguva yekuzvitakura kunodzivirira zvirwere mumucheche. CMV inogona kuparadzirwa kubva kune mumwe munhu kuenda kune imwe kuburikidza nemasero, zvepabonde, nezvakadaro.
# 5: Dzivisa Chimwe Chirairo Mishonga
Mishonga yakawanda ine zvinetso zvakashata zvinogona kukanganisa pamuviri. Zvisinei, zvinenge zvitatu zvinodhaka zvinodanwa zvinozivikanwa neatatogen, izvo zvinogona kukonzera kukanganisa kuberekwa. Zvimwe zvinokonzerwa netatogogenic zvinosanganisira zvinotevera:
- intrauterine kukura kwemiganhu
- kusagadzikana
- neonatal toxicities
- mararamiro anonyadzisa (kureva, migumisiro yakaipa yemishonga inokanganisa kushanda kwemazuva ese)
- kufa kwe fetus
Kusvikira pakati pezana ramakore rechimakumi maviri, vanachiremba vaitenda kuti fetus aigara munzvimbo yakachengetedzeka yakasiyana nemadzimai. Kutenda uku kuti mhumbu yakadzivirirwa kubva pamishonga yemishonga uye zvimwe zvinogona kutyisa zvakasviba zvakabva zvawira pasi pashure pemigumisiro ye thalidomide yakaguma nenhamo yakawanda muma1960. Thalidomide yaishandiswa kurapa kurwara kwemazuva asi yakaguma nokudzika kwechimiro chakakomba, kushata kwemaziso, nezvimwe zvakadaro muzvitsva.
Kubvira pakatarisana nenhamo ye thalidomide, vanachiremba vane gingerly vanouya kune mishonga yezvinodhaka panguva yekuzvitakura nokuda kwekutya matatogenic effects. Nenzira inofadza, vazhinji vanoita zvemasitimu havatauri panguva yekuzvitakura.
Heano mamwe anozivikanwa mishonga iyo inonzi tatatogens:
- cyclophosphamide
- diethylstilboestrol
- warfarin
- lithium
- isotretinoin
- carbamazepine
- phenytoin
- tetracycline
- ACE inhibitors
# 6: Tora Zvinyorwa zvePolate
Nyaya, kana folic acid, inonzi B vitamin. Munguva yepamuviri, kudiwa kwehuputi kunowedzera pakati pechishanu ne gumi nokuti vitamini iyi inotamirwa kumucheche. Kushayikwa kwevarume kunogona kuva kwakaoma kuona panguva yekuzvitakura, uye kunyange mukadzi ane zvakakosha angazviona. Nyaya, michero, mashizha ane mashizha akakwirira mumatare.
Nokuti hafu yematambudziko ose muUnited States isarongorongororwa uye kushaya urombo kunogona kukanganisa fetus pakutanga - amai vasati vaziva kuti ane pamuviri-CDC inokurudzira kuti vakadzi vose vezera rekubereka (pakati pe15 ne45) vanofanira kutora ma microgram folate zuva nezuva.
Izvi zvinotevera zvinowedzera kudiwa kwehutano mumamai:
- kudya kwakashata
- kuwirirana kweanemia
- anticonvulsant mishonga
- kunwisa
- utachiona
Kushayikwa kwechirwere kunogona kutungamirira kukuremara kwakakomberedza kuberekwa kusanganisira spina bifida uye anencephaly. Zvose izvi izvi zvinonzi neural tube defects. Ne spina bifida, mapfupa emutsana haasati akagadzira zvakapoteredza rwonzi rwomukona. Neinencephaly, zvikamu zve musoro uye uropi hazviiti zvakanaka.
Kutsvakurudza kunoratidza kuti folic acid supplementation panguva yekuberekwa ichienderera mberi kuburikidza nemavhiki 12 okutanga ekudzivirira kunogona kuderedza dambudziko reNeural tube zvisikwa zvinenge makumi manomwe kubva muzana.
# 7: Ramba Uine Utano Hwakanaka
Kusachengetedzwa kwechirwere cheshuga panguva yekudzivirira pamwe nekuwedzerwa pamberi uye panguva yekudzivirira kunogona kuwedzera kungozi yekuremara kwekuberekwa pamwe nezvimwe zvirwere zvakakomba zvehutano.
Kana chirwere cheshuga chisingatongorwi panguva yekuzvitakura, kukwirira kwemashuga eropa kunogona kukanganisa zvose fetus uye amai. Vacheche vanoberekerwa vanaamai vane chirwere cheshuga kazhinji vari makuru, uye vane nhengo dzakakura, izvo zvinoita kuti kuberekwa kuve kwakaoma zvikuru. Izvozvi vana vanoonawo ropa shoma shoma mushure mekuberekwa. Uyezve, vana vanoberekerwa vanaamai vane chirwere cheshuga vane mungozi yakawanda yekuzvarwa patsva, uye fetusheni inowedzera mungozi yekuparara.
Heano mamwe maitiro akajeka anowanikwa nevana vakaberekerwa vanaamai vane chirwere cheshuga:
- ganda rebhuruu uye rinoputika, kukurumidza kwemwoyo uye kukurumidza kufema (zviratidzo zvepapu uye mwoyo kusagadzikana)
- kudya zvakashata
- lethargy
- kuzvikudza
- kudengenyeka
- jaundice
- congenital heart defects
Vakadzi vane chirwere cheshuga vanofanira kuedza kuwana hutano hwakanaka vasati vava nemimba. Munguva yepamuviri, vakadzi vane chirwere cheshuga vanofanira kushandira kuvhara uremu pamwe nekurovedza muviri, kutarisa shuga yeropa, uye kunwa mishonga sezvinorayirwa nachiremba.
Saizvozvowo, vakadzi vanoderera vanofanira kuedza kurasikirwa nehutatu vasati vava nemubhedha kuburikidza nekudya, kurovedza muviri, uye mamwe mararamiro ehupenyu.
> Sources:
> Barbieri RL, Repke JT. Matambudziko Emishonga Panguva Yokurara. Muna: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
> Chung, W. "Teratogens Nemigumisiro Yadzo." Columbia University Medical Center. http://www.columbia.edu.
> Hoffbrand A. Megaloblastic Anemias. Muna: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
> Masters SB, Trevor AJ. The Alcohols. Mu: Katzung BG, Trevor AJ. eds. Basic & Clinical Pharmacology, 13e New York, NY: McGraw-Hill; 2015.
> Powrie RO, Rosene-Montella K. Kurapa Mishonga. Mu: McKean SC, Ross JJ, Dressler DD, Scheurer DB. eds. Nheyo nemitoo yePiritiri Medicine, 2e New York, NY: McGraw-Hill.