Kurapa kwegestational hypertension kunotevera maitiro akasiyana-siyana emitungamiri pane kurapwa kwehuwandu hwehuwandu hwemhepo kunze kwekubata pamuviri. Chinangwa chikuru chekurapa mukati madzimai vane pamuviri ndechekudzivirira kusimbiswa kwemamiriro ezvinhu akaoma sekumera kwekukura kwekukura kana kuti kuparara kwechimbichimbi. Kuberekwa kunounzawo zvimwe zvinetso mumagadziro emagariro evanhu, sezvo hupenyu hwemucheche hunofanirwa kuverengwa pamwe chete nehwaamai.
Zvisarudzo zvinowanzoshandiswa kurapwa kwevakadzi vane pamuviri vane high blood pressure ndezvi:
- Bhedha zororo
- Nguva pfupi (acute) drug therapy
- Yenguva refu (isingaperi) inodhaka remishonga
Mukusarudza imwe chirongwa chekurapa, tsanangudzo dzakadai sokuti ropa rakakura rakavapo musati mutevedzeri, kusvika kure zvakadini pamuviri, uye kuti mwana ari kuita sei zvinofanira kufungwa.
Kurapa Kwezorora Kwezororo
Kurara kwebhedha, kana basa rakadzikidzwa, rave rakagara rakarongerwa nokuda kwezviitiko zvegestational hypertension, zvisinei nokuti chii chinokonzera. Kunyange zvazvo tsika iyi yakashandiswa kwenguva yakareba uye inoenderera mberi ichive yakakurumbira kurapwa, pane humwe humwe uchapupu hwakasimba hunotsigira kukwanisa kwechirapa ichi. Zvidzidzo zvishoma zvemakiriniki zvakaitwa, pamwe chete nekuongorora kwebhuku rakawanda, asi hapana zvidzidzo zvikuru zvakaitwa. Muzhinji, zvigumisiro zvakasanganiswa. Zvimwe zvidzidzo zvakaratidza kuti mubhedha wekuzorora unopa zvipo zvekudzivirirwa, asi zvimwe zvidzidzo zvakaratidza zvishoma, asi zvinooneka, zvinoderedza dambudziko rekuwedzera kukura kwehuwandu hwehutano hwepamusoro kana kutengesera nguva isati yakwana.
Nokuda kwekushayikwa kwehupupuri hwakasimba, zororo rekurara harifaniri kuonekwa senzira yekujekesa nzira. Kunyange zvakadaro, basa rakanyanyiswa rakadzivirirwa hariiti chero hutano hwakakomba hwehutano uye rinogona kushandiswa kana risina kukanganisa purogiramu yako chaiyo. Mumamiriro ezvinhu apo pane anozivikanwa nezvinetso neropa rinoyerera kuburikidza ne placenta - "uteroplacental insufficiency" - zororo rinogona kupa mamwe mazano.
Mhedziso Yenguva Pfupi uye Yakareba Mishonga
Kushandisa mishonga inodhaka inzira inoshanda, inopupurirwa yekuenzanisa kushandiswa kweropa panguva yekuzvitakura, asi kutarisira kunofanira kushandiswa mukusarudza nekugadzira mishonga. Nemhaka yokuti kurapa kwemishonga panguva yekuzvitakura kunogona kutakura matambudziko kune vose amai nechecheche, inowanzochengeterwa kushandiswa chete mumamiriro ezvinhu apo ropa rakanyanya kukwirira, kazhinji> 150/100 mmHg.
Kwemishonga pfupi kwenguva pfupi, mishonga inowanzosarudzwa ndeyekuti:
- Labetalol - a beta blocker
- Hydralazine
- Kusunungurwa-kusunungurwa nifedipine - a calcium channel blocker
- Nenguva isunungurwa nicardipine - a calcium channel blocker
Munguva pfupi, kana mishonga iyi isingagoni kudzora ropa, chirwere chinonzi diazoxide dzimwe nguva chinoshandiswa kana pakarepo ropa rekudzivirira rinoda.
Kwekugara kwenguva refu kurapwa kunofanira kupfuurira kwevhiki kana mwedzi, kusarudzwa kwemishonga kwakafanana. Labetalol ndeimwe yemishonga inowanzoshandiswa mumadzimai ane pamuviri. Kunyange zvazvo mishonga yose ine ngozi dzakasiyana-siyana kune varwere vane pamuviri, labetalol yakaratidzwa kuva yakachengeteka kuti ishandiswe panguva yekuzvitakura. Pamwe chete ne labetalol, mamwe mishonga inogona kushandiswa inosanganisira:
- Methyldopa
- Long-acting calcium channel blockers (Nifedipine)
Fetal Assessment
Fetal kuongorora - kuongorora hutano uye chimiro chemucheche - chimwe chikamu chinopesana chekurapa gestational hypertension.
Kunyange zvazvo ultrasound inofanirwa kuitwa pamasvondo makumi matanhatu nemakumi maviri nematanhatu kuti ipe ruzivo rwakarurama rwekuverenga kuverengera kuongorora kukura kwevana, hapana chibvumirano chakajeka pamusoro pebasa reimwe mimwe miedzo. Vanachiremba vazhinji vanoita "nonstress test" pamwe chete ne "amniotic fluid index" kana "biophysical profile" pane vhiki nevhiki kusvika kumagumo ekudzivirira, senzira yekuvimbisa kuti kukura kuri kufambira mberi kazhinji. Pakati pese, kutarisa pedyo kunongoda chete apo mamiriro ezvinhu anoratidza kuti mwana angave ari pangozi. Iyi mamiriro akasiyana nevakadzi vakasiyana asi asi inogona kusanganisira zviratidzo zvekuti ropa rinopfuurira kune mwana rave ratorwa.
Basa uye Kuendeswa neHypertension
Vanenge vose vakadzi vane chisingadikanwi chekuita gemikari rekuwedzera kwehupombwe vacharamba vachive nekugoverwa kwenguva yakazara panguva yakazara. Vakadzi ava vanowanzobudirira zvekudzivirira vagari uye hapana zvimwe zvinetso zvakakomba. Mumamiriro ezvinhu apo kuwedzera kweropa kunowedzera zvakanyanya, kana mumatambudziko e preeclampsia, kuberekwa kwekutanga kunowanzoonekwa. Muzviitiko zvezvinetso zvakakomba, kufanana neEclampsia, kuberekwa kwekutanga kunowanzoedza kudzivisa kukura kwezvinhu zvinogona kutyisa upenyu. Asiwo, yeuka, yeuka kuti huwandu hwevakadzi vane pamuviri-huwandu hwehutano hwakanyanya hunoita kuti uve nehubudirira, nguva yakazara yepamuviri uye vane vana vane utano hwakanaka.
Sources:
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> Remuzzi, G, Ruggenenti, P. Kudzivirira uye kurapwa kwehutano hwehutano hwakabatana: Chii chatakadzidza mumakore gumi apfuura? Am J Kidney Dis 1991; 18: 285.
> Duley, L, Henderson-Smart, DJ, Meher, S. Zvinodhaka zvekurapa kukwirira kwepamusoro pehutano panguva yekuzvitakura. Cochrane Database Database Rev 2006; 3: CD001449.
> Abalos, E, Duley, L, Steyn, DW, Henderson-Smart, DJ. Antihypertensive drug therapy kuti ive nekodzero yepamusoro yeupemhesi panguva yekuzvitakura (Cochrane Review). Cochrane Database Database Rev 2007; : CD002252.
> Podymow, T, August, P. Postpartum nguva yegestational hypertension uye preeclampsia. Hypertension in pregnancy 20006; 25: 210.