Kutarisira Vanaamai Vane Matambudziko Emwoyo
Kubata pamuviri inzira yemuviri inokonzera shanduko huru mumuviri waamai. Shanduko idzi dzinonyanya kukanganisa hurongwa hwemwoyo: kuwanda kweropa, kurova kwemoyo kunowedzera, uye basa remoyo rinowedzera. Muvakadzi vane pamuviri vane matambudziko emwoyo—kungave ekuzvarwa nawo kana akawanikwa—shanduko idzi dzinogona kukonzera kusashanda zvakanaka kwemuviri, kuwedzera zviratidzo, uye kutowedzera njodzi yematambudziko kuna amai nemwana ari mudumbu. Nokudaro, kutarisira vakadzi vane matambudziko emwoyo kunoda nzira yakazara, yekushandira pamwe, uye inoenderera mberi kubva vasati vabata pamuviri kusvika panguva yekusununguka.
Kunzwisisa uye Mhando dzeMwoyo Usina Kunaka muKubata
Zvirwere zvemwoyo zvemadzimai zvinogona kusanganisira chirwere chemwoyo chekuzvarwa nacho (semuenzaniso, atrial/ventricular septal defect), chirwere chevharuvhu (mitral/aortic stenosis kana regurgitation), cardiomyopathy, arrhythmias, uye chirwere chemwoyo chinokonzerwa ne pulmonary BP kana coronary artery disease. Muchokwadi, dambudziko guru nderekuongorora kuti mwoyo unokwanisa sei kugadzirisa zvinodiwa nepamuviri. Kuoma kunowanzoonekwa kuburikidza nekupatsanurwa kwebasa (semuenzaniso, zvichibva pakushivirira kushanda), kuvapo kwe pulmonary BP, nhoroondo yekukundikana kwemoyo, uye mashandiro e ventricular pa echocardiography.
Kukanganiswa Kwepamuviri Pamuviri Patsinga Dzemwoyo
Munguva yekuzvitakura, kubuda kwemoyo kunowedzera ne30–50%, zvichikwira mumwedzi mitatu yechipiri kusvika mitatu. Kuwanda kweropa muropa kunowedzera, zvichiwedzera njodzi yekuzvimba uye kushaya mweya. Munguva yekusununguka, marwadzo echibereko anowedzera kushandiswa kweokisijeni uye basa remwoyo. Mushure mekusununguka, "autotransfusion" inoitika kubva muchibereko ichienda kuropa raamai, zvichikonzera kuwedzera kamwe kamwe kwebasa remwoyo kwemaawa 24–72 mushure mekusununguka. Nguva iyi yekusununguka inowanzova nguva yakakosha kuna vanaamai vane chirwere chemwoyo, sezvo njodzi yekuzvimba kwemapapu uye kutadza kwemoyo ichiwedzera.
Chinangwa Chekutarisira
Kutarisira vanaamai vane matambudziko emwoyo kunotarisira:
1. Kuchengetedza kugadzikana kweropa raamai uye kudzivirira kutadza kushanda kwemoyo.
2. Deredza njodzi yematambudziko e thromboembolic, arrhythmia, pulmonary edema, uye hutachiona.
3. Tarisa kukura nekukura kwemwana ari mudumbu uye kudzivirira matambudziko emvura inoyerera mudumbu.
4. Kuronga kusununguka kwakachengeteka kwakakodzera zvirwere zvemwoyo.
5. Gadzirirai rubatsiro rwakachengeteka rwemwana mushure mekusununguka uye rwekuyamwisa, kusanganisira kugadziriswa kwemishonga.
Kutarisirwa Kwemwana Asati Azvarwa (Panguva Yekuzvitakura)
1. Kuongorora Njodzi uye Kuongorora
Ongororo yekutanga inosanganisira nhoroondo yechirwere chemwoyo (rudzi, kuvhiyiwa kwakamboitwa, mishonga), nhoroondo yekufema zvishoma, kurwadziwa pachipfuva, kufenda, kurova kwemoyo, uye chero chii zvacho chinokonzera zviratidzo. Ongororo yemuviri inoongorora zviratidzo zvekushaya simba kwemoyo (tachycardia, dyspnea, rhonchi, kuzvimba, kuwedzera kweropa mutsinga) uye oxygen saturation. Mimwe miedzo inosanganisira ECG, echocardiography, uye bvunzo dzerabhoritari dzakadai seye hemoglobin uye bvunzo dzekushanda kweitsvo, kana zvichidikanwa. Ongororo yenjodzi inosanganisirawo zvinhu zvepamuviri zvakaita se preeclampsia, anemia, kana hutachiona, izvo zvinogona kuwedzera mutoro pamoyo.
2. Kushanya kweANC kakawanda uye kushanda pamwe chete nechikwata
Vanaamai vane matambudziko emwoyo vanowanzoda kushanyirwa nguva nenguva vasati vaberekwa kupfuura avo vasina matambudziko akafanana. Nzira yakanakisisa ndeyekubatana nevamwe: chiremba wezvekubereka, chiremba wemwoyo, nyamukuta, mukoti, chiremba wevaya vanonzwa kurwadziwa, uye, kana zvichidikanwa, chiremba wevana/vana vacheche. Kushanda pamwe chete uku kwakakosha pakugadzira hurongwa hwekusununguka uye kuona kuti vanotumirwa nguva nenguva kana paine dambudziko.
3. Kugadziriswa kweDzidzo neMararamiro
Dzidzo inosimbisa kukosha kwekuziva zviratidzo zvinonyevera: kuwedzera kwekufema kushoma, kuoma kurara nekuda kwekufema kushoma (orthopnea), kukosora kunotyisa, kurova kwemoyo zvakanyanya, kuzvimba nekukurumidza, kupera simba, kana kurwadziwa pachipfuva. Vanaamai vanokurudzirwa kudzora mashandiro avo nekuzorora, kurara vakagara pasi kana vachiwanzo tadza kufema zvakanaka, uye kudzivisa mabasa anorema anokonzera zviratidzo. Kudya kwakakwana kunofanirwa kupihwa, nekudzikiswa kwemunyu kana paine katsika kekuramba mvura. Kushaya ropa kunofanirwa kudzivirirwa uye kurapwa sezvo kunogona kuwedzera basa remoyo.
4. Kutevedzera Kurapa uye Kutevedzera Mishonga
Haisi mishonga yese yemwoyo yakachengeteka panguva yekuzvitakura. Saka, kutevedzera mitemo yekurapa kunofanira kuperekedzwa nekugadzirisa mishonga nachiremba. Semuenzaniso, mimwe mishonga yekuderedza BP kana yekudzivirira ropa kuvhara ropa ine zvirambidzo mukati memwedzi mitatu yekuzvitakura. Vanaamai vanofanira kutsanangurwa zvakajeka nezvemuyero, nguva yekutora mishonga, migumisiro yakaipa, uye kurambidzwa kwekumisa mushonga pasina kubvunza. Kumanikidzwa kweropa, kurova kwemoyo, huremu, uye zviratidzo zvinofanirwa kutariswa nguva nenguva.
5. Kutarisa Mwana Asina Kuzvarwa
Chirwere chemwoyo chaamai chinogona kuderedza kubuda kweropa mudumbu, zvichiisa mwana ari mudumbu panjodzi yekusakura zvakanaka, kutadza kukura zvakanaka, kana kutambudzika kwemwana ari mudumbu. Kuongororwa kuburikidza nekuyera hurefu hwedumbu, ultrasound yekukura, uye kuongororwa kwehutano hwemwana ari mudumbu (semuenzaniso, kufamba kwemwana zuva nezuva uye kuongororwa sezvakaratidzwa) zvikamu zvakakosha pakutarisira.
Kutarisirwa Kwemwana Mukati Mekusununguka (Panguva Yekusununguka)
1. Kuronga Kuzvara
Vakadzi vazhinji vane matambudziko emwoyo vanogona kusununguka vachibatsirwa nemukadzi kana mamiriro avo akasimba, sezvo kubviswa kwepamuviri nepamuviri kune njodzi huru yekubuda ropa, hutachiona, uye shanduko huru dzeropa. Zvisinei, nzira yekusununguka inofanira kusarudzwa zvichienderana nemamiriro emwoyo, mamiriro ekusununguka, uye mazano echikwata. Kusununguka kunofanirwa kuitirwa munzvimbo ine mukana wekutarisa uye wekutarisira emergency.
2. Kunyatsoongorora uye Kuisa Nzvimbo Yacho
Munguva yekusununguka, zviratidzo zvehupenyu, kuwanda kweokisijeni, uye kuenzana kwemvura zvinofanira kutariswa zvakanyanya. Amai vanokurudzirwa kurara nerutivi rwavo rweruboshwe kuti vagadzirise kudzoka kwetsinga uye kubuda kweropa mudumbu. Kuiswa kwemvura mutsinga kunoitwa nokungwarira kudzivirira kuwanda kwemvura. Okisijeni inopihwa kana kuwanda kwayo kwaderera kana kuti amai vachiita sevanoshaya mweya.
3. Kudzora Marwadzo uye Kuderedza Mutoro weMwoyo
Marwadzo nekuzvidya mwoyo zvinowedzera mutoro wemwoyo. Nokudaro, kudzora marwadzo kwakakwana (zvichienderana nekuwanikwa kwemishonga inonyaradza marwadzo uye mazano) kunogona kubatsira kudzikamisa hemodynamics. Danho rechipiri rekusununguka rinowanzopfupikiswa (semuenzaniso, nerubatsiro rwezvishandiso) mune mamwe mamiriro ezvinhu kuderedza kusundidzira kwenguva refu, izvo zvinogona kuwedzera kumanikidzwa mukati mechipfuva uye kushungurudza moyo.
4. Kudzivirira Matambudziko
Chenjerera zviratidzo zvekukundikana kwemoyo zvakanyanya: kufema nekukurumidza, kunyorova, kudzikira kwehuwandu hweropa, kusagadzikana, kukosora, kana cyanosis. Kurapa kunofanira kuitwa nekukurumidza, kusanganisira kushanda pamwe chete nechikwata, kuisa musoro panzvimbo, okisijeni, uye kurapwa kwakakodzera protocol. Uyezve, njodzi ye thromboembolism inogona kuwedzerwa nezvimwe zvirwere (semuenzaniso, atrial fibrillation, mechanical valves, immobilization), saka nzira dzekudzivirira dzinofanira kugadziriswa zvichienderana nekurudziro yachiremba.
Kutarisirwa Kwemwana Mushure mekusununguka (Nguva yekusununguka)
Nguva yekusununguka inowanzo furatirwa, asi inguva yakakosha. Mushure mekusununguka, kuchinja kwemvura kunogona kukonzera kuzvimba kwemapapu uye kutadza kushanda kwemoyo, kunyanya mumazuva maviri kusvika matatu ekutanga. Kutarisirwa mushure mekusununguka kunosanganisira kutarisa zviratidzo zvinokosha, kuongorora kufema kushoma, kuongorora kuzvimba, uye kunyora kudya uye kubuda kweropa. Kukurumidza kufambisa mwana kunoitwa zvakachengeteka, zvichienderana nemamiriro emwana, kudzivirira thrombosis, ukuwo zvichikosha kushivirira kushanda.
Kuyamwisa uye Kugadziriswa Kwemishonga
Kuyamwisa kunowanzo kurudzirwa, asi mimwe mishonga yemwoyo inogona kupinda mumukaka wezamu. Saka, zvakakosha kuongorora kuchengetedzeka kwemishonga panguva yekuyamwisa uye kufunga nezvedzimwe nzira kana zvichidikanwa. Vanaamai vanodawo rutsigiro kudzivirira kuneta; nguva yakakwana yekuzorora, rutsigiro rwemhuri, uye kudzora kushushikana zvakakosha kudzivirira kudzoka kwezviratidzo.
Mazano ekuronga mhuri uye kuronga pamuviri unotevera
Kupa mazano ekuronga mhuri chikamu chakakosha chekurapa. Mamwe matambudziko emwoyo ane njodzi huru yekubata pamuviri mune ramangwana, saka sarudzo dzekudzivirira pamuviri dzinofanira kunge dzakachengeteka pamatambudziko emwoyo uye kusangana kwemishonga (semuenzaniso, mishonga inorwisa ropa). Kana mukadzi ari kuronga kubata pamuviri mune ramangwana, timu inokurudzira zvikuru kuti aongorore nguva yekubata pamuviri.
Basa reVananyamukuta neVashandi veHutano
Vananyamukuta nevanamukoti vanoita basa rakakosha sekutaurirana pakati paamai, mhuri, nechikwata chezvekurapa. Basa iri rinosanganisira kuona zviratidzo zvengozi nekukurumidza, kudzidzisa, kutarisa kutevedzera mishonga, rutsigiro rwepfungwa, uye kuona kuti varwere vanotumirwa kuchipatara nenguva. Zvinyorwa zvakakodzera—kusanganisira zviratidzo, zviratidzo zvinokosha, mhinduro yekurapwa, uye zvirongwa zvekutevera—zvinotsigira kuchengetedzeka kwemurwere.
Mhedziso
Kuchengeta vanaamai vane matambudziko emwoyo kunoda nzira yakakwana kubva pakuva nepamuviri kusvika pakusununguka uye mushure mekusununguka. Zvinokosha kuti ubudirire kuongorora njodzi nemazvo, kutarisisa zvakanyanya, dzidzo yakakodzera, kugadzirisa mabasa nekushandisa mvura mumuviri, uye kushanda pamwe chete mumapoka akasiyana-siyana. Nekutarisirwa kwakarongwa uye kuenderera mberi, vanaamai vazhinji vane matambudziko emwoyo vanogona kubata pamuviri nekuzvara vana vakachengeteka, uye kubereka vana vane hutano.
