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პრეეკლამფსია | ჯანმრთელობა | vidal.ge

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პრეეკლამფსია

თარიღი: 29 მაისი, 2020

პრეეკლამპსია ორსულობის გართულებაა, რომელიც ხასიათდება მაღალი წნევით, პროტეინურიით (შარდში ცილა) და სხვადასხვა ორგანოთა სისტემების დაზიანებით როგორიცაა ღვიძლი და ფილტვები. პრეეკლამპსია ძირითადად იწყება 20 კვირის ვადაზე იმ ქალებში რომლებსაც ჰიპერტენზია ორსულობამდე არ აწუხებდათ.

პრეეკლამპსიამ შესაძლოა სერიოზულ გართულებებამდე მიგვიყვანოს და იმ შემთხვევაში თუ არ ვუკმურნალებთ ლეტალურიც კი იყოს. პრეეკლამპსიის განკურნების ერთადერთი საშუალება მშობიარობაა. პრობლემა იქმნება მაშინ, როდესაც ორსულობის ნაადრევ ვადაზე ისმება დიაგნოზი. როდესაც ნაყოფსმზად არ არის დაბადებისთვის, დედის მდგომარეობა კი მოცდის საშუალებას არ გვაძლევს.

პრეეკლამპსია კლასიფიცირდება როიგორც მსუბუქი და მძიმე ფორმა. მსუბუქი ფორმის მძიმე ფორმაში გადასვლა შესაძლოა ძალიან სწრაფად მოხდეს. ამიტომ ყველა სიმპტომი და მინიშნება საყურადღებოა. პრეეკლამსიის სიმპტომებიდან სახლის პირობებში ყველაზე მარტივად არტერიული წნევის მატების დაფიქსირებაა შესაძლებელი. იგი შესაძლოა უეცრად დაფიქსირდეს ან ნელ-ნელა გამოიხატოს. არტერიული წნევის კონტროლი ძალიან მნიშვნელოვანია ორსულობისას.

სიმპტომებია:
არტერიული წნევის მატება.
პროტეინურია >0,3გ/ლ
თავის ტკივილი
მხედველობის დარღვევა
ტკვილი მარჯვენა ფერდქვეშა არეში
ოლიგურია (შარდის რაოდენობის შემცირება)
გენერალიზებული შეშუპება
თრომბოციტოპენია 1,2გ/დლ;
მომატებული ALT/AST/LDH;
ექოსკოპიურად ნაყოფის სავარაუდო წონა 10 პერცენტილზე ნაკელბი
ნაყოფის ბიოფიზკური პროფილი 8 ქულაზე ნაკლები
დოპლეროგრაფიით ჭიპლარის არტერიაში დიასტოლური სისხლისდინების სიჩქარის შენელებული, ნულოვანი, ან რევერსული ტიპი.

როდის მივმართოთ ექიმს?
თუკი ოთხი საათის ინტერვალით ორჯერ დაფიქსირდა სისხლის წნევა 140/90 მმ.ჰგ ზე მეტი.
თუ გაწუხებთ თავისტკივილი, მხედველობის დაბინდვა
თუ შეგაწუათ ტკივილმა მარჯვენა ფერდქვეშა მიდამოში
გრძნობთ რომ შეგიშუპდათ კიდურები და სახე.

რისკფაქტორებია:
პრეეკლამპსია წინა ორსულობისას,
ქრონიკული ჰიპერტენზია
პირველი ორსულობა
ასაკი (ახალგაზრდა დედებში უფრო ხშირია ვიდრე 40-ს გადაცილებულ ორსულებში)
სიმსუქნე
მრავალ ნაყოფიანი ორსულობა
10 წელზე დიდი ან 2 წელზე მცირე ინტერვალი ორსულობებს შორის
დიაბეტი
ინ ვიტრო განაყოფიერება

გართულებები:
ნაყოფის ზრდაში შეფერხება
ნაადრევი მშობიარობა
პლაცენტსი აცლა

ჰელპ სინდრომის ჩამოყალიბება - ეს დაავადება პრეეკლამპსიის გართულებული ფომაა სადაც სხვა სიმპტომებთან ერთად დართულია ჰემოლიზი, თრომბოციტოპენია და ღვიძლის პერმენტების მატება.

ეკლამპსია - პრეეკლაპმპსიის სიმპტომებს თან დართული გულყრები (კრუნჩხვები)

პრეეკლამპსიისას შეიძლება განვითარდეს თირკმლისა და ღვიძლის დაზიანებები. აევე შესალიოა გაიზარდოს მომავალში გულსისხლძარღვთა დაავადებების განვითარების რისკი.

პრეეკლამპსიის დროულად აღმოჩენა და სწორი მკურნალობის ტაქტიკა დიდ როლს თამაშობს ზემო აღნიშნული გართულებებისთავიდან აცილებაში.

ორსულობის პერიოდში ძალიან მნიშვნელოვანია ანტენატალური ვიზიტების განხორციელება , რათა მსგავი გართულებები თავიდან ავიცილოთ ან დროზე ვუმკურნალოთ. პრეეკლამპსიის დიაგნოზის დასმის შემთხვევაში აუცილებელია ორსულმა ექიმთან ერთად იზრუნოს საკუთარი და ნაყოფის ჯანმრთელობაზე.