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varjishi da orsuloba
ufro aqtiurad
orsuloba avadmyofoba ar aris. miuxedavad imisa, rom es martivi cheshmariteba yvelam icis, orsuls mainc avadmyofuri sifrtxilit epyrobian: ???bevri ar iseirno???, ???bevri ar imushao???, ???bevri ar ilaparako???...
emansipaciam moitana tu ubralod sachiroebam, ver getyvit, magram faqtia, rom qalebs xshirad lamis mshobiarobamde uxdebat ofisshi profesiuli movaleobis shesruleba, zogierti ki mteli am xnis ganmavlobashi varjishsa tu curvazec ar ambobs uars.
asea, tanamedrove orsuls shin ver chaketav, patar-patara diskomfortis shesamsubuqeblad ki viqcevit ase:
. vaqrobt guldzmarvas da gulisrevis shegrdznebas. ertica da meorec umtavresad dilaobit ichens xolme tavs, tumca arc is aris gamoricxuli, mteli dghe gagyvet. usiamovno shegrdznebebis shesasusteblad eridet noyier vaxshams, mdzafr suns, mushaobis dros xshir-xshirad waixemset. ofisshi gaiyolet sawuwni kanfeti, chiri, umarilo krekeri da, rac mtavaria, svit bevri sitxe.
gulisrevis shegrdzneba mdzafrdeba, rodesac orsuli gamodzinebas ver axerxebs. ase rom, srulfasovani dzili aucilebelia. nurc sawolidan wamodgomas ichqarebt. rom gaighvidzebt, mcire xans sawolshi inebivret, shemdeg mshvidad wamodeqit da profesiuli movaleobis shesasruleblad nela gaudeqit gzas.
. vebrdzvit motentilobas. nu daelodebit gadaghlas. xshirad wamodeqit, otaxshi gaiar-gamoiaret, tu shesadzlebelia, mcire xnit shuqi chaaqret, tavi magidaze dadet da tvalebi daxuchet.
tu mushaoba metismetad gghlit, dziritadi samushao dghis pirvel naxevarshi moiliet, meore naxevristvis nakleb damghleli saqme moitovet.
dilit tavi mxned rom igrdznot, saghamos droulad miashuret sawols. rogorc ki dzlier daghlilobas grdznobt, icodet: dzilis droa!
. vmushaobt komfortulad. iolad ar daighlebit, tu iset skams shearchevt, romelsac saxelurebic eqneba da modzravi sazurgec. tu aseti skami ar gaqvt, zurgs ukan patara balishi amoidet ??� ase xerxemali naklebad daighleba. aseve sasurvelia, fexebi shemaghlebul saganze, magalitad, patara skamze shemoawyot.
tu didxans giwevt fexze dgoma, cali fexi periodulad shemaghlebulze shedgit. aseve sasurvelia, sxeulis zewola xan ert, xan meore fexze gadaitanot. da, ra tqma unda, ataret komfortuli fexsacmeli. winaaghmdeg shemtxvevashi tqvens kidurebs, ufro zustad ki venebs, uzarmazari jafa daadgeba.
dabolos: samushao arsad gaiqceva, arc sheusrulebeli darcheba. ase rom, nerviulobas tavi daanebet da moeshvit. damshvidebul gulze samushaoc uket sruldeba da arc janmrtelobas adgeba ziani.
ra sargebloba moaqvs varjishs
varjishi da, sazogadod, fizikuri aqtiuroba arc orsuls avnebs da arc mis mucelshi mokalatebul pawias. es imitom, rom:
. martivi varjishis shemdegac ki organizmshi gamomushavdeba endorfini ??� nivtiereba, romelic siamovnebis gancdas moggvrit.
. varjishi aqrobs zurgis tkivils, romelsac umtavresad adgilze gaundzrevlad jdoma iwvevs, amushavebs saxsrebs, tonusshi mohyavs kuntebi.
. varjishi stress xsnis da mshvid dzils gibrunebt.
. varjishi dagexmarebat, momxiblavad gamoiyurebodet ??� fizikuri datvirtvis dros sisxlis mimoqceva umjobesdeba da kanic jansagh elfers idzens.
. roca sxeuli navarjishevia, mshobiaroba gacilebit iolia.
daixsomet: shesadzloa, varjishis wyalobit wonashi naklebi moimatot, magram orsulobis dros fizikuri aqtiurobit wonis dakleba aramc da aramc ar scadot ??� amit shesadzloa avnot rogorc sakutar tavs, ise bavshvsac.
viwyebt varjishs
tu daorsulebamde regularulad varjishobdit, arc orsulobis dros gagichirdebat, tumca isic sheidzleba, varjishs swored am cxra tvis ganmavlobashi mohyot xeli.
amerikis janmrtelobisa da sazogadoebrivi momsaxurebis saagento orsulebs urchevs, kvirashi 150 wuti (2 saati da 30 wt) mainc dautmon fizikur aqtiurobas.
jobs, varjishis saxeoba eqimtan ertad shearchiot. sasargebloa curva, wylis aerobika, ioga, pilatesi, velosipedit siaruli, cekva da ubralod fexit seirnoba. girchevt, tavdapirvelad mocions kvirashi mxolod sami dghe dautmot, titoeul jerze ??� ociode wuti. shemdeg seirnobas tandatan mouxshiret da xangrdzlivobac nel-nela gazardet.
yuradghebit usminet sakutar organizms. tu sheatyobt, rom mcire datvirtvac dzlier diskomforts gayenebt, nu gariskavt, daisvenet.
varjishis shewyveta jobs, tu shegawuxat:
. maghalma arteriulma wnevam;
. dzlierma motentilobam;
. dzilianobam;
. guliscemis gaxshirebam;
. haeris ukmarisobam;
. sashodan sisxldenam;
. tkivilma welisa da mcire menjis ghrus areshi.
daixsomet: maghali temperaturis pirobebshi varjishic gekrdzalebat da mushaobac ??� shesadzloa, gadaxurdet, rac nayofistvis aramc da aramc ar aris sasargeblo.
aramc da aramc
rogorc ar unda iyot shepyrobili sportuli jinit, rac ar unda idealur formashi iyot, arsebobs fizikuri datvirtvis saxeobebi, romlebsac tavi unda aridot. kerdzod, ar sheidzleba xtunva, varjishi, romlis drosac mimartulebis swrafi shecvlaa sachiro an romlis shedegadac maghalia muclis travmis albatoba. amrigad, tavi unda aridot sportis iset saxeobebs, rogoric aris txilamurebit sriali, yvintva, jiriti.
tu step-aerobikit xart gatacebuli, shegidzliat, orsulobis drosac isiamovnot, oghond mxolod mashin, tu koordinaciis unari shenarchunebuli gaqvt (orsulebs koordinaciis unari xshirad erghvevat).
rac mtavaria: orsulistvis ar sheidzleba varjishit gadaghla.
usafrtxo starti
vidre varjishs sheudgebit, konsultaciistvis eqims mimartet, magram ramdenime principis codna tavadac ar gawyendat. matze vrclad ukve visaubret, axla mxolod shevajamebt:
. daiwyet mcire datvirtvit. yoveldghiurad 5 wuti dasawyisistvis savsebit sakmarisia. kvirashi ertxel 5-5 wuti daumatet, vidre 30 wutze ar axvalt.
. varjishis dros rac sheidzleba komfortulad chaicvit. shearchiet specialuri sportuli biusthalteri, romelic mkerds efeqturad ichers.
. varjishis dros rac sheidzleba meti sitxe daliet ??� es organizms gadaxurebisgan daicavs.
. tu tavs sheudzlod igrdznobt, ar aris aucilebeli, ivarjishot. roca momjobindebit, varjishi mashin ganagrdzet.
. cxel, nestian amindshi (am dros sicxe ufro mdzafrad sheigrdznoba) didxans nu iseirnobt. ecadet, es dro kondicirebul otaxshi gaatarot.
dabolos: yuradghebit usminet sakutar organizms. tu gitxrat: ???shecherdi!??? ??� nu daayovnebt. varjishistvis mshobiarobis shemdegac moiclit, ramdenime weliwadshi ki ufro meti xalisit ivarjishebt ??� mashin xom tqveni pawiac dagimshvenebt gverds

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ORSULI DA VARJISHI

am temis ganxilva drois motxovnaa. cxovrebis aqtiuri wesi sul ufro da ufro popularuli xdeba. amitom qalebisatvis, romlebic aqtiur cxovrebas michveulebi arian, mnishvnelovania, ramdenad sheidzleba asetve cxovrebis gagrdzeleba orsulobis periodshi. dghes tbilisshi qalta fexburti, karate da chidaoba ukve gavrcelebul sportis saxeobebad sheidzleba chaitvalos.
orsulobisas fizikuri aqtivobis mnishvneloba dzalian didia. magrdeba kuntebi, varjishdeba gul??�sisxldzarghvta sistema, umjobesdeba fsiqoemociuri tonusi, dzili, mada. yovelive amas tavisi dadebiti gavlena aqvs nayofze,magram ar unda dagvaviwydes, rom orsuloba gansakutrebuli mdgomareobaa da aqvs tavisi specifikuri momentebi:
1. sportis yvela saxeoba ar aris mizanshewonili orsulobis dros, zogierti ki kategoriuliad akrdzalulia. es exeba potenciurad travmatul sportis saxeobebs ??� alpinizmi, wyalshi xtoma, txilamurebi, kontaqturi ortabrdzolebi, cxenosnoba, velosipedi. gunduri tamashebi ??� fexburti, kalatburti, frenburti sxva droisatvis unda gadaidos. ra tqma unda am statiis farglebshi sportis yvel saxeobas cal??�calke ver chamovtvlit, amitom gaitvaliswinet sakutari da sxvis gamocdileba ??� tqveni potenciuri travmireba sulac ar aris sachiro nayofisatvis. mitumetes am travmis mkurnalobis processhi eqims sheidzleba arc darches sashualeba nayofisatvis uvnebeli preparatebis gamoyenebis. aseve orsuloba ar aris profesiuli sportuli shejibrebebisatvis sauketeso dro, chadrakshic ki!
2. aranakleb mnishvnelovani momenti ??� fizkuri datvirtva unda iyos dozirebuli. gadatvirtva sruliad unda gamoiricxos, radgan mas jangbadit momaragebis gauarebastan mivyavart.
dozireba da mastan dakavshirebuli usafrtxoeba dakavshirebulia:
1. orsulobis taviseburebebtan
2. ramdenad navarjishevi iyavit orsulobamde,
3. orsulobis vadaze
oriod sityva pirvel faqtorze: tu orsuloba gartulebebit mimdinareobs,fizikuri aqtivoba unda sheizghudos da zogjer dzalian mnishvnelovnadac. aseti gartulebebia mdzime qronikuli daavadebebi: shaqriani diabeti, revmatizmi,gulis manki, farsiebri jirkvlis daavadebebi, gulis ishemiuri daavadebebi.samkurnalo fizkulturis dozireba am dros xdeba mean??�ginekologisa da fizikuri reabilitaciis specialistis mier.
orsulobis sxva tipiuri tavisebureba, rac fizikur aqtivobas zghudavs,sameano gartulebebia ??� abortis sashishroeba, sashvilosnos anatomiuri anomaliebi, hipertonusi da sxv. ase rom orsulze zedamxedvel eqims mnishvnelovani roli aqvs fizikuri datvirtvis moculobis gansazghvrashi
exla visaubrot meore pirobaze ??� ramdenad navarjishevi iyavit orsulobamde. tu tqven intensiurad navarjishevi qalbatoni brdzandebit, shegidzliat tavs ufleba miscet iseti fizikuri datvirtvebis, romelic sashualostatistikur qalisatvis dzalze bevria. magalitad sportis ostatisatvis nel tempshi 3 km??�iani garbenic dasashvebia. tu tqveni pulsi varjishis damtavrebis shemdeg 5 wt??�is shemdeg 100d/wt??�ze dabla ar chamovida, datvirtva gadametebulad unda chaitvalos da intensivoba unda shemcirdes. amave droshi unda moxdes arteriuli wnevis normalizeba. intensiuri fizikuri datvirtvis xangrdzlivoba aravitar shemtxvevashi 15 wt??�ze meti ar unda iyos. intensiur datvirtvad itvleba iseti datvirtva, roca purlsis sixshire 150 da metia. umjobesia meti dro daxarjot gaxurebaze. varjishi aravitar shemtxvevashi 1,5 st??�ze meti ar unda gagrdzeldes.
xolo tu tqven bolo krosi 5??�6 wlis win irbinet, tvaisufal dros ki wignis kitxva da televizoris yureba girchevniat, es imas nishnavs, rom axali xart olimpiur samyaroshi. tqventvis fizikuri aqtivoba aratu sasargebloa, aramed aucilebeli, magram am shemtxvevashi dzalze mnishvnelovania fizikuri aqtivobis specifikisa da dozirebis swori shercheva.
damwyebtatvis specialistebi archeven shemdeg fizikur varjishebs: aerobika, relaqsacia, kalistineqsi da kegelis varjishebi. titoeul matganze calke statiis dawera sheidzleba, magram amjerad mokled vityvit, rom aerobika da kalistineqsi aumjobeseben nayofis jangbadit momaragebas, relaqsacia da kegelis varjishebi avarjisheben sasuntq sistemas da menjis kuntebs. tqven shegidzliat airchiot am ramdenime tipis varjishta kombinacia, yvela shemtxvevashi varjishi gamocdil instruqtortan ertad individualurad unda daigegmos.
tqveni yuradgheba gvinda mivapyrot ramdenime mnishvnelovan moments, rata fizikuri varjishi uxifato iyos tqventvis da nayofisatvis:
fizikuri aqtivobis gegmis shedgena daiwyet eqimtan vizitit. saerto mdgomareoba, sameano anamnezi, qronikul daavadebata gamoricxva, orsulobis shemdgomi mimdinareobis prognozireba gansazghvravs tqveni fizikuri datvirtvis moculabas. unda naxot ginekologic da terapevtic. tu eqimebisagan mwvane shuqia, mashin:
ar daiwyot varjishebi mkvetrad, sruli datvirtvit. tqven rekordi ki ar unda daamyarot, aramed praqtikuli sargebeli miighot am varjishebidan. sawyis etapze ivarjishet 20??�30 wt dgheshi. drota ganmavlobashi varjishis xangrdzlivoba 1 st??�mde sheidzleba mivides. ar gadaighalot. tu varjishis shemdeg tavs sustad grdznobt da gichndebat wamowolis survili, datvirtva araadekvaturia. tvalyuri adevnet pulss (zemot ukve visaubret)
mtavari nawili varjishis aris gaxureba. gaxureba unda moxdes nel??�nela. tu tqven sruli datvirtvit daiwyebt varjishs, didi riskia, rom travma miighot.
yuradgheba miaqciet savarjisho kostiums da fexsacmels, ramdenad moxerxebulia. naklebad gamoiyenet shemocherili sintetikuri sashualebebi. ufro bambis sportuli tansacmeli gamoiyenet.
sifrtxile da kidev sifrtxile ??� mtavari devizia orsulobisas. gaxsovdet, rom modzraobis koordinacia orsulobis meore naxevarshi iseti aghar aris, rogoric iyo orsulobamde. shezghudet iseti varjishebi, sadac sheidzleba wonasworoba dakargot da daecet. sadac varjishobt,ar unda iyos arc dzalian magari, arc sriala iataki. sufta haerze varjishisas sasurvelia ivarjishot mokle mshral balaxze an sashualo sirbilis gruntze (datkepnili qvishis tipis)
mudam yuradghebit daakvirdit sakutar tavs, tu varjishis shemdeg gawuxebt tavis tkivili, tavbrusxveva, an gaqvt sisxliani gamonadeni, dauyovnebliv mimartet eqims. konsultaciaze misvlis mizezi sheidzleba iyos nebismieri uqeifoba, gansakutrebit tu igi gashfotebt.
yuradgheba miaqciet imasac, rom sadac varjishobt, is shenoba kargad niavdebodes. ar ivarjishot tbil da chaxutul shenobashi. garet ar ivarjishot sicxeshi. cxel da nestian amindshi mkvetrad uaresdeba sitbocvla garemostan, amitom varjishis dros arsebobs gadaxurebis sashishroeba, rac saxifatoa nayofisatvis
daukavshirdet instruqtors, an ukidures shemtxvevashi ishovet raime saxelmdzghvanelo orsulta fizkulturis. tu gaqvt sashualeba, midit orsulta jgufur varjishebze, \"kolegebtan\" urtiertoba dagexmarebat stresebis moxsnashi. rac mtavaria, iqnebit gamocdili instruqtoris dakvirvebis qvesh.
unda icodet, rom sruli fizikuri umoqmedoba orsulobisas aris mnishvnelovani risk??�faqtori iseti arasasurveli movlenebisatvis, rogoricaa samshobiaro travma, jangbadis qronikuli nakleboba nayofisatvis, ase rom tu ver axerxebt \"mecnierulad dasabutebuli\" dozebit varjishs, modzebnet misi eqvivalentebi ??� iseirnet fexit, icuret sufta wyalsatevebshi, ivarjishet ise rom ar daighalot ??� amis gamo uaresad ar gaxdebit.
mesame mtavari piroba, romelic orsulobisas fizikuri aqtivobis xasiatze moqmedebs, aris orsulobis vada. ar aris sachiro detaluri axsna imisatvis, rom mesame trimestrshi es aqtivoba unda shemcirdes. gazrdili nayofi mnishvnelovnad zghudavs tqvens modzraobis unars, tqven chqara ighlebit. amitom momavali dedebi avtomaturad gadadian iset rejimshi, romelic mattvis misaghebia.
unda gaxsovdet, rom dawyebuli 32 kviridan, tu varjishebi grdzeldeba, daakvirdet nayofis aqtivobas varjishamde da mis shemdeg. tu nayofis aqtivoba varjishis shemdeg mcirdeba, sachiroa sheamcirot datvirtva da mimartot eqims.

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ORSULIS KVEBA

orsulobis periodshi qalis sakvebshi, rogorc cximebi, ise naxshirwylebi (gansakutrebit fqvleulis saxit) zedmeti raodenobit ar unda shediodes, vinaidan igi xels uwyobs rogorc dedis gasuqebas, ise bavshis wonis momatebas, rac xels sheushlis mshbiarobis normalurad chatarebas.
fexmdzimobis dros qals schirdeba dghe-ghameshi chveulebrivze 300 kkal-it meti (tu momavali dedis wona sashualoze naklebia an igi 18 welze naklebi asakisaa, mashin 500 kkal-it meti).
momavali dedis organizms yoveldghiurad schirdeba cilebi, cximebi, naxshirwylebi, vitaminebi, mineralebi, sitxeebi da sxva. dedis organizmshi cilebi ishlebian aminomjavebad, romlebidanac dedac da nayofic asintezeben axal, mattvis sachiro cilebs. cximebi gamoiyeneba ujredebis shenebistvis da uzrunvelyofen organizms energiit. naxshirwylebi gamoiyeneba rogorc sasheni masala da energiis matareblebi. vitaminebi da mikroelementebi mushaoben rogorc regulatorebi nivtierebata cvlis umnishvnelovanes qimiur procesebshi.
orsulobis periodshi qalis swori kveba adzlierebs misi organizmis winaaghmdegobis unars sxvadssxva daavadebebis mimart, romelebic advilad ikideben fexs rogorc orsulobis, ise loginobis dros. orsulobis periodshi qals unda hqondes noyieri, advilad shesatvisebeli, mravalferovani, cilebis, cximebis, naxshirwylebis shemcveli da vitaminebit mdidari sakvebi. orsulis dghis racionidan gamoricxuli unda iyos yovelgvari alkoholiani sasmeli

marilis shesaxeb: adre gavrcelebuli iyo azri, rom fexmdzime qalma rac sheidzleba naklebi marili unda miighos, magram uaxlesi gamokvlevebit dadginda, rom tu garkveuli chvenebebi ara gaqvt (magalitad, tirkmelebis problemebi, proeklampsia da sxva), shegidzliat miighot marilis (sasurvelia iodizirebuli marili) chveulebrivi raodenoba.

vegetarianuli kvebis shesaxeb: cilebis motxovnileba shegidzliat daikmayofilot xorcisa da tevzis gareshe. tumca tu rdzesac da kvercxsac ar chamt, amas albad ver shedzlebt. mtavaria kalciumis deficiti shesadzlebelia agretve B12 vitaminis deficitic. es sakitxi gaarchiet tqvens eqimtan.

chamis rejimis shesaxeb: fexmdzimobis dasawyisshi chamet cota da xshir-xshirad (amgvarad miighebt nivtierebebis sakmaris raodenobas, radgan daqveitebuli geqnebat mada-adreuli toqsikozis gamo). shemdgomshi ki-gadadit tqventvis yvelaze mosaxerxebel tavisufali chamis rejimze.

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ORSULIS PROBLEMEBI

pirveli trimestris gartulebebi

orsulobata umetesoba gartulebebis gareshe mimdinareobs, magram am dros garkveuli problemebic ar aris gamoricxuli. umetes shemtxvvevashi riski sagrdznoblad mcirdeba tu gamafrtxilebel nishnebs droze gaacnobierebt da shesabamisad moagvarebt. amdenad, tqventvis dzalzed mnishvnelovania imis codna, ra gartulebebs aqvs adgili orsulobis adreul etapze, ra simptomebshi vlindeba igi da ra shemtxvevashia aucilebeli eqimtan dakavshireba.
gadacharbebuli pirghebineba (Hyperemisis Gravidarium)
ra iwvevs mas?
es aris orsulobis dros gadacharbebuli ghebinebis samedicino saxelwodeba. (hyper - nishnavs ???gadacharbebuli???, emesis ??� ???ghebineba???, xolo gravidarium ??� ???orsul mdgomareoba???-s.) es simptomi 300 orsulidan erts aghenishneba. es mdgomareoba xasiatdeba xshiri, mudmivi da mwvave ghebinebit. tu droulad ar moxda misi mkurnaloba, igi qals ar miscems orsulobisatvis aucilebeli sakvebis da sitxis mighebis sashualebas. tu igi xangrdzlivad mimdinareobs, sheidzleba nayofsac daemuqros.
pirghebinebis gamomwvevi mizezebi bolomde cnobili ar aris. magram itvleba rom igi dakavshirebulia hCG (adamianis qoreogenuli hormonis) da estrogenis hormonebis chveulebrivze maghal donestan; ufro xshirad aghinishneba shedarebit axalgazrda dedebtan da ertze meti nayofis shemtxvevashi.
ra mkurnaloba enishnebat am dros?
mkurnalobis dawyebamde eqims daschirdeba ghebinebis sxva mizezebis gamoricxva: mag, kuchnawlavis daavadeba, farisebri jirkvlis problema an bushtnamqeri orsuloba. shedarebit msubuq shemtxvevebs dietit, wolit (dasvenebit), da antacidit (kuchis simjavis damwevi sashualeba) mkurnaloben. ufro mwvave shemtxvevebisas sachiroa saavadmyofoshi wola, radgan deda sakvebs da sitxes intravenuri infuziis sashualebit miighebs.
tu tqven dzlieri gulisreva da ghebineba gaqvt ise, rom ver icherebt sakvebs, an tu es mdgomareoba asetive simwvavit orsulobis meore perodshic (13-dan 27 kviramde) grdzeldeba, aucileblad daukavshirdit eqims. aseve, nu daayovnebt eqimtan dakavshirebas, tu ghebinebas axlavs tkivili da sicxe.
sashvilosnos gareta orsuloba
sashvilosnos gare (sg) orsulobaa, rodesac ganyofierebuli kvercxujredi sashvilosnosgan gansxvavebul adgilas magrdeba. sg fexmdzimobis 95% falopis milshi mimdinareobs. dzalian ishviatad rom kvercxujredi sxvagan ??� muclis ghrushi, sakvercxeebshi an sashvilosnos yelshi motavsdes.
radgan viwro falopis mili ar aris gamiznuli mzardi embrionis shesanarchuneblad, ganayofierebuli kvercxujredi aset dros normalurad ar vitardeba. sabolood, milis txeli kedlebi gaskdomamde ichimeba. aset dros sicocxlistvis saxifato sisxldenaa mosalodneli.
1980 wlidan sg orsulobis sixshire gaizarda. ukanaskneli monacemebit a.sh.sh.-shi sg orsuloba 1,000-dan 7-s aghenishneba. miuxedavad amisa, sg orsulobit gamowveuli sikvdilianoba ishviatia da 2,500-dan ertze naklebi shemtxvevaa. es dabali machvenebeli tanamedrove samedicino teqnikis shedegia, romlis sashualebitac sg orsuloba adreul stadiaze vlindeba, mashin rodesac misi safrtxe umnishvneloa.
ra iwvevs mas?
sg orsuloba umetes shemtxvevashi gamowveulia ganayofierebuli kvercxujredis sheudzleblobit gadavides falopis milidan sashvilosnoshi. es xshirad milis infeqciit an antebit aris gamowveuli, ris gamoc mili naxevrad an mtlianad gauvalia. infeqciidan darchenilma nachrilobevma an milze gaketebulma operaciam sheidzleba aseve sheaferxos kvercxujredis modzraoba. mizezi sheidzleba iyos endometriozi, romlis drosac qsovili, romelic normalur shemtxvevashi sashvilosnos shignit imyofeba, garetaa. shemdegi mizezia milis patologiuri zoma, romelic tandayolili defeqtit an patologiuri zrdit aris gamowveuli.
sg orsulobis umetesoba 35-44 wlis asakshi aghinishneba. mtavari risk-faqtoria mcire menjis antebiti daavadebebi. es aris sashvilosnos, falopis milis an sakvercxeebis antebebi. sg orsulobis riski maghalia shemdeg shemtxvevebshi:
wina sg orsuloba
falopis milis qirurgiuli operacia
ramodenimejer muclis moshla
unayofoba an ovulaciis mastimulirebeli medikamentebit mkurnaloba
ra simptomebi aghinishneba am dros?
umetes shemtvevashi, tavdapirvelad sg orsulobaze sheidzleba araferi ar miganishnebdet. normaluri orsulobis nishnebi, mag, menstrualuri ciklis gamotoveba, sg orsulobis drosac chveulebriv vlindeba.
sg orsulobis pirveli nishani chveulebriv tkivilia, romelic aghinishneba mcire menjshi, muclis ghrushi an mxrebis da kisris adgilebshi. tkivili aghiwereba rogorc mwvave da mchreli. igi sheidzleba movliti da cvalebadi xasiatis iyos.
sg orsulobis gamafrtxilebeli nishnebia:
vaginaluri sisxldena
kuch-nawlavis simptomebi
tavbrusxveva an gabruebuli mdgomareoba
rogor xdeba diagnostireba?
tu eqims sg orsulobaze aqvs echvi, pirvelad igi mcire menjs gamoikvlevs ??� tkivilis lokalizaciis da muclis ghrushi sirbilis an simagris dasadgenad. aseve, sheidzleba sachiro gaxdes laboratoriuli gamokvlevebi. yvelaze mnishvnelovania hCG??�s (adamianis qoriogonadotropini) gazomva. normaluri orsulobisas am hormonis done pirveli 10 kviris ganmavlobashi daaxloebit yovel 2 dgheshi ormagdeba. sg orsulobis dros ki aghinishneba dabali hCG. es badebs echvs sg orsulobaze. hCG??�s done sheidzleba garkveul periodshi ramodenimejer shemowmdes, imis dasadgenad, normaluri tempit izrdeba tu ara.
meore hormoni, romelic sg orsulobis diagnostikashi exmareba eqims, progesteronia. am hormonis dabali done imis machvenebelia rom orsuloba patologiurad mimdinareobs. sg orsulobis da misi lokalizaciis dasadgenad sxva gamokvlevebic aris sachiro.
diagnostikisatvis aseve mnishvnelovania ultrabgeriti gamokvlevebi. es mowyobiloba maghali sixshiris bgerit talghebs ushvebs, misi nawili muclis ghrus teritoriaze modzraobs an motavsebulia vaginashi. aparatis mier gamoshvebuli bgeriti talghebi shinagani organoebidan airekleba, ris shedegadac am organoebis ekranuli gamosaxuleba miigheba. am procedurit eqimi akvirdeba tu rogor mimdinareobs sashvilosnoshi nayofis ganvitareba.
procedura, romelsac culdocentessis uwodeben ishviatad gamoiyeneba sg orsulobis diagnostikashi. es teqnika, vaginis wveroshi, duglasis fososhi (sashvilosno-swori nawlavis chaghrmavebashi) nemsis motavsebas gulisxmobs punqciis miznit. am adgilas sisxlis arseboba falopis milis gaxetqvis manishnebelia.
ra mkurnaloba enishnebat am dros?
sg orsulobis mkurnaloba patologiuri orsulobis qirurgiuli gzit mocilebashi mdgomareobs. operacias diagnostirebidan uaxloes momavalshi nishnaven.
zogjer sg orsulobis dros zogadi anesteziaa sachiroa. operaciisas mcire menji didi chrilobit ixsneba. axla sg orsulobis mkurnaloba ufro sxva teqnikitac shesadzlebelia. am proceduras laparoskopia ewodeba. am dros, chriloba muclis qvevit chipshi an mastan axlos ketdeba. qirurgi shemdeg laparoskops mcire menjis areshi ghrmad atavsebs. laparoskopi milia, romlis ert boloshi damagrebulia patara natura. am milis sashualebit shesadzlebelia shinagani organoebis danaxva da sxva instrumentis motavseba. zogjer, muclis qveda ghrushi meore chrilobac ketdeba, imisatvis rom qirurgiuli instrumentebi motavsdes. laparoskopias qirurgi sg orsulobis mocilebisas an dazianebuli falopis milis rekonstruqcia/mocilebisas iyenebs. loparoskopia zogjer adgilobrivi anesteziit, xolo ufro xshir shemtxvevashi zogadi anesteziit ketdeba.
sg orsulobit gaxetqili falopis mili chveulebriv unda mocildes. qirurgiuli mkurnaloba tardeba mashinac rodesac sg orsuloba adreul asakshi vlindeba manam, sanam mili dzalian daichimeba an gaskdeba. aset shemtxvevashi sg orsulobas wyveten da milis rekonstruqcias aketeben ise, rom shedzlos tavis danishnulebis gagrdzeleba.
sg orsulobis shesawyvetad ishviatad gamoiyeneba medikamenturi mkurnaloba. am dros metotreqsats (methothrexate) nishnaven. aghnishnuli medikamenti laparoskopiit an mis gareshe gamoiyeneba, es damokidebulia orsulobis vadaze.
rogoria momavali?
sg orsulobis mkurnalobis shemdeg tqven mogiwevt eqimtan xshiri viziti imisatvis rom eqims hCG hormonze dakvirvebis sashualeba hqondes. es manamde gagrdzeldeba, sanam hCG-s done nulamde ar dava. hCG-s shenarchunebuli maghali done imis mimanishnebelia rom eqtopuri qsovili srulyofilad ar aris mocilebuli. aset dros sachiroa damatebiti qirurgiuli an medikamenturi (metotreqsatit) mkurnaloba.
momavali orsulobis normaluri mimdinareoba damokidebulia imaze tu ra saxis qirururgiuli mkurnaloba chatarda sg orsulobis mosacileblad. miuxedavad imisa rom aghnishnuli sg orsulobis shemdgom warmatebuli orsulobis albatoba mcirea, shenarchunebuli falopis milis shemtxvevashi albatoba 60% izrdeba. tu mocilebulia erti mili, kvercxujredi sheidzleba meore milshi ganayofierdes. erti milis shemtxvevashi warmatebuli mshobiarobis albatoba 40%-ze metia.
tu sg orsuloba ertxel aghinishna mosalodnelia misi gameoreba. da rac ufro metia sg orsulobis shemtxveva, mit metia misi gameorebis albatoba. tu ertxel gqondat sg orsuloba gaesaubret eqims sanam xelmeored dafexmdzimdebit, imisatvis rom uketesad dagegmot metvalyureoba momaval orsulobaze.
bushtnamqeri
ra iwvevs mas?
samedicino saxelwodeba hydatidiform mole (hydatid -- nishnavs ???wylis daghvras???, - mole nishnavs ???laqas an chirqs???); bushtnamqeri shedarebit ishviatia da a.sh.sh.-s monacemebit 1,500-2,000 orsulidan erts aghenishneba. bushtnamqeris dros normalur sashvilosnoshi, ganayofierebis shemdeg, embrionis nacvlad raghac (patologiuri) masa formirdeba. bushtnamqeri ar gulisxmobs mzard bavshvs, es ufro patologiuri placentas msgavsi warmonaqmnia.
bushtnamqers adgili aqvs mashin rodesac ujredebi, romelic chveulebriv qmnis qorionul wamwams (patara titis msgavsi gamonashveri, romelic placentas aertebs sashvilosnos shrestan) normalurad ar vitardeba. amis sanacvlod, saxezea bushtis msgavsi, wyalwyala grova, romelsac ar sheudzlia ganvitarebad embrions daexmaros. bushtnamqeris riski 40 wels gadacilebul qalebshi maghalia.
bushtnamqeris gamomwvevi mizezia spermis qromosomuli problemebi, romelic kvercxujreds anayofierebs, kvercxujredis problemebi an orive ertad. bushtnamqeri orgavaria: sruli da nawilobrivi. sruli bushtnamqeris dros sashvilosno embrionis sanacvlod carieli parkis mcire grovas sheicavs. nawilobrivi bushtnamqeris dros embrioni patologiurad yalibdeba da chveulebriv ar gadarcheba.
qalebi, romeltac bushtnamqeri aqvt, sashvilosnoshi avtvisebiani simsivnis an invaziuri daavadebebis riskis qvesh imyofebian. am simsivnidan zogierti imdenad metastazuria, rom misi gavrceleba sxeulis sxva nawilebshic aris mosalodneli. bushtnamqeris mqone nebismieri qali invaziuri daavadebebis riskis qvesh imyofeba. am daavadebebis mkurnalobis xarisxi sakmaod maghalia.
ra simptomebi aghinishneba am dros?
bushtnamqeris titqmis yvela shemtxvevashi orsulobidan 12 kvirisatvis sisxldena aghinishneba. sxva shesadzlebeli simptomia sashvilosnos didi zoma romelic aghnishnuli orsulobis vadas ar sheesabameba.
rogor xdeba diagnostireba?
bushtnamqeris umetesi shemtxveva orsulobis pirvel trimestris ganmavlobashi vlindeba. normaluri orsulobisagan gansxvavebit, sisxldena da hCG-s maghali done shesadzlebelia gamafrtxilebeli simptomebi iyos. es mdgomareoba eqims karnaxobs mousminos chanasaxis guliscemas. tu araferi ar ismis, mashin eqims bushtnamqerze uchndeba echvi. ultrabgeriti gamokvlevit eqimi naxulobs, aris tu ara sashvilosnoshi normaluri chanasaxi.
ra mkurnaloba enishnebat am dros?
bushtnamqeris diagnostirebis shemdeg, mkurnaloba orsulobis shewyvetashi mdgomareobs. es yvelaze xshirad vakuumis aspiraciit xorcieldeba. es procedura anesteziit ketdeba, romlis drosac afartoeben sashvilosnos yels, saidanac gamowovit frtxilad acileben ???nayofs???. amave dros, sashvilosnos shekumshvis stimulirebisatvis, pacients sheidzleba oqsitocini daunishnon.
rogoria momavali?
umetes shemtxvevashi bushtnamqeris mkurnaloba warmatebit mimdinareobs. magram eqimtan xshiri vizitebia aucilebeli, radgan arsebobs invaziuri daavadebebis riski. orsulobis shewyvetis shemdeg eqimi amowmebs hCG-s dones. xshirad, qals romelsac bushtnamqeri hqonda urcheven tavi aaridos orsulobas sul mcire erti wlis ganmavlobashi. avtvisebiani daavadebebis shedarebit ishviati forma romelic bushtnamqers moyveba qimio terapiit ganikurneba. am simsivnuri daavadebebis mkurnalobis shedegebi sakmaod kargia, titqmis 100%.
muclis moshla
ra iwvevs mas?
muclis moshlas spontanur aborts uwodeben, romelic orsulobis 20 kviramde asakshi nayofis dakargvit ganisazghvreba. muclis moshla orsulta 15-29% aghinishneba. realuri ricxvi ufro maghalia. muclis moshlis umetesoba sheumchnevlad xdeba iset adreul asakshi, rodesac qalma jer arc icis orsulobis shesaxeb.
muclis moshlis 80% orsulobis pirveli 12 kviris ganmavlobashi xdeba. adreuli moshlis daaxloebit naxevari itvleba, rom nayofis qromosomuli problemebit aris gamoweveuli.
nayofis qromosomuli problemebis umetesoba, romelic muclis moshlas iwvevs mshoblebisgan memkvidreobit ar miigheba. sxvagvarad rom vtqvt, chanasaxis qromosomuli defeqti ar aris gamowveuli mshoblebtan arsebuli igive defeqtit. es mashin xdeba roca ganayofierebuli kvercxujredi gayofas iwyebs.
qromosomuli defeqtit gamowveuli moshla mashin xdeba, roca chanasaxs ar sheudzlia gadarches. adreuli orsulobis periodshi moshla sheidzleba ramodenime kviris shemdeg moxdes, roca embrioni kvdeba. zogjer chanasaxi ar aris membranis shignit.
moshlis sxva mizezebi sheidzleba dedis janmrtelobastan iyos dakavshirebuli. aset dros moshla shedarebit orsulobis gvian periodshi xdeba. es aris: infeqcia, qronikuli daavadebebi mag, diabeti, maghali wneva, da imunur sistemastan dakavshirebuli problemebi. aseve, moshla sheidzleba gamoiwvios sashvilosnos an sashvilosnos yelis anomaliebma. am problemebis ricxvshia sashvilosnos yelis funqciuri ukmarisoba, roca sashvilosnos yeli orsulobisas dzalian adre iwyebs gafartoebas. es titqmis yvela shemtxvevashi orsulobis meore trimestrshi xdeba.
ganmeorebit moshlas orjer an samjer miyolebul moshlas uwodeben. amis mizezi igivea, rac ertxel moshlis shemtxvevashi. miuxedavad amisa, ganmeorebiti moshlis mizezis dasadgenad tardeba gamokvleva, xolo mkurnalobis archevani sakmaod shezghudulia. tumca, miuxedavad amisa qalta umetesobas momavalshi warmatebuli orsuloba aqvs.
tu muceli mogeshalat an nerviulobt, rom ar mogeshalot tqventvis mnishvnelovani iqneba imis codna tu ra shemtxvevebi ar iwvevs mas. tqven pirveli ara xart, visac es awuxebs. aseti shishebi orsuli qalebisatvis damaxasiatebelia, miuxedavad imisa muclis moshlis gamocdileba aqvs, tu ara.
moshla varjishis, sqesobrivi urtiertobis, mushaobis, an simdzimeebis awevis gamo ar xdeba. orsulobis adreul vadebshi gulis reva da ghebineba, dzalian mwvave shemtxvevis drosac, ar iwvevs moshlas. aseve ar aris mosalodneli, rom moshla gamoiwvios dacemam da uecarma shishma. aseti ziani ar avnebs chanasaxs, tu es dedis sicocxles ar uqmnis safrtxes.

ra simptomebi aghinishneba am dros?
titqmis yvela moshlas win uswrebs vaginaluri sisxldena. orsulebis 25%-s sisxldena aghenishnebat da am qalebis naxevars muceli eshleba. sisxldena, romelic moshlas gauwyebt sheidzleba mcire an dzleri iyos. igi sheidzleba mudmivi an movliti xasiatis iyos. sisxldenas sheidzleba muclis spazmuri tkivilebi da welis areshi yru tkivili moyves. shesadzlebelia arsebobdes am simptomebis sxva gamomwvevi mizezi. aucileblad unda daukavshirdet eqims, tu orsulobisas nebismieri saxis sisxldena an mwvave tkivili gaqvt.

rogor xdeba diagnostireba?
tu eqimtan sisxldenis chivilit mixvalt, pirveli rasac igi gaaketebs, es aris sashvilosnos yelis gamokvleva, imis sanaxavad, dawyebulia tu ara sashvilosnos yelis gaxsna. tu es asea, mashin tqven operacias gagiketeben ??� radgan am dros moshlis didi riski arsebobs. magram es yoveltvis ar xdeba.
eqimi aseve amowmebs dazianebulia tu ara membrana, romelic chanasaxs aqvs garshemortymuli. tu membrana dazianebulia da sashvilosnos yeli ixsneba, mashin moshla gardauvalia. am dros sheudzlebelia muclis moshlis shekaveba.
tu tqven raghac qsovils kargavt, am dros eqimi aseve echvobs moshlas. tu shesadzlebelia am qsovilis naxva, eqimi sheamowmebs chanasaxovani qsovilia, tu placentis shenadedi an misi nawili.
ultrabgeriti gamokvleva mnishvnelovania imis sanaxavad cocxalia tu ara nayofi sashvilosnoshi. am gamokvlevit da specialuri saxis ultrasonografiis gamoyenebit eqimi naxavs chantas romelic chanasaxs gars exveva da sheamowmebs mis (chanasaxis) guliscemas. tu chanasaxi ar aris cocxali da dedis sxeulidan jer kidev ar aris gamosuli, amas idzulebit aborts uwodeben.

ra mkurnaloba enishnebat am dros?
mosalodneli moshlis dros aucilebelia loginshi wola da tkivilgamayuchebeli sashualebebis migheba,sanam sisxldena an tkivili ar shewydeba. tu sisxldena da tkivili mwvavea, sheidzleba saavadmyofoshi dawola gaxdes aucilebeli.
rodesac chanasaxis membrana dazianebulia, chveulebriv amas moshla moyveba. tu membrana ar aris dazianebuli da sisxldenas tkivili da sicxe axlavs, mashin seriozuli infeqciis riski arsebobs. aset dros unda moxdes sashvilosnodan chanasaxovani qsovilis mocileba. es procedura anesteziis qvesh xdeba; am dros nela xsnian sashvilosnos yels da qsovils frtxilad an gamotumbaven an gamofxeken.
tu muceli mogeshalat an gamosuftavebis procedura chaitaret da mainc gaqvt sicxe, mwvave sisxldena, cieba an mwvave tkivili, im wamsve daureket eqims. es sheidzleba infeqciis manishnebeli iyos.

rogoria momavali?
qalta umetesobas, romeltac idzulebiti aborti gadaitanes, warmatebuli momavali orsuloba elodeba. iset dros, roca qals ara erti moshla aqvs gadatanili 70-dan 85%-mdea imis shansi, rom momaval orsulobas mshvidobianad daasrulebs. chveulebriv aset dros urcheven cota xnit tavi sheikavon daorsulebisgan. eqimi tqven konkretulad girchevt rodis shegidzliat daorsuldet moshlis shemdeg.

PARTIZANKA

MEORE TRIMESTRIS GARTULEBEBI

qalta umetesobisatvis meore trimestri shedarebit problemebis gareshe mimdinareobs. es aris eqimtan shexvedrebis, gamokvlevebis da janmrteli cxovrebis wesis dacvis periodi. magram am etapzec arsebobs potenciuri problmebi.
yvela mosalodneli gartulebebis warmatebit mogvareba mashin xdeba tu droze umkurnalebt; amitom tqventvis da tqveni bavshvisatvis mnishvnelovania gamafrtxilebeli nishnebis codna. qvemot shesadzlebeli shemtxvevebia aghwerili.

SISXLDENA
moshla orsulobis meore periodshi shedarebit naklebad aris mosalodneli, .magram riski mainc arsebobs. rogorc dasawyisshi aseve shua orsulobis periodshic vaginaluri sisxldena moshlis manishnebelia. daukavshirdit eqims nebismieri sisxldenis shemtxvevashi. tu dena mcirea an aratanabari, sheidzleba ar iyos dzalian sayuradghebo. sashualo da dzlieri sisxldenis shemtxvevashi daukavshirdit eqims; es sheidzleba shemdegis mimanishnebeli iyos:
moshla ( tu amas adgili aqvs 20 kviramde)
naadrevi mshobiaroba (tu es xdeba 20 dan 37 kviris periodshi)
placentis problemebi: placenta an dzalian qvevit aris ganlagebuli, an mshobiarobamde iwyebs aclas sashvilosnos kedlidan
tu sisxldenas tkivili an spazmi axlavs, aucileblad daukavshidrdit eqims

NAADREVI MSHOBIAROBA
orsuloba 37 dan 42 kviramde mimdinareobs. 37 kviramde mshobiaroba naadrev mshobiarobad itvleba. naadrevad gachenili bavshvebi dzalian mcire wonis arian (2,5 kg-ze naklebi). mcire wona bevri problemis winashe ayenebs naadrevad gachenil bavshvebs.

RA IWVEVS MAS?
naadrevi mshobiarobis zusti mizezi cnobili ar aris. qvemot chamotvlilia naadrevi mshobiarobis shesadzlebeli faqtorebi:
wina naadrevi mshobiaroba
ertze meti chanasaxis arseboba
wina ramodenime moshla da aborti
amnioturi sitxis an chanasaxovani membranis infeqcia
hidramniozi (zedmeti amnioturi sitxe)
sashvilosnos patologiebi
placentastan dakavshirebuli problemebi
dedis seriozuli daavadebebi

RA SIMPTOMEBI AGINISHNEBA AM DROS?
naadrevi mshobiarobis siptomebi sheidzleba ioli an mwvave formis iyos. umetes shemtxvevashi naadrevi mshobiarobis mimanishnebelia sashvilosnos shekumshva. tu erti saatis ganmavlobashi xutze meti shekumshva gaqvt, unda daukavshirdet eqims. pirvelad es ganicdeba rogorc muclis ghrus dachimva, romelic titis wverit sheidzleba igrdzno.

MSHOBIAROBIS SXVA NISHNEBI
sashvilosnos shekumshvebs sheidzleba tan axldes welis msubuqi tkivili, qvevit mcire menjshi da bardzayebis zeda nawilshi -- simdzimis gancda; aseve tipiuria cvlilebebi vaginalur gamonadenshi. sheidzleba chintvebs tan axldes susti sisxldena, an igrdznot vaginidan sitxis gamosvla. es sheidzleba amnioturi sitxe iyos, nishani imisa, rom chanasaxis garshemomxvevi membrana gaskda. tu sashvilosnos yelshi dagrovebuli lorwo gamodis, tqven sheamchnevt sqel gamonadens, romelic sisxlit aris sheferili.
zogierts es cvlilebebi sashvilosnos shekumshvebis gareshe aghenishneba. tu tqven echvebi gaqvt tqveni mdgomareobis mimart, an sisxldena gaqvt muclis ghrus tkivilebtan an spazmebtan ertad, aucileblad daukavshirdit eqims.

ROGOR XDEBA DIAGNOSTIREBA?
tu gichndebat echvi naadrev mshobiarobaze, garkveuli gamokvlevebi unda chaitarot. am dros pasuxi unda gaices or kitxvaze: daiwyo tu ara gaxsna sashvilosnos yelma da chanasaxis membrana gaskda tu ara. amisatvis mnishvnelovania sashvilosnos yelis gamokvlevebi. sashvilosnos monitorirebit akvirdebian shekumshvata (chintvis) xangrdzliobas da mat shoris drois intervals. amit irkveva mshobiaroba dawyebulia tu ara.

RA MKURNALOBA INISHNEBA AM DROS?
rodesac iwyeba naadrevi mshobiaroba am dros unda gadawydes, sheacheron es procesi, tu xeli ar sheushalon mas. am gadawyvetilebas bevri shemtxveva ganapirobebs. orive shemtxvevashi unda gaitvaliswinon dedis da bavshvis janmrtelobis mdgomareoba.

ANEMIA
mzardi chanasaxi moitxovs dedis organizmshi rkinis didi maragis arsebobas. rkina mineralia, romelic did rols tamashobs sisxlis witeli ujredebis chamoyalibebashi. orsulobamde tqven gchirdebodat dgheshi 15 miligrami rkina. axla orjer meti - 30 miligramia sachiro. iseve rogorc yvela qals, tqvens organizmshic ar iqneba aseti raodenobis rkina, gazrdili motxovnebis dasakmayofileblad. dznelia miigho sakmarisi raodenobis rkina sakvebidan mashin, roca cdilobt ar chamot dzalian bevri; radgan orsulebis 20% rkinis naklebobas ganicdis, amisatvis orsulobis meore trimestrshi xshirad nishnaven rkinis preparatebs.

RA IWVEVS MAS?
anemia gamowveulia sisxlshi hemoglobinis koncentraciis daklebit. hemoglobini cilis saxea romelic motavsebulia sisxlis witel burtulebshi. igi gadamwyvet rols tamashobs sxeulis qsovilebisatvis jangbadis miwodebashi. orsulobis dros hemoglobinis dakleba sisxlis moculobis gazrdit aris gamowveuli.
orsulobis dros sisxlis moculoba sagrdznoblad izrdeba, daaxloebit 45%. sisxlis moculobis gazrda sisxlis plazmis momatebis xarjze xdeba (sisxlis witeli da tetri burtulebisagan gansxvavebuli nawili). orsulobis pirvel naxevarshi sisxlis plazmis moculoba ufro swrafad izrdeba, vidre witeli burtulebi. amis shedegad, shesabamisad mcirdeba witeli burtulebis koncentracia.
anemia mashin vitardeba, rodesac ar aris sakmarisi rkina imisatvis, rom witeli ujredebis meti raodenoba awarmoos. shedegia sisxlshi hemoglobinis daweva.
rkinis deficitis garda anemiis sxva mizezebic arsebobs. es aris: didi raodenobit sisxlis dakargva (hemoragia), gamowveuli qirurgiuli mkurnalobit an raime zianit: qronikuli daavadeba (seriozuli infeqciebi an tirkmlis daavadebebi): an foliumis mjavis deficiti (vitamini, romelic sisxlis witeli burtulebis produqciashi mnishvnelovan rols asrulebs). orsul qalebtan rkinis nakleboba anemiis yvelaze xshiri mizezia.
a.sh.sh.-shi qalebis umetesoba, romlebic orsulad arian, ganicdian rkinis naklebobas. qali menstruaciis periodshi rkinas sisxltan ertad kargavs, es aris mati anemiisadmi ganwyobis ert-erti mizezi. aradeqvaturi dieta anemiis meore mizezia. qali, romelic prenataluri metvalyureobis qvesh imyofeba da rkinis damatebebs ighebs, dazghveulia rkinis deficittan dakavshirebuli problemebisagan. winaaghmdeg shentxvevashi rkinis nakleboba dzalian xshiria. anemiam orsulebshi sheidzleba daghla, stresi da daavadebebis mimart ganwyoba gamoiwvios. magram am dros ziani ar emuqreba chanasaxs. e.i. roca deda rkinis naklebobas ganicdis placenta da chanasaxi mainc ighebs mistvis aucilebel raodenobas.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
msubuqi anemiis shemtxvevashi tqven sheidzleba ar gqondet simptomebi. sashualo an dzlieri anemiis dros sheidzleba shemdegma simptomebma ichinos tavi:
dzlieri daghla da sisuste
sifermkrtale
suntqvis gaxshireba
gulis friali
tavbrusxveva, gabrueba

ROGOR XDEBA DIAGNOSTIREBA?
eqimtan pirveli vizitis dros, orsulobis dasawyisshi, sisxlis analizi ketdeba imis dasadgenad aris tu ara hemoglobini normashi. tu tqven anemiuri ara xart, es problema sheidzleba tandatan, sisxlis moculobis zrdastan ertad warmoiqmnas, radgan sul ufro meti sakvebis gadacema xdeba mzardi chanasaxisatvis. faqtiurad rkinis naklebobit gamowveuli anemia xshiria orsulobis me-20 kviridan. eqimebis umetesoba anemiis tavidan acilebis an profilaqtikis miznit rkinis damatebas nishnavs.

RA MKURNALOBA INISHNEBA AM DROS?
mkurnaloba kafsulebis an abebis saxit rkinis damatebit mighebashi mdgomareobs, sanam hemoglobinis shemadgenloba sisxlshi ar miaghwevs sasurvel dones. umetesad damatebit rkinas orsulobis meore trimestrshi igheben; tu am shemtxvevashic ar mogvarda tqveni problema, sachiroa dozis gazrda.
rkinis mighebam sheidzleba gaadzlieros gulis revis shegrdzneba da ghebineba. sheidzleba danishnuli rkinis migheba tqventvis uketesia dzilis win, tu es iwvevs kuchis moqmedebis ashlas. imisatvis, rom ar dagaviwydet danishnulebis yoveldghiurad migheba kbilis jagristan dadet. rogorc yvela sxva wamali bavshvebisatvis xelmiuwvdomel adgilas dadet rkinis shemcveli abebi an kafsulebi. dzalian ishviatad sachiroa sisxlis gadasxma, im shemtxvevashi tu qali dzalin anemiuria, an didi raodenobit sisxli dakarga.

SASHVILOSNOS YELIS SISUSTE
orsulobis meore da mesame trimestrshi muclis moshla gamowveulia sashvilosnos yelis sisustit, rodesac yeli iwyebs gaxsnas, sanam mshobiaroba daiwyeba. rodesac es problemebi sashvilosnos yelis sisustit aris gamowveuli, adgili ara aqvs tkivils da sashvilosnos shekumshvebs. es tandatanobiti gaxsna, normaluri shemtxvevisagan gansxvavebit, gamowveulia sust sashvilosnos yelze mzardi nayofis zewolis shedegad. tu misi shechereba droulad ar moxda membranis gaxetqva da naadrevi mshobiaroba gardauvalia.
tu tqven gaqvt sashvilosnos yelis sisuste, am mdgomareobis samedicino saxelwodebam sheidzleba gafiqrebinot, rom tqven susti da araadeqvaturi janmrtelobis xart. sisuste am shemtxvevashi nishnavs imas, rom sashvilosnos yelis kuntebs ar sheudzlia aitanos mzardi nayofis zewola.

RA IWVEVS MAS?
es shedarebit ishviati mdgomareobaa, orsulebis daaxloebit 1-2% aghinishneba. magram am shemtxvevidan 20-25% moshla orsulobis meore trimestrshi xdeba. shesadzlebeli mizezebia:
sashvilosnos yelze gadatanili operacia
sashvilosnos yelis dazianeba wina rtuli mshobiarobis gamo
sashvilosnos yelis tanshobili defeqti.
aseti faqtorebis arsebobis shemtxvevashi shemdegi orsulobis dros mosalodnelia igive gameordes.
sxva shemtxvevebshi, mizezi sheidzleba iyos ertze meti chanasaxis arseboba, an zedmeti amnioturi sitxe (hidramniozi). aset mizezebis arsebobis dros ar aris mosalodneli igives gameoreba sxva orsulobis drosac.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
sashvilosnos yelis sisustem sheidzleba moshlis an naadrevi mshobiarobis tipiuri simptomebi gamoiwvios. rodesac aghnishnuli simptomebi saxezea muclis ghrus tkivilis gareshe, mashin mizezi sashvilosnos yelis sisuste sheidzleba iyos.
dalaqaveba an sisxldena
vaginaluri gamonadeni, romelic sisxliani, sqeli an lorwos msgavsi
muclis qvevit simdzimis shegrdzneba.
aseti simptomebi uyuradghebod ar unda datovot, gansakutrebit im shemtxvevashi tu adre sashvilosnos yelis sisustis gamo mogeshalat muceli.

ROGOR XDEBA DIAGNOSTIREBA?
cdiloben misi gamovlena moxdes sanam garkveul problemebs gamoiwvevs, magram es dzalisxmeva jer-jerobit warmatebuli ar aris.

RA MKURNALOBA INISHNEBA AM DROS?
tu tqven am problemis gamo mogeshalat muceli, mashin eqimi garkveul zomebs miighebs, rom msgavsi problema mimdinare orsulobis dros ar gameoreds. mkurnaloba xdeba qirurgiuli charevit- serklajit (wriuli, aragamwovi nakeris dadeba sashvilosnos xvrelis garshemo) romelic sashvilosnos yelis kunts adzlierebs.
amisatvis ramodenime procedura tardeba. magram yvela gulisxmobs nakeris motavsebas sashvilosnos yelis xvrelshi arxis dasaviwroeblad.
serklaji warmatebulad tardeba tu igi orsulobis 18-20 kviris vadashi xorcieldeba. imis mixedvit tu ra procedura tardeba, nakeri sheidzleba datovon an moacilon mshobiarobis dghisatvis. es srulad ar icavs orsul qals naadrevi mshobiarobisgan an muclis moshlisgan. amisatvis sachiroa dametebiti zomebis migheba; es aris: woliti rejimi da tokolitebit mkurnaloba (medikamenti, romelic acherebs sashvilosnos shekumshvebs). aset shemtxvevashi, sashvilosnos yelis sisustis mizezit naadrevi mshobiarobis riski 25% rcheba.

PARTIZANKA

MESAME TRIMESTRIS GARTULEBEBI

yvela problema, romelic orsulobis mesame trimestrshia mosalodneli, drouli charevis shemtxvevashi ufro warmatebit ganikurneba. am periodisatvis gamiznuli yvela rutinuli gamokvleva swored amisatvis aris gamiznuli.

ORSULOBIS (GESTACIURI) DIABETI,
RA IWVEVS MAS?
diabeti es aris mdgomareoba, romlis drosac sisxlshi shaqris anu glukozas done satanadod ar aris regulirebuli. es dakavshirebulia hormontan - insulini, romelic glukozas dones akontrolebs.
arsebobs ori saxis diabeti; diabeti, romelic mozardobis asakshi vlindeba, gamowveulia organizmis mier arasakmarisi insulinis warmoqmnit. diabetis sxva formis dros organizmi ar iyenebs efeqturad warmoqmnil insulins. es aris diabetis iseti saxe, romelic mozrdilobis an orsulobis periodshi vlindeba.
diabets, romelic aghinishneba mxolod orsulobis dros, gestaciur diabets uwodeben. gestaciuri diabetis gamomwvev mizezad am mdgomareobit gamowveuli - metaboluri, hormonaluri cvlilebebi itvleba. gestaciuri diabeti 1-5% aghinishneba.
gestaciuri diabetis dros ar aris glukozis iseti maghali done, rom riskis qvesh daayenos qalis janmrteloba. umetes shemtxvevebshi aranairi simptomebi ar vlindeba da dedis janmrteloba ushualo safrtxis winashe ar dgas. es aris adreuli nishani imisa, rom mas momavalshi shesadzlebelia diabeti ganuvitardes.
miuxedavad imisa rom, es mdgomareoba tviton dedas ar emuqreba, yoveltvis xdeba sisxlshi glukozis donis shemowmeba, radgan es bavshvis janmrtelobas uqmnis safrtxes. tu diabeti adreve gamovlinda da droulad ganikurna, mashin bavshvs araferi aghar emuqreba.
gestaciuri diabetis dros sayuradgheboa makrosomia ??� bavshvis didi wona. umetesi eqimi makrosomiad miichnevs 4,5 kg-ze mets. aset bavshvebs udzneldebat dabadeba. makrosomiis dros izrdeba sakeisro kvetis da mshobiarobis travmebis albatoba. dedis glukozis donis gakontroleba amcirebs bavshvebtan aghnishnul risks.
gestaciuri diabetis sxva shesadzlo shedegia hipoglikemia, bavshvebshi shaqris dabali done dabadebisas. es gamowveulia imit, rom muclad yofnis dros chanasaxi glukozis maghal odenobas ighebs da egueba, rac chiplaris mochrisas wydeba.
diabetiani dedebis bavshvebs dabadebis shemdeg regularulad unda sheumowmdet sixlshi glukozis done. isini dabadebis shemdeg glukozis mighebas sachiroeben sakvebis an intravenuri infuziis gzit.
tu tqven gestaciuri diabeti gaqvt, bunebrivia gagichndebat shekitxva ??� daemarteba tu ara momavalshi bavshvs diabeti. sabednierod, ar arsebobs riski imisa rom gestaciuri diabetis mqone dedebis bavshvebi mozardobis asakshi diabetit daavaddebian.
orsulobis diabetis risk-faqtorebia: 30 welze meti asaki, ojaxis sxva wevrebis diabetit daavadeba, wina orsulobis didi wonis nayofi, mkvdradshobadoba da zedmeti wona. magram gestaciuri diabetis mqone naxevarze met qals ar aghenishneba chamotvlili risk-faqtorebi. orsulobas ar sheudzlia arc misi gamowveva da arc shewyveta, radgan gestaciuri diabetis ganvitarebashi genetikuri faqtori tamashobs did rols. miuxedavad imisa, rom swori kveba mnishvnelovania orsulobis dros, tqven ar shegidzliat wonis momatebit, an bevri tkbilis mighebit gamoiwviot es daavadeba.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
zogadad gestaciuri diabeti ar iwvevs raime simptomebs. sheidzleba msubuqi formit gamoxatuli iyos daghla, dzlieri wyurvili an xshiri shardva, magram aseti simptomebi orsulobisas gestaciuri diabetis gareshec aghinishneba. radgan diabetis gamovlena sheudzlebelia dedis simptomebis sashualebit, amisatvis tardeba glukozis analizi.

ROGOR XDEBA DIAGNOSTIREBA?
rogorc aghvnishnet gestaciuri diabeti glukozis analizit vlindeba. chveulebriv es analizi orsulobis 26-28 kviris asakshi ketdeba, magram tu arsebuli risk-faqtorebis gamo eqims echvi uchndeba, mashin analizi orsulobis adreul periodshic ketdeba. radgan gestaciuri diabeti risk-faqtorebis miuxedavadac vlindeba, eqimebis umetesoba tavis dazghvevis miznit qalis asakis da mdgomareobis miuxedavad glukozis analizs itxovs.

ROGOR UNDA MOGVARDES ES PROBLEMA?
gestaciuri diabetis mogvareba glukozis donis kontrolit xdeba. umetes shemtxvevashi es shesadzlebelia dietis dacvit, varjishit da sisxlis regularuli analizit.
tu ertxel daisva gestaciuri diabetis diagnozi, eqimi mshobiarobamde xshirad moitxovs glukozis shemowmebas. gamokvleva moicavs sisxlis aghebas rogorc dilis sauzmemde (uzmoze), aseve sauzmidan ori saatis shemdeg. zogierti eqimi shuadghis sisxlis analizsac itxovs.
imis shesamowmeblad, tu ramdenad kargad akontrolebt glukozis dones, eqimma sheidzleba specialuri testis gamoyeneba girchiot, romelsac saxlshi ufro regularulad gaiketebt. orsulobis dros shardshi glukozis shemowmeba ar aris mizanshewonili, radgan dzalian mcire kavshiria sisxlshi da shardshi glukozis doneebs shoris.
titqmis yvela shemtxvevashi shesadzlebelia glukozas kontroli dietit. magram tu amis miuxedavad glukoza mainc maghalia, sachiroa yoveldghe insulinis ineqcia. insulini ar aghwevs bavshvamde. orsulobis dros sisxlshi glukozis donis shesamcireblad oraluri gzit ar xdeba medikamentis migheba.
damatebit, orsulobis bolo tves eqimma sheidzleba girchiot bavshvis mdgomareobis yovelkvireuli monitorireba. es ganxorcieldeba shemdegi gamokvlevbit: testi datvirtvis gareshe, shekumshvis stres-testi, biofizikuri profili.
ultrabgeriti gamokvlevit daakvirdebian bavshvis wonas da zomas mshobiarobamde. am gamokvlevit eqimi gadawyvets gaketdes tu ara sakeisro kveta. tqven sheidzleba aseve gtxovon daakvirdet da chaiwerot ra sixshirit igrdznobt bavshvis modzraobas.
diabetis dros yvelaze xshiria sakeisro kveta, radgan am dros xshiria bavshvis didi zoma. mshobiarobamde sakeisro kvetis gadawyveta dznelia, radgan an bavshvis zomaa didi an dedis menjia mcire. xshirad sakeisro kvetas mashin mimartaven, rodesac mshobaroba veghar grdzeldeba. es xdeba mashin, rodesac sashvilosnos yeli aghar ixsneba an bavshvi ar gamodis. gestaciuri diabetis dros, bavshvis didi zomis gamo samshobiaro tramvebis riski didia.
diabetis dros bavshvi titqmis ar ibadeba droze adre. tu mshobiaroba 40-41 kviristvis ar iwyeba, sheidzleba igi oqsitocinit daachqaron. sheidzleba sachiro gaxdes amniocentezi, imis dasadgenad aris tu ara bavshvis filtvebi sakmarisad momwifebuli.

ROGORIA MOMAVALI?
gestaciuri diabeti titqmis yoveltvis qreba mshobiarobis shemdeg. tqven 6 kviris ganmavlobashi dagchirdebat sisxlis analizi, rom darwmundet daiwia tu ara glukozas donem mshobiarobis shemdeg.
tu tqven ertxel gqondat gestaciuri diabeti, misi gameorebis alabatoba shemdgomi orsulobis dros izrdeba. aseve shesadzlebelia diabetis ganvitareba mogvianebit. gestaciuri diabetis mqone qalebidan titqmis naxevars shemdgomshi aghenishnebat diabeti. amitom, mnishvnelovania mshobiarobis shemdeg miyvet eqimis rchevebs da daicvat dieta, ivarjishot da sheamowmot glukozas done yovelwliurad. qalebs, romeltac orsulobis dros diabeti aqvt, sheudzliat bavshvebi dzudzuti gamokvebon.

PREEKLAMSIA
RA IWVEVS MAS?
preeklamsia es aris daavadeba, romelic orsulobidan 20 kviris shemdeg maghali wnevit, saxis da xelebis sheshupebit da shardshi cilis maghali shemcvelobit xasiatdeba. es sakmaod seriozuli mdgomareobaa da misma uyuradghebod datovebam shesadzlebelia seriozuli gartulebebi, an dedis an bavshvis sikvdili gamoiwvios.
preeklemsias ???toqsemiasc??? uwodeben. es ufro nacnobi saxelwodebaa. am daavadebis mizezad sisxlshi toqsini itvleboda, swored amotom uwodebdnen toqsemias. axla itvleba rom preeklamsia ar aris gamowveuli toqsinit, magram misi ashkara mizezi jer kidev dadgenili ar aris. mizezis daudgenlobis gamo ucnobia misi mkurnalobis da tavidan acilebis gzebic. ertaderti gamosavali am dros bavshvis dabadebaa, im shemtxvevashic ki, roca bavshvi jer ar aris momwifebuli.
es gamowveulia im mizezit, rom preeklamsiam shesadzlebelia dzalian didi riskis qvesh daayenos dedis da bavshvis sicocxle. dedisatvis shesadzlebeli gartulebebia: ghvidzlis dazianeba, tirkmlis dazianeba, sisxldena an gulyrebi. bavshvis problemebs warmoadgens arasakmarisi sakvebis da jangbadis migheba placentidan. aman shesadzlebelia zrdashi chamorchena, an chanasaxovani distresi gamoiwvios.
es daavadeba orsulebis 6-8% aghenishneba. am shemtxvevebis 85% pirveli orsulobis dros gamoixateba. preeklamsiis sxva risk faqtorebia: ertze meti nayofi, diabeti, maghali wneva, tirkmlis qronikuli daavadeba, revmatiuli daavadebebi da ojaxuri anamnezis datvirtva. preeklamsia aseve xshiria mozardebshi da 35 wels gadacilebul qalebshi.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
tavidan ar aghinishneba simptomebi, xolo drota ganmavlobashi roca ashkara simptomebi vlindeba daavadeba ukve sakmaod ganvitarebulia. amitom eqimtan yoveli vizitis dros mnishvnelovania wnevis gazomva.
zogierttan preeklamsiis pirveli nishnebi wonis swrafi matebit vlindeba (1 kg-ze meti kvirashi an 2-3-4 kg. tveshi). wonis mateba sitxis shekavebit da ara cximis dagrovebit aris gamowveuli. aseve sheidzleba aghinishnos saxis da xelebis sheshupeba, tavis tkivilebi, mxedvelobis problemebi, tkivili muclis ghrus zeda nawilshi.

ROGOR XDEBA DIAGNOSTIKA?
preeklamsiis diagnostireba xdeba mashin rodesac drois garkveul periodshi wneva mudmivad maghalia. wnevis awevis erteuli shemtxvevebi ar gulisxmobs preeklamsiis arsebobas.
eqimi, visi metvalyureobis qveshac imyofebit, adarebs tqveni wnevis axlandel machveneblebs orsulobis pirveli trimestris machveneblebtan. wneva sakmaod maghalia tu pirvel monacemebtan shedarebit sistoluri wneva (pirveli machvenebeli) 30 mm-it aris momatebuli, xolo diastoluri (meore machvenebeli) 15 mm-it an metit. zogadad 140/90 an meti normaze maghal machveneblad itvleba.
arsebobs sxvadasxva simwvavis preeklamsia. tu tqven marto maghali wneva aghgenishnebat, am mdgomareobas eqimma sheidzleba orsulobit gamowveuli hipertenzia uwodos.
maghali wnevis garda preeklamsiis mimanishnebelia shardshi didi raodenobis cila. misi gamokvleva ramodenime gzit aris shesadzlebeli. zusti metodia 24 saatis ganamavlobashi shardis shegroveba da shemdeg laboratoriuli analizis chatareba. aseve shesadzlebelia eqimma sisxlis analizi mogtxovot, im miznit, rom inaxos tu rogor funqcionirebs tirkmeli da ghvidzli. sisxlis analizi sachiroa imis dasadgenadac aris tu ara trombocitebis (romelic aucilebelia sisxlis shededebisatvis) normaluri raodenoba.
preeklamsiis yvelaze mwvave formaa e.w. ???HELPP syndrome???. igi, shedarebit msubuqi formebisagan gansxvavebit xasiatdeba ghvidzlis funqciuri sinjebis donis awevit da sisxlshi trombocitebis dabali donit.

ROGOR UNDA MOGVARDES ES PROBLEMA?
ertaderti gamosavali da preeklamsiis mkurnaloba mshobiarobis dachqarebaa. zogjer maghal wnevas wamlebit mkurnaloben, magram upiratesoba sxva sashualebebs enicheba.
preeklamsiis msubuqi formis mogvareba woliti rejimis dacvit xdeba. tqven kerdzo shemtxvevazea damokidebuli, tu ramdeni xani unda iwvet. tqven aseve gircheven, romel mxares unda iwvet marjvena tu marcxena, imisatvis rom sisxls placentisken midinebis sashualeba mieces. aucileblad unda daukavshirdet eqims, tu romelime simptoms shenishnavt. eqimi albat kvirashi or shexvedras daginishnavt, imisatvis rom xshirad daakvirdes wnevas, gaketdes sisxlis da shardis analizi, da aseve moxdes bavshvis statusze dakvirveba. tqven saxlshic mogiwevt wnevis regularuli gazomva da shesabamisi chanawerebis warmoeba.
preeklamsiis mwvave formis dros saavadmyofoshi dawolaa sachiro. bavshvze dakvirvebis miznit tqven iq regularulad chagitardebat testi datvirtvis gareshe, shekumshvis stres testi da biofizikuri machveneblebis gamokvlevebi. damatebiti, ultrabgeriti gamokvlevit amnioturi sitxis moculobas gazomaven. tu misi machvenebeli sakmaod dabalia, es imis nishania rom bavshvis sisxlit momarageba sakmarisad ar xdeba, amitom sheidzleba aucilebeli gaxdes mshobiarobis dachqareba.
am shemtxvevashi gaitvaliswineben bavshvistvis ramdenad sariskoa sashvilosnoshi arsebul mdgomareobastan shedarebit naadrevi mshobiaroba. sanam gadawyvetilebas miigheben, sheidzleba chatardes amniocentezi, imis dasadgenad tu ramdenad momwifebulia bavshvis filtvebi. tu dedis mdgomareoba safrtxeshia, mashin mshobiaroba am proceduris gareshe dachqardeba.
preeklamsiis umetesi shemtxveva sashualo sirtulisaa da aghinishneba mshobiarobis dghestan axlo periodshi. am problemas tavs artmeven wolit da bunebriv mshobiarobamde mudmivi monitorirebit. ufro mdzime shemtxvevebshi mimartaven mshobiarobis dachqarebas an sakeisro kvetas.
preeklamsiit gartulebuli orsuloba, romelic chanasaxs uqmnis safrtxes, ishviatad aghwevs 40 kviramde. sashvilosnos yelis ???simwife??? (rbildeba) sheidzleba mshobiarobis dachqarebis mizezi gaxdes.

ROGORIA MOMAVALI?
mshobiarobidan ramodenime dgheshi an kvirashi wneva normashi dgeba. sheidzleba dagenishnot wnevis wamlebi. tu es danishnuleba aucilebelia, misi migheba mshobiarobidan ert an or tveshi tandatanobit unda shewydes. albat eqimtan xshiri viziti dagchirdebat wnevaze xshiri dakvirvebis miznit.
riski imisa, rom preeklamsia shemdgomi orsulobisas gameordeba damokidebulia imaze, tu ramdenad rtuli formit gqondat igi. sashualo formisas riski sakmaod dabalia, xolo mwvave shemtxvevisas es albatoba 25-45% izrdeba.

PLACENTASTAN DAKAVSHIREBULI PROBLEMEBI
placenta orsulobisatvis unikaluri organoa. orsulobis dros igi dedasa da shvils akavshirebs. placenta dedis sisxlidan jangbads da sakvebs gadascems bavshvs, xolo fekaluri narchenebi ukanmimartulebit gamoaqvs.
placentis ori dziritadi problema, romelic sheidzleba orsulobis mesame trimestrshi aghinishnos, erti da imave simptomit vlindeba: es aris vaginaluri sisxldena. nebismieri sisxldenis shesaxeb, romelic orsulobis mesame trimestrshia, eqims unda sheatyobinot.

RA IWVEVS MAS?
es aris mshobiarobamde placentis acla, an chamocla sashvilosnos shida kedlidan. aman sheidzleba sheamciros an shewyvitos bavshvisatvis jangbadit mdidari sisxlis miwodeba.
placentis acla orsulobis mesame trimestrshi chanasaxis daghupvis dziritadi mizezia. aman sheidzleba gamoiwvios hemoragiis shedegad dedis shoki an mwvave sisxlis mimoqcevis problemebi. sabednierod, dedis da bavshvis mudmivi monitorirebit da shesabamis dros mshobiarobis dachqarebit, sheidzleba am problemebis mogvareba.
placentis chamocla sheidzleba moxdes mxolod placentas nawilis mocilebit, an sashvilosnos shida kedlidan mtliani gamoyofit. miuxedavad imisa rom placentis chamocla yoveltvis iwvevs sisxldenas, es sheidzleba sheumchneveli iyos. zogjer placentis shua nawili sashvilosnos kedlidan iweva. sisxli amgvarad sheidzleba daimalos ???jibeshi???. an sxva shemtxvevashi bavshvis tavi an sxeulis sxva nawili ise daawves sashvilosnos kedels, rom sisxlma ver naxos garet gamosasvleli.
placentis acla aghinishneba yoveli 150-e mshobiareze. amis mizezi ucnobia, magram igi yvelaze xshirad aghinishneba shavkanian, 40 wels gadacilebul qalebtan, mravalshvilian dedebtan, da mwevelebtan.
aseve, placentis aclastan yvelaze xshirad dakavshirebuli mdgomareobaa hipertenzia orsulobis periodshi. qalebs, romeltac orsulobis dros maghali wneva aqvt-miuxedavad imisa es adre awuxebdat tu ara ??� ufro metad arian placentis aclisken midrekilebi.
aclis risk-faqtors warmoadgens membranis (apkis) naadrevi (mshobiarobamde) gaxeva, romelic chanasaxis garshemoa shemortymuli. dzalian ishviatad, rom dedis raime travmam an dazianebam gamoiwvios placentis acla.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
placentis aclis adreul etapze sheidzleba aranairi simptomi ar aghinishnebodes. yvelaze xshirad ki igi vaginaluri sisxldenis saxit vlindeba. sisxldena sheidzleba iyos sxvadasxva raodenobis, magram misi odenoba ar gansazghvravs placentis sashvilosnodan aclis xarisxs. placentis acla aseve sheidzleba gamoixatos welis an muclis tkivilit, sashvilosnos shekumshvebit. sashvilosno sheidzleba sheigrdznot rogorc magari da mdzime.

ROGOR XDEBA DIAGNOSTIREBA?
rodesac qals orsulobis mesame trimestrshi vaginaluri sisxldena aghenishneba, eqimma unda gamoricxos placentis winamdebareobis mizezis arseboba (ix. qvemot). placentis aclis diagnostireba xdeba sisxldenis sxva mizezebis gamoricxvit. ultrabgeriti gamokvleva aclili placentis gamosavlenad tardeba, magram xshir shemtxvevashi es teqnika udzluria aghnishnuli mdgomareobis dasadgenad.

RA MKURNALOBA INISHNEBA AM DROS?
tu eqimi placentis aclas varaudobs, imis mixedvit tu ra mdgomareobashia bavshvi da deda, xdeba garkveuli zomebis migheba. bavshvis guliscemis dasakvirveblad gamoiyeneba eleqtro monitorireba. tu igi ar achvenebs bavshvis sagangasho mdgomareobas, mashin dedas saavadmyofoshi atavseben ushualo dakvirvebisatvis.
tu bavshvis mdgomareoba safrtxeshia, mashin achqareben mshobiarobas. tu dzlieri sisxldena aghinishneba, dedas sisxls usxamen. aris shemtxvevebi, rodesac sakeisro kvetaa aucilebeli, zogiert situaciashi ki fiziologiuri mshobiaroba shesadzlebelia.

ROGORIA MOMAVALI?
samwuxarod, 10% riski arsebobs imisa, rom placentis acla shemdgomi orsulobis drosac ganmeordeba. magram drouli daxmarebis aghmochenis shemtxvevashi dadebiti shedegebi miighweva rogorc bavshvisatvis, aseve dedistvis.

PLACENTIA WINAMDEBAREOBA,
RA IWVEVS MAS?
placenta chveulebriv lokalizebulia sashvilosnos fudzestan axlos, zemot. zogiert shemtxvevashi placenta qvemot aris ganlagebuli, ise rom nawilobriv an mtlianad faravs yelis xvrels. am mdgomareobas uwodeben placentis winamdebareobas, romelic mshobiarobamde an mis shemdeg hemoragiis (dzlieri sisxldena) risks warmoadgens. es saxifatoa rogorc dedistvis aseve bavshvistvisac.
placentis winamdebareoba sheidzleba iyos shemdegnairi:
ganapira. rodesac placentis napiri sashvilosnos yelis kidezea. rodesac mshobiarobis dros yeli ixsneba, placenta sheidzleba zevit avides. mxolod garkveul pirobebshia shesadzlebeli fiziologiuri mshobiaroba.
nawilobrivi. placenta nawilobriv faravs sashvilosnos yels. fiziologiurma mshobiarobam sheidzleba sisxldena gamoiwvios, radgan am dros skdeba placentis sisxldzarghvebi.
mtliani. placenta mtlianad faravs sashvilosnos yels. am dros sheudzlebelia fiziologiuri mshobiaroba dzalian dzlieri sisxldenis gamo.
placenta sheidzleba sashvilosnos yeltan axlos iyos orsulobis meore trimestrshi an mesame trimestris daswyisshi. magram igi yoveltvis modzraobs sashvilosnos wverosken rodesac mshobiarobis dro axlovdeba. es mdgomareobaa e.w. ???qvemot ganlagebuli placenta???.
placentis winamdebareobis gamomwvevi mizezi ucnobia. placentis aclis msgavsad igi ufro xshirad aghinishneba mravalshvilian dedebtan, asakovan qalebtan da mwevelebtan. sakeisro kveta da idzulebiti aborti zrdis placentis winamdebareobis risks. aseve didi zomis placenta zrdis imis albatobas, rom igi an daiwevs sashvilosnos yelisken, an dafaravs mas.

RA SIMPTOMEBI AGINISHNEBA AM DROS?
dziritadi simptomia vaginaluri sisxldena tkivilis gareshe. xshir shemtxvevashi mas adgili aqvs meore trimestris bolos an mesames dasawyisshi. sisxli am dros chveulebriv ghia witelia da raodenoba sheidzleba iyos bevric da cotac. sisxldena sheidzleba shewydes tavisit, magram ramodenime dgheshi an kvirashi igi isev gameordeba.
tu orsulobis mesame trimestrshi sisxldena gaqvt, miuxedavad imisa axlavs tu ara tkivili da tavisit shewyda tu ara, aucileblad daukavshirdit eqims.

ROGOR XDEBA DIAGNOSTIREBA?
placentis ganlagebaze dasakvirveblad ultrabgeriti gamokvleva gamoiyeneba. placentis winamdebareobis 98% am gzit vlindeba. sashvilosnos yelis gasinjva tardeba garkveul shemtxvevebshi. gasinjva frtxilad xdeba, radgan am proceduramac sheidzleba gamoiwvios dzlieri sisxldena, igi tardeba mashin roca mshobiaroba dagegmilia.

RA MKURNALOBA INISHNEBA AM DROS?
placentis winamdebareobis problemis mogvareba damokidebulia or faqtorze:
aris tu ara chanasaxi mshobiarobisatvis momwifebuli;
aris tu ara dzlieri vaginaluri sisxldena;
tu placenta ar faravs sashvilosnos yels da mxolod axlos aris ganlagebuli, ar aghinishneba sisxldena, mashin orsuls saxlshi awvnen im pirobit, rom sisxldenis shemtxvevashi saswrafod daukavshirdeba eqims. tu sisxldena kontrols ar eqvemdebareba, es mdgomareoba achqarebs bavshvis sakeisro kvetit gachenas (im shemtxvevashic ki, tu mshobiaroba naadrevia). aset shemtxvevashi bavshvisatvis uketesia iyos mzrunveli eqimebis garemoshi da kargad aghchurvili neonataluri intensiuri terapiis ganyofilebashi, vidre dedis sashvilosnoshi.

ROGORIA MOMAVALI?
radgan umetes shemtxvevebshi sanam chanasaxs raime safrtxes sheuqmnis, placentis winamdebareobis gamovlena droulad xdeba, igi aghar warmoadgens dedisa da bavshvisatvis did risks. mowinave teqnikuri aghchurviloba exmareba eqims am mdgomareobis gamoashkaravebashi manam, sanam deda sheamchnevs simptomebs.

NAYOFIS PRENATALUR GANVITAREBASHI CHAMORCHENA,
RA IWVEVS MAS?
yovel weliwads a.sh.sh-shi 40,000-ze meti bavshvi ibadeba 2,5 kg-ze naklebi wonit. miuxedavad sashvilosnoshi arsebuli yvelanairi pirobisa, es bavshvebi ar izrdebian iseti siswrafit rogorc unda gaizardon. es problema cnobilia nayofis prenatalur ganvitarebashi chamorchenis saxit (npgch).
tanamedrove mighwevebma medicinashi mnishvnelovnad sheamcira zrdashi chamorchenili bavshvebis riski, magram isini mainc dganan garkveuli problemebis winashe. aset bavshvebs cximebis da glikogenis (karbohidratis tipi, romelic glukozad gardaiqmneba, energiis wyaro) dzalian mcire maragi aqvt. aset bavshvebs ar sheudzliat sheinarchunon sitbo, ris shedegadac sheidzleba ganvitardes hipotermia. mkvdrad shobadoba da nayofis distresi xshiria zrdashi chamorchenil bavshvebshi. normaluri zomis bavshvebtan shedarebit, aseti bavshvebi mcire energiuli maragis gamo naklebad itanen mshobiarobis stresebs.
npgch-s shesadzlebel mizezebshi shedis placentis problemebi, ris shedegadac chanasaxs ar miewodeba sakmarisi sakvebi da jangbadi. aseve maghali wnevac mizezad itvleba. magram xshirad mizezi ucnobia. aseve npgch-s gamomwvevi mizezebi sheidzleba iyos:
sigaretis moweva
zogierti saxis infeqciebi (mag, witura, citomegalovirusi an toqsoplazmozi)
tandayololi defeqtebi an qromosomuli patologiebi
arasrulfasovani kveba
alkoholis da narkotikebis migheba
diabeti mozardobis periodshi
revmatiuli daavadebebi
dedis sxva qronikuli daavadebebi
tu zrdashi chamorchenili bavshvi gachnda, didi albatobaa rom igive gameordes shemdgomi orsulobisas. sabednierod, drouli daxmarebis aghmochena bevr problemas agvarebs. zogiert shemtxvevashi es problema mtlianad gvardeba.

ROGOR XDEBA DIAGNOSTIREBA?
rogorc wesi qalebs, romlebic zrdashi chamorchenil bavshvebs atareben, mcire an saertod aravitari simptomi ar aghenishnebat. eqimi tqventan yoveli shexvedrisas ecdeba npgch adreul etapze gamoaashkaravos.
am miznit eqimi zomavs sashvilosnos fudzis simaghles ??� es aris mandzili simfizis dzvalsa da sashvilosnos fudzes an mwvervals shoris. 18-dan 34-kviramde misi zoma santimetrebshi uxeshad sheesabameba orsulobis kviris ricxvs. imaze dakvirvebit tu rogor izrdeba zoma drota ganmavlobashi, eqimi sheidzleba daechvdes npgch-s arsebobashi. tu sashvilosnos zoma shesabamisad ar izrdeba, es npgch-s nishania.
orsulobis zusti vada mnishvnelovania npgch-s diagnostikashi. tu erti an ori kviris cdomilebaa esec adznelebs npgch-s zust diagnostikas. 20 kviramde orsulobis vadis dasazusteblad ultrabgeriti gamokvleva gamoiyeneba.
tu fudzis simaghlis zoma npgch-ze iwvevs echvs, am diagnozis dasamowmeblad ultrabgeriti gamokvleva gamoiyeneba. amit chanasaxis zogierti fizikuri monacemebi dazustdeba. ert-erti mnishvnelovani kriteriumia bavshvis tavisa da muclis garshemowerilobis dadgena da mati tanafardoba. aseve izomeba bavshvis tavis sigane (uwodeben biparietalur diametrs, an mandzils tavis qalis dzvlebs shoris), bardzayis dzvlis sigrdze da amnioturi sitxis odenoba.

RAMKURNALOBA INISHNEBA AM DROS?
pirveli nabiji am problemis mogvarebisa, mdgomareobs ert-erti arsebuli faqtoris mosxnashi, mag. narkotiki an cudi kveba. zogjer saavadmyofoshi wolaa mizanshewonili. bavshvis mdgomareobis sanaxavad tardeba testi datvirtvis gareshe, shekumshvis stres testi da biofizikuri machveneblebis gamokvlevebi. sheidzleba dedas stxovon bavshvis modzraobaze dakvirveba da chawera. ultrabgeriti gamokvlevebi tardeba or kvirashi ertxel, bavshvis zrdaze da amnioturi sitxis raodenobaze dasakvirveblad.
qromosomuli patologiebis an infeqciebis dasadgenad amniocentezi tardeba.
tu gamokvlevebi achvenebs rom chanasaxi adeqvaturad ar vitardeba, an raime xifatis winashea, es mdgomareoba eqims mshobiarobis dachqarebas afiqrebinebs. am gadwyvetilebis sabolood mighebashi ori faqtori tamashobs rols:
ramdenad aris bavshvi momwifebuli
ramdenad saxifatoa sashvilosnos garemo
pirvel shekitxvaze pasuxis gasacemad tardeba amniocentezi, rata inaxos bavshvis filtvebi momwifebulia tu ara. arsebobs shemtxvevebi rodesac bavshvis yofna intensiuri terapiis ganyofilebashi moumwifebeli filtvebitac ufro uketesia, vidre sashvilosnoshi araxelsayrel pirobebshi.
individualuri mdgomareobis gatvaliswinebit sheidzleba dachqardes mshobiaroba, bunebrivi gzit an sakeisro kvetit

PARTIZANKA

DAGHLA.
RA IWVEVS MAS?

qalebis umetesoba orsulobis adreul periodshi daghlas ganicdis. es gasagebi mdgomareobaa tu gavitvaliswinebt im faqts ??� ra samushaos aketebs tqveni organizmi. orsulobis pervel kvireebshi organizmi iwyebs meti sisxlis warmoebas, imisatvis rom chanasaxs sakvebi miewodos. tqveni guli gazrdili sisxlis nakadis gadasatumbad bevrad mets mushaobs. pulsi wutshi 10 ??�15 dartymit izrdeba. icvleba organizmis mier wylis, cilebis, karbohidratis da cximis gamoyeneba. am ghrma cvlilebebis kombinacia tqvens mier ganicdeba rogorc daghla.
am damghleli fizikuri cvlilebebis garda tqven aseve axal gancdebs da fiqrebs eguebit. rac ar unda sasurveli iyos orsuloba, mas damatebiti stresi moaqvs. tqven sheidzleba shishobdet bavshvis janmrtelobis shesaxeb, nerviulobdet imaze tu rogor sheeguebit dedobas, da aseve, gazrdil xarjebze. am dros garkveul rols tqveni samsaxuric tamashobs - ramdenad produqtuli iqnebit orsulobis periodshi.
shfotva yoveltvis chndeba, ara aqvs mnishvneloba pirveli orsulobaa tu meotxe. es bunebrivi da normaluri mdgomareobaa. nu dagaviwydebat, rom es tqvens fizikur mdgomareobaze aisaxeba.
ra shemidzlia gavaketo am dros?
dasveneba. ecadet xshirad (ramdenic gchirdebat) daisvenot. bavshvis gachenis shemdeg tqveni cxovrebis wesi sheicvleba, amitom amis regulireba tqven exla shegidzliat aseve mnishvnelovania - kargi kveba, nikotinis da alkoholis mavne zemoqmedebis tavidan acileba. monaxet yvelaniri sashualeba imisatvis rom daisvenot.
ecadet dghis ganmavlobashi daidzinot. samsaxurshi daisvenet, es energias aghgidgent.
tu dghis ganmavlobashi ar shegidzliat dadzineba, mashin es samsaxuris shemdeg unda moaxerxot, sauzmis da saghamos saqmianobebis win. tu sxva bavshvebic gyavt, axloblebs miecit sashualeba, rom xeli shegiwyon. sheamciret vizitebi tu es tqven gghlit, tqven exla iset mdgomareobashi imyofebit, rom amas gagigeben. stxovet sxvebs gagigon da dagexmaron, tandatan tqven es ufro dagchirdebat.
tu adre gindat dawvet, nurafers moeridebit. sheecadet ar daliot bevri sitxe dzilis win ramodenime saatis ganmavlobashi. shedegad ar dagchirdebat ghame adgoma, da normaluri dzilis sashualeba mogecemat.
varjishi. energiis momatebisatvis sauketeso sashualebaa varjishi. rac ufro mets varjishobt mit ufro meti energia geqnebat. iseti varjishi rogoricaa dgheshi naxevari saati siaruli, sagrdznoblad mogimatebt energias.
swori kveba. balansirebuli kveba ufro mnishvnelovania fexmdzimobis dros. daghla, romelic bunebrivia fexmdzimobis pirevel periodshi, ufro mwvavdeba tu ar ighebt sakmarisi odenobis rkinas da cilebs.