Shandisa Pakutanga Trimester Kunowedzera Matambudziko Okuberekwa
Kunyange zvazvo mishonga yakawanda inoshandiswa kurapa huwandu hwehutachiona inogona kutorwa yakachengeteka kuvakadzi vane pamuviri, zviviri zvakabatana zvakasiyana-siyana zveropa zvinodhaka mishonga zvinofanira kudziviswa. Aya ndiwo angiotensin anoshandura enzyme (ACE) inhibitors uye angiotensin II receptor blocker (ARB) zvinodhaka. Mhando dzemishonga dzinoisa njodzi dzakakomba kumucheche mwana, uye haafaniri kushandiswa chero nguva panguva yekuzvitakura.
Kunzwisisa ACE Inhibitors uye ARBs
ACE inhibitors nemishonga yeArb zvose inoshanda nekuvhara zvikamu zve renin-angiotensin nenzira, chimwe chemasimba makuru emuviri ekugadzirisa ropa. Nekuvhara zvishoma zvikamu zvema molecules zvakagadziriswa ne renin-angiotensin mugwagwa, ACE inhibitors neAARB zvinogona kuderedza kushanda kweropa mune varwere vazhinji vane hypertension .
Nei Izvi Zvinodhaka Zvisingafaniri Kushandiswa Panguva Yokuzvitakura?
Chidzidzo kubva kuTennessee muna 2006 chokutanga chakaona chinetso neACE inhibitors mumadzimai ane pamuviri. Mumakore anoda kusvika makumi matatu nemakumi matatu kubva kumabhadharo akachengeterwa Tennessee Medicaid, 411 vacheche vakange vachinetseka nemishonga inopesana nehuwandu munguva yekutanga kwemwedzi. Vaya vakazarurirwa neACE inhibitors (vana 209) vaiva nemukana wekuremara kwekuberekwa kwaive kaipetwa katatu kupfuura avo vasina kuzarurirwa kune ACE inhibitors: mapfumbamwe aiva nehutano hwemwoyo, vatatu vaiva nehutachiona hwehutano husina kunaka, uye matanhatu aiva nemamwe marudzi ekuzvarwa zvikanganiso.
Kakawanda, 7% yevana vakaratidzwa kuACE inhibitors mumutambo wekutanga wekutanga vaiva nechimwe chimiro chekuremara kwekuberekwa, vachienzanisa nehuwandu hwehuwandu hwehutachiwana hwehutachiwana hunenge huwandu hwehutachiona hunenge huwandu hwehutachiona hwehutachiona hunenge huwandu hwehutachiona hwehutachiona hunopera. Vacheche vainge vaine zvirwere zvinodhaka zvakanyanya kunze kweACE inhibitors havana kuratidza kuwedzera kwengozi.
Kubvira pakuongorora kwekutanga, zvimwe zvidzidzo zvakawanda zvakatsigira kuti ACE inhibitors panguva yekuzvitakura inobatanidza nehuwandu hwekuwedzera kwekukanganisa kwekuberekwa uye mamwe matambudziko.
Mukuwedzera, zvidzidzo zvinotevera zvakaratidza kuti kushandiswa kweAARB panguva yekudzivirira kwekutanga kunobatanidzwa nemhando imwechete yekuremara kwekuberekwa. Kana pane chimwe chinhu, njodzi neAAs inoratidzika kunge yakakwirira kudarika neACE inhibitors.
Kushandiswa kweACE inhibitors neAARB panguva yechipiri neyechitatu mitatu yekudzivirira kunokonzera zvinetso zvakakomba, kunyange zvakadaro.
Iyo yakashandiswa gare gare pakuberekwa, mishonga iyi inokonzera zvinetso zvakakomba zvepvo mucheche, kusanganisira kusakanganiswa kwechirwere chebasa kana kuti kusagadzikana kwetsvo . Kushanda-kuberekwa kwemishonga yemishonga iyi kunogonawo kukonzera kuberekwa kunorema, kuwedzera kukurumidza, uye kusununguka nguva isati yakwana.
The Bottom Line
Nemhaka yezvipingamupinyi zvakakomba zvinowanikwa kune vacheche vanaamai vanotora ACE inhibitors kana maArab chero nguva panguva yepamuviri, uye nekuti mamwe makirasi akawanda emishonga akachengeteka uye anowanzobudirira pakurapa huwandu hwehutano mumadzimai ane pamuviri, vanachiremba vanokurudzira kuti mishonga iyi isasashandiswa pa zvose mumadzimai ekuzera kwezera.
Kana kurapa huwandu hwehutano hwakakwana hakugoni kuitika pasina kuwedzera ACE inhibitors kana maArab, vakadzi vezera rokurera vanofanira kutora matanho ekudzivisa kubata pamuviri. Vanofanira kumira kutora mishonga yavo chero nguva iyo nguva yavo yekuenda kumwedzi inononoka nemaawa anopfuura makumi mashanu, uye inoita mimba yekuedzwa.
Sources
Cooper WO, Hernandez-Diaz S, Arbogast PG, et al. Maitiro makuru ekuzvarwa asina kufanana pashure pekutanga-katatu achionekwa kuACE inhibitors. N Engl J Med 2006; 354: 2443-24511.
Friedman JM. ACE inhibitors uye congenital anomalies. N Engl J Med 2006; 354: 2498-2500.
Bullo M, Tschumi S, Bucher BS, et al. Kubata mitezo pashure pekutsvaga angiotensin-kushandura enzyme inhibitors kana kuti angiotensin mutevedzeri wevanopikisa: kuronga kuongorora. Hypertension 2012; 60: 444.