#16
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Çäðàâñòâóéòå!
Áåðåìåííîñòü 12 íåäåëü Íà ñðîêå 5-6 íåäåëü ñäàâàëà àíàëèçû: Ãåìîãëîáèí 140 ã/ë Ýðèòðîöèòû 4.53 *10^12ë Ht 33.8 % Ëåéêîöèòû 3.98 *10^9/ë Òðîìáîöèòû 305 *10^9/ë ÀËÒ 14.2 Åä/ë ÀÑÒ 17.4 Åä/ë Áèëèðóáèí îá. 13.57 ìêÌ/ë Îáù. áåëîê 72.9 ã/ë Êðåàòèíèí 90.1 ìêÌ/ë Ìî÷åâèíà 3.77 ììîëü/ë Ãëþêîçà 4.04 ììîëü/ë ÏÎ 1.01 ÌÍÎ 1.01 ÒÒà 3.27 ìàìå/ìë À×Ò 29.1 ñåê Òðîìáèíîâîå âðåìÿ 19.2 ñåê Ôèáðèíîãåí 2.79 ã/ë D-äèìåð <137 íî/ìë Àíòèòðîìáèí III 101% Ïëàçìèíîãåí 91% Íà ñðîêå 9 íåäåëü Ôåððèòèí 43 ìêã/ë ÒÒà 2.78 ìàìå/ìë Ò3 ñâîá 3.07 ïî/ìë Ò4 ñâîá 1.12 íã/äëÿ ÀÒ-Òà 172 ÌÅ/ìë (ïðè íîðìå äî 115) ÀÒ-ÒÏÎ 9.29 ÌÅ/ìë (íîðìà 0-34) Íà îñíîâàíèè ýòèõ àíàëèçîâ áûë íàçíà÷åí l-òèðîêñèí 50 Òàêæå ãåìàòîëîãîì áûë íàçíà÷åí Êàðäèîìàãíèë 150 äëÿ ïðîôèëàêòèêè ïðåýêëàìïñèè ñ 12 íåäåëü Àíàëèçû â 12 íåäåëü: Ãåìîãëîáèí 116 ã/ë Ýðèòðîöèòû 3.87 *10^12 ë Ãåìàòîêðèò 0.33 ë/ë MCV 85 ôë MCH 30 ïã ÌÑÍÑ 35,3 ã/äë RDW-CV 13,3 % Ëåéêîöèòû 4.56 *10^9 ë Òðîìáîöèòû 321 *10^9ë PDW 10,9 ôë P-LCR 24.5% PCT 0,32% Ïðîòðîìáèíîâîå âðåìÿ 11,9 ñåê Ïðîòðîìáèí ïî êâèêó 132% ÌÍÎ 0.87 À×Ò 33.8 ñåê Ôèáðèíîãåí 4.4 ã/ë Àíòèòðîìáèí III 92.7% Ôåððèòèí 41,11 íã/ìë ÒÒà 1.11 ìê/ìë Ê ìîìåíòó ñäà÷è àíàëèçîâ 2 äíÿ ïèëà àñïèðèí Ïðèíèìàþ òðîìáî àññ íà íî÷ü, l òèðîêñèí 50, óòðîæåñòàí 200 âå÷åðîì + 100 óòðîì Ôîëèåâóþ êèñëîòó 400, Éîäîìàðèí 200, àêâàäåòðèì 1-2 êàïëè Ïîäñêàæèòå, ïîæàëóéñòà, ñòîèò ëè áåñïîêîèòüñÿ èç-çà ñíèæåíèÿ ãåìîãëîáèíà äî íèæíåé ãðàíèöû íîðìû? Ïðè ýòîì ôåððèòèí ñíèçèëñÿ íåçíà÷èòåëüíî. Ïî íàçíà÷åíèÿì ñëåäóþùàÿ ñäà÷à àíàëèçîâ òîëüêî íà 20-22 íåäåëå (îàê, ôåððèòèí, êîàãóëîãðàììà) |
#17
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íà ìîé âçãëÿä òèðîêñèí íå íóæåí áûë, òàê êàê òòã ìåíåå 3.0, åñëè ïðå-ýêëàìïñèè íå áûëî, òî àñïèðèí íå íóæåí, ãåìîãëîáèí áîëåå 110 = íîðìà â ïåðâîì òðèìåñòðå, êîàãóëîãðàììà íå íóæíà áûëà è íå áóäåò íóæíà íè â êàêèõ íåäåëÿõ áîëüøå äî êîíöà áåðåìåííîñòè; åñëè ìèîìà â ïîëîñòè ìàòêè, òî ìîæåò óâåëè÷èâàòü ðèñê ïðåðûâàíèÿ â ïåðâûå 12-18 íåäåëü
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#18
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Âàäèì Âàëåðüåâè÷, ñïàñèáî áîëüøîå çà îòâåò!
Ïî äàííûì ñêðèíèíãîâîãî óçè, ìèîìà òèï 4, ðàçìåð 30õ27õ19, ýõîãåííîñòü ñðåäíÿÿ, ðàñïîëîæåíà ïî ïåðåäíåé ñòåíêå â íèæíåé òðåòè ñïðàâà (ïëàöåíòà òîæå ïî ïåðåäíåé ñòåíêå). Íà ïðåäûäóùåì óçè â 8 íåäåëü ïèñàëè, ÷òî îíà ðàñïîëàãàåòñÿ èíòåðñòèöèàëüíî, 19õ20 ìì Òàêàÿ ìèîìà óâåëè÷èâàåò ðèñêè? |
#19
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íå ñïåöèàëèñò â äàííîì âîïðîñå, ïðîñòî åñëè îïÿòü íàñòóïèò ïðåðûâàíèå, òî óäàëåíèå ìîæåò ïîìî÷ü âûíàøèâàíèþ; íàïðèìåð: óñïåõ âûíàøèâàíèÿ 43% ïîñëå óäàëåíèÿ ïî ñðàâíåíèþ ñ 27% áåç óäàëåíèÿ
patients who underwent myomectomy for resection of submucosal fibroids had higher clinical pregnancy rates when compared to patients with fibroids that did not undergo surgery (43.3% for operated versus 27.2% for unoperated)
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#20
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Öèòàòà:
Ìåíüøå äóìàéòå î íåãàòèâíîì. À ïðåðâàëàñü ïðåäûäóùàÿ, ñêîðåå âñåãî, èç-çà íåäîñòàòêà "ïèòàíèÿ" - ÆÄ Âàø íåëå÷åíûé àäåêâàòíî. Ìû, êîíå÷íî, íå çíàåì õðîìîñîìíûé íàáîð àáîðòàòà, íî ïî ôèëîñîôñêîìó çàêîíó ñàìîå ïðîñòîå îáúÿñíåíèå ÷àùå è åñòü ïðàâèëüíîå. ÈÌÕÎ |
#21
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Ñïàñèáî!
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#22
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Çäðàâñòâóéòå! 26 íåäåëÿ áåðåìåííîñòè, ãåìîãëîáèí óïàë äî 100, ãåìàòîêðèò 29, ôåððèòèí 11, íà ôîíå ïðèåìà ïðåïàðàòîâ æåëåçà. Ïðîïèñàëè ôåðèíæåêò 10 ìë. Ïîäñêàæèòå, ïîæàëóéñòà, áåçîïàñíî ëè â/â ââåäåíèå ïðåïàðàòîâ æåëåçà äëÿ ïëîäà íà ìî¸ì ñðîêå?
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#23
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áåçîïàñíî:
Ferinject is generally safe unless you have a known sensitivity or allergy to iron supplements or a liver problem, or you are in the first trimester (first 12 weeks) Ferric carboxymaltose vs. oral iron in the treatment of pregnant women with iron deficiency anemia [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#24
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Ñïàñèáî áîëüøîå çà îòâåò!
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#25
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Çäðàâñòâóéòå! Ñïàñèáî áîëüøîå çà êîíñóëüòàöèè!
29.10 íà ñðîêå 38.1 ðîäèëà äåâî÷êó, 8/9 ïî Àïãàð. Ñåé÷àñ íå ìîæåì íàéòè ïðè÷èíó ïîâûøåíèÿ áèëèðóáèíà â êðîâè. Âûïèñàëè èç ðîääîìà íà 3 ñóòêè. ×óòü ìåíüøå, ÷åì ÷åðåç ñóòêè ïîñëå ðîäîâ, íà÷àëàñü æåëòóõà, ïî ñëîâàì âðà÷åé - ôèçèîëîãè÷åñêàÿ. Ðåáåíîê áûë îðàíæåâîãî îòòåíêà. ×åðåç íåäåëþ ïîñëå âûïèñêè ïî áèëèòåñòó - 425. Çà 3 äíÿ ïîä ëàìïàìè äîìà ñáèëè ïî áèëèòåñòó äî 150. ×åðåç íåñêîëüêî äíåé ïðîâåëè êîíòðîëüíîå èçìåðåíèå - áèëèðóáèí ñíîâà ïîâûñèëñÿ äî 185. Îïÿòü ïðîëåæàëè íåäåëþ ïîä ëàìïàìè. Ñíèçèëè ïî áèëèòåñòó äî 150.×åðåç íåäåëþ êîíòðîëüíîå èçìåðåíèå áèëèòåñòîì - 230. ×åðåç äåíü ñäàëè àíàëèç êðîâè â ëàáîðàòîðèè, îáùèé 252 (240 íåïðÿìîé, 12 ïðÿìîé) Åù¸ ÷åðåç äåíü â áîëüíèöå - 320. Íåäåëþ â áîëüíèöå ëå÷èëè ëàìïîé + Óðñîôàëüê.  ðåçóëüòàòå - îáùèé áèëèðóáèí 240. Òàêæå ïîâûøåíà ùåëî÷íàÿ ôîñôàòàçà â êðîâè (770 ïðè íîðìå äî 700) Íåïîíÿòíî, â ÷åì ïðè÷èíà. Åñòü ðàçíûå òåîðèè - èç-çà ãðóäíîãî ìîëîêà, íåäîñòàòî÷íîñòè ïèòàíèÿ, ïðåïàðàòîâ, ïðèíèìàåìûõ ïðè áåðåìåííîñòè èëè íàñëåäñòâåííûõ ñèíäðîìîâ.  áëèæàéøèå äíè ñäàäèì íà ñèíäðîì Æèëüáåðà è Íàéÿðà. Ìîæíî ëè ïî êëèíèêå ðàçëè÷èòü ýòè äâà ñèíäðîìà, èëè òîëüêî ïî àíàëèçó? Êàêèå ìîãóò áûòü ïðè÷èíû ïîâòîðíîãî íàðàñòàíèÿ áèëèðóáèíà äî âûñîêèõ öèôð? Äåâî÷êà íà ãâ.  ïîñëåäíèå äâå íåäåëè äîêàðìëèâàþ ñìåñüþ. Ðîäèëàñü 2950, âûïèñàëè 2650, â ìåñÿö âåñ 3600. Äåëàëè óçè áðþøíîé ïîëîñòè, íñã, âñå â íîðìå. Ðåçóñ êîíôëèêòà è êîíôëèêòà ïî ãðóïïå êðîâè íåò. Êëèíè÷åñêèé àíàëèç êðîâè 28.11 WB 7,88 Ëèìô % 76,48 Ìîíîé % 9,68 Íåéò % 11,06 Ýîç, % 2,76 Áàç % 0.02 RBC 4,12 Hb 136 PLT 360 ÑÎÝ 6 |
#26
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åòî áèëèðóáèíåìèÿ àáûâàåò äî 3 ìåñ., â 99% èç-çà ìóòàöèé Æèëüáåðà, íè÷åãî ðåáåíêó íå íóæíî, óðñîôàëüê óáðàòü èç-çà âîçì. òîêñè÷íîñòè ïð-òà, ïîèñê ïî ôîðóìó èëè https://forums.rusmedserv.com/showthread.php?p=2489221
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#27
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Ñïàñèáî âàì îãðîìíîå!
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#28
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íå ìó÷àéòå ðåáåíêà íèêàêèìè àíàëèçàìè êðîâè
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#29
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....ïðåïàðàòû ïðèíèìàåìûå âî âðåìÿ áåðåìåííîñòè - ôîðìóëèðîâêó êàê ïðè÷èíó çàáûòü.
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#30
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Ñïàñèáî îãðîìíîå çà êîíñóëüòàöèè!
Ïî íàçíà÷åíèþ ïåäèàòðà ïåðåä âàêöèíàöèåé ñäàëè àíàëèçû. Âûÿâèëîñü ïîâûøåíèå òðîìáîöèòîâ è óìåíüøåíèå èõ îáúåìà.  âûïèñêå èç ðîääîìà áûëè óêàçàíû ïîõîæèå îòêëîíåíèÿ (ïðè âûïèñêå òðîìáîöèòû 463, îáúåì 8.6, ñåé÷àñ òðîìáîöèòû ïî÷òè 700, îáú¸ì 8.6). Ýòî ìîæåò áûòü âàðèàíòîì íîðìû? Ññûëêà íà ðåçóëüòàòû àíàëèçîâ: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |