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特殊男女備孕應(yīng)該注意些啥

出處：網(wǎng)絡(luò)收集 日期：2024-06-20 19:50:28 編輯：秩名

在備“孕”前3個(gè)月的孕前檢查里，有些女方可能查出患有滴蟲、霉菌、宮頸炎等婦科炎癥，或男方查出了衣原體、支原體感染，礙不礙事？
 
　　●滴蟲、霉菌性陰道炎這些病對(duì)精子有一定殺傷力，女性還是等治好病再懷孕吧！通常，內(nèi)服抗生素、局部外用栓劑，一周左右就能治愈。然后，在月經(jīng)或前或后1周左右復(fù)查白帶常規(guī)，如果連續(xù)3次呈陰性，就能放心大膽地懷孕了。
 
　　●盆腔炎、附件炎也建議先治療再懷孕。因?yàn)槠渲幸徊糠只颊呖赡苡信枨徽尺B、輸卵管不通等問題，易導(dǎo)致流產(chǎn)、宮外孕或早產(chǎn)等。經(jīng)過(guò)治療等癥狀消失后，下個(gè)月經(jīng)周期(不用藥)一過(guò)，便能考慮要孩子。
 
　　●宮頸炎、宮頸糜爛若程度較輕，又不存在感染問題，隨時(shí)都能受孕。如果糜爛程度較重或有感染，最好等感染消失、糜爛程度減輕后，醫(yī)生說(shuō)能懷孕了再懷孕，一是擔(dān)心感染影響胎兒，二是擔(dān)心糜爛程度重者，分娩時(shí)容易出血。但提醒一點(diǎn)，沒要孩子的女性治宮頸糜爛不建議手術(shù)，手術(shù)瘢痕可能影響自然分娩。
 
　　●男方支原體、衣原體感染如果做精液支原體培養(yǎng)呈陽(yáng)性，說(shuō)明支原體和精子黏附在一起的，治療原則是支原體轉(zhuǎn)陰才能要孩子。一般，中西醫(yī)結(jié)合治療1~2周后，停藥一周，復(fù)查精液支原體培養(yǎng)，結(jié)果呈陰性的話，再等一個(gè)月(讓藥物充分代謝)，才能要孩子。男方查出衣原體感染，90%以上的妻子也會(huì)感染。
 
　　由于支原體、衣原體感染比較頑固，女患者從治療到懷孕差不多需要半年的時(shí)間。治療前，可以先做藥敏試驗(yàn)，看看紅霉素、阿奇霉素等哪種藥物更對(duì)癥，治療效果會(huì)更好。通常，10天為一療程，須連續(xù)治療3個(gè)月經(jīng)周期(每個(gè)月經(jīng)周期，治療一療程)，再連續(xù)3個(gè)月經(jīng)周期經(jīng)前或經(jīng)后1周左右復(fù)查宮頸分泌物，倘若結(jié)果都呈陰性，就能懷孕了。
 

　　關(guān)于胎停育

 
　　一些孕媽媽有過(guò)胎停育史，若再懷孕，需要做一些特殊檢查，盡可能找到胎停育的原因。通常，夫妻雙方要查血型不合、染色體及一些免疫、代謝疾病。此外，男方還要進(jìn)行精液測(cè)定、女方測(cè)卵泡等。一旦發(fā)現(xiàn)異常，可提早干預(yù)。然而，很多免疫、代謝等疾病是無(wú)法篩查的，即使檢查各項(xiàng)指標(biāo)都正常，也可能有隱藏問題。
 

　　關(guān)于乙肝

 
　　患了乙肝還能懷孕嗎？啥時(shí)候懷孕好？這是廣大未生育乙肝男女最關(guān)心的事，他們怕母嬰感染，更怕妊娠加重病情。事實(shí)上，如果你是乙肝病毒攜帶者，不管是大三陽(yáng)還是小三陽(yáng)，只要肝功正常，也沒采取任何治療，隨時(shí)都可以懷孕。
 
　　但是，假如你的肝功能受損了，乙肝病毒DAN呈陽(yáng)性，并且正在進(jìn)行抗病毒治療，暫時(shí)就不太適合懷孕，建議等DAN轉(zhuǎn)陰、肝功恢復(fù)正常，再受孕。
 
　　不過(guò)，達(dá)到這一治療目標(biāo)談何容易，很多大齡青年根本等不及那一天，就迫切希望有個(gè)孩子，這可咋辦？這時(shí)，你可以在肝病專科醫(yī)生指導(dǎo)下，在準(zhǔn)備懷孕前的一個(gè)月，將抗病毒藥物換成妊娠安全性較高的拉米夫定、替比夫定。但切記不能自行停藥，否則病情很容易反彈，甚至有生命危險(xiǎn)。
 
　　此外，對(duì)于使用干擾素治療的乙肝女患者，必須停藥半年以上才能考慮懷孕，干擾素會(huì)影響胎兒生長(zhǎng)發(fā)育。
 
　　對(duì)于身患乙肝的男方，到底父嬰傳播的風(fēng)險(xiǎn)有多大，目前存在爭(zhēng)議。當(dāng)然，等DAN轉(zhuǎn)陰、肝功正常再懷孕，最安全不過(guò)了。
 

　　關(guān)于高血壓、高血脂

 
　　人們都知道高血壓需要終身服藥，但要孩子怎么辦？王浩認(rèn)為目前沒有任何藥物能夠證明對(duì)精子、卵子、受精卵沒有影響，為了確保優(yōu)生優(yōu)育，男女高血壓患者最好都停藥半年以上再考慮懷孕。
 
　　停了藥怎么控制血壓呢？他建議：1.低鹽飲食，每人每日3克以下。2.每天運(yùn)動(dòng)30分鐘以上，維持正常體重。3.心理上多放松。
 
　　提醒：停藥必須在醫(yī)生指導(dǎo)下進(jìn)行，假如二聯(lián)藥物治療仍不能控制血壓者，不適合停藥。
 
　　至于高血脂癥者，盡量避免高膽固醇飲食，增大運(yùn)動(dòng)消耗，多數(shù)人都能停藥后再懷孕。
 

　　關(guān)于心臟病

 
　　幾年前，一妊娠7個(gè)月的孕婦被急診送至鄭大一附院心內(nèi)科，她呼吸困難、下肢嚴(yán)重水腫，波及會(huì)陰部。經(jīng)過(guò)檢查，她患有風(fēng)濕性心臟病二尖瓣嚴(yán)重狹窄，當(dāng)時(shí)不管繼續(xù)妊娠或引產(chǎn)、剖宮產(chǎn)終止妊娠，她很可能都耐受不了，甚至母子喪命。后來(lái)，張金盈及時(shí)從網(wǎng)上搜索到歐洲采取的二尖瓣狹窄球囊擴(kuò)張術(shù)先進(jìn)技術(shù)，成功搶救了這個(gè)準(zhǔn)媽媽，她還足月生下一個(gè)健康男嬰。
 
　　這件事提醒患有風(fēng)濕性心臟病的女性，一定要在醫(yī)生監(jiān)護(hù)下備孕。若病變程度較輕，在非“抗風(fēng)濕治療”期可以考慮妊娠。但有嚴(yán)重風(fēng)濕性心臟病的女患者，最好別要孩子。
 
　　此外，先心病女患者若要孩子，建議先通過(guò)外科手術(shù)或封堵治療1年后，再在醫(yī)生指導(dǎo)下懷孕。
 

　　關(guān)于糖尿病

 
　　年輕糖友想要升格為父母，遇到的麻煩事也比健康人多。
 
　　男方患糖尿病：只要血糖控制達(dá)標(biāo)，空腹血糖在6.0mmol/L以下、餐后2小時(shí)血糖在7.8mmol/L以下，就能要孩子。但究竟父方口服降糖藥對(duì)胎兒有沒有影響，尚無(wú)定論，孕前準(zhǔn)備期，男方最好在醫(yī)生指導(dǎo)下將口服降糖藥改成胰島素治療。
 
　　女方患糖尿?。罕仨氃趯？漆t(yī)生的評(píng)估下備孕了。
 
　　如果女方不存在嚴(yán)重病發(fā)癥，健康狀況良好，血糖及糖化血紅蛋白控制達(dá)到理想水平，口服降糖藥(可致胎兒畸形)改用胰島素(不通過(guò)胎盤，不必?fù)?dān)心導(dǎo)致胎兒畸形)治療3~6個(gè)月以后，只需再得到?？漆t(yī)生的允許，就能考慮懷孕。
 

　　關(guān)于腎病

 
　　●感染性腎病患者(腎膿腫、腎積水、膀胱炎、腎結(jié)核等)治療需要大劑量地用抗生素，而這些藥物很可能影響胎兒的生長(zhǎng)發(fā)育。無(wú)論男女，只有在感染完全控制住了，且反復(fù)尿檢沒有問題，可在停藥兩周后考慮懷孕。
 
　　●自身免疫性腎病(紅斑狼瘡、腎病綜合征等)
 
　　男女都應(yīng)在尿蛋白轉(zhuǎn)陰或1克以下，腎功能正常，沒有狼瘡活動(dòng)指征，激素用藥停用半年以上，才能在醫(yī)生指導(dǎo)下懷孕。
 
　　●腎血管疾病(腎動(dòng)脈高壓)這種病對(duì)想要孩子的男性影響不大，但女性不同，必須把腎動(dòng)脈狹窄問題解決了才能懷孕。
 
　　●腎功能衰竭由于體內(nèi)毒素聚集，精、卵子質(zhì)量很難有保障，男女患者一般都不主張要孩子。
 

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