Kunezingozi eziningi ezihlobene nokukhulelwa kwamabili, kodwa ezinye zazo zithinta kuphela izinhlobo ezithile zamawele. I-MoMo amawele ayizimpande ze-monozygotic ezithuthuka esikhwameni esisodwa, esabelwe amniotic. Lesi simo sibangela ingozi kubantwana ngenxa yokungena kwetambo.
Yini ama-MoMo Twins?
Igama elithi MoMo lincane ku-Monoamniotic Monochorionic. Ichaza amawele athola nge-chorion eyodwa kanye ne-sac amniotic eyodwa.
Isikhwama se-amniotic yisigqoko samanzi esine-fetus, kanti i-chorion yi-membrane yangaphandle.
Ama-twin ama-MoMo athuthuka kusuka kuhlanganiswa kweqanda / insimu eyodwa ehlukaniswa kabili. Uma ukuhlukaniswa kubambezeleka, ngokuvamile ngesonto noma ngemuva kokukhulelwe, inqubo yokukhulisa i-placenta, i-chorion, ne-amniotic sac isiqalile kakade, futhi imibungu emibili iyokhula ngaphakathi kwesigxobo esisodwa esabiwe. Kuphela amaphesenti angu-1 okukhulelwa okubili azokwenzeka ngale ndlela. Iningi lamawele e-monozygotic lizokhula ngama-sacs ahlukene, noma ngezinye izikhathi ngama-amnions ahlukene ngaphakathi kwe-chorion eyabelwe. (Lezi zichazwe njenge-monochorionic-diamniotic noma i-MoDi.)
Indlela Abaxhunywa Ngayo
I-Ultrasound yindlela kuphela yokuthola amawele we-MOMo. Ngesikhathi sokukhulelwa kwamabili, iningi labesomama lijwayele ukuhlolwa nge-ultrasound. Odokotela bazobheka ukuba khona kwebhande elihlukanisayo ukukhombisa ukuthi amawele asemasakeni ahlukile. Ukuntuleka kwekhanda noma umzila omncane noma ongaqondakali kungaholela ekuhlaziyweni okuqhubekayo ukuqinisekisa isimo.
Izingozi
Ama-fetus amawele ahlangene ne-placenta ngezintambo zawo zomzimba. Ukuphumula ndawonye esikhwameni esifanayo kubeka engozini yokuxoshwa kwentambo noma ukucindezela intambo. Izintambo zomzimba zihlinzeka ngempilo ebalulekile ezinganeni, ukuhlinzeka ngegazi kanye nezakhi ezisiza ukuba zikhule futhi zikhule. Njengoba izinsana zihambela esibelethweni, izintambo zingadlula noma zicindezele, zinciphise ukunikezwa.
Kungaba yisimo esisongela ukuphila. Uma izintambo zifakwe isikhathi eside, ingozi enkulu yokulimala ezintanjeni, futhi ingozi yokufa komntwana oyedwa noma womabili isanda.
Ukwelapha
Ngenhlanhla, ubuchwepheshe bwanamuhla buvumela odokotela ukuba babone izingane esibelethweni bese beqaphela isimo. Ama-ultrasound high-resolution, imaging doppler, kanye nokuhlolwa okungewona ukucindezeleka kusiza ukuhlola izimpawu futhi ukukhomba izinkinga zenkambo ezingenzeka. Ukwehlukaniswa kwezintambo nokucindezela ngokuvamile kuvama izinqubo, ngakho abazali nabahlengikazi banesikhathi sokwenza izinqumo. Ezinye izimo zizodinga ukuqapha okusheshayo ukuthi umama olindelekile kumele ahlale esibhedlela.
Ayikho yokwelashwa okuvunyelwe noma inqubo yokulungisa isimo. Isixazululo kuphela ukulethwa kwezinsana. Cishe zonke izingane ze-MoMo zizalwa ngaphambi kwesikhathi. Odokotela kumele balinganise izingozi zempilo yabantwana esibelethweni kanye nemiphumela yokuqeda isimo .
Uma ukucindezela kwentambo kwenzeka ekuqaleni kokukhulelwa, izingane zingase zingakwazi ukusinda. Abanye odokotela bakhetha ukuhlela ukulethwa kwezinsana ze-MOMo ema-32, 34, noma emavikini angama-36, becabanga ukuthi indawo yesizalo isengozini kakhulu esikhathini esidlule. Ngezinye izikhathi i-steroids ingase ihlinzekwe ukuthuthukisa ukuthuthukiswa kwephunga labantwana futhi ithuthukise amathuba abo okusinda ngaphandle kwesisu.
Isigaba sokugcoba sinqunyelwe ukuba izingane ze-MoMo zigweme i-cord prolapse, isimo esenzeka lapho ingane yesibili intambo ixoshwa lapho ingane ikhululwa.
Ulwazi olungaphezulu
- Amantombazane akwa-MOMo ahlale efana nobulili obufanayo: kungaba abafana ababili noma amantombazane amabili. Njengoba cishe wonke amawele e-monozygotic, ayenjalo ubulili obufanayo ngoba athola isethi efanayo yegenes. (Azikho amacala okungafani kwe-chromosomal okudala ukungafani kobulili kumawele we-monozygotic atholakala kumawele we-MOMo.)
- I-MoMo amawele ayinqabile kakhulu. Amaphesenti angu-1 kuphela okukhulelwa kokubili azoba monoamniotic.
- Ngemva kwamasonto angu-24, izinga lokusinda kwamawele e-MoMo cishe ngamaphesenti angu-75 kuya ku-80.
- Ukwelashwa okusha kuhlolwa. I-Sulindac iyisidakamizwa esinciphisa inani le-amniotic fluid nokunciphisa isikhala lapho izingane zingakwazi ukuhamba khona.
- Abomama beziphindaphindiwe ze-MoMo kufanele banakekelwe yi-perinatologist (isazi sezidakamizwa esihloswe ngokukhulelwa kakhudlwana), noma kufanele okungenani uthintane nodokotela ohlangene namawele we-MOMo.
- I-MoMo amawele ngokuvamile aqondakali kahle emasontweni okuqala okukhulelwa lapho i-membrane ilukhuni kangangokuthi ingaba ingabonakali. Ngokuvamile i-ultrasound kamuva iveza isibalo sokuhlukanisa esiqinisekisa ukuthi amawele empeleni yi-MoDi (i-Monochorionic, i-Diamniotic).
Imithombo:
Ukuthanda F, Fichera A, Pagani G, et al. Umlando wemvelo we-monoamniotic twin pregnancy: uchungechunge lwamacala nokubuyekezwa okuhlelekile kwezincwadi. Drenat Diagn . 2015; 35 (3): 274-80.
Roque H, Gillen-Goldstein J, Funai E, Young BK, Lockwood CJ. Imiphumela ye-Perinatal ekusebenziseni kwe-monoamniotic. I-Matern Fetal Fetal Neonatal Med . 2003; 13 (6): 414-21.