Isifo sokumpontshelwa kwe- twwin -to-twin yisimo se- placenta esithinta ukukhulelwa okufanayo okufanayo. Ku-TTTS, ukuxhumeka okungavamile phakathi kwemithambo yegazi ku-placenta kuvumela igazi kusuka kwelinye ihlangothi ukuba ligijime kwezinye amawele. Kwezinye izimo, amawele ahlanganyela i-placenta evamile ngokungalingani, futhi amawele amabili angenayo isabelo esikhulu ngokwanele ukuthola izakhi ezidingekayo ukuze zikhule ngokuvamile noma zisinde.
Ngabe i-TTTS ivele nini?
I-twwin-to-twin transfusion syndrome kwenzeka kuphela lapho amawele afanayo ahlanganyela nge-placenta. I-TTTS ingenzeka ku-triplet noma ukukhulelwa okuphakeme uma izinsana ezimbili zifana futhi zihlanganyela i-placenta. Amawele womzimba namawele afana nama-placentas ahlukene awasemngciphekweni we-TTTS.
Yiziphi izimpawu ze-TTTS?
Amawele we-TTTS anezimpawu ezehlukene ngokusekelwe ukuthi bangabanikeli noma abamukeli .
Amawele we-TTTS ama- donor athola igazi elingaphansi kwe-placenta futhi alahlekelwa igazi ukuya kwamanye amawele. Amani amawele amancane, kokubili ngaphambi nangemva kokuzalwa. Ziyaguqukile futhi zine-anemic, zinciphise umkhiqizo we-urine ku-utero, futhi ezincane-kune-ezijwayelekile izibopho. Uma amawele anezikhwama ezimbili ze-amniotic, amawele womnikelo azobe anciphisa amniotic fluid ( oligohydramnios ).
Amawele omamukeli athola igazi eliningi, kokubili kusukela e-placenta nakwezinye amawele. Lezi zingane zikhulu futhi zinamanzi amaningi amniotic ( polyhydramnios ).
Ngenxa yokuthi lezi zinsana zinegazi eliningi emzimbeni yazo, izinhlelo zabo zokujikeleza zingase zithwale ngokweqile, zenze izinkinga zenhliziyo.
Zibucayi kangakanani i-TTTS?
I-twwin kuya kwe-twin-transfusion syndrome ingase ibe mncane kakhulu noma ibucayi kakhulu, kuye ngokuthi igazi elingenalutho libelwana kanjani nezingane. Uma i-TTTS isitholiwe, odokotela bayolandela ukukhulelwa okusheshayo ukubona ukuthi izimpawu ziyaqhubeka yini noma cha.
Izigaba ze-TTTS ziyi:
- Isigaba I: I-twin donor inciphise amniotic fluid; i-twin yomamukeli ine-amniotic ngokweqile.
- Isigaba II: Okufanayo njengenhla. Isikhwama se-twin donor ayibonakali kwi-ultrasound - uphawu lokunciphisa umchamo we-urine ku-utero.
- Isigaba III: Zonke izimpawu ezingenhla zikhona; Ukugeleza kwegazi emithanjeni ye-umbilical akuvamile.
- Isigaba IV: Zonke izimpawu ezingenhla zikhona; iwele elimukeli lihlelekile futhi libonisa izimpawu zokuhluleka kwenhliziyo.
- Isigaba V: Zonke izimpawu ezingenhla zikhona futhi iwele elilodwa lifile.
I-TTTS iphathwe kanjani?
Uma odokotela beqaphela ukuthi amawele afanayo afana ne-placenta, umama uzolandelwa eduze ukuze abe nezimpawu ze-TTTS. Uma isigaba I-TTTS sitholwa, umama ngokuvamile uzohlolwa ngokucophelela. Uma i-TTTS iqhubekela phambili esigabeni II noma III, odokotela bangase bazame ukuhlinza laser fetal noma amniotic fluid ukunciphisa. Ukwelashwa kungase kusetshenziswe ngokuhamba kwesikhathi esifundeni, kodwa amathuba okuphumelela aphansi.
Ekuhlinzekeni kwe-laser fetal , ukwelashwa kwama-laser kusetshenziselwa ukwehlukanisa imithwalo yegazi ku-placenta evumela igazi ukuba ligijime kusuka kwelinye ihlangothi kuya kwesinye. Ngokuvamile ukuhlinzwa kubhekwa njengempumelelo kakhulu kune-amniotic fluid ukunciphisa. Amawele amabili azalwa ngemuva kokuhlinza laser fetal anethuba eliphakeme lokuphila kanye nethuba eliphansi lokuba nemiphumela enzima yesikhathi eside TTTS.
Ukuhlinzwa ngezinye izikhathi kwehluleka, noma kunjalo, futhi i-TTTS izoqhubeka nokuqhubeka.
E- serial amniotic fluid ukunciphisa , i-amniotic fluid igxiliwe esikhwameni esungeze amawele amabili. Inqubo ingenziwa kanye kanye noma izikhathi eziningana. Imfundiso ye-amniotic fluid ukunciphisa yukuthi ukunciphisa uketshezi kunciphisa inhlanzi enhliziyweni yomuntu oyedwa futhi kuvimbela ukuqala komsebenzi okuvela lapho kwenzeka lapho umthamo we-amniotic ngokweqile ubeka umthamo esibelethweni somlomo wesibeletho.
Yiziphi Imiphumela Zesikhathi eside ZamaTTTS?
Izimpawu eziningi ze-TTTS ezincane, kubandakanya i-anemia ne-polycythemia (isibalo esiphezulu se-cell cell), singaphathwa ngempumelelo ngemva kokuzalwa.
Ngenxa yokuthi ukukhulelwa kwama-TTTS amaningi akuhambanga esikhathini, imiphumela yesikhathi eside ye-TTTS ifana nemiphumela yesikhathi eside yokuqeda isimo.
Ezimweni ezithuthukisiwe ze-TTTS, izinsana ezibandakanyekayo zingase zibe nemiphumela yesikhathi eside ngaphesheya kwezinkinga zokungabi nesikhathi sokuqala. Ukuzibulala kwesinye isikhathi nezinye izilonda zobuchopho zivame kakhulu ezinganeni ze-TTTS, ngisho nangemva kokwelashwa kwe-laser noma amnioreduction. Uma lesi sifo singelashwa futhi singalandelwa eduze, imiphumela yesikhathi eside ingabandakanya ukuhluleka kwenhliziyo nokufa kwesinye noma zombili amawele.
Imithombo:
Lenclen, MD, Richard, Paupe, MD, Alain, Ciarlo, MD, Giuseppina, Castela, MD, Sophie, Castela, MD, Florence, Ortqvist, MD, Lisa, Ville, MD, Yves. "Umphumela we-Neonatal in Preterm Ama-Monochorionic Twins nge-Twin-to-Twin Transfusion Syndrome Ngemuva kokulashwa kwe-Intrauterine ne-Amnioreduction noma i-Fetoscopic Laser Ukuhlinzwa: I- American Journal of Obstetrics and Gynecology May 2007: 450e1-450e7.
Norton, MD, uMary. "Ukuhlolwa Nokuphathwa Kwe-Twin-Twin Transfusion Syndrome: Kusengumngeni" I- American Journal of Obstetrics and Gynecology May 2007. 196: p 419-420.
I-Twin kuya ku-Twin Transfusion Syndrome Foundation. "Ochwepheshe bezokwelapha."
Isikhungo Sezokwelapha sase-San Diego. "Ukuqonda Izitebhisi ze-TTTS."