Kulinganiselwa ukuthi isigamu samawele sizalwa masinyane, ngaphambi kwamasonto angu-36 ukubeletha, cishe cishe inyanga ngaphambi kokuba kuphele amasonto angu-40 ukubeletha komntwana ongasenayo. Izintathu kanye nezinye iziphindaphinda ze-oda eziphakeme zinethuba elikhulu lokuzalwa ekuqaleni. Kwezinye izimo, ukuqala komsebenzi wangaphambi kokuqala akukwazi ukumiswa, kanti kwezinye izimo, izingozi kumama noma ezinganeni zidinga isiphetho sokuqala sokukhulelwa. Nazi ezinye zezizathu ezivame kakhulu ukuthi kungani amawele ezalwa ekuqaleni.
Umsebenzi wokuqala
Ukuqala kokuqala komsebenzi akuyona into evamile ekukhulelweni okuningi. Ukuthatha izingane ezincane nje kubandisa kakhulu ingozi yokuqashwa kwabasebenzi, ngakho kubalulekile ukuthi omama abalindele amawele noma ngaphezulu bazi izimpawu futhi bafune ukunakekelwa okufanele kwezempilo. Ezinye zezinkinga nezimo ezichazwe ngezansi zingabangela ukuqala komsebenzi, kodwa ngezinye izikhathi isizathu esiqondile asicacile. Kodwa kungakhathaliseki ukuthi yisiphi isizathu, lapho isibeletho siqala ukuvumelanisa futhi / noma umlomo wesibeletho uqala ukuvula ukulungiselela ukuzalwa, umphumela uwukuqala komsebenzi. Kwamanye amacala, angamiswa okwesikhashana, kepha uma engenakukwazi, abantwana bazonikezwa ngaphambi kwesikhathi futhi bazalwe kusenesikhathi.
Okuningi
Preeclampsia
Amama omama amaningi amaningi azobhekana ne-hypertension (high blood pressure) ngenkathi ekhulelwe, enye yezinkinga ezivame kakhulu zokukhulelwa. I-preeclampsia yisifo esibhekene nengcindezi ephakeme yegazi ehlangene nezinga eliphezulu lamaprotheni emcinini. Ukungahlosiwe, kungabangela ukwelashwa okujulile kumama, kuhlanganise nokuhlukunyezwa, ukulimala, nokulimala kwesibindi. I-preeclampsia ingalawulwa, kodwa ayikho ikhambi ngaphandle kokuletha izingane. Uma izimo ze-preeclampsia zikhungathekile ngokwanele, ukubelethwa kwamawele okuqala kunganconywa.
Izinkinga ze-Placenta
Ngamawele, kungaba khona i- placentas eyodwa noma amabili, okuyilungu elisekela abantwana ngesikhathi sabo esibelethweni. Ihlanganiswe nengaphakathi lesisu somama futhi ixhunywe ezinganeni 'ngezingcingo zabo ze-umbilicaI. Ngama-placenta (ama) ekukhulelwe okuningi okuhlanganisa ingxenye enkulu yodonga lwe-uterine, kukhona ingozi ephezulu yokucindezeleka okungaba yingozi kumama noma entsana. Ukuphazamiseka kwamapulazi , lapho i-placenta ichitheka khona, noma i- placenta previa, lapho i-placenta ihlezi khona esibelethweni, ehlanganisa ukuvulwa komlomo wesibeletho, ezinye izimo ezingase zenze ukuhanjelwa kokuqala.
Ngenkathi izinkinga ze-placental ezifana nalezi zingathinta ama-singletons, i-Twin-to-Twin Transfusion Syndrome (i-TTTS) isifo esiyingqayizivele kumawele. Kuyenzeka lapho imithwalo yegazi engavamile ikhula nge-placenta eyodwa, okwabelwana ngayo, okuholela ekushintsheni okungalingani kokugeleza kwegazi. Ezimweni ezinzima eziyekezela izingane, ukulethwa kungaba yindlela yokukhetha.
Izimbungulu ze-Amniotic Ruptured
Ngesikhathi sokukhulelwa, i-fetus - noma esimweni samawele, amantombazane - ihlanganiswe esikhwameni se-fluid, esikhwameni se-amniotic. Njengengxenye yenqubo yokusebenza, isikhwama sizovuleka (esaziwa ngokuthi "ukuphuza amanzi"). Kodwa ngezinye izikhathi i-sac ruptures ekuqaleni, eyaziwa ngokuthi i-PROM (Ukukhuphuka Kwemfucumfucu Ngaphambi Kokuqala) noma i-PPROM (Preterm Premature Rupture of Membranes) uma kwenzeka ngaphambi kwamasonto angu-37 ukubeletha. Lapho isikhwama samanzi siphula, sinikeza ithuba lokutheleleka uma ukulethwa kungaseduze, futhi kungase kuvuselele ukubeletha kwezinwele.
Ama-Mo-Mo Twins
Amaphesenti amancane amawele e-monozygotic (afanayo) afakwa njengamawele e- monochorionic-monoamniotic (Mo-Mo) . Abagcini nje ngokuhlanganyela i-placenta eyodwa kuphela kodwa futhi bahlanganiswe esikhwameni esisodwa se-amniotic. Kukhona ingozi yokweqa intambo noma ukucindezela intambo kule simo, isimo esibucayi esibangele ukusinda kwezingane. Kwezinye izimo lapho lokhu kwenzeka khona, ukhetho olungcono kakhulu lwezingane lungeniswa ngaphambi kwesikhathi.
Ukumiswa kokukhula
IUGR - noma ukuvimbela ukukhula kwe-intrauterine - yiqembu elikhulu lamagama asetshenziselwa ukuchaza inkinga encane ngemiphumela emikhulu. Lona ngumntwana noma zombili izingane ezincane kakhulu futhi ezingakhuli ngokwanele. Kwezinye ukukhulelwa okubili, iwele elilodwa lithinteka yi-IUGR ngenkathi enye engekho (eyaziwa ngokuthi i-Selective Intrauterine Growth Restriction noma i-SIUGR). Nakuba amawele avame ukuzalwa amancane kunama-singletons, i-IUGR enzima ingabonisa izinkinga ezinkulu ezinganeni. Kuze kube yikota yesine yokukhulelwa isipiliyoni i-IUGR. Kunezimbangela eziningi zokwenza umkhawulo wokukhula; ezinye zihilela ezinye izimo okukhulunywe ngazo lapha, njengokungasebenzi kahle kwe-placental, i-low amniotic fluid, noma i-Twin-to-Twin Transfusion Syndrome (TTTS). Uma kunqunywa ukuthi iwele liye layeka ukukhula noma libhekene nokucindezeleka, ukulethwa kokuqala kungaba yindlela engcono kakhulu.
Kucatshangwa Isikhathi emavikini angu-37 noma angu-38
Imibono ihlukile ngesikhathi sokubeletha kwamawele noma ngaphezulu. Lapho umsebenzi wokuqala noma ezinye izinkinga ezifakiwe, umgomo uvame ukuthi "ngokuhamba kwesikhathi kube ngcono." Kodwa emasontweni ambalwa edlule wokukhulelwa, odokotela abahlukene bangase babe nezindlela ezahlukene. Kwabanye, ukubeletha okhethweni emavikini angu-37 noma angu-38 kungcono ukukhulelwa okungafani nakakhulu, ngakho-ke udokotela wakho angase ahlele ukulethwa kwamasonto ambalwa ekuqaleni. Abanye bakhetha ukulinda nokubona.
Imithombo:
Dodd, JM, et al., "Ukubeletha okukhethwa emasontweni angu-37 wokubeletha ngokuhambisana nokunakekelwa okujwayelekile kwabesifazane abanomama wokukhulelwa okungaqondakali ngesikhathi: I-Twins Time of Birth Birth Randomized Trial." I- British Journal of Obstetrics and Gynecology, ngoJuni 2012. pg. 964.
UHabli, M., et al. "I-Twin-to-twin transfusion syndrome: ukubuyekezwa okuphelele." Amakhamikhali e-Perinatology , ngoJuni 2009. pg. 391.
ULeeman, L. kanye noFistaine, uP., "Ukucindezeleka Kwama-Hypertensive of Pregnancy." I- American Family Physician , ngoJulayi 2008, pg. 93.
Moh, W., et al., "Izinto ezingaphezulu kwe-Infrinsic Influence Deformations Deformations kanye ne-Intrauterine Growth Restriction .: Journal of pregnancy , June 2012.
"Ukukhulelwa Okuphindaphindiwe." I- American College of Obstetricians and Gynecologists , Efinyelelekile kuFebhuwari 27, 2016. http://www.acog.org/Patients/FAQs/Multiple-Pregnancy
Saliva, HM, et al., "Ukushona kwe-Perinatal okuhlobene ne-abruptio placenta kuma-singletons kanye nokuphindaphinda." I- American Journal of Obstetrics and Gynecology , July 2005, pg. 198.
"Izinkinga Zokukhulelwa Kwesisindo Sezintathu." Isikhungo se-UCSF Fetal Treatment. Ifinyelele ngo-February 27, 2016. https://web.archive.org/web/20111221205053/http://fetus.ucsfmedicalcenter.org/twin/