So wo nso worewo mmanoma anaa mma mmiɛnsa? (Multiple Pregnancy) Momma yɛnka eyi ho asɛm!

Sɛ oduruyɛfo no ka kyerɛ wo sɛ worewo nkokoaa bɛboro biako, kyerɛ sɛ, mmanoma anaa mmanoma abiɛsa (nyinsɛn pii) a, ɛbɛyɛ sɛ wotee nka sɛ ɛyɛɛ wo nwonwa na w’ani gyei kɛse, ɛnte saa? Nanso bere koro no ara mu no, ɛyɛ ade a ɛfata sɛ wubesuro kakra na nsɛmmisa kakraa bi aba w’adwenem. Ebia woredwen nneɛma te sɛ, "Mɛyɛ dɛn ahwɛ abien?", "So metumi adi eyi ho dwuma?" Mma ɛnhaw wo, ɛnyɛ wo nko ara. Wɔ saa asɛm yi mu no, yɛbɛka saa "nyinsɛn pii" yi ho asɛm wɔ ɔkwan tiawa a wubetumi ate ase so.

Dɛn ne nyinsɛn pii yi?

Sɛ yɛbɛka no tiawa a, nyinsɛn pii ne bere a woso nkokoaa bɛboro biako bere koro mu. Sɛ woso nkokoaa baanu a, yɛfrɛ wɔn mmanoma . Sɛ woso nkokoaa baasa a, yɛfrɛ wɔn mma abiɛsa . Ɛtɔ mmere bi a, wubetumi asoa nkokoaa pii mpo wɔ nyinsɛn koro no ara mu, a wɔfrɛ no high-order multiples . Mpɛn pii no, asiane kakraa bi na ɛwɔ nyinsɛn pii mu sen nyinsɛn biako mu. Nanso mma ɛnhaw wo, sɛ aduruyɛfo hwɛ wo so yiye a, wobetumi adi eyi nyinaa ho dwuma yiye.

Ɔkwan bɛn so na wɔwo mmanoma ne mmabaa yi?

Akwan atitiriw abien na eyi betumi afa so aba:

1. Nkwaa/awotwaa biako a wɔawo no mu mpaapaemu: Nkwaa biako a mmadwoa biako awo mu no mu kyekyɛ yɛ abien anaa nea ɛboro saa ansa na wɔde ahyɛ awotwaa no fasu mu.

2. Nkesua pii: Wɔnam mmadwoa a ɛsono emu biara so ma nkesua pii bere koro mu.

Saa akwan abien yi na ɛkyerɛ sɛ mmanoma no yɛ pɛ anaasɛ wɔyɛ onuanom .

Henanom ne mmanoma a wɔyɛ pɛ?

Fa no sɛ, mmadwoa biako na ɛma ɛwo biako nyinsɛn, na afei ɛpaapae abien (anaa nea ɛboro saa). Wɔfrɛ nkokoaa a wɔyɛ saa no sɛ mmanoma a wɔyɛ pɛ. Wɔn awosu mu nneɛma yɛ pɛ koraa. Ɛno kyerɛ sɛ wɔn ho yɛ pɛ na wɔn bɔbeasu yɛ pɛ (mmeawa yɛ mmeawa, mmarimaa yɛ mmarimaa) . Ɛte sɛ carbon copy!

Henanom ne onuanom mmanoma?

Nea ɛkɔ so wɔ ha ne sɛ mmadwoa a ɛsono emu biara na ɛma nkesua abien (anaa nea ɛboro saa) a ɛsono emu biara nyinsɛn. Afei hwɛ, ɛsono nkesua no, ɛsono mmadwoa no. Enti nkokoaa a wɔwo wɔn no awosu mu nsɛm nso yɛ soronko. Ɛno nti na saa nkokoaa yi nsɛ, na wobetumi nso afrafra sɛ ɔbarima ne ɔbea. Te sɛ anuanom a wɔwɔ abusua koro mu, a wɔwoo wɔn da koro ara kwa.

Wɔ nyinsɛn a ɔwɔ mma abiɛsa anaa nea ɛboro saa mu no, nkokoaa no nyinaa betumi ayɛ pɛ, wɔn nyinaa betumi ayɛ dizygotic, anaasɛ abien no nyinaa afra. Eyi kyerɛ sɛ, sɛ wo nipadua no gyae nkesua pii, na ɛboro biako na ɛwo, na saa nkesua a wɔahyɛ no ma no mu biako anaa nea ɛboro saa mu paapae bio a, eyi betumi aba.

So mmanoma a wɔyɛ pɛ yɛ bɔbeasu koro bere nyinaa?

Aane! Esiane sɛ wɔwo mmanoma a wɔyɛ pɛ fi nkesua ne mmadwoa koro mu nti, wɔwɔ awosu mu nsɛm koro. Wɔnam chromosome ko a ɛwɔ mmadwoa a wɔahyɛ no mu no so na ɛkyerɛ sɛ akokoaa yɛ ɔbarima anaa ɔbea. Ɛna no nkesua no wɔ X chromosome. Sɛ agya no mmadwoa no wɔ X chromosome a, akokoaa no bɛyɛ XX (ɔbea), na sɛ Y chromosome wɔ mu a, akokoaa no bɛyɛ XY (ɔbarima). Enti, esiane sɛ ɛmo koro no ara mu paapae nti, akokoaa biara benya chromosome a wɔaka abom sɛnea na ɛte kan no.

Nneɛma bɛn na ɛma asiane a ɛwɔ hɔ sɛ wobenya nyinsɛn pii no yɛ kɛse?

Nneɛma pii wɔ hɔ a ɛma hokwan a wowɔ sɛ wobɛwo mmanoma anaa nea ɛboro saa no yɛ kɛse. Eyinom nso betumi aka wo:

• Mfe a wɔadi: Ɛtɔ mmere bi a mmea a wɔadi mfe 30 no nya su sɛ wobeyi nkesua bɛboro biako adi bere koro mu.
• Abusua abakɔsɛm: Sɛ woyɛ mmanoma, anaasɛ sɛ mmanoma wɔ w’abusua mu (titiriw wɔ wo maame afã) a, ɛda adi sɛ wo nso wobɛwo mmanoma. Eyi yɛ biribi a ɛkɔ so wɔ w’awosu mu.
• Nnuru a wɔde ma awo ne ayaresa: Awo a wontumi nwo ho ayaresa bi te sɛ In Vitro Fertilization (IVF) , ma hokwan a ɛwɔ hɔ sɛ wobenya mmanoma no yɛ kɛse denam nkesua bɛboro biako a wɔde bɛkɔ awotwaa no mu na ama hokwan a ɛwɔ hɔ sɛ nyinsɛn a edi mu no yɛ kɛse no so.
• Ɔsorokɔ ne ne mu duru: Nhwehwɛmu ahorow bi kyerɛ sɛ mmea a wɔware anaa wɔn mu duru sen sɛnea wɔtaa yɛ no betumi anyinsɛn pii kakra.

Nnansa yi, bere a nnipa pii rehwehwɛ awo ho ayaresa no, mmofra a wɔwo wɔn mpɛn pii nso dodow akɔ soro kakra.

Mɛyɛ dɛn ahu sɛ merewo mmanoma? Dɛn ne nsɛnkyerɛnne no?

Ɔkwan biako pɛ a wobɛfa so ahu no yiye sɛ worewo nkokoaa bɛboro biako ne sɛ wobɛkɔ oduruyɛfo nkyɛn na woayɛ wo ultrasound scan. Saa sɔhwɛ yi tumi hu nkokoaa dodow a wɔwɔ w’awotwaa mu pefee.

Nanso, ɛtɔ mmere bi a, yare no ho sɛnkyerɛnne betumi ayɛ kɛse sen nyinsɛn a ɛyɛ biako. Nhwɛsoɔ:

• Anɔpa yare a emu yɛ den ne ɔfe.
• Mu duru a ɛkɔ soro ntɛmntɛm wɔ nyinsɛn no asram abiɛsa a edi kan no mu.
• Ɛyaw a emu yɛ den anaasɛ ɛyɛ mmerɛw a wɔte nka wɔ nufu no mu.
• Hormone bi a wɔfrɛ no Human Chorionic Gonadotrophin (hCG) a ɛdɔɔso wɔ mogya anaa nsu mu. Wɔnam nyinsɛn mu nhwehwɛmu so hu saa hormone yi.
• Protein bi a wɔfrɛ no Alpha-fetoprotein a ɛdɔɔso wɔ mogya no mu.

Afei nso, sɛ oduruyɛfo no te koma bɔ bɛboro biako bere a ɔreyɛ awotwaa mu Doppler scan , a, ebia obesusuw sɛ ebetumi ayɛ mmanoma.

Nsɛnnennen bɛn na ɛba bere a wɔwo mmanoma no?

Obiara betumi anya nsɛnnennen wɔ nyinsɛn mu, ɛmfa ho nkokoaa dodow a ɔwo no. Nanso, nnuruyɛfo bu nyinsɛn pii sɛ asiane kɛse wom sen nyinsɛn a ɛyɛ biako. Eyi nkyerɛ sɛ ɛna biara a ɔrehwɛ mmanoma kwan no behyia ɔhaw ahorow. Nanso, sɛ worehwɛ mmanoma kwan a, wo duruyɛfo bɛhwɛ wo daa na wahwɛ yiye sɛ ebia ɔhaw ahorow bi bɛba. Wɔbɛkyerɛkyerɛ asiane ahorow no nyinaa mu akyerɛ wo.

Nsɛnnennen a ebetumi aba wɔ nyinsɛn pii mu no bi ne:

• Awo a ɛba ntɛm ne awo: Eyi ne ɔhaw a wɔtaa hu wɔ awo pii mu. Eyi kyerɛ sɛ wobetumi awo nkokoaa no ansa na nyinsɛn no dapɛn a ɛto so 37 adu. Wɔ mmanoma fam no, adapɛn 37 a wobewie no ne ɛnanom dodow no ara botae. Afei ɛda adi sɛ wɔbɛwo nkokoaa no a wɔwɔ apɔwmuden na wɔn mu duru yɛ papa. Nkokoaa a wɔwo wɔn ntɛm nso wɔ asiane mu sɛ wobenya ɔhaw foforo a wɔfrɛ no awo mu duru a ɛba fam.

• Preeclampsia anaa Gestational hypertension: Wɔfrɛ mogya mmoroso bere a wɔyem no mogya mmoroso. Wo duruyɛfo bɛhwɛ wo mogya mmoroso daa ahwɛ sɛ wowɔ nyinsɛn mu mogya mmoroso anaa. Ɛtɔ mmere bi a eyi betumi de tebea bi a asiane wom a wɔfrɛ no preeclampsia aba . Ɛna a ɔwɔ mmanoma betumi anya saa tebea yi mmɔho abien sen ɛna a ɔwɔ akokoaa a onni ɔhokafo. Afei nso, saa tebea yi betumi aba ntɛm wɔ nyinsɛn mu anaasɛ ebetumi aba ntɛmntɛm.

• Asikreyare a ɛba wɔ nyinsɛn mu: Asikreyare betumi anya bere a wɔyem no. Eyi fi hormone dodow a awotwaa no yi fi mu a ɛkɔ soro no. Sɛnea awotwaa no kɛse te nso betumi aka eyi. Sɛ wowɔ awotwaa abien a, insulin a ɛko tia no yɛ kɛse.

• Placenta abruption: Eyi yɛ asɛm a egye ntɛmpɛ. Ɛyɛ bere a awotwaa no tetew ne ho fi awotwaa no fasu ho ansa na wɔawo akokoaa no. Saa tebea yi taa ba ɛnanom a wɔso mmanoma so.

• Awotwaa mu nyin anohyeto: Wɔsan frɛ no intrauterine growth restriction (IUGR) anaasɛ ketewaa bi ma nyinsɛn mfe (SGA) , eyi ne bere a wo nkokoaa no mu biako anaa nea ɛboro saa nnyin yiye. Eyi betumi ama wɔawo nkokoaa no ntɛm anaasɛ wɔn mu duru sua wɔ awo mu. Saa ɔhaw yi ba nyinsɛn pii a wonyin nyinaa mu bɛyɛ fã mu.

Anuanom mmanoma wɔ awotwaa abien bere nyinaa. Asiane a ɛwɔ nyinsɛn a ɛka ho no te sɛ nyinsɛn a wɔde akokoaa biako ba no, nanso ɛboro so kakra.

Nwansena a wɔyɛ pɛ betumi anya awotwaa biako (bere no mu 70%) anaa awotwaa abien (bere no mu 30%). Asiane a ɛwɔ mmanoma a wɔyɛ pɛ a wɔwɔ awotwaa abien mu no te sɛ nea ɛwɔ mmanoma a wɔyɛ anuanom mu no.

Asiane titiriw a ɛwɔ mmanoma a wɔyɛ pɛ a wɔkyɛ awotwaa biako mu (Monochorionic) .

Nwansena a wɔyɛ pɛ a wɔkyɛ awotwaa biako (yɛfrɛ eyi monochorionic) wɔ asiane soronko bi:

• Twin-Twin-Transfusion-Syndrome (TTTS): Saa tebea yi ba wɔ 5% kosi 15% mu. Eyi fi ntini mu nkitahodi a ɛda mmanoma no ntam wɔ awotwaa no mu. Esiane saa abusuabɔ yi nti, mmanoma no kyɛ wɔn mogya. Sɛ eyi ba a, sɛ wɔanyɛ hwee a, asiane 90% wɔ hɔ sɛ mmanoma no bewuwu wɔ awotwaa no mu. Nneɛma bi wɔ hɔ a wɔyɛ wɔ awotwaa mu a wɔde bɛtew asiane yi so.

• Twin-Anemia-Polycythemia Sequence (TAPS): Eyi nso yɛ tebea a mogya fi twin biako mu kɔ foforo mu esiane awotwaa mu nkitahodi nti. Wɔ eyi mu no, sɛ akokoaa biako mogya so tew (mogya mu nkwammoaa kɔkɔɔ a ɛba fam) a, akokoaa foforo no bɛyɛ polycythemic (mogya mu nkwammoaa kɔkɔɔ a ɛdɔɔso). Sɛ eyi ba a, wɔde ayaresa/nneɛma ahorow di dwuma.

• IUGR a Wɔpaw: Eyi yɛ tebea foforo a wohu wɔ mmanoma a wɔyɛ pɛ a wɔkyɛ awotwaa biako mu. Bere a akokoaa biako nyin yiye no, akokoaa foforo no nyin so tew kɛse.

• (Twin-Reversed-Arterial-Perfusion - TRAP) syndrome: Wɔ tebea yi mu no, akokoaa biako koma de mogya kɔ nkokoaa abien no nyinaa mu. Akokoaa foforo no nni koma ma enti ɔntra ase wɔ awo akyi. Akokoaa a ɔwɔ koma a ɛteɛ no akwahosan betumi ayɛ soronko. Nea eye ne sɛ, saa yare yi ho yɛ na koraa (bɛyɛ 20,000 kosi 40,000 biara mu 1) na wotumi sa wɔ awotwaa mu.

• Monoamniotic: Ɛtɔ mmere bi a mmanoma a wɔyɛ pɛ a wɔkyɛ awotwaa biako no betumi akɔ nyinsɛn kotoku koro mu. Wɔfrɛ eyi Monochorionic-Monoamniotic . Saa tebea yi ba wɔ nyinsɛn pii mu bɛyɛ 1% mu. Wɔ eyi mu no, asiane kɛse wɔ hɔ ma akokoaa biako anaa abien no nyinaa.

Wo duruyɛfo nam ultrasound scan so hu saa tebea horow yi nyinaa.

So hokwan pii wɔ hɔ sɛ wɔde oprehyɛn (C-section) bɛwo akokoaa no bere a wɔwo mmanoma no?

Oprehyɛn a wɔde twa akokoaa no yɛ ɔkwan a wɔfa so wo akokoaa denam yafunu mu ntwitwiridii so. Wobetumi ayɛ eyi esiane nneɛma ahorow nti, nanso wɔtaa yɛ wɔ awo pii mu. Ɛda adi sɛ wɔbɛyɛ oprehyɛn a wɔde twa oprehyɛn wɔ nyinsɛn a ɛyɛ mmanoma mu sen nyinsɛn a ɛyɛ biako mu. Nanso, wɔ nyinsɛn biako mpo mu no, ɛtɔ mmere bi a oprehyɛn a wɔde oprehyɛn yɛ ne ɔkwan a ahobammɔ wom sen biara a wɔfa so wo akokoaa.

Mpɛn pii no, wɔwo nkokoaa wɔ breech gyinabea (ti ase). Afei nso, sɛ wunya nsɛnnennen bi wɔ wo nyinsɛn no mu, na awo a wɔde fa ɔbea awotwaa mu no nyɛ nea asiane biara nni ho mma wo anaa wo ba no a, ebia ebehia sɛ wɔyɛ wo oprehyɛn. Wo duruyɛfo bɛhwɛ wo yiye akosi sɛ wobɛyɛ krado sɛ wobɛwo na ɔne wo akasa afa ɔkwan a eye sen biara a wobɛfa so awo wo ba no ho.

Dɛn na ɛsɛ sɛ meyɛ na ama manya apɔwmuden bere a merehwɛ mmanoma kwan no?

Nnuan a ahoɔden wom a wubedi, ahomegye a ɛfata, ne wo duruyɛfo a wobɛkɔ akɔhwɛ no daa nyinaa ho hia ma nyinsɛn a ahoɔden wom ma ɛna biara a ɔrehwɛ kwan. Saa nneɛma yi ho hia kɛse mpo ma ɛna a ɔrehwɛ mmanoma kwan.

Sɛ wokura mmanoma a, ɛsɛ sɛ wohwɛ yiye titiriw wɔ w’aduan ho. Ɛho hia sɛ wunya protein ne nsu (nsu) a ɛdɔɔso. Ɛsɛ sɛ wudi calories foforo a ɛdɔɔso nso na ama woatumi aboa wo ba a ɔrenyin no. Sɛnea mmara kyerɛ no, akokoaa biara hia bɛyɛ calories foforo 300 da biara . Ɛno kyerɛ sɛ sɛ wokura mmanoma a, wuhia calories bɛyɛ 600 foforo da biara. Wo ne wo duruyɛfo nka w’aduan ne dodow pɔtee a wuhia na ama woanyinsɛn a ahoɔden wom ho asɛm.

Ɛnanom a wɔwɔ mmanoma betumi anya ɔhaw ahorow a ɛtaa ba wɔ nyinsɛn mu no bi (sɛ nhwɛso no, akyi yaw, ɔbrɛ). Ɛho hia sɛ wohwɛ wo ho yiye na wunya ahomegye pii.

Wɔ tebea horow bi mu no, eye sɛ wobɛkɔ akɔhwɛ oduruyɛfo titiriw bi a ɔwɔ osuahu wɔ awo pii ho. Eyi bɛma wo ne wo ba no anya ɔhwɛ a eye sen biara. Ɛho hia yiye sɛ wonya ɔhwɛ a emu yɛ den daa ansa na wɔawo bere a wanyinsɛn pii no. Bisa w’abusua oduruyɛfo anaa OBGYN ma ɔmma wo afotu wɔ eyi ho.

So wubetumi ateɛteɛ w’apɔw mu bere a wowɔ mmanoma no?

Apɔw-mu-teɛteɛ ho hia wɔ nyinsɛn biara mu. Mpɛn pii no, wubetumi akɔ so ateɛteɛ w’apɔw mu bere a woanyinsɛn no. Apɔw-mu-teɛteɛ a emu nyɛ den a ennya nkɛntɛnso kɛse ye sen biara. Nhwɛsoɔ:

• Reboro nsuo
• Renante
• Yoga a wɔyɛ ansa na wɔawo

Bere a apɔw-mu-teɛteɛ ye no, ɛbɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa akyerɛ apɔw-mu-teɛteɛ a ɛfata wo. Ebia apɔw-mu-teɛteɛ a emu yɛ den bi renyɛ papa mma wo wɔ nyinsɛn a wowɔ mmanoma mu no. Nhwɛsoɔ:

• Mmirkatuo bɔkɔɔ
• Aerobics a nea ɛka ho ne ahurututu

Afei nso, ma ɛntra w’adwenem sɛ sɛ wuhyia nsɛnnennen bi a, ebia ebehia sɛ wosakra wo apɔw-mu-teɛteɛ nhyehyɛe no.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Mmabanin anaa mmanoma baasa a wobɛwo no yɛ nhyira ampa! Yiw, ebia nsɛnnennen bi wɔ hɔ, nanso wubetumi adi ne nyinaa so.

Nea ɛho hia sen biara ne sɛ wubedi wo duruyɛfo akwankyerɛ akyi na woakɔ ayaresabea ahorow no bere ano. Wɔbɛhwɛ wo ne wo ba no yiye.

• Didi na nom yiye, titiriw bere a wode protein ne calories foforo ka ho.
• Nya ahomegye pii. Ahomegye ho hia efisɛ ɛde adwennwen kɛse ba wo nipadua so.
• Yɛ apɔw-mu-teɛteɛ a emu nyɛ den, nanso fi ase bere a woakɔ wo duruyɛfo nkyɛn awie nkutoo.
• Sɛ wuhu biribi a ɛyɛ soronko anaa ɛsono a, ka kyerɛ wo duruyɛfo ntɛm ara. Mmu w’ani ngu ade ketewaa bi mpo so.
• Wo ne wo kunu, w’abusua, anaa oduruyɛfo nkasa mfa wo suro ne wo haw ahorow ho. Mfa wɔn nhyɛ toa mu.

Ɛnyɛ wo nkutoo na worekɔ saa akwantu yi. Nnipa pii wɔ hɔ a wɔbɛboa wo na wɔahwɛ wo. Nya osuahu a ɛyɛ nwonwa yi mu anigye!

` Nwansena, mma mmiɛnsa, nyinsɛn pii, nyinsɛn akwahosan, awo mu nsɛnnennen, mmanoma a wɔyɛ pɛ, anuanom mmanoma