So wowɔ mmanoma? So wunim tebea a asiane wom yi? (Twin-to-Twin Mogya a Wɔde Ma - TTTS) .

Sɛ woyɛ ɛna a worehwɛ mmanoma kwan a, nea edi kan koraa no, ma wo akwaaba! Nanso, ɛho hia nso sɛ wuhu tebea titiriw a ɛtɔ mmere bi a ebetumi aba wɔ nyinsɛn a wɔyɛ mmanoma mu no. Tebea a ɛte saa biako a wɔnhwɛ kwan kakra nanso ɛfata sɛ wuhu ne Twin-to-Twin Transfusion Syndrome , a wɔsan frɛ no TTTS tiawa no. Mma ɛnhaw wo, momma yɛnka ho asɛm tiawa.

Dɛn ne Twin-to-Twin Mogya a Wɔde Ma Ayaresa (TTTS)? Sɛ yɛbɛka no tiawa a...

Fa no sɛ mmanoma baanu a wɔwɔ wo yafunu mu no wɔ awotwaa koro . Yɛfrɛ saa mmanoma yi (monochorionic twins) . Mpɛn pii no, nkokoaa baanu no nyinaa nya mogya ne aduannuru koro fi awotwaa yi mu. Nanso, wɔ eyi mu (TTTS) no, saa mpaapaemu no nsi yiye.

Sɛ yɛbɛka no tiawa a, akokoaa biako (momma yɛmfrɛ no ‘donor twin’ ) nnya mogya a ɛdɔɔso mfi awotwaa no mu. Akokoaa foforo no (momma yɛmfrɛ no ‘recipient twin’ ) nya pii dodo. Saa mogya a ɛnkari pɛ yi ne nea ɛde TTTS ba. Eyi yɛ tebea a ɛntaa nsi nanso ebetumi ayɛ nea emu yɛ den. Ɛho hia sɛ Ɛnanom ne Awotwaa mu Aduruyɛ (MFM) ho ɔbenfo bɛhwɛ wɔn yiye. Sɛ wohu nkokoaa abien no nyinaa ntɛm, hwɛ wɔn so, na wɔsa wɔn yare a, ebetumi ama nneɛma pa afi mu aba.

Dɛn na ɛto ‘donor twin’ no?

Akokoaa no renya mogya kakraa bi afi awotwaa no mu. Enti, mogya dodow a ɛwɔ ne nipadua mu nso so tew. Eyi betumi ama akokoaa no anyin nkakrankakra, na nsu a ɛwɔ awotwaa mu a atwa ne ho ahyia no nso so betumi atew. Nea enti a ɛte saa ne sɛ akokoaa no ntow nsu pii. Eyi te saa efisɛ akokoaa no nsu dodow no ara na ɛyɛ amniotic fluid. Sɛ nsu a ɛwɔ akokoaa no mu no so tew a, kotoku a ɛkura akokoaa no betumi atew, anaasɛ ayera mpo. Eyi yɛ asiane, efisɛ akokoaa no ntumi nkɔ baabiara yiye, na awotwaa hama no betumi amia.

Dɛn na ɛto ‘twin a ogye’ no?

Akokoaa yi renya mogya pii sen sɛnea ɛsɛ sɛ onya. Mogya a ɛboro so yi ma akokoaa no koma yɛ den kɛse, na ebetumi mpo ama koma no ayɛ adwuma yiye . Sɛ akokoaa a wɔde ama no no nipadua nni aduan pa a, ɛsɛ sɛ akokoaa a wɔde ama no no nipadua yɛ adwumaden kɛse. Esiane sɛ ɛsɛ sɛ akokoaa yi yɛ mogya pii ho adwuma nti, ɔtow nsu pii sen sɛnea ɔtaa yɛ no. Ne saa nti, ne amniotic kotoku no yɛ kɛse koraa.

Henanom na saa (TTTS) tebea yi ka wɔn?

TTTS ka nyinsɛn a mmanoma kyɛ awotwaa biako (monochorionic) , na wɔn ho yɛ pɛ (mmanoma a wɔyɛ pɛ) nkutoo. Mpɛn pii no, saa mmanoma a wɔwɔ TTTS yi wɔ amniotic kotoku abien a ɛsono emu biara (diamniotic). Yɛfrɛ saa mmanoma yi (monochorionic diamniotic twins) .

Nanso, ɛntaa nsi koraa sɛ nsɛm bi wɔ hɔ a nkokoaa baanu kyɛ awotwaa ne awotwaa kotoku koro (monoamniotic). Wɔ tebea horow a ɛtete saa mu no, TTTS nso betumi aba. Nanso, mmanoma a wɔte saa ho yɛ na koraa.

TTTS betumi aba akyiri ahe wɔ nyinsɛn mu?

Mpɛn pii no, saa tebea yi betumi afi ase aba ntɛm wɔ adapɛn 16 mu, nanso ebetumi aba bere biara wɔ nyinsɛn mu.

(TTTS) abu so dɛn?

TTTS ba wɔ bɛyɛ 15% mu wɔ monochorionic twin nyinsɛn mu.

Dɛn ne TTTS ho sɛnkyerɛnne ahorow?

Ɛnanom dodow no ara a wɔwɔ TTTS no nhu sɛnkyerɛnne pɔtee biara. Nanso, ebinom betumi ahu sɛ:

• Sɛ́ wobɛte nka sɛ awotwaa no renyin ntɛmntɛm sen sɛnea na wɔhwɛ kwan no.
• Ɛyaw anaa yafunu a ɛyɛ den a wɔte nka.
• Mu duru a ɛkɔ soro mpofirim.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn ntɛm ara.

Dɛn na ɛde TTTS ba?

Mpɛn pii no, wɔ nyinsɛn a ɛyɛ mmanoma a ɛwɔ awotwaa biako mu no, nkokoaa abien no nyinaa nya mogya dodow a efi awotwaa no mu no mu. Nanso, wɔ TTTS mu no, ɔkwan a mogya ntini a ɛwɔ awotwaa no mu no ka bom no ma mogya no mu kyɛ a ɛnyɛ pɛ. Akokoaa biako (akokoaa a wɔde no ma no) nya mogya pii, na akokoaa foforo (akokoaa a ɔde ma no) nya kakraa bi.

Worentumi nni sɛnea awotwaa no nyin no so. (TTTS) yɛ adeyɛ a ɛba kwa. Ɛnyɛ biribi a woyɛɛ anaasɛ woannyɛ. Enti mfa asodi nto wo ho so. (TTTS) no nyɛ nea wontumi nsiw ano.

Hena na ɔwɔ asiane mu ma (TTTS)?

Eyi nni abusuabɔ biara a efi awosu anaa awosu mu. Ɛyɛ ade a ɛba kwa. Nanso, eyi betumi aba wɔ nyinsɛn a ɛyɛ mmanoma a wɔkyɛ awotwaa biako (monochorionic) nkutoo mu .

Dɛn ne nsɛnnennen a ebetumi afi TTTS mu aba?

Sɛ wɔansa, anaasɛ tebea no ba ntɛm wɔ nyinsɛn mu a, TTTS betumi de akwahosan ho haw a emu yɛ den aba akokoaa no so, na ebetumi akum no mpo. Enti, ɛho hia sɛ wɔhwehwɛ ayaresa anaasɛ wɔhwɛ no yiye fi ɛnanom ne awotwaa mu aduruyɛ ho ɔbenfo (MFM ɔbenfo) anaa beae a wɔhwɛ awotwaa so. Sɛ wɔsa yare ntɛm mpo a, asiane wɔ hɔ sɛ nyinsɛn bɛtu.

Nsɛnnennen afoforo a ɛtaa ba wɔ TTTS ho ne:

• Nsɛnnennen a efi awo a ɛba ntɛm mu (te sɛ ɔhome a ɛyɛ den, ntini mu haw).
• Ebia mmanoma a wɔde no ma no no benya komayare anaa komayare afoforo esiane nsu a ɛboro so no nti.
• Ebia mmanoma a wɔde ma no benyin no ntumi nnyin anaasɛ ɔwɔ asaabo mu haw.

Ɔkwan bɛn so na wohu TTTS?

Wo ho ɔyaresafo a ɔhwɛ wo ansa na wɔawo wo no de ultrasound scan bɛkyerɛ sɛ wowɔ TTTS . Ade a edi kan a oduruyɛfo no behu wɔ scan no mu ne sɛ mmanoma baanu a wɔyɛ pɛ wɔ hɔ a wɔkyɛ awotwaa koro.

Sɛ wosusuw sɛ wowɔ TTTS a, wo duruyɛfo betumi de wo akɔma ɛna ne awotwaa mu aduruyɛ ho ɔbenfo (MFM ho ɔbenfo) ma wakɔyɛ nhwehwɛmu foforo.Ɛhɔ no, oduruyɛfo titiriw no behu nneɛma yi mu biako anaa nea ɛboro saa wɔ ultrasound scan no so:

• Nsonsonoe a ɛwɔ nkokoaa baanu no kɛse mu.
• Akokoaa biako wɔ awotwaa mu nsu pii dodo, bere a akokoaa foforo no nni awotwaa mu nsu kakraa bi dodo.
• Mogya a ɛkɔ nkokoaa mu a ɛnteɛ (wobetumi de Doppler ultrasound nhwehwɛmu ahu eyi).

Wɔ tebea horow bi mu no, ebia ɛho behia nso sɛ wɔyɛ awotwaa no MRI (magnetic resonance imaging) nhwehwɛmu ne awotwaa mu echocardiography (echo) .

Wo kuw a wɔhwɛ wo ansa na wɔawo wo no bɛhwɛ wo yiye wɔ wo nyinsɛn no nyinaa mu. Ebia ɛho behia sɛ wotaa yɛ ultrasound scan de hwɛ sɛnea wo ba no te.

Oduruyɛfo no nso bɛhwɛ w’akwahosan. Ɛtɔ mmere bi a, awotwaa mu nsu a ɛkɔ soro wɔ nea wɔde ma no no afã no betumi ama w’awotwaa no ayɛ kɛse na w’awotwaa no ayɛ mmerɛw. Saa nsakrae yi nso betumi ama wɔawo awo ntɛm.

Dɛn ne (TTTS) no fã ahorow?

Ultrasound scan hwɛ sɛnea tebea no mu yɛ den (TTTS), kyerɛ sɛ, ɔfã a ɛwɔ mu Eyi ma oduruyɛfo no hu sɛnea tebea no rekɔ so na ɔkamfo ayaresa a eye sen biara kyerɛ.

TTTS no akwan anum na ɛwɔ hɔ:

• Ɔfã 1: Nsu kakraa bi pɛ na ɛwɔ akokoaa a wɔde ma no ho anaasɛ enni hɔ koraa. Mpɛn pii no, nsu a ɛwɔ awotwaa mu no dɔɔso dodo wɔ akokoaa a wɔde no ma no no ho.
• Ɔfã 2: Akokoaa a wɔde ma no no akisikuru no ntumi nhu wɔ ultrasound so. Eyi kyerɛ sɛ akokoaa a wɔde ama no no agyae nsu a ɔtow sɛnea ɛsɛ.
• Ɔfã 3: Mogya a ɛnkari pɛ kɛse wɔ nkokoaa no ntam. Eyi betumi aka akokoaa biako koma dwumadi.
• Ɔfã 4: Nkokoaa biako anaa abien no nyinaa da honam ani hwɛbea anaa nipadua a ɛho ahonhon ho sɛnkyerɛnne adi.
• Ɔfã 5: Nkokoaa biako anaa wɔn baanu nyinaa awuwu.

Wɔ ɔfã 1 (TTTS) mu no, ebia nea wɔhwɛ nkutoo bɛdɔɔso. Nanso, sɛ tebea no mu yɛ den a, ebetumi asi ntɛmntɛm paa. Wɔ ɔfã 2 (TTTS) akyi no, sɛ wo nyinsɛn no nnu adapɛn 26 a, wɔtaa kamfo kyerɛ sɛ wɔnyɛ awotwaa no oprehyɛn .

Dɛn ne ayaresa ahorow a wɔde sa (TTTS)?

Ayaresa no gyina baabi a woakɔ akyiri wɔ wo nyinsɛn no mu ne TTTS fã a wowɔ mu so.

• Hwɛ ne hwɛ a wobɛhwɛ: Wo duruyɛfo de ultrasound scan bɛhwɛ wo nyinsɛn no yiye. Eyi yɛ ɔkwan a wobɛfa so sɛ wowɔ stage 1 (TTTS) anaasɛ ntease ahorow bi wɔ hɔ a enti oprehyɛn anaa ayaresa afoforo ntumi nyɛ yiye a.
• Septostomy: Nea ɛka eyi ho ne sɛ wɔbɛyɛ tokuru ketewaa bi wɔ ntini a ɛda nkokoaa abien no awotwaa kotoku ntam no mu. Eyi betumi ama nhyɛso a ɛwɔ amniotic kotoku abien no nyinaa mu no ayɛ pɛ. Eyi nyɛ asiane kɛse, nanso ɛnsa nea ɛde TTTS ba no.
• Amnioreduction: Ɔde ne nsa kyerɛɛ ne so.Wɔ saa adeyɛ yi mu no, oduruyɛfo no de ade ketewaa bi a ɛyɛ tokuru di dwuma de yi awotwaa mu nsu a ɛboro so fi akokoaa a wɔde no ma no no kotoku mu. Ebia wo duruyɛfo bɛkamfo eyi akyerɛ wɔ ɔfã 1 (TTTS) anaasɛ TTTS a emu yɛ den akyiri yi wɔ nyinsɛn mu. Saa adeyɛ yi nsa nea ɛde TTTS ba no, enti sɛ awotwaa mu nsu no san kɔ soro bio a, ebia ebehia sɛ wɔyɛ no mpɛn pii.
• Fetoscopic laser ablation: Nea ɛka saa adeyɛ yi ho ne sɛ wɔde mfoninitwa afiri ketewaa bi (fetoscope) kɔ awotwaa no mu na wɔde laser hann di dwuma de to mogya ntini a ɛwɔ awotwaa no ani a ɛrema mogya anyɛ pɛ wɔ nkokoaa no ntam no mu. Adeyɛ yi botae ne sɛ ɛbɛsakra mogya a ɛkɔ akokoaa biako mu akɔ foforo mu, sɛnea ɛbɛyɛ a akokoaa biara benya mogya dodow a ɛsono emu biara. Eyi yɛ ɔkwan a wobetumi afa so ama stage 2 anaa nea ɛboro saa (TTTS) ne nyinsɛn a ɛwɔ adapɛn 16 kosi 26 ntam.
• Umbilical cord occlusion: Eyi yɛ ɔkwan a etwa to a ebia wo duruyɛfo bɛkamfo akyerɛ bere a wontumi nnye nkokoaa abien no nyinaa nkwa, anaasɛ bere a akokoaa biako wɔ tebea a ɛde ne nkwa to asiane mu mu. Oprehyɛn yi ma mogya a ɛkɔ akokoaa biako mu no gyae, na ɛma akokoaa foforo no nya hokwan a eye sen biara sɛ obenya nkwa.
• Awo: Sɛ akokoaa no boro nyinsɛn mfe a ebetumi atra ase a, oduruyɛfo no betumi akamfo akyerɛ sɛ ɔnwo.

W’akwahosan kuw no bɛboa wo ma woapaw ayaresa a eye ma wo. Wɔbɛbua wo nsɛmmisa nyinaa na wɔne wo akasa afa asiane, mfasoɔ, ne akwan foforɔ a ɛwɔ ayaresa biara a wobɛfa so no ho.

Ɔkwan bɛn so na wɔhwɛ TTTS so?

W’akwahosan ho ɔyaresafo, ne ɛna ne awotwaa mu aduruyɛ ho ɔbenfo (MFM ho ɔbenfo) bɛhwɛ wo nyinsɛn no yiye. Wɔbɛyɛ wo ultrasound scan daa (ebia pɛnkoro anaa mprenu dapɛn biara), na ebia ɛho behia nso sɛ woyɛ awotwaa mu echocardiogram bere a wonyinsɛn no. Wo hwɛ kuw no bɛma wo aduruyɛ ne nkate fam mmoa wɔ wo nyinsɛn no nyinaa mu.

Sɛ eyi te saa a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Nea ebefi mu aba no gyina baabi a woakɔ akyiri wɔ wo nyinsɛn no mu bere a wɔahu sɛ wowɔ yare no ne sɛnea tebea no mu yɛ den (stage). Esiane sɛ wɔanya nkɔso wɔ aduruyɛ ho nyansahu mu nti, nkokoaa baanu no nyinaa a wɔbɛhwɛ wɔn yiye na wɔasa wɔn yare ntɛm no betumi ama wɔanya hokwan a eye sɛ wobenya nkwa. Wo ne wo duruyɛfo nkasa fa nea wɔhwɛ kwan ne nea ebetumi afi mu aba ho na ama woate sɛnea TTTS bɛka wo nyinsɛn ne wo ba no ase. Ɛsɛ sɛ mmanoma pii a wɔda so te ase no tra NICU (Neonatal Intensive Care Unit) bere tiaa bi wɔ awo akyi na ama wɔanya mfiase a wohia.

(TTTS) betumi ayɛ osuahu a ɛkanyan nkate ne adwennwen kɛse. Kae sɛ wobɛhwɛ wo ho na woahwehwɛ mmoa afi w’akwahosan kuw, wo hokafo, ne wo nnamfo hɔ.

Dɛn ne nkwagye dodow wɔ (TTTS) mu?

Nnipa dodow a wonya nkwa no gyina sɛnea TTTS no mu yɛ den, bere a wohu sɛ wowɔ wo, ne sɛ ebia wo nsa bɛka ayaresa no so. Ayaresa a ɛfata a wubenya no betumi ama nsonsonoe kɛse aba nkwa a wunya wɔ TTTS mu no mu:

• Nwansena a wɔahu sɛ wɔwɔ TTTS a emu yɛ den wɔ nyinsɛn mfiase no mu bɛyɛ 90% wɔ asiane mu sɛ wobewuwu ansa na wɔawo wɔn (sɛ wɔansa wɔn yare a).
• Nyinsɛn a wɔasa (TTTS) no mu 85% kosi 90% ma anyɛ yiye koraa no akokoaa biako nya nkwa.
• Wɔ nyinsɛn a wɔasa wɔn yare (TTTS) mu 50% kosi 65% mu no, nkokoaa abien no nyinaa tra ase.

Esiane sɛ nneɛma pii ka nkwagye nti, wo ne kuw a wɔhwɛ wo ba no nkasa mfa wo ba no nkɔmhyɛ ho asɛm.

Nsɛmmisa bɛn na ɛsɛ sɛ mibisa m’akwahosan kuw no?

Nsɛmmisa bi a wubetumi abisa:

• Ɔkwan bɛn so na ɛsono me nyinsɛn no wɔ nyinsɛn a ɛyɛ mmanoma a enni (TTTS) ho?
• So ebehia sɛ mekɔ oduruyɛfo titiriw bi nkyɛn? Hena na ɔka me hwɛ kuw no ho?
• Mpɛn ahe na ebehia sɛ wɔyɛ me scan anaa nhwehwɛmu afoforo?
• Ɔkwan bɛn so na (TTTS) bɛka me delivery nhyehyɛe ahorow?
• So mɛte nsakrae bi nka wɔ me nipadua mu esiane TTTS nti? Sɛ saa a, dɛn na ɛsɛ sɛ mehwɛ kwan?
• Ayaresa bɛn na wokamfo kyerɛ ma me tebea no? Adɛn?
• Asetra mu su ahorow bɛn (te sɛ aduan, apɔw-mu-teɛteɛ, ahomegye, ayaresa) a wokamfo kyerɛ sɛ ɛbɛboa m’akwahosan?

Dɛn ne ‘Daisy Baby’ yi?

‘Daisy baby’ yɛ din foforo a wɔde frɛ akokoaa a ɔwɔ TTTS. Twin-to-Twin Transfusion Syndrome (TTTS) Foundation no dii kan de edin no dii dwuma. Edin no bae bere a nea ɔhyehyɛɛ no ​​no ne ne mmabarima mmanoma a wɔda so te ase no duaa daisy aba wɔ wɔn turo mu no. Daisy turo no yɛ anidaso ho sɛnkyerɛnne sɛ akokoaa biara a ɔwɔ TTTS no benya nkwa.

Awiei koraa no, ade a ɛho hia sen biara! (Nkrasɛm a Wɔde Kɔ Fie)

Sɛ obi hu sɛ ɔwɔ Twin-to-Twin Transfusion Syndrome (TTTS) a, ebetumi ayɛ osuahu a ɛyɛ hu. Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka na woahaw wɔ nea edi hɔ ama wo ne wo mmanoma no ho. Wo ne wo duruyɛfo nkasa mfa ayaresa a eye sen biara a wubetumi apaw ama wo tebea no ho. Hwehwɛ mmoa fi nnamfo ne w’abusuafo hɔ bere a wo nyinsɛn no kɔ so no. Sɛ wode wo ho hyɛ mmoa kuw bi a wɔde ma mmusua a wɔanya TTTS mu suahu no nso betumi ayɛ ɔkwan pa a wobɛfa so aboa wo wɔ akwantuo yi mu. Kae sɛ ɛnyɛ wo nko ara. Sɛ wonya aduruyɛ mu afotu ne mmoa a ɛfata a, wubetumi agyina asɛnnennen yi ano anim!

` Twin-to-Twin Transfusion Syndrome, TTTS, mmanoma, nyinsɛn, awotwaa, awotwaa mu nsu, monochorionic