Olina abalongo? Embeera eno ey’akabi ogimanyi? (Obulwadde bw’okuteekebwamu omusaayi okuva mu babiri okudda mu babiri - TTTS)

Bw’oba ​​oli maama asuubira abalongo, okusookera ddala, nkuyozaayoza! Wabula era kikulu okumanya embeera ez’enjawulo eziyinza okubaawo oluusi mu lubuto lw’abalongo. Embeera emu ng’ezo etasuubirwa katono naye ng’esaana okumanya ye Twin-to-Twin Transfusion Syndrome , era emanyiddwa nga TTTS mu bufunze. Tofaayo, ka tukyogereko mu ngeri ennyangu.

Obulwadde bwa Twin-to-Twin Transfusion Syndrome (TTTS) kye ki? Mu ngeri ennyangu...

Teebereza nti abalongo bombi abali mu lubuto lwo bagabana enseke emu . Abalongo bano tubayita (monochorionic twins) . Mu budde obwabulijjo, abalongo bombi bafuna omusaayi n’ebiriisa bye bimu okuva mu nnabaana ono. Naye mu mbeera eno (TTTS), enjawukana eyo tebaawo bulungi.

Mu ngeri ennyangu, omwana omu (tumuyite ‘donor twin’ ) tafuna musaayi gumala okuva mu nnabaana. Omwana omulala (tumuyite 'recipient twin' ) afuna ekisusse. Obutakwatagana buno mu ntambula y’omusaayi kye kireeta TTTS. Eno embeera etatera kubaawo naye nga eyinza okuba ey’amaanyi. Okulondoola ennyo omukugu mu ddagala lya maama n’omwana ali mu lubuto (MFM) kyetaagisa nnyo. Okuzuula amangu, okulondoola, n’okujjanjaba kiyinza okuvaamu ebirungi eri abalongo bombi.

Kiki ekituuka ku ‘donor twin’?

Omwana afuna omusaayi mutono okuva mu nnabaana. Kale, omuwendo gw’omusaayi mu mubiri gwe nagwo gukendeera. Kino kiyinza okuleetera omwana okukula mpola, era n’amazzi g’omu lubuto agamwetoolodde nago gayinza okukendeera. Kino kiri bwe kityo kubanga omwana aba afuka kitono. Kino kiri bwe kityo kubanga amazzi g’omu lubuto gasinga kukolebwa musulo gwa mwana. Amazzi g’omu lubuto bwe gakendeera, ensawo ekwata omwana esobola okukendeera, oba n’okubula. Kino kya bulabe, kubanga omwana tasobola kutambula bulungi, era omuguwa gw’omu nnabaana guyinza okunyigirizibwa.

Kiki ekituuka ku ‘recipient twin’?

Omwana ono afuna omusaayi mungi okusinga bwe gulina. Omusaayi guno ogw’enjawulo guteeka akazito kungi ku mutima gw’omwana, era guyinza n’okumuviirako omutima okulemererwa . Omubiri gw’omwana amuwadde bwe guba tegulina mmere nnungi, omubiri gw’omwana amuwadde gulina okukola ennyo. Olw’okuba omwana ono alina okulongoosa omusaayi omungi, afuka nnyo okusinga bulijjo. N’ekyavaamu, ensawo ye ey’omu lubuto efuuka nnene nnyo.

Embeera eno (TTTS) ekosa ani?

TTTS ekosa embuto zokka nga abalongo bagabana nnabaana emu (monochorionic) , era nga balabika kye kimu (abalongo abafaanagana). Ebiseera ebisinga, abalongo bano abalina TTTS balina ensawo bbiri ez’enjawulo ez’omu lubuto (diamniotic). Abalongo bano tubayita (monochorionic diamniotic twins) .

Wabula, si bulijjo nnyo, waliwo emisango ng’abalongo babiri bagabana nnabaana y’emu n’ensawo y’omu lubuto (monoamniotic). Mu mbeera ng’ezo, TTTS nayo esobola okubaawo. Kyokka abalongo ng’abo tebatera nnyo.

TTTS eyinza okulwawo okutuuka mu lubuto?

Embeera eno etera okutandika okukula nga bukyali mu wiiki 16, naye esobola okubaawo essaawa yonna ng’oli lubuto.

(TTTS) ya bulijjo etya?

TTTS ebeerawo mu bitundu nga 15% eby’embuto z’amabaale aga monochorionic.

Bubonero ki obulaga TTTS?

Bamaama abasinga abalina TTTS tebafuna bubonero bwonna obw’enjawulo. Kyokka, abamu bayinza okufuna:

• Okuwulira nga nnabaana akula mangu okusinga bwe kyali kisuubirwa.
• Okuwulira obulumi oba okunyiga mu lubuto.
• Okugejja mu bwangu.

Bw’oba ​​olina obubonero buno, olina okulaba omusawo mu bwangu.

Kiki ekivaako TTTS?

Mu budde obwabulijjo, mu lubuto lw’abalongo nga lulina nnabaana emu, abaana bombi bagabana omusaayi gwe gumu okuva mu nnabaana. Wabula mu TTTS, engeri emisuwa mu nnabaana gye gikwataganamu ereetera omusaayi okugabanyizibwamu mu ngeri etaali kyenkanyi. Omwana omu (omwana afuna omusaayi) afuna omusaayi omungi, ate omulala (omwana agaba) afuna mutono.

Tosobola kufuga ngeri nnabaana gy’ekulaamu. (TTTS) kintu ekibaawo mu ngeri ey’ekifuulannenge. Si kintu kye wakola oba kyotakola. Kale tewenenya. (TTTS) tekiyinza kuziyizibwa.

Ani ali mu bulabe bw’okulwala (TTTS)?

Kino tekirina kakwate konna ku buzaale oba obuzaale. Kiba kibaawo mu ngeri ya kimpowooze. Wabula kino kiyinza okubaawo mu mbuto z’amawanga abiri zokka ezigabana enseke emu (monochorionic) .

Bizibu ki ebiyinza okuva mu TTTS?

Singa embeera eno tegijjanjabwa, oba singa embeera eno ekula nga bukyali nnyo ng’oli lubuto, TTTS esobola okuleeta obuzibu obw’amaanyi mu bulamu bw’omwana, era eyinza n’okumutta. N’olwekyo, kyetaagisa okunoonya obujjanjabi oba okulondoola ennyo okuva eri omukugu mu ddagala lya maama n’omwana ali mu lubuto (omukugu mu MFM) oba ekifo ekirabirira omwana ali mu lubuto. Ne bw’ofuna obujjanjabi obw’amangu, wabaawo akabi k’okuggyamu olubuto.

Ebizibu ebirala ebiyinza okuva mu TTTS mulimu:

• Ebizibu ebiva mu kuzaala nga tebanneetuuka (nga obuzibu mu kussa, obuzibu mu nkola y’obusimu).
• Omulongo afuna eddagala lino ayinza okulemererwa omutima oba obuzibu obulala ku mutima olw’amazzi agasukkiridde.
• Omulongo agaba ayinza okuba n’obuzibu mu kukula oba obuzibu mu kibumba.

TTTS ezuulibwa etya?

Omusawo wo nga tonnazaala ajja kuzuula TTTS ng'akozesa ultrasound scan . Ekintu omusawo ky’agenda okusooka okulaba ku sikaani kwe kuba nti waliwo abalongo babiri abafaanagana nga bagabana enseke emu.

Singa oteeberezebwa nti TTTS, omusawo wo ayinza okukusindika ew’omukugu mu ddagala lya maama n’omwana ali mu lubuto (omukugu mu MFM) okwongera okukeberebwa.Eyo, omukugu ajja kulaba ekimu oba ebisingawo ku bintu bino ku ultrasound scan:

• Enjawulo mu sayizi wakati w’abalongo bano bombi.
• Omwana omu alina amazzi g’omu lubuto amangi ennyo agamwetoolodde, ate omulala alina amazzi g’omu lubuto matono nnyo agamwetoolodde.
• Obutatambula bulungi mu musaayi mu balongo (kino osobola okukiraba n’okukebera Doppler ultrasound ).

Mu mbeera ezimu, okukeberebwa mu lubuto mu MRI (magnetic resonance imaging) n’okukeberebwa mu lubuto echocardiography (echo) nabyo biyinza okwetaagisa.

Ttiimu yo ey’okulabirira abaana nga tonnazaala ejja kukulondoola nnyo mu kiseera kyonna eky’olubuto lwo. Oyinza okwetaaga okwekebejjebwa enfunda eziwera okusobola okukebera obulamu bw’omwana.

Omusawo era ajja kukebera obulamu bwo. Oluusi, amazzi g’omu lubuto ageeyongedde ku ludda lw’oyo afuna amazzi gayinza okuvaako nnabaana wo okugaziwa n’omumwa gwa nnabaana okunafuwa. Enkyukakyuka zino era ziyinza okuvaako okuzaala nga tannatuuka.

Mitendera ki egya (TTTS)?

Ultrasound scan okwekenneenya obuzibu bw’embeera eno (TTTS), kwe kugamba, omutendera gw’erimu Kino kisobozesa omusawo okulaba engeri embeera gy’egenda mu maaso n’okumuwa amagezi ku ngeri ezisinga obulungi ez’obujjanjabi.

Waliwo emitendera etaano egya TTTS:

• Omutendera 1: Waliwo amazzi g’omu lubuto matono nnyo oba tegaliiwo okwetoloola omwana agaba. Ebiseera ebisinga wabaawo amazzi g’omu lubuto amangi ennyo okwetoloola omwana afuna.
• Omutendera 2: Ekibumba ky’omwana agaba tekirabika ku ultrasound. Kino kitegeeza nti omwana amuwadde yalekera awo okufuka mu ngeri eya bulijjo.
• Omutendera 3: Waliwo obutakwatagana bwa maanyi mu ntambula y’omusaayi wakati w’abalongo. Kino kiyinza okukosa enkola y’omutima gw’omwana omu.
• Omutendera 4: Omwana omu oba bombi balaga obubonero bw’okuzimba olususu oba omubiri.
• Omutendera 5: Omwana omu oba bombi bafudde.

Mu mutendera 1 (TTTS), okwetegereza kwokka kuyinza okumala. Kyokka embeera eno bw’eyongera okwonooneka, eyinza okubaawo amangu ddala. Oluvannyuma lw’omutendera ogw’okubiri (TTTS), singa olubuto lwo luba terunnaweza wiiki 26, ebiseera ebisinga kirungi okulongoosebwa omwana ali mu lubuto .

Bujjanjabi ki obuweebwa (TTTS)?

Obujjanjabi businziira ku bbanga ly’oli mu lubuto lwo n’omutendera ki ogwa TTTS gw’oli mu.

• Okwetegereza n’okulondoola: Omusawo ajja kulondoola nnyo olubuto lwo ng’akozesa ‘ultrasound scans’. Kino ky’oyinza okukola singa oba olina omutendera 1 (TTTS) oba singa wabaawo ensonga lwaki okulongoosebwa oba obujjanjabi obulala tebusoboka.
• Septostomy: Kino kizingiramu okukola ekituli ekitono mu luwuzi wakati w’ensawo z’abalongo bombi ez’omu lubuto. Kino kiyinza okwenkanya puleesa mu nsawo zombi ez’omu lubuto. Kino tekiba kya bulabe nnyo, naye tekiwonya kivaako TTTS.
• Okukendeeza ku lubuto:Mu nkola eno, omusawo akozesa empiso entono eriko ekituli okuggya amazzi g’omu lubuto agasukkiridde mu nsawo y’omwana afuna. Omusawo ayinza okukuwa kino mu mutendera 1 (TTTS) oba mu mbeera ez’amaanyi eza TTTS oluvannyuma lw’olubuto. Enkola eno tejjanjaba kivaako TTTS, n’olwekyo singa amazzi g’omu lubuto gaddamu okweyongera, kiyinza okwetaagisa okukolebwa emirundi egiwerako.
• Fetoscopic laser ablation: Enkola eno erimu okuyisa kkamera entono (fetoscope) mu nnabaana n’okukozesa ekitangaala kya laser okuggala emisuwa ku ngulu ku nnabaana egireeta omusaayi okutambula obutenkanankana wakati w’abalongo. Ekigendererwa ky’enkola eno kwe kukyusa entambula y’omusaayi okuva ku mwana omu okudda ku mulala, buli mwana abeere n’obungi bw’omusaayi obw’enjawulo. Kino kya kulonda ku mutendera ogw’okubiri oba okusingawo (TTTS) n’embuto eziri wakati wa wiiki 16 ne 26.
• Okuzibikira omusuwa gw’omu nnabaana: Eno y’enkola esembayo omusawo gy’ayinza okukuwa amagezi ng’abalongo bombi tebasobola kutaasibwa, oba ng’omwana omu ali mu mbeera eyinza okutta obulamu. Okulongoosa kuno kuyimiriza okutambula kw’omusaayi eri omwana omu, ne kiwa omwana omulala omukisa ogusinga okuwona.
• Okuzaala: Singa omwana aba ayise mu myaka gy’olubuto, omusawo ayinza okukuwa amagezi okuzaala.

Ttiimu yo ey’ebyobulamu ejja kukuyamba okulonda obujjanjabi obusinga okukuyamba. Bajja kuddamu ebibuuzo byo byonna era boogere naawe ku kabi, emigaso, n’engeri endala eziri mu buli bujjanjabi.

TTTS eddukanyizibwa etya?

Omusawo wo, wamu n’omukugu mu ddagala lya maama n’omwana ali mu lubuto (omukugu mu MFM), bajja kulondoola nnyo olubuto lwo. Ojja kukeberebwa buli kiseera mu ‘ultrasound scans’ (oboolyawo omulundi gumu oba ebiri mu wiiki), era oyinza n’okukwetaagisa okukeberebwa omutima gw’omwana mu lubuto ng’oli lubuto. Ttiimu yo ey‟okulabirira ejja kukuwa obuyambi mu by‟obujjanjabi n‟enneewulira mu kiseera kyonna eky‟olubuto lwo.

Kiki kye nsuubira singa bwe kiba bwe kityo?

Ebivaamu bisinziira ku bbanga ly’oli mu lubuto lwo ng’ozuuliddwa n’embeera gy’eri ey’amaanyi (omutendera). Olw’enkulaakulana mu sayansi w’obusawo, okulondoola ennyo n’okujjanjabibwa amangu kiyinza okuwa abalongo bombi omukisa omulungi okuwona. Yogerako n’omusawo wo ku bisuubirwa n’ebiyinza okuvaamu okutegeera engeri TTTS gy’egenda okukosaamu olubuto lwo n’omwana wo. Abalongo bangi abasigaddewo beetaaga okubeera mu NICU (Neonatal Intensive Care Unit) okumala akaseera katono oluvannyuma lw’okuzaalibwa okusobola okufuna entandikwa gye beetaaga.

(TTTS) kiyinza okuba ekintu ekikwata ennyo ku nneewulira n’okunyigirizibwa. Jjukira okwerabirira era onoonye obuwagizi okuva mu ttiimu yo ey’ebyobulamu, munno, n’emikwano gyo.

Omuwendo gw’abawona mu (TTTS) guli gutya?

Emiwendo gy’okuwona gisinziira ku ngeri TTTS gy’eri ey’amaanyi, ddi lw’ozuulibwa, n’okumanya oba ofuna obujjanjabi. Okufuna obujjanjabi obutuufu kiyinza okuleeta enjawulo nnene mu muwendo gw’okuwangaala kwo ne TTTS:

• Ebitundu nga 90% ku balongo abazuuliddwa nga balina TTTS ey’amaanyi nga bukyali nnyo mu lubuto bali mu bulabe bw’okufa nga tebannazaalibwa (singa tebajjanjabwa).
• Wakati wa 85% ne 90% ku mbuto ezijjanjabiddwa (TTTS) zivaamu waakiri omwana omu okuwona.
• Mu mbuto wakati wa 50% ne 65% ezijjanjabiddwa (TTTS), abalongo bombi bawangaala.

Olw’okuba ebintu bingi bikosa okuwangaala, yogerako ne ttiimu yo elabirira omwana wo ku mbeera y’omwana wo.

Bibuuzo ki bye nnina okubuuza ttiimu yange ey’ebyobulamu?

Ebimu ku bibuuzo by’oyinza okubuuza:

• Olubuto lwange lwawukana lutya ku lubuto lw’abalongo nga sirina (TTTS)?
• Nnaaba nneetaaga okulaba omusawo omukugu? Ani ali ku ttiimu yange ey’okulabirira?
• Emirundi emeka gye nja okwetaaga okukeberebwa sikaani oba okukeberebwa ebirala?
• (TTTS) ejja kukosa etya enteekateeka zange ez’okuzaala?
• Nnawulira enkyukakyuka yonna mu mubiri gwange olw’obulwadde bwa TTTS? Bwe kiba bwe kityo, kiki kye nsuubira?
• Bujjanjabi ki bw’ogamba ku mbeera yange? Lwaaki?
• Mize ki egy’obulamu (nga endya, dduyiro, okuwummula, obujjanjabi) gy’ogamba okuwagira obulamu bwange?

Ono ‘Daisy Baby’ kye ki?

‘Daisy baby’ linnya eddala eriyitibwa omwana alina TTTS. Ekitongole kya Twin-to-Twin Transfusion Syndrome (TTTS) Foundation kyasooka kukozesa linnya lino. Erinnya lino lyajja oluvannyuma lw’omutandisi waayo okusimba ensigo za daisy mu lusuku lwabwe ne batabani be ab’amabaale abasigaddewo. Olusuku lwa daisy kabonero ka ssuubi nti buli bbebi alina obulwadde bwa TTTS ajja kuwona.

N’ekisembayo, ekisinga obukulu! (Obubaka Obutwala Awaka)

Okuzuulibwa nti olina obulwadde bwa Twin-to-Twin Transfusion Syndrome (TTTS) kiyinza okukutiisa. Kya bulijjo okuwulira ng’otya n’okweraliikirira ekiddako gy’oli n’abalongo bo. Yogerako n’omusawo wo ku bujjanjabi obusinga obulungi ku mbeera yo. Noonya obuyambi okuva mu mikwano gyo n’ab’omu maka go ng’olubuto lwo lugenda mu maaso. Okwegatta ku kibiina ekiwagira amaka agafunye obumanyirivu mu TTTS nakyo kiyinza okuba engeri ennungi ey‟okukuyamba okuyita mu lugendo luno. Jjukira nti toli wekka. Bw’ofuna amagezi amatuufu n’obuwagizi bw’abasawo, ojja kusobola okwolekagana n’okusoomoozebwa kuno ku mutwe!

` Twin-to-Twin Transfusion Syndrome, TTTS, abalongo, olubuto, nnabaana, amazzi g’omu lubuto, monochorionic