Twins i nei em? He dinhmun hlauhawm tak hi i hria em? (Twin-to-Twin Transfusion Syndrome - TTTS) a ni a, a rilru a hah lutuk a, a rilru a buai em em bawk a.

Nu nei tur fapa mal nei tur i nih chuan a hmasa berah chuan lawmthu ka sawi e! Mahse, twin pregnancy-a a chang chuan special condition awm thei te pawh hriat a pawimawh hle. Chutiang dinhmun pakhat chu beisei loh deuh mahse hriat hlawh tak chu Twin-to-Twin Transfusion Syndrome , a tawi zawngin TTTS tia hriat bawk hi a ni. Ngaihtuah buai suh, awlsam takin sawi ila.

Twin-to-Twin Transfusion Syndrome (TTTS) hi eng nge ni? A awlsam zawngin...

I pum chhunga twins pahnih hian placenta inang an nei ang tih han ngaihtuah teh . Heng twins te hi (monochorionic twins) kan ti a. A tlangpuiin naute pahnih hian he nausen atang hian thisen leh ei tur tha inang an dawng thin. Mahse, he thilah hian (TTTS) chu inthenna chu a thleng dik lo.

A awlsam zawngin, naute pakhat ( ‘donor twin’ ti ila ) hian nausen atanga thisen a hmu tlem hle. Naute dang ( ‘recipient twin’ ti ila ) chu a tam lutuk. He thisen kal dan inthlauhna hi TTTS thlentu a ni. Hei hi a awm lo hle a, mahse na tak a ni thei. Maternal-Fetal Medicine (MFM) specialist-in uluk taka enkawl a pawimawh hle. A hmaa hmuhchhuah, enkawl leh enkawl hian naute pahnih tan pawh result tha zawk a thlen thei a ni.

‘Donor twin’ hi engtin nge a awm?

Naute hian nausen atanga thisen a dawng tlem chho zel a. Chuvangin, a taksaa thisen awm zat pawh a tlahniam bawk. Hei hian naute chu a ti thang zawi thei a, a chhehvela amniotic fluid awm zat pawh a tlahniam thei bawk. Hei hi naute a zun a tlem vang a ni. Hei hi a chhan chu amniotic fluid hi naute zun atanga siam a nih tam vang a ni. Amniotic fluid a tlahniam chuan naute chelhtu sac chu a tlahniam thei a, a bo thei bawk. Hei hi a hlauhawm hle a, a chhan chu naute chu a che tha thei lo va, umbilical cord pawh a compress thei bawk.

‘Recipient twin’ chu eng nge thleng?

He naute hian thisen a dawng tur aia tam a dawng mek a ni. He thisen tam zawk hian naute thinlungah harsatna nasa tak a siam a, thinlung chak lohna pawh a thlen thei bawk . Donor naute taksa chu chaw tha lo a nih chuan a dawngtu naute taksa hian nasa zawkin hna a thawh a ngai a ni. He naute hian thisen a process tam a ngaih avangin a zun a tam zawk. Chuvang chuan a amniotic sac chu a lian ta hle a ni.

He (TTTS) dinhmun hian tute nge nghawng?

TTTS hian naupai, twins te hian placenta pakhat (monochorionic) , leh an hmel inang (identical twins) te chauh a nghawng a ni. A tam zawkah chuan heng TTTS vei twins te hian amniotic sac (diamniotic) hrang hrang pahnih an nei thin. Heng twins te hi (monochorionic diamniotic twins) kan ti a.

Mahse, a tlem hle a, naute pahnih hian placenta leh amniotic sac (monoamniotic) inang an neihna a awm thin. Chutiang hunah chuan TTTS pawh a awm thei bawk. Mahse, chutiang twins chu an tlem hle.

Naupai laiin eng chen nge TTTS hi a lo awm theih?

Hetiang dinhmun hi kar 16 atang khan a lo awm tan thei tlangpui a, mahse naupai laiin engtik lai pawhin a awm thei.

Engtiang chiahin nge (TTTS) hi a hluar?

TTTS hi monochorionic twin naupai zinga 15% vel ah a awm thin.

TTTS natna lan chhuah dan chu engte nge ni?

TTTS vei nu tam zawk chuan symptom bik an nei lo. Mahse, ṭhenkhat chuan hetiang hian an tawng mai thei:

• Nausen pum chu beisei aia chak zawka inhriatna.
• Pum natna emaw, tightness emaw hriatna.
• Sudden thau lutuk.

Heng symptoms te hi i neih chuan doctor pan nghal tur a ni.

Eng thilin nge TTTS hi a thlen?

A tlangpuiin, naupai pahnih (twin pregnancy)-ah chuan nausen pakhat (placenta)-ah chuan nausen pahnih hian nausen atanga thisen an insem zat chu a inang vek a ni. Mahse, TTTS-ah chuan nausen chhunga thisen kalna kawngte inzawmkhawm dan chuan thisen chu a insem darh lo a ni. Nausen pakhat (naute dawngtu) chuan thisen a hmu tam zawk a, naute dang (naute petu) chuan thisen a hmu tlem zawk bawk.

Placenta lo thanglian dan chu i thunun thei lo. (TTTS) hi random event a ni. I tih leh tih loh thil a ni lo. Chuvangin nangmah leh nangmah in dem suh. (TTTS) hi ven theih a ni lo.

Tute nge (TTTS) atana hlauhawm?

Hei hian genetic leh hereditary link a nei lo. Random thil thleng a ni. Mahse, hei hi naupai pahnih , nausen pakhat (monochorionic) nei (monochorionic) ah chauh a thleng thei a ni.

TTTS avanga harsatna awm thei te chu engte nge ni?

Enkawl loh a nih chuan, emaw, naupai tirh lamah a lo awm a nih chuan, TTTS hian naute tan hriselna lama harsatna lian tak a thlen thei a, thihna pawh a thlen thei bawk. Chuvangin, specialist maternal-fetal medicine (MFM specialist) emaw, nausen enkawlna hmun emaw atanga enkawlna emaw, uluk taka enkawl emaw lak a pawimawh hle. Enkawl vat a nih pawhin nau pai theihna a awm.

TTTS-a harsatna awm thei dangte chu:

• Nau piang hmaa harsatna (thâwk harsa, nervous system lama harsatna ang chi).
• Recipient twin hian extra fluid avang hian heart failure emaw heart problem dang emaw a nei thei a ni.
• Donor twin hian growth retardation emaw kidney lama harsatna emaw a nei thei.

Engtin nge TTTS hi hmuhchhuah a nih?

I nau neih hmaa enkawltu chuan ultrasound scan hmangin TTTS hi a hmuchhuak ang . Scan-a doctor-in a hmuh hmasak ber tur chu, nausen piang inang pahnih, nausen inang pahnih an awm tih hi a ni.

TTTS nia rinhlelh a nih chuan i doctor chuan maternal-fetal medicine specialist (MFM specialist) hnenah test dang neih belh turin a refer thei che a ni.Chutah chuan specialist chuan ultrasound scan-ah heng thil pakhat emaw a aia tam emaw a hmu ang:

• Naute pahnih inkara lian leh te inthlauhna.
• Naute pakhat hian amniotic fluid a nei tam lutuk a, naute dang erawh chuan amniotic fluid a nei tlem lutuk thung.
• Naute thisen kal dan dik lo (hei hi Doppler ultrasound test hmanga hmuh theih a ni).

A then phei chuan nausen MRI (magnetic resonance imaging) test leh nausen echocardiography (echo) te pawh a ngai thei bawk.

I naupai chhung zawngin i prenatal care team chuan uluk takin an lo enkawl ang che. Naute hriselna endik nan ultrasound scan neih fo a ngai mai thei.

Doctor pawhin i hriselna a enfiah ang. A châng chuan, a dawngtu lam a amniotic fluid a pun chuan i nausen pum a ti lian thei a, i serh pawh a tichak lo thei bawk. Heng inthlak danglamna te hian nau piang hmasa a thlen thei bawk.

(TTTS) hi eng stage nge ni?

Ultrasound scan hian natna nasat dan (TTTS) a teh a, chu chu a dinhmun a zirchiang a, hei hian doctor chu a natna kal zel dan a hmu thei a, enkawlna tha ber berte a rawt thei bawk.

TTTS hi stage panga a awm a, chungte chu:

• Stage 1: Donor naute chhehvelah hian amniotic fluid a tlem hle emaw, a awm lo emaw a ni. Naute dawngtu chhehvelah hian amniotic fluid a tam lutuk fo thin.
• Stage 2: Ultrasound-ah chuan donor naute zun (bladder) hmuh tur a awm lo. Chumi awmzia chu donor naute chu a zun pangngaiin a chawlhsan tawh tihna a ni.
• Stage 3: Naute inkarah thisen kal danah inthlauhna nasa tak a awm a. Hei hian naute pakhat thinlung hnathawh a nghawng thei a ni.
• Stage 4: Naute pakhat emaw, pahnih emaw hian vun emaw, taksa emaw a hring chhuak tih hriatna an nei.
• Stage 5: Naute pakhat emaw pahnih emaw an thi tawh.

Stage 1 (TTTS)-ah chuan enfiahna chauh pawh a tawk mai thei. Mahse, a dinhmun a zual chuan a thleng thuai thei hle. Stage 2 (TTTS) hnuah chuan i naupai chu kar 26 aia rei lo a nih chuan nausen zai (fetal surgery) neih a tha tlangpui.

(TTTS) enkawlna tur engte nge ni?

Enkawlna chu i naupai lai hian eng chen nge i awm tawh tih leh TTTS eng stage nge i nih tih a innghat a ni.

• Enfiahna leh enkawl dan: I doctor chuan ultrasound scan hmangin i naupai chu uluk takin a enfiah ang. Hei hi stage 1 (TTTS) i neih emaw, surgery emaw, enkawlna dang emaw tih theih loh chhan a awm chuan duhthlan tur a ni.
• Septostomy: Hei hian naute pahnih amniotic sacs inkar membrane-ah khur te tak te siam a ni. Hei hian amniotic sac pahnih a pressure chu a inang tlang thei a ni. Hei hi a hlauhawm lo zawk a, mahse TTTS awm chhan bulpui chu a tidam lo.
• Amnioreduction tih hi a ni.Hetiang tihnaah hian doctor chuan needle te tak te, hollow tak hmangin a dawngtu naute bawm atanga amniotic fluid tam lutuk chu a paih chhuak thin. I doctor chuan stage 1 (TTTS)-ah emaw, naupai hnu lama TTTS na tak takah emaw a rawt thei ang. Hetiang tih hian TTTS awm chhan bulpui chu a enkawl lo va, chuvangin amniotic fluid a pung leh a nih chuan vawi tam tak tih a ngai mai thei.
• Fetoscopic laser ablation: Hetiang tih danah hian camera te tak te (fetoscope) chu nausen pum chhungah pass a, laser beam hmangin nausen inkara thisen kal dan inang lo titu nausen chunglam a thisen kalna kawngte chu khar a ni. Hetiang tih dan hian a tum ber chu naute pakhat atanga a dang thisen kal dan thlak danglam a ni a, chutiang chuan naute tin hian thisen volume hrang hrang an nei thei ang. Hei hi stage 2 emaw a chunglam (TTTS) leh naupai kar 16 leh 26 inkar tan pawh duhthlan tur a ni.
• Umbilical cord occlusion: Hei hi naute pahnih chhanchhuah theih loh hunah emaw, naute pakhat nunna atana hlauhawm dinhmunah emaw i doctor-in a rawt theih hnuhnung ber a ni. He surgery hian naute pakhat thisen kal chu a titawp a, naute dang chu dam theihna hun tha ber a pe a ni.
• Nau neih dan: Naute chu viable gestational age a pel tawh chuan doctor chuan nau neih a rawt thei ang.

I healthcare team chuan i tana tha ber tur enkawlna thlang turin an pui ang che. I zawhna zawng zawng an chhang ang a, enkawlna kawng hrang hranga hlauhawmna, a hlawkna leh a danglamna te an sawipui ang che.

Engtin nge TTTS hi enkawl a nih?

I healthcare provider chuan maternal-fetal medicine specialist (MFM specialist) nen i naupai chu uluk takin an enkawl ang. Ultrasound scan reng reng i nei ang (kar khatah vawi khat emaw vawi hnih emaw pawh a ni thei), i naupai lai hian nausen echocardiogram i neih a ngai bawk ang. I care team chuan i naupai chhung zawngin medical leh emotional support an pe ang che.

Hetiang a nih chuan eng nge ka beisei ang?

A rah chhuah chu i naupai lai hian i natna hmuhchhuah a nih lai khan eng chen nge i awm tawh tih leh i natna hi engtiang chiahin nge a nasat (stage) ah a innghat a ni. Medical science lama hmasawnna a awm avangin uluk taka enkawl leh enkawl hmasak hian naute pahnih hi damchhuahna chance tha zawk a pe thei a ni. TTTS hian i naupai leh i naute a nghawng dan tur hriatthiam nan i doctor nen beisei tur leh a chhuah theih dan tur sawiho rawh. Twins damchhuak tam tak chuan an mamawh bul tanna an neih theih nan an pian hnu rei vak lo NICU (Neonatal Intensive Care Unit)-ah an awm a ngai a ni.

(TTTS) hi emotional leh stressful experience nasa tak a ni thei. Nangmah in enkawl la, i healthcare team, i partner leh i thiante hnen atangin tanpuina zawng rawh.

(TTTS) ah hian damchhuah zat chu engzat nge ni?

Survival rates hi TTTS nasat dan te, engtikah nge i hmuhchhuah tih te, leh enkawlna i dawn leh dawn lohah a innghat a ni. Enkawlna dik tak hmuh hian TTTS vei damchhuahna rate-ah danglamna nasa tak a thlen thei a ni:

• Naupai tirh lama TTTS na tak vei nia hriat twins zinga 90% vel chu nau piang hma (enkawl loh chuan) thih hlauhawmna an nei a ni.
• Naupai enkawl (TTTS) zinga 85% leh 90% inkar chuan naute pakhat tal a dam thei a ni.
• Naupai enkawl (TTTS) zinga 50% leh 65% inkar ah chuan naute pahnih hi an dam chhuak vek a ni.

Thil tam takin dam khawchhuahna a nghawng avangin, i naute prognosis chungchang hi i enkawltu team nen sawiho rawh.

Ka healthcare team te hnenah eng zawhna nge ka zawh tur?

Zawhna i zawh theih ṭhenkhat chu:

• Engtin nge ka naupai hi twin pregnancy nei lo (TTTS) nen a danglam?
• Specialist ka hmuh a ngai dawn em ni? Ka care team-ah hian tute nge awm?
• Eng chen nge scan emaw test dang emaw tih ka mamawh ang?
• Engtin nge (TTTS) hian ka delivery plan-te a nghawng ang?
• TTTS vang hian ka taksaah danglamna ka nei em? A nih chuan eng nge ka beisei ang?
• Ka dinhmun hi eng enkawlna nge i rawt? Engati nge?
• Ka hriselna thlawp turin eng nunphung (ei leh in, exercise, chawlh, therapy ang chi) nge i rawt?

He ‘Daisy Baby’ hi eng nge ni?

‘Daisy baby’ tih hi TTTS vei naute hming dang a ni. He hming hi Twin-to-Twin Transfusion Syndrome (TTTS) Foundation chuan an hmang hmasa ber a ni. He hming hi a dintu hian a fapa mal la damte nen an huana daisy chi an phun hnua lo piang a ni. Daisy huan hi TTTS vei naute zawng zawng an dam khawchhuah theih beiseina chhinchhiahna a ni.

A tawp berah chuan a pawimawh ber! (In lama hruai tur thuchah)

Twin-to-Twin Transfusion Syndrome (TTTS) tih hriat chhuah chu thil hlauhawm tak a ni thei. Nang leh i twins te tan eng nge lo thleng dawn tih hlauhna leh lungkhamna i neih hi thil pangngai a ni. I dinhmun atana enkawlna tha ber berte chu i doctor nen sawiho rawh. I naupai lai hian ṭhiante leh chhungte hnen aṭangin ṭanpuina zawng rawh. TTTS tawng tawh chhungkaw tan support group-a tel hi he zinkawng zawh kawngah hian i tanpui theihna tur kawng tha tak a ni thei bawk. Nangmah chauh i ni lo tih hre reng ang che. Damdawi lam thurawn leh puihna dik tak i neih chuan he harsatna hi head on-in i hmachhawn thei ang!

` Twin-to-Twin Transfusion Syndrome, TTTS, twins, naupai, nausen, amniotic fluid, monochorionic