Kodi muli ndi mapasa? Kodi mukudziwa za vuto loopsa ili? (Twin-to-Twin Transfusion Syndrome - TTTS)

Ngati ndinu mayi woyembekezera mapasa, choyamba, zikomo! Komabe, ndikofunikiranso kudziwa za matenda apadera omwe nthawi zina amapezeka m'mimba mwa mapasa. Chimodzi mwa matenda amenewa chomwe sichingayembekezereke koma choyenera kudziwa ndi Twin-to-Twin Transfusion Syndrome , yomwe imadziwikanso kuti TTTS mwachidule. Musadandaule, tiyeni tikambirane mwachidule.

Kodi matenda a Twin-to-Twin Transfusion Syndrome (TTTS) ndi chiyani? Mwachidule...

Tangoganizani kuti mapasa awiri omwe ali m'mimba mwanu ali ndi placenta imodzi . Timawatcha mapasa awa (mapasa a monochorionic) . Kawirikawiri, makanda onse awiri amalandira magazi ndi michere yofanana kuchokera ku placenta iyi. Komabe, pankhaniyi (TTTS), kugawikana kumeneko sikumachitika bwino.

Mwachidule, mwana mmodzi (tiyeni timutche kuti 'mapasa opereka' ) salandira magazi okwanira kuchokera ku placenta. Mwana wina (tiyeni timutche kuti 'mapasa olandira' ) amalandira magazi ambiri. Kusalinganika kumeneku kwa kayendedwe ka magazi ndiko kumayambitsa TTTS. Imeneyi ndi vuto losowa koma lomwe lingakhale lalikulu. Kuyang'aniridwa mosamala ndi katswiri wa Maternal-Fetal Medicine (MFM) ndikofunikira. Kuzindikira msanga, kuyang'anira, ndi chithandizo kungathandize kuti ana onse awiri apeze zotsatira zabwino.

Kodi chimachitika ndi chiyani kwa 'mphasa wopereka'?

Mwanayo akulandira magazi ochepa kuchokera ku placenta. Chifukwa chake, kuchuluka kwa magazi m'thupi lake kumachepanso. Izi zingayambitse mwana kukula pang'onopang'ono, ndipo kuchuluka kwa madzi amniotic omwe amamuzungulira kungachepenso. Izi zili choncho chifukwa mwana akukodza pang'ono. Izi zili choncho chifukwa madzi amniotic amapangidwa makamaka ndi mkodzo wa mwana. Madzi amniotic akachepa, thumba lomwe limasunga mwana limatha kuchepa, kapena kutha. Izi ndizowopsa, chifukwa mwana sangathe kuyenda bwino, ndipo chingwe cha umbilical chingakanikizidwe.

Kodi chimachitika ndi chiyani kwa 'mapasa olandira'?

Mwana uyu akulandira magazi ambiri kuposa momwe ayenera kukhalira. Magazi owonjezerawa amaika mtima wa mwana pamavuto ambiri, ndipo angayambitse kulephera kwa mtima . Thupi la mwana woperekayo likapanda kudya mokwanira, thupi la mwana wolandirayo liyenera kugwira ntchito molimbika. Chifukwa mwana uyu ayenera kukonza magazi ambiri, amakodza kwambiri kuposa nthawi zonse. Zotsatira zake, amniotic sac yake imakula kwambiri.

Kodi vuto ili (TTTS) limakhudza ndani?

TTTS imangokhudza mimba pomwe mapasa amagawana placenta imodzi (monochorionic) , ndipo amawoneka ofanana (mapasa ofanana). Nthawi zambiri, mapasa awa omwe ali ndi TTTS amakhala ndi matumba awiri osiyana a amniotic (diamniotic). Timawatcha mapasa awa (monochorionic diamniotic mapasa) .

Komabe, nthawi zina, pamakhala zochitika pamene makanda awiri amagawana placenta imodzi ndi amniotic sac (monoamniotic). Nthawi zina, TTTS imatha kuchitikanso. Komabe, mapasa otere ndi osowa kwambiri.

Kodi TTTS imatha kufika mochedwa bwanji mimba?

Matendawa nthawi zambiri amayamba kukula ali ndi masabata 16, koma amatha kuchitika nthawi iliyonse panthawi ya mimba.

Kodi (TTTS) ndi yofala bwanji?

TTTS imapezeka pafupifupi 15% ya mimba ya mapasa a monochorionic.

Kodi zizindikiro za TTTS ndi ziti?

Amayi ambiri omwe ali ndi TTTS sakumana ndi zizindikiro zilizonse. Komabe, ena angakumane ndi izi:

• Kumva ngati chiberekero chikukula mofulumira kuposa momwe chimayembekezeredwa.
• Kumva kupweteka kapena kutsekeka m'mimba.
• Kulemera kwadzidzidzi.

Ngati muli ndi zizindikiro izi, muyenera kuonana ndi dokotala nthawi yomweyo.

Kodi chimayambitsa TTTS ndi chiyani?

Kawirikawiri, pa mimba ya mapasa yokhala ndi placenta imodzi, makanda onse awiri amagawana magazi ofanana kuchokera ku placenta. Komabe, mu TTTS, momwe mitsempha yamagazi mu placenta imalumikizirana zimapangitsa kuti magazi agawikane mosiyana. Mwana mmodzi (mwana wolandira) amalandira magazi ambiri, ndipo mwana wina (mwana wopereka) amalandira magazi ochepa.

Simungathe kulamulira momwe placenta imakulira. (TTTS) ndi chinthu chomwe chimachitika mwangozi. Si chinthu chomwe munachita kapena chomwe simunachite. Choncho musadziimbe mlandu. (TTTS) sichitha kupewedwa.

Ndani ali pachiwopsezo cha (TTTS)?

Izi zilibe ubale wa majini kapena cholowa. Zimachitika mwachisawawa. Komabe, izi zitha kuchitika kokha m'mimba ya mapasa yomwe ili ndi placenta imodzi (monochorionic) .

Kodi mavuto omwe angakhalepo chifukwa cha TTTS ndi ati?

Ngati sanalandire chithandizo, kapena ngati vutoli layamba msanga kwambiri pa nthawi ya mimba, TTTS ikhoza kuyambitsa mavuto aakulu pa thanzi la mwana, ndipo ikhoza kupha. Chifukwa chake, ndikofunikira kupeza chithandizo kapena kuyang'aniridwa mosamala ndi dokotala wamankhwala odziwa bwino ntchito ya amayi ndi mwana wosabadwayo (MFM specialist) kapena malo osamalira ana osabadwayo. Ngakhale mutalandira chithandizo mwachangu, pali chiopsezo chotaya mimba.

Mavuto ena omwe amapezeka nthawi zambiri ndi TTTS ndi awa:

• Mavuto obwera chifukwa chobadwa msanga (monga mavuto opuma, mavuto a mitsempha).
• Mapasa olandira chithandizocho akhoza kukhala ndi vuto la mtima kapena mavuto ena a mtima chifukwa cha madzi owonjezera.
• Mapasa opereka chithandizo angakhale ndi vuto la kuchedwa kukula kapena impso.

Kodi TTTS imapezedwa bwanji?

Wopereka chithandizo cha amayi oyembekezera adzazindikira matenda a TTTS pogwiritsa ntchito ultrasound scan . Chinthu choyamba chomwe dokotala adzachiwona pa scan ndichakuti pali mapasa awiri ofanana omwe amagawana placenta imodzi.

Ngati mukukayikira kuti muli ndi TTTS, dokotala wanu angakutumizireni kwa katswiri wa mankhwala a amayi ndi mwana wosabadwayo (MFM specialist) kuti akakuyeseninso.Kumeneko, katswiri adzawona chimodzi kapena zingapo mwa zinthu izi pa ultrasound scan:

• Kusiyana kwa kukula pakati pa makanda awiriwa.
• Mwana mmodzi ali ndi madzi ambiri a amniotic, pomwe mwana winayo ali ndi madzi ochepa a amniotic.
• Kusayenda bwino kwa magazi mwa makanda (izi zitha kuwonedwa ndi mayeso a Doppler ultrasound ).

Nthawi zina, mayeso a fetal MRI (magnetic resonance imaging) ndi fetal echocardiography (echo) angafunikenso.

Gulu lanu losamalira ana aang'ono lidzakuyang'anirani mosamala nthawi yonse yomwe muli ndi pakati. Mungafunike kuyesedwa pafupipafupi kuti muwone thanzi la mwana.

Dokotala adzayang'ananso thanzi lanu. Nthawi zina, kuchuluka kwa madzi amniotic kumbali ya wolandirayo kungayambitse kukula kwa chiberekero chanu komanso kufooka kwa chiberekero chanu. Kusintha kumeneku kungayambitsenso kubadwa msanga.

Kodi magawo a (TTTS) ndi ati?

Kujambula ndi ultrasound kumayesa kuopsa kwa vutoli (TTTS), kutanthauza kuti, gawo lomwe lili. Izi zimathandiza dokotala kuona momwe vutoli likupitira patsogolo ndikupereka malangizo a njira zabwino kwambiri zochiritsira.

Pali magawo asanu a TTTS:

• Gawo 1: Madzi amniotic amakhala ochepa kwambiri kapena palibe. Nthawi zambiri madzi amniotic amakhala ambiri mozungulira mwana wolandira.
• Gawo lachiwiri: Chikhodzodzo cha mwana wopereka sichikuwoneka pa ultrasound. Izi zikutanthauza kuti mwana woperekayo wasiya kukodza bwino.
• Gawo lachitatu: Pali kusalingana kwakukulu kwa kayendedwe ka magazi pakati pa makanda. Izi zitha kusokoneza magwiridwe antchito a mtima wa mwana m'modzi.
• Gawo 4: Mwana m'modzi kapena onse awiri amasonyeza zizindikiro za kutupa kwa khungu kapena thupi.
• Gawo 5: Mwana mmodzi kapena onse awiri amwalira.

Mu gawo loyamba (TTTS), kuyang'anitsitsa kokha kungakhale kokwanira. Komabe, ngati vutoli likuipiraipira, likhoza kuchitika mwachangu kwambiri. Pambuyo pa gawo lachiwiri (TTTS), ngati mimba yanu ili yosakwana milungu 26, opaleshoni ya mwana wosabadwayo nthawi zambiri imalimbikitsidwa.

Kodi mankhwala a (TTTS) ndi otani?

Chithandizo chimadalira kutalika kwa mimba yanu komanso gawo la TTTS lomwe muli nalo.

• Kuyang'anira ndi kuyang'anira: Dokotala wanu adzayang'anira mimba yanu mosamala pogwiritsa ntchito ultrasound scans. Iyi ndi njira ngati muli ndi gawo 1 (TTTS) kapena ngati pali zifukwa zomwe opaleshoni kapena njira zina zothandizira sizingatheke.
• Septostomy: Izi zimaphatikizapo kupanga dzenje laling'ono mu nembanemba pakati pa matumba awiri a amniotic a makanda. Izi zitha kulinganiza kuthamanga kwa magazi m'matumba onse awiri a amniotic. Izi sizowopsa kwenikweni, koma sizimachiritsa chomwe chimayambitsa TTTS.
• Kuchepetsa Amniore:Mu njira imeneyi, dokotala amagwiritsa ntchito singano yaying'ono, yopanda kanthu kuti achotse madzi ochulukirapo a amniotic m'thumba la mwana wolandirayo. Dokotala wanu angakulangizeni izi mu gawo loyamba (TTTS) kapena pazochitika zazikulu za TTTS pambuyo pa mimba. Njirayi sichiza chomwe chimayambitsa TTTS, kotero ngati madzi a amniotic akuwonjezekanso, ingafunike kuchitidwa kangapo.
• Kuchotsa magazi pogwiritsa ntchito laser ya fetoscopic: Njirayi imaphatikizapo kulowetsa kamera kakang'ono (fetoscope) m'chiberekero ndikugwiritsa ntchito kuwala kwa laser kutseka mitsempha yamagazi pamwamba pa placenta yomwe imayambitsa kuyenda kwa magazi kosagwirizana pakati pa makanda. Cholinga cha njirayi ndikusintha kuyenda kwa magazi kuchokera kwa mwana mmodzi kupita kwa wina, kuti mwana aliyense akhale ndi magazi osiyana. Iyi ndi njira yogwiritsira ntchito gawo lachiwiri kapena kuposerapo (TTTS) ndi mimba pakati pa masabata 16 ndi 26.
• Kutsekeka kwa chingwe cha umbilical: Iyi ndi njira yomaliza yomwe dokotala wanu angakulangizeni ngati makanda onse awiri sangathe kupulumutsidwa, kapena ngati mwana mmodzi ali pachiwopsezo chachikulu. Opaleshoniyi imaletsa kuyenda kwa magazi kupita kwa mwana mmodzi, zomwe zimapatsa mwana winayo mwayi wabwino wopulumuka.
• Kubereka: Ngati mwana wapitirira msinkhu woyenera wa mimba, dokotala angakulangizeni kubereka.

Gulu lanu lazachipatala lidzakuthandizani kusankha chithandizo chomwe chili choyenera kwa inu. Adzayankha mafunso anu onse ndikukambirana nanu za zoopsa, maubwino, ndi njira zina zochiritsira.

Kodi TTTS imayendetsedwa bwanji?

Wopereka chithandizo chamankhwala wanu, pamodzi ndi katswiri wa zamankhwala a amayi ndi mwana wosabadwayo (katswiri wa MFM), adzakuyang'anirani mosamala mimba yanu. Mudzayesedwa pafupipafupi ndi ultrasound (mwina kamodzi kapena kawiri pa sabata), ndipo mungafunikenso kuchitidwa echocardiogram ya fetal panthawi ya mimba yanu. Gulu lanu losamalira lidzakupatsani chithandizo chamankhwala komanso chamaganizo panthawi yonse ya mimba yanu.

Kodi ndiyenera kuyembekezera chiyani ngati izi zitachitika?

Zotsatira zake zimadalira nthawi yomwe muli ndi pakati pamene mwapezeka ndi matenda komanso momwe matendawa alili oopsa (siteji). Ndi kupita patsogolo kwa sayansi ya zamankhwala, kuyang'anira mosamala komanso kulandira chithandizo msanga kungapatse ana onse awiri mwayi wabwino wopulumuka. Lankhulani ndi dokotala wanu za zomwe mukuyembekezera komanso zotsatira zake kuti mumvetse momwe TTTS ingakhudzire mimba yanu ndi mwana wanu. Mapasa ambiri otsala amafunika kukhala mu NICU (Neonatal Intensive Care Unit) kwa kanthawi kochepa atangobadwa kuti ayambe kumene.

(TTTS) ikhoza kukhala nthawi yovuta kwambiri komanso yovutitsa maganizo. Kumbukirani kudzisamalira nokha ndikupempha thandizo kuchokera kwa gulu lanu lazachipatala, mnzanu, ndi anzanu.

Kodi chiŵerengero cha kupulumuka mu (TTTS) ndi chiani?

Kuchuluka kwa anthu omwe akupulumuka kumadalira momwe matenda a TTTS alili ovuta, nthawi yomwe mwapezeka ndi matendawa, komanso ngati mwalandira chithandizo. Kupeza chithandizo choyenera kungapangitse kusiyana kwakukulu pa kuchuluka kwa anthu omwe akupulumuka ndi TTTS:

• Pafupifupi 90% ya mapasa omwe amapezeka ndi matenda oopsa a TTTS kumayambiriro kwa mimba ali pachiwopsezo cha kufa asanabadwe (ngati sanalandire chithandizo).
• Pakati pa 85% ndi 90% ya mimba zomwe zimathandizidwa (TTTS) zimapangitsa kuti mwana mmodzi kapena kuposerapo apulumuke.
• Pakati pa 50% ndi 65% ya mimba zomwe zapatsidwa chithandizo (TTTS), ana onse awiri amapulumuka.

Popeza pali zinthu zambiri zomwe zimakhudza kupulumuka, lankhulani ndi gulu lanu la chisamaliro za matenda a mwana wanu.

Ndi mafunso ati omwe ndiyenera kufunsa gulu langa lazaumoyo?

Mafunso ena omwe mungafunse:

• Kodi mimba yanga imasiyana bwanji ndi mimba ya mapasa opanda TTTS?
• Kodi ndiyenera kuonana ndi katswiri? Ndani ali m'gulu langa losamalira odwala?
• Kodi ndiyenera kuyesedwa kangati kapena kuyesedwa kwina?
• Kodi (TTTS) imakhudza bwanji mapulani anga obereka?
• Kodi ndikumva kusintha kulikonse m'thupi langa chifukwa cha TTTS? Ngati ndi choncho, ndiyembekezere chiyani?
• Kodi mumalimbikitsa chithandizo chanji pa vuto langa? Chifukwa chiyani?
• Ndi zizolowezi ziti za moyo wanga (monga zakudya, masewera olimbitsa thupi, kupuma, ndi chithandizo) zomwe mumalimbikitsa kuti ndikhale ndi thanzi labwino?

Kodi 'Daisy Baby' uyu ndi chiyani?

Dzina lakuti 'Daisy baby' ndi dzina lina la mwana yemwe ali ndi TTTS. Bungwe la Twin-to-Twin Transfusion Syndrome (TTTS) Foundation linayamba kugwiritsa ntchito dzinali. Dzinali linayamba pambuyo poti woyambitsa wake anabzala mbewu za daisy m'munda mwawo ndi ana ake aamuna amapasa omwe anatsala. Munda wa daisy ndi chizindikiro cha chiyembekezo chakuti mwana aliyense amene akudwala TTTS adzapulumuka.

Pomaliza, chinthu chofunika kwambiri! (Uthenga Wopita Nawo Kunyumba)

Kupeza matenda a Twin-to-Twin Transfusion Syndrome (TTTS) kungakhale koopsa. N'zachibadwa kukhala ndi mantha komanso nkhawa ndi zomwe zikubwera kwa inu ndi mapasa anu. Lankhulani ndi dokotala wanu za njira zabwino kwambiri zochiritsira matenda anu. Funsani thandizo kwa anzanu ndi abale anu pamene mimba yanu ikupita patsogolo. Kulowa nawo gulu lothandizira mabanja omwe adakumana ndi TTTS kungakhalenso njira yabwino yokuthandizani paulendowu. Kumbukirani, simuli nokha. Ndi upangiri woyenera wachipatala komanso chithandizo, mudzatha kuthana ndi vutoli mwachindunji!

Matenda a Kuika Mapazi Awiri , TTTS, mapasa, mimba, placenta, madzi amniotic, monochorionic