Ngaba unawo amawele? Ngaba uyazi ngale meko iyingozi? (Twin-to-Twin Transfusion Syndrome - TTTS)

Ukuba ungumama okhulelweyo, okokuqala, ndiyakuhalalisela! Nangona kunjalo, kubalulekile ukuqaphela iimeko ezikhethekileyo ezinokubakho ngamanye amaxesha ekukhulelweni kwamawele. Enye yezi meko ingalindelekanga kodwa kufanelekile ukuyazi yiTwin -to-Twin Transfusion Syndrome , eyaziwa ngokuba yiTTTS ngamafutshane. Ungakhathazeki, masithethe ngayo ngokulula.

Yintoni i-Twin-to-Twin Transfusion Syndrome (TTTS)? Ngamafutshane...

Khawucinge ukuba amawele amabini esibelekweni sakho abelana nge-placenta efanayo . Siwabiza la mawele ngokuthi (amawele e-monochorionic) . Ngokwesiqhelo, zombini iintsana zifumana igazi elifanayo kunye nezondlo ezivela kule placenta. Nangona kunjalo, kule meko (TTTS), ukwahlukana akwenzeki kakuhle.

Ngamafutshane, umntwana omnye (masimbize ngokuthi 'liwele elinikelayo' ) akafumani gazi laneleyo kwi-placenta. Omnye umntwana (masimbize ngokuthi 'liwele elifumanayo' ) ufumana igazi elininzi kakhulu. Oku kungalingani kokuhamba kwegazi yikona okubangela i-TTTS. Le yimeko engaqhelekanga kodwa enokuba yingozi. Ukuhlolwa ngokusondeleyo yingcali ye-Maternal-Fetal Medicine (MFM) kubalulekile. Ukufunyanwa kwangoko, ukubekwa esweni, kunye nonyango kunokukhokelela kwiziphumo ezingcono kuzo zombini iintsana.

Kwenzeka ntoni 'kwiwele elinikelayo'?

Umntwana ufumana igazi elincinci kwi-placenta. Ngoko ke, inani legazi emzimbeni wakhe nalo liyancitshiswa. Oku kunokubangela ukuba umntwana akhule kancinci, kwaye inani le -amniotic fluid elimjikelezileyo nalo linokuncipha. Oku kungenxa yokuba umntwana uchama kancinci. Oku kungenxa yokuba i-amniotic fluid yenziwe kakhulu ngumchamo womntwana. Xa i-amniotic fluid incipha, ingxowa ebambe umntwana inokuncipha, okanye inyamalale. Oku kuyingozi, kuba umntwana akanakushukuma kakuhle, kwaye intambo yesisu inoxinzelelo.

Kwenzeka ntoni 'kwiwele elifumanayo'?

Lo mntwana ufumana igazi elingaphezulu kunokuba kufanele. Eli gazi lingaphezulu libeka uxinzelelo olukhulu entliziyweni yomntwana, kwaye linokukhokelela ekuphelelweni yintliziyo . Xa umzimba womntwana onikelayo ungondlekanga, umzimba womntwana ofumanayo kufuneka usebenze nzima. Ngenxa yokuba lo mntwana kufuneka acubungule igazi elingaphezulu, uchama ngaphezu kwesiqhelo. Ngenxa yoko, ingxowa yakhe ye-amniotic iba nkulu kakhulu.

Le meko (TTTS) ichaphazela bani?

I-TTTS ichaphazela kuphela ukukhulelwa apho amawele abelana nge-placenta enye (i-monochorionic) , kwaye ajongeka efana (amawele afanayo). Amaxesha amaninzi, la mawele ane-TTTS aneengxowa ezimbini ze-amniotic ezahlukeneyo (i-diamniotic). Siwabiza la mawele ngokuthi (amawele e-monochorionic diamniotic) .

Nangona kunjalo, kunqabile kakhulu, kukho iimeko apho abantwana ababini babelana nge-placenta efanayo kunye ne-amniotic sac (i-monoamniotic). Kwimeko ezinjalo, i-TTTS nayo inokwenzeka. Nangona kunjalo, amawele anjalo anqabile kakhulu.

I-TTTS inokwenzeka emva kwexesha elingakanani xa ukhulelwe?

Le meko idla ngokuqala ukubonakala kwangethuba kwiiveki ezili-16, kodwa inokwenzeka nangaliphi na ixesha ngexesha lokukhulelwa.

Ixhaphake kangakanani (i-TTTS)?

I-TTTS yenzeka kwi -15% yokukhulelwa kwamawele angama-monochorionic.

Zithini iimpawu ze-TTTS?

Uninzi loomama abane-TTTS abanazo naziphi na iimpawu ezithile. Nangona kunjalo, abanye banokufumana oku kulandelayo:

• Ukuziva ngathi isibeleko sikhula ngokukhawuleza kunokuba bekulindelwe.
• Ukuva intlungu okanye ukuxinana esiswini.
• Ukunyuka kwesisindo ngequbuliso.

Ukuba unale mpawu, kufuneka ubone ugqirha wakho ngoko nangoko.

Yintoni ebangela i-TTTS?

Ngokwesiqhelo, xa ukhulelwe amawele ane-placenta enye, zombini iintsana zabelana ngegazi elifanayo elivela kwi-placenta. Nangona kunjalo, kwi-TTTS, indlela imithambo yegazi ekwi-placenta edibene ngayo ibangela ukuba igazi lahlulwe ngokungalinganiyo. Umntwana omnye (umntwana owamkelayo) ufumana igazi elingakumbi, kwaye omnye umntwana (umntwana onikelayo) ufumana igazi elincinci.

Awunakulawula indlela i-placenta ekhula ngayo. (TTTS) sisiganeko esingacwangciswanga. Asinto oyenzileyo okanye ongayenzanga. Ngoko ke ungazibeki tyala. (TTTS) ayinakuthintelwa.

Ngubani osengozini ye (TTTS)?

Oku akunalo unxibelelwano lwemfuza okanye ilifa. Yinto eyenzeka ngokungacwangciswanga. Nangona kunjalo, oku kunokwenzeka kuphela kumamawele akhulelweyo abelana nge-placenta enye (i-monochorionic) .

Ziziphi iingxaki ezinokubakho ze-TTTS?

Ukuba ayinyangwa, okanye ukuba imeko ikhula kwangethuba kakhulu ekukhulelweni, i-TTTS inokubangela iingxaki zempilo ezinzulu kumntwana, kwaye inokubulala. Ke ngoko, kubalulekile ukufuna unyango okanye ukubekwa esweni ngokusondeleyo kwingcali yamayeza oomama nosana (ingcali ye-MFM) okanye kwiziko lokunyamekela umntwana ongekazalwa. Nokuba unyango lukhawulezileyo, kukho umngcipheko wokuphuma kwesisu.

Ezinye iingxaki ezinokwenzeka rhoqo nge-TTTS ziquka:

• Iingxaki zokuzalwa ngaphambi kwexesha (ezifana nobunzima bokuphefumla, iingxaki zenkqubo yemithambo-luvo).
• Iwele elamkelayo lisenokuba nesifo sentliziyo okanye ezinye iingxaki zentliziyo ngenxa yolwelo olongezelelweyo.
• Iwele elinikelayo lisenokuba neengxaki zokukhula okanye zezintso.

Ifunyaniswa njani i-TTTS?

Ugqirha wakho uza kuxilonga i-TTTS nge-ultrasound scan . Into yokuqala ugqirha aza kuyibona kwi-scan kukuba kukho amawele amabini afanayo abelana nge-placenta efanayo.

Ukuba kurhanelwa ukuba i-TTTS inokuba nayo, ugqirha wakho unokukuthumela kwingcali yamayeza oomama abakhulelweyo (ingcali ye-MFM) ukuze ivavanywe ngakumbi.Apho, ingcali iya kubona enye okanye ezingaphezulu kwezi zinto kwi-ultrasound scan:

• Umahluko ngobukhulu phakathi kwabantwana ababini.
• Omnye umntwana unolwelo lwe-amniotic oluninzi kakhulu, ngelixa omnye umntwana enolwelo lwe-amniotic oluncinci kakhulu.
• Ukungahambi kakuhle kwegazi kwiintsana (oku kunokubonwa ngovavanyo lwe-Doppler ultrasound ).

Kwezinye iimeko, uvavanyo lwe-MRI ye-fetal (magnetic resonance imaging) kunye ne-echocardiography ye-fetal (echo) nazo zinokuba yimfuneko.

Iqela lakho lonyango lwangaphambi kokukhulelwa liza kukubeka esweni ngokusondeleyo kulo lonke ixesha lokukhulelwa kwakho. Kusenokufuneka ukuba wenze ii-ultrasound scans rhoqo ukuze kuhlolwe impilo yomntwana.

Ugqirha uza kujonga nempilo yakho. Ngamanye amaxesha, ukwanda kolwelo lwe-amniotic kwicala lomntu ofumana isibeleko kunokubangela ukuba isibeleko sakho sande kwaye umlomo wesibeleko sakho ube buthathaka. Olu tshintsho lunokubangela ukuba ubeleke ngaphambi kwexesha.

Zithini izigaba ze (TTTS)?

I-ultrasound scan ivavanya ubukhali bemeko (TTTS), oko kukuthi, inqanaba ekulo. Oku kuvumela ugqirha ukuba abone indlela imeko eqhubeka ngayo aze acebise iindlela zonyango ezilungileyo.

Kukho amanqanaba amahlanu e-TTTS:

• Inqanaba loku-1: Kukho ulwelo lwe-amniotic oluncinci kakhulu okanye alukho kwaphela olujikeleze umntwana onikelweyo. Kudla ngokubakho ulwelo lwe-amniotic oluninzi kakhulu olujikeleze umntwana ofumanayo.
• Inqanaba lesi-2: Isinyi somntwana onikelayo asibonakali kwi-ultrasound. Oku kuthetha ukuba umntwana onikelayo uyekile ukuchama ngokuqhelekileyo.
• Inqanaba lesi-3: Kukho ukungalingani okukhulu ekuhambeni kwegazi phakathi kweentsana. Oku kunokuchaphazela ukusebenza kwentliziyo yomntwana omnye.
• Inqanaba lesi-4: Usana olunye okanye bobabini babonisa iimpawu zokudumba kwesikhumba okanye umzimba.
• Inqanaba lesi-5: Usana olunye okanye bobabini baswelekile.

Kwinqanaba loku-1 (i-TTTS), ukuqwalasela kuphela kunokwanela. Nangona kunjalo, ukuba imeko iba mandundu, inokwenzeka ngokukhawuleza kakhulu. Emva kwenqanaba lesi-2 (i-TTTS), ukuba ukukhulelwa kwakho kungaphantsi kweeveki ezingama-26, utyando losana olungekazalwa ludla ngokucetyiswa.

Ziziphi iindlela zonyango (TTTS)?

Unyango luxhomekeke ekubeni ukhulelwe ixesha elingakanani kwaye ukwinqanaba elingakanani le-TTTS.

• Ukujonga nokubeka esweni: Ugqirha wakho uza kujonga ngokusondeleyo ukukhulelwa kwakho nge-ultrasound scans. Olu lukhetho ukuba unesigaba 1 (TTTS) okanye ukuba kukho izizathu zokuba utyando okanye olunye unyango lungenzeki.
• I-Septostomy: Oku kuquka ukwenza umngxuma omncinci kwi-membrane phakathi kweengxowa ze-amniotic zeentsana ezimbini. Oku kunokulinganisa uxinzelelo kuzo zombini iingxowa ze-amniotic. Oku akunabungozi kangako, kodwa akunyanga unobangela we-TTTS.
• Ukunciphisa i-Amniore:Kule nkqubo, ugqirha usebenzisa inaliti encinci, engenanto ukususa ulwelo lwe-amniotic olugqithisileyo kwisingxobo somntwana ofumana umntwana. Ugqirha wakho unokucebisa oku kwinqanaba loku-1 (i-TTTS) okanye kwiimeko ezinzima ze-TTTS kamva ekukhulelweni. Le nkqubo ayinyangi unobangela oyintloko we-TTTS, ngoko ke ukuba ulwelo lwe-amniotic luyanda kwakhona, kunokufuneka lwenziwe amaxesha amaninzi.
• Ukususwa kwe-laser ye-fetoscopic: Le nkqubo ibandakanya ukudluliselwa kwekhamera encinci (i-fetoscope) esibelekweni kunye nokusebenzisa umqadi we-laser ukuvala imithambo yegazi kumphezulu we-placenta ebangela ukuhamba kwegazi okungalinganiyo phakathi kweentsana. Injongo yale nkqubo kukutshintsha ukuhamba kwegazi ukusuka kolunye usana ukuya kolunye, ukuze umntwana ngamnye abe negazi elahlukileyo. Olu lukhetho lwesigaba sesi-2 okanye ngaphezulu (i-TTTS) kunye nokukhulelwa phakathi kweeveki ezili-16 nezingama-26.
• Ukuvalelwa kwentambo ye-umbilical: Le yindlela yokugqibela ugqirha wakho anokuyicebisa xa zombini iintsana zingenakusindiswa, okanye xa olunye usana lukwimeko esongela ubomi. Olu tyando luthintela ukuhamba kwegazi kolunye usana, nto leyo enika olunye usana ithuba elihle lokusinda.
• Ukuzalwa: Ukuba umntwana udlulile kwiminyaka yokukhulelwa, ugqirha angacebisa ukuba azelwe.

Iqela lakho lezonyango liza kukunceda ukhethe unyango olukulungeleyo. Liza kuphendula yonke imibuzo yakho lize lithethe nawe malunga neengozi, iingenelo, kunye nezinye iindlela zonyango ngalunye.

Ilawulwa njani i-TTTS?

Umboneleli wakho wezempilo, kunye nengcali yamayeza oomama nosana (ingcali ye-MFM), baya kujonga ngokusondeleyo ukukhulelwa kwakho. Uya kwenziwa ii-ultrasound scans rhoqo (mhlawumbi kube kanye okanye kabini ngeveki), kwaye unokufuna nokuhlolwa kwe-echocardiogram ye-fetal ngexesha lokukhulelwa kwakho. Iqela lakho lokhathalelo liza kukunika inkxaso yezonyango neyeemvakalelo kulo lonke ixesha lokukhulelwa kwakho.

Ndingalindela ntoni ukuba oku kunjalo?

Isiphumo sixhomekeke ekubeni ukhulelwe ixesha elingakanani na kwaye imeko imbi kangakanani (inqanaba). Ngokuhambela phambili kwisayensi yezonyango, ukubekwa esweni ngokusondeleyo kunye nonyango kwangethuba kunokunika zombini iintsana ithuba elingcono lokusinda. Thetha nogqirha wakho malunga nolindelo kunye neziphumo ezinokubakho ukuze uqonde indlela i-TTTS eya kuyichaphazela ngayo ukukhulelwa kwakho kunye nosana lwakho. Amawele amaninzi asaphilayo kufuneka ahlale kwi-NICU (iYunithi yoKhathalelo oluNzulu lweZingane eziSandula ukuzalwa) ixesha elifutshane emva kokuzalwa ukuze aqalise ukukhulelwa kwawo.

(TTTS) inokuba ngamava abangela uxinezeleko olukhulu ngokweemvakalelo. Khumbula ukuzinyamekela kwaye ucele inkxaso kwiqela lakho lezempilo, iqabane lakho kunye nabahlobo.

Ingakanani izinga lokusinda kwi (TTTS)?

Amanqanaba okusinda axhomekeke ekubeni i-TTTS inzima kangakanani, ukuba uxilongwe nini, nokuba ufumana unyango na. Ukufumana unyango olufanelekileyo kunokwenza umahluko omkhulu kwizinga lakho lokusinda nge-TTTS:

• Malunga nama-90% amawele afunyaniswe ene-TTTS enzima kwasekuqaleni kokukhulelwa asengozini yokufa ngaphambi kokuzalwa (ukuba ayenganyangwa).
• Phakathi kwama-85% nama-90% okukhulelwa okunyangiweyo (TTTS) kubangela ukuba ubuncinane umntwana omnye asinde.
• Phakathi kwama-50% nama-65% okukhulelwa okunyangiweyo (TTTS), zombini iintsana ziyasinda.

Ngenxa yokuba zininzi izinto ezichaphazela ukusinda, thetha neqela lakho lokhathalelo malunga noqikelelo lomntwana wakho.

Yeyiphi imibuzo endifanele ndiyibuze iqela lam lezempilo?

Eminye imibuzo onokuyibuza:

• Ukukhulelwa kwam kwahluke njani ekukhulelweni kwamawele ngaphandle kwe-TTTS?
• Ngaba kuza kufuneka ndidibane nogqirha wezifo zengqondo? Ngubani okwiqela lam lokhathalelo?
• Kuza kufuneka ndihlolwe kangaphi okanye kwenziwe ezinye iimvavanyo?
• (TTTS) iza kuzichaphazela njani izicwangciso zam zokuzalwa?
• Ngaba ndiza kuva naluphi na utshintsho emzimbeni wam ngenxa ye-TTTS? Ukuba kunjalo, ndimele ndilindele ntoni?
• Luluphi unyango olucebisayo ngemeko yam? Ngoba?
• Zeziphi iindlela zokuphila (ezifana nokutya, ukuzilolonga, ukuphumla, unyango) ozicebisayo ukuxhasa impilo yam?

Yintoni le 'Daisy Baby'?

Igama elithi 'Daisy baby' lelinye igama lomntwana one-TTTS. I-Twin-to-Twin Transfusion Syndrome (TTTS) Foundation yaqala ukusebenzisa eli gama. Eli gama lavela emva kokuba umsunguli wayo etyale imbewu ye-daisy emyezweni wabo kunye noonyana bakhe abangamawele abasindileyo. Igadi ye-daisy luphawu lwethemba lokuba wonke umntwana onesifo se-TTTS uza kusinda.

Okokugqibela, eyona nto ibalulekileyo! (Umyalezo oya nawo ekhaya)

Ukufumana uxilongo lwe-Twin-to-Twin Transfusion Syndrome (TTTS) kunokuba ngamava othusayo. Kuqhelekile ukuziva usoyika kwaye uxhalabile malunga nento eza kwenzeka kuwe nakumawele akho. Thetha nogqirha wakho malunga neendlela zonyango ezilungileyo kwimeko yakho. Funa inkxaso kubahlobo nakusapho njengoko ukukhulelwa kwakho kuqhubeka. Ukujoyina iqela lenkxaso kwiintsapho eziye zafumana i-TTTS kunokuba yindlela entle yokukunceda kulo lonke olu hambo. Khumbula, awuwedwa. Ngeengcebiso zonyango ezifanelekileyo kunye nenkxaso, uya kukwazi ukujongana nalo mngeni ngqo!

Isifo sokudluliselwa kweTwin -to-Twin Transfusion Syndrome, i-TTTS, amawele, ukukhulelwa, i-placenta, ulwelo lwe-amniotic, i-monochorionic