Ingabe unamawele? Uyazazi lezi zimo eziyingozi? (I-Twin-to-Twin Transfusion Syndrome - TTTS)

Uma ungumama okhulelwe, okokuqala, halala! Kodwa-ke, kubalulekile futhi ukuqaphela izimo ezikhethekile ezingase zenzeke ngezinye izikhathi ekukhulelweni kwamawele. Esinye isimo esinjalo esingalindelekile kodwa okufanele sisazi yi -Twin-to-Twin Transfusion Syndrome , eyaziwa nangokuthi i-TTTS ngamafuphi. Ungakhathazeki, ake sixoxe ngakho kalula.

Kuyini i-Twin-to-Twin Transfusion Syndrome (TTTS)? Kalula nje...

Cabanga ukuthi amawele amabili esibelethweni sakho abelana nge-placenta efanayo . Siwabiza ngokuthi amawele (amawele e-monochorionic) . Ngokuvamile, womabili abantwana athola igazi elifanayo kanye nezakhamzimba ezivela kule placenta. Kodwa-ke, kulokhu (TTTS), lokho kuhlukana akwenzeki kahle.

Kalula nje, ingane eyodwa (masiyibize ngokuthi 'iwele elinikelayo' ) ayitholi igazi elanele elivela ku-placenta. Enye ingane (masiyibize ngokuthi 'iwele elitholayo' ) iba ningi kakhulu. Lokhu kungalingani kokugeleza kwegazi yikho okubangela i-TTTS. Lesi yisimo esingavamile kodwa esingaba yingozi. Ukuqapha eduze kochwepheshe beMithi Yomama Nengane (i-MFM) kubalulekile. Ukutholwa kusenesikhathi, ukuqapha, kanye nokwelashwa kungaholela emiphumeleni engcono kuzo zombili izingane.

Kwenzekani 'kwiwele elinikelayo'?

Ingane ithola igazi elincane elivela ku-placenta. Ngakho-ke, inani legazi emzimbeni wayo nalo liyancishiswa. Lokhu kungabangela ukuthi ingane ikhule kancane, kanti nenani le -amniotic fluid elizungezile nalo lingancipha. Lokhu kungenxa yokuthi ingane ichama kancane. Lokhu kungenxa yokuthi i-amniotic fluid yakhiwe kakhulu ngomchamo wengane. Lapho i-amniotic fluid yehla, isikhwama esibamba umntwana singancipha, noma sinyamalale. Lokhu kuyingozi, ngoba ingane ayikwazi ukunyakaza kahle, futhi intambo yesisu ingase icindezelwe.

Kwenzekani 'kwiwele elitholayo'?

Lo mntwana uthola igazi eliningi kunalokho okufanele. Leli gazi elengeziwe libeka ukucindezeleka okukhulu enhliziyweni yomntwana, futhi lingaholela nasekuhlulekeni kwenhliziyo . Lapho umzimba womntwana onikelayo ungondlekile kahle, umzimba womntwana otholayo kufanele usebenze kanzima. Ngenxa yokuthi lo mntwana kufanele acubungule igazi eliningi, uchama kakhulu kunokujwayelekile. Ngenxa yalokho, isikhwama sakhe se-amniotic siba sikhulu kakhulu.

Lesi simo (i-TTTS) sithinta bani?

I-TTTS ithinta kuphela ukukhulelwa lapho amawele abelana khona nge-placenta eyodwa (i-monochorionic) , futhi abukeka afana (amawele afanayo). Ngokuvamile, la mawele ane-TTTS anezikhwama ezimbili ezihlukene ze-amniotic (i-diamniotic). Sibiza la mawele ngokuthi (amawele e-monochorionic diamniotic) .

Kodwa-ke, akuvamile kakhulu, kunezimo lapho izingane ezimbili zabelana khona nge-placenta efanayo kanye ne-amniotic sac (i-monoamniotic). Ezimweni ezinjalo, i-TTTS nayo ingenzeka. Kodwa-ke, amawele anjalo awavamile kakhulu.

I-TTTS ingaba sekwephuzile kangakanani ekukhulelweni?

Lesi simo ngokuvamile singaqala ukukhula emavikini angu-16, kodwa singavela nganoma yisiphi isikhathi ngesikhathi sokukhulelwa.

Kuvamile kangakanani (i-TTTS)?

I-TTTS yenzeka cishe ku-15% wokukhulelwa kwamawele angama-monochorionic.

Ziyini izimpawu ze-TTTS?

Iningi lomama abane-TTTS alinazo izimpawu ezithile. Kodwa-ke, abanye bangase babe nalokhu:

• Ukuzizwa sengathi isibeletho sikhula ngokushesha kunalokho obekulindelwe.
• Ukuzwa ubuhlungu noma ukuqina esiswini.
• Ukukhuluphala okungazelelwe.

Uma unalezi zimpawu, kufanele ubonane nodokotela wakho ngokushesha.

Yini ebangela i-TTTS?

Ngokuvamile, ekukhulelweni kwamawele nge-placenta eyodwa, bobabili abantwana babelana ngenani elifanayo legazi elivela kwi-placenta. Kodwa-ke, ku-TTTS, indlela imithambo yegazi e-placenta exhumene ngayo ibangela ukuthi igazi lihlukaniswe ngokungalingani. Umntwana oyedwa (umntwana owamukelayo) uthola igazi eliningi, kanti omunye umntwana (umntwana onikelayo) uthola igazi elincane.

Awukwazi ukulawula indlela i-placenta ekhula ngayo. (TTTS) yisenzakalo esingahleliwe. Akuyona into oyenzile noma ongayenzanga. Ngakho ungazibeki icala. (TTTS) ayinakuvinjelwa.

Ubani osengozini yokuthola (i-TTTS)?

Lokhu akunasixhumanisi sofuzo noma sofuzo. Kuyisenzakalo esingahleliwe. Kodwa-ke, lokhu kungenzeka kuphela ekukhulelweni kwamawele abelana nge-placenta eyodwa (i-monochorionic) .

Yiziphi izinkinga ezingaba khona ze-TTTS?

Uma ingelashwa, noma uma lesi simo siqala ekuqaleni kokukhulelwa, i-TTTS ingadala izinkinga ezinkulu zempilo enganeni, futhi ingabulala ngisho nokufa. Ngakho-ke, kubalulekile ukufuna ukwelashwa noma ukuqapha eduze kochwepheshe bezokwelapha komama nomntwana (uchwepheshe we-MFM) noma isikhungo sokunakekelwa komntwana. Ngisho nangokwelashwa okusheshayo, kunengozi yokuphuphuma kwesisu.

Ezinye izinkinga ezingase zenzeke nge-TTTS zifaka:

• Izinkinga zokuzalwa ngaphambi kwesikhathi (njengobunzima bokuphefumula, izinkinga zesimiso sezinzwa).
• Iwele elitholayo lingase libe nokwehluleka kwenhliziyo noma ezinye izinkinga zenhliziyo ngenxa yoketshezi olwengeziwe.
• Iwele elinikelayo lingase libe nezinkinga zokukhula noma zezinso.

I-TTTS itholakala kanjani?

Umhlinzeki wakho wokunakekelwa kwangaphambi kokubeletha uzoxilonga i-TTTS nge-ultrasound scan . Into yokuqala udokotela azoyibona ku-scan ukuthi kunamawele amabili afanayo abelana nge-placenta efanayo.

Uma kusolwa ukuthi i-TTTS inesifo, udokotela wakho angakudlulisela kuchwepheshe wezokwelapha umama nomntwana (uchwepheshe we-MFM) ukuze ahlolwe okwengeziwe.Lapho, uchwepheshe uzobona eyodwa noma ngaphezulu yalezi zinto ku-ultrasound scan:

• Umehluko ngobukhulu phakathi kwalezi zingane ezimbili.
• Ingane eyodwa inoketshezi oluningi kakhulu lwe-amniotic, kanti enye inoketshezi oluncane kakhulu lwe-amniotic.
• Ukuphazamiseka kokugeleza kwegazi ezinganeni (lokhu kungabonakala ngokuhlolwa kwe-Doppler ultrasound ).

Kwezinye izimo, ukuhlolwa kwe-fetal MRI (magnetic resonance imaging) kanye ne-fetal echocardiography (echo) nakho kungadingeka.

Ithimba lakho lokunakekelwa kwangaphambi kokubeletha lizokuqapha eduze phakathi nokukhulelwa kwakho. Kungase kudingeke ukuthi uhlolwe njalo nge-ultrasound ukuze uhlole impilo yomntwana.

Udokotela uzohlola nempilo yakho. Ngezinye izikhathi, ukwanda koketshezi lwe-amniotic ohlangothini lomamukeli kungabangela ukuthi isibeletho sakho sikhule futhi umlomo wesibeletho sakho ube buthaka. Lezi zinguquko zingaholela nasekuzalweni ngaphambi kwesikhathi.

Yiziphi izigaba ze-(TTTS)?

I-ultrasound scan ihlola ubukhali besimo (TTTS), okungukuthi, isigaba esikuso. Lokhu kuvumela udokotela ukuthi abone ukuthi isimo siqhubeka kanjani futhi ancome izindlela zokwelapha ezingcono kakhulu.

Kunezigaba ezinhlanu ze-TTTS:

• Isigaba 1: Kuncane kakhulu noma akukho nhlobo uketshezi lwe-amniotic oluzungeze umntwana onikelwe. Ngokuvamile kuba noketshezi lwe-amniotic oluningi kakhulu oluzungeze umntwana otholelwe lona.
• Isigaba sesi-2: Isinye somntwana onikelayo asibonakali ku-ultrasound. Lokhu kusho ukuthi umntwana onikelayo useyekile ukuchama ngendlela evamile.
• Isigaba 3: Kukhona ukungalingani okukhulu ekugelezeni kwegazi phakathi kwezingane. Lokhu kungathinta ukusebenza kwenhliziyo yomntwana oyedwa.
• Isigaba 4: Umntwana oyedwa noma bobabili babonisa izimpawu zokuvuvukala kwesikhumba noma komzimba.
• Isigaba 5: Ingane eyodwa noma zombili sezishonile.

Esigabeni 1 (TTTS), ukubheka kuphela kunganele. Kodwa-ke, uma isimo siba sibi kakhulu, kungenzeka ngokushesha okukhulu. Ngemva kwesigaba 2 (TTTS), uma ukukhulelwa kwakho kungaphansi kwamasonto angama-26, ukuhlinzwa kombungu kuvame ukunconywa.

Yiziphi izindlela zokwelapha (TTTS)?

Ukwelashwa kuncike ekutheni usukhulile kangakanani ekukhulelweni kwakho nokuthi ukusiphi isigaba se-TTTS.

• Ukuqaphela nokuqapha: Udokotela wakho uzokuqapha ngokucophelela ukukhulelwa kwakho ngokuskena nge-ultrasound. Lokhu kuyindlela uma unesigaba 1 (TTTS) noma uma kunezizathu zokuthi kungani ukuhlinzwa noma ezinye izindlela zokwelapha zingenakwenzeka.
• I-Septostomy: Lokhu kuhilela ukwenza imbobo encane olwelwesini phakathi kwezikhwama ze-amniotic zezingane ezimbili. Lokhu kungalinganisa ingcindezi kuzo zombili izikhwama ze-amniotic. Lokhu akunangozi kangako, kodwa ayelaphi imbangela eyinhloko ye-TTTS.
• Ukususwa kwe-Amniore:Kule nqubo, udokotela usebenzisa inaliti encane, engenalutho ukususa uketshezi lwe-amniotic oluningi esikhwameni somntwana otholayo. Udokotela wakho angancoma lokhu esigabeni 1 (TTTS) noma ezimweni ezimbi kakhulu ze-TTTS kamuva ekukhulelweni. Le nqubo ayilaphi imbangela eyinhloko ye-TTTS, ngakho-ke uma uketshezi lwe-amniotic lukhula futhi, kungadingeka ukuthi lwenziwe izikhathi eziningana.
• Ukususwa kwe-laser ye-fetoscopic: Le nqubo ihilela ukudlulisa ikhamera encane (i-fetoscope) esibelethweni nokusebenzisa umsebe we-laser ukuvala imithambo yegazi ebusweni be-placenta ebangela ukugeleza kwegazi okungalingani phakathi kwezingane. Umgomo wale nqubo ukushintsha ukugeleza kwegazi kusuka komntwana oyedwa kuya komunye, ukuze umntwana ngamunye abe negazi elihlukile. Lokhu kuyindlela yesigaba sesi-2 noma ngaphezulu (i-TTTS) kanye nokukhulelwa phakathi kwamasonto ayi-16 nama-26.
• Ukuvaleka kwentambo ye-umbilical: Lena inqubo yokugcina udokotela wakho angase ayincome lapho zombili izingane zingenakusindiswa, noma lapho ingane eyodwa isesimweni esisongela ukuphila. Lokhu kuhlinzwa kuvimbela ukugeleza kwegazi kumntwana oyedwa, okunikeza enye ingane ithuba elihle lokusinda.
• Ukubeletha: Uma umntwana esedlulile eminyakeni yokukhulelwa efanele, udokotela angase ancome ukubeletha.

Ithimba lakho lezokunakekelwa kwempilo lizokusiza ukhethe ukwelashwa okukulungele. Lizophendula yonke imibuzo yakho futhi likhulume nawe ngezingozi, izinzuzo, kanye nezinye izindlela zokwelapha.

Iphathwa kanjani i-TTTS?

Umhlinzeki wakho wezempilo, kanye nochwepheshe wezokwelapha umama nomntwana (uchwepheshe we-MFM), bazoqapha ngokucophelela ukukhulelwa kwakho. Uzoba nezikrini ze-ultrasound njalo (mhlawumbe kanye noma kabili ngesonto), futhi kungadingeka ukuthi uhlolwe i-echocardiogram yengane ngesikhathi sokukhulelwa kwakho. Ithimba lakho lokunakekela lizokunikeza ukwesekwa kwezokwelapha nokwemizwa phakathi nokukhulelwa kwakho.

Yini okufanele ngiyilindele uma kunjalo?

Umphumela uncike ekutheni usukhulile kangakanani ekukhulelweni kwakho lapho uxilongwa nokuthi isimo sibi kangakanani (isigaba). Ngokuthuthuka kwesayensi yezokwelapha, ukuqapha eduze kanye nokwelashwa kwasekuqaleni kunganikeza zombili izingane ithuba elingcono lokusinda. Khuluma nodokotela wakho mayelana nokulindela kanye nemiphumela engaba khona ukuze uqonde ukuthi i-TTTS izokuthinta kanjani ukukhulelwa kwakho kanye nomntwana wakho. Amawele amaningi asindayo adinga ukuhlala e-NICU (i-Neonatal Intensive Care Unit) isikhathi esifushane ngemva kokuzalwa ukuze aqale kahle.

(TTTS) kungaba yinto ethinta kakhulu ngokomzwelo futhi ecindezelayo. Khumbula ukuzinakekela futhi ufune ukwesekwa eqenjini lakho lezempilo, umlingani wakho, kanye nabangani bakho.

Lingakanani izinga lokusinda ku-(TTTS)?

Amazinga okusinda ancike ekutheni i-TTTS inzima kangakanani, ukuthi uxilongwa nini, nokuthi uthola ukwelashwa yini. Ukuthola ukwelashwa okufanele kungenza umehluko omkhulu ezingeni lakho lokusinda nge-TTTS:

• Cishe amawele angu-90% atholakale ene-TTTS enzima kakhulu ekuqaleni kokukhulelwa asengozini yokufa ngaphambi kokuzalwa (uma engelashwa).
• Phakathi kuka-85% no-90% wokukhulelwa okwelashwayo (i-TTTS) kuphumela ekutheni okungenani ingane eyodwa isinde.
• Phakathi kuka-50% no-65% wokukhulelwa okwelashwayo (TTTS), zombili izingane ziyasinda.

Ngenxa yokuthi ziningi izinto ezithinta ukusinda, khuluma nethimba lakho lokunakekela mayelana nokubikezelwa kwengane yakho.

Yimiphi imibuzo okufanele ngiyibuze ithimba lami lezempilo?

Eminye imibuzo ongayibuza:

• Ukukhulelwa kwami ​​kuhluke kanjani ekukhulelweni kwamawele ngaphandle kwe-TTTS?
• Ingabe kuzodingeka ngibone uchwepheshe? Ubani oseqenjini lami lokunakekela?
• Kukangaki ngidinga ukwenza amaskeni noma ezinye izivivinyo?
• (TTTS) izothinta kanjani izinhlelo zami zokuzalwa?
• Ingabe ngizozwa noma yiluphi ushintsho emzimbeni wami ngenxa ye-TTTS? Uma kunjalo, yini okufanele ngiyilindele?
• Yikuphi ukwelashwa okuncomayo ngesimo sami? Kungani?
• Yimiphi imikhuba yokuphila (njengokudla, ukuzivocavoca, ukuphumula, nokwelapha) oyincomayo ukuze isekele impilo yami?

Iyini le 'Daisy Baby'?

Igama elithi 'Daisy baby' elinye igama lomntwana one-TTTS. I-Twin-to-Twin Transfusion Syndrome (TTTS) Foundation yaqala ukusebenzisa leli gama. Leli gama lavela ngemuva kokuba umsunguli wayo etshale imbewu ye-daisy engadini yabo namadodana akhe amawele asindile. Ingadi ye-daisy iwuphawu lwethemba lokuthi wonke umntwana ohlushwa yi-TTTS uzosinda.

Okokugcina, into ebaluleke kakhulu! (Umyalezo Wokuya Ekhaya)

Ukuthola ukuxilongwa kwe-Twin-to-Twin Transfusion Syndrome (TTTS) kungaba yinto eyesabekayo. Kuvamile ukuzizwa wesaba futhi ukhathazekile ngalokho okuzokwenzeka kuwe namawele akho. Khuluma nodokotela wakho ngezinketho zokwelapha ezingcono kakhulu zesimo sakho. Funa ukwesekwa kubangani nomndeni njengoba ukukhulelwa kwakho kuqhubeka. Ukujoyina iqembu lokusekela lemindeni eye yabhekana ne-TTTS kungaba yindlela enhle yokukusiza kulolu hambo. Khumbula, awuwedwa. Ngeseluleko sezokwelapha esifanele kanye nokusekelwa, uzokwazi ukubhekana nale nselele ngqo!

I- Twin-to-Twin Transfusion Syndrome, i-TTTS, amawele, ukukhulelwa, i-placenta, uketshezi lwe-amniotic, i-monochorionic