Ukukhulelwa okubini kuza neengozi, zombini unina kunye neentsana. Amanye amaMama athemba ukuba azalwe ngamawele okanye aphindwe ngokuphindaphindiweyo kwaye aza kuthatha amanyathelo asebenzayo ngexesha lonyango lokunyanga ukwenzela ukwandisa izigaba zabo . Amanye amaMama enza oko abakwaziyo ukuphepha ukukhulelwa amawele, kodwa esakhulelwa ngaphezu kwengane.
Ukuqonda ingozi yokukhulelwa kwamawele ngaphambi kokuba ukhulelwe kunokukunceda wenze izigqibo malunga nokunyanga kwakho .
Ngokomzekelo, ukuba ugqirha wakho unikezela ukutshintshisa ama-embryo amaninzi ngokubhekisele kwi-embryo enye ngexesha lonyango lwe-IVF , unokuba uzimisele ngakumbi ukuzama ukudluliselwa komzimba omnye (SET) ukuba uyazi ingozi yakho. (Okanye, ukuba ugqirha wakho akakwazi ukukhankanya SET, unokubuza ukuba ungumviwa olungileyo, kodwa kuphela ukuba uyazi zakho iinketho.)
Ukuqonda imingcipheko yokukhulelwa ngamawele emva kokuba sele usubele iwele, kubalulekile. Ngokomzekelo, unokuzifundisa kwimpawu kunye neempawu zentsuku zokuqala , kuba ukwazi ukuqala kokungcoliseka kuyingozi kuba namawele.
Ayikho ingozi yonke ikhuselekayo okanye ekulawuleni kwakho. Sekunjalo, ukwazi okumele ujongeyo kunokuncedisa ukunciphisa iindlobongela endleleni kunye nokwandisa ulwazi lwakho malunga neempawu ezinzima.
Ubungozi boMama Ngexesha lokukhulelwa kweTwin
Ukukhulelwa kwe-Twin akuyona nje ingozi kwiintsana, kodwa nakumama. Nangona kunjalo, ezininzi iingozi kumama nazo ziyingcipheko kubantwana abangazalwanga, kuba bangakhokelela ekusebenzeni kwangaphambili, iingxaki, okanye kwiimeko ezimbi kakhulu, ukufa komntwana.
Ezinye zezo mngcipheko ziyinkxalabo kunokuba yingozi ingozi, kanti abanye bangasongela ubomi xa beshiywa bengakhange baphathwe.
- Ukukhulelwa kwengcinezelo yenyongweni (PIH) kukunyuka kwengcinezelo yegazi ngexesha lokukhulelwa. Amanqaku angama-37% eemini ezikhulelweyo zibandakanya i-PIH, ephindwe kathathu ukuya kwesine kwizinga lokukhulelwa. Ukungaphendulwanga, kungakhokelela ekusebenzeni kwangaphambi komntwana , umntwana ongakhuli kakuhle , okanye umntwana osweleyo. Kungaba yingozi enkulu kwimpilo kamama, ingakumbi ukuba iqala ukuya kwi-preeclampsia.
- I-Preeclampsia yimeko equka zombini uxinzelelo lwegazi kunye neprotheyini emcini. Iimpawu zingabandakanya ukuvuvukala, intloko enzima, kunye nokufumana isisindo somzimba ngokukhawuleza. Kuphindwe kabili ukuza kwenzeka koomama beeplani. Ukuba ishiywe ingaphatywa, i-preeclampsia ingakhokelela ekutheni i-eclampsia, eyaziwa nangokuthi i-toxemia. I-Eclampsia ibangela ukuxhamla kwaye ingasongela ubomi kumama kunye nabantwana abangazalwa. Nangona unyango lwegazi kunye neyeza ze-anticonbulsant zingenza uzinze umama kwiimeko ezinzima, ngoko umntwana usenokuchitha ixesha elincinane kwisibeleko, kuphela ukunyanga kwe-preeclampsia ukuhanjiswa kwengane.
- Isifo sikashukela sesifo sikashukela yimeko apho umfazi, ongengesifo sikashukela ngaphambi kokukhulelwa, kunzima ukugcina amanqanaba eeshukela egazi. Isifo sikashukela sesifo sesifo sikashukela senzeka malunga no-5% wokukhulelwa komzimba, kodwa abafazi abakhulelweyo ngamawele bafumana kabini ukuba bafumane. Isifo sikashukela sesifo sikashukela sinokuphathwa ngokutya kunye neenguqu zokuphila.
- Oomama abakhulelweyo baninzi banokuhlangabezana neengxaki zokuphuma kwegazi ngaphambi okanye ngexesha lokunikezelwa.
- Ukugula kwasekuseni kakhulu kunokwenzeka kubafazi abakhulelwe ngamawele. Kweminye, le nto yinkxalabo kunokuba yingozi, kodwa abanye banokuphuhlisa i-hyperemesis gravidarum . I-Hyperemesis gravidarum kukugula okusa kusasa, okukhokelela ekulahlekeni kwe-5% kwisisindo somzimba kumama kwaye kungadinga ukuhlala esibhedlele.
- AmaMama amawele asemandleni okufumana iingxaki zesisu ngexesha lokukhulelwa, njengokuzibamba.
- Ukuba abasebenzi bexesha elide belisongela, ukukhulelwa okuphindaphindiweyo kunokufuna ukuphumla kokulala , oku kunokukhokelela ekudakaleni nasekulahlekeni komsebenzi.
- Ukuba kuqale ukusebenza komsebenzi , loo mfazi unokufuna ukuba athathe unyango ukuyeka umsebenzi kunye nokuvumela iintsana ixesha elithile kwisibeleko. Ezi zonyango zingaba nemiphumo emibi, ezinye zinyameko kwaye ezinye ziqine.
- Icandelo le-Caesarea linokuthi liphindwe ngokuphindaphindiweyo, ngenxa yenkcazo engathandekiyo (njengokuba umntwana oqalayo engakhangeli phantsi) okanye iingxaki, oku kuthetha ukubuyisela ixesha elide kumama emva kokuzalwa kunye nomngcipheko ophezulu weengxaki ngexesha lomsebenzi.
- Oomama abaninzi bafumana ithuba lokuva noxinzelelo lwentlungu.
Ingozi yabantwana Ngethuba lokukhulelwa kweTwin
Ukukhulelwa kwe-Twin kunomlinganiselo ophezulu wokukhulelwa kwesisu. Kwezinye iimeko, elinye iwele lihlehlise okanye "liphele," lishiye iwele eliphilayo. Oku kwaziwa nangokuthi i- Vanishing Twin Syndrome .
Amawele asemngciphekweni wokukhula kwe-intrauterine, apho iwele elinye likhula ngokukhawuleza kunomnye. Ngokukhulelwa okufana namabini okanye ukukhulelwa apho amawele abelana khona nge-placenta enye, oku kungabonakalisa isifo se -transfusion syndrome (i-TTTS) , apho elinye iwele lithatha ngaphezu kwesabelo sawo sokuphuma kwegazi ukusuka kwi-placenta. I-TTTS ivela kwi-10% ye- monochorionic pregnancy . Ukuba ishiywe ingaphendulwanga, i-TTTS enamandla ingakhokelela ekufeni kweentliziyo zentsana okanye ukufa kwesinye okanye amawele.
Amawele ayenzeka kakhulu ukuba abe nesisindo esiphantsi sokuzalwa, nangona bazalwa ngexesha. Amawele aphindaphinda avuke.
Umngcipheko wokuQala ukuQala
Ukukhulelwa kwe-Twwin kunomngcipheko ophezulu wokungabikho kokuqala, oku kuthetha ukuzalwa okwenzeka emva kweveki ezingama-20 kodwa ngaphambi kweveki ezingama-37. U-40% wama-twin ekukhulelwe ahamba ixesha elipheleleyo. Umlinganiselo wokukhulelwa we-twin iiveki ezingama-35, xa kuthelekiswa nokukhulelwa kwe-singleton, okuyieyure ezingama-39.
Ukuqhawuka kwangaphambili kunokukhokelela kwiinkalo ezininzi, kuquka:
- Iimiphunga ezingapheliyo, ezikhokelela ekuphefumuleni. Iintsana ezinokuqala zingagcinwa kwiindawo zokuqhubela umoya kuze kube yimiphunga ekhulile.
- Iingxaki zesisu kunye namathumbu emathumbu.
- Iingxaki zenkqubo yesifo, kuquka ukuphuma kwegazi kwingqondo.
- Isisindo sokuzalwa esincinane.
- Ukutya iingxaki, kubandakanya ubunzima bokuncelisa.
Ndiyabulela intuthuko kwezobuchwepheshe, i-90% yabantwana abazalwa emva kweiveki ezingama-28 ziphila. Nangona kunjalo, kwanentsana ephila kwi-prematurity inobungozi bexesha elide. Iingxaki zexesha elide lokungcoliswa kwangaphambili zingabandakanya:
- I-Bronchopulmonary dysplasia (BPD), imeko engapheliyo yemiphunga engadinga inkxaso yeoksijini kwiiveki okanye kwiinyanga emva kokuzalwa.
- Iingxaki zokuphefumula eziqhelekileyo, ezibandakanya amathuba angcono okuphucula i-asthma kunye nezifo zokuphefumula.
- Ukulibaziseka okuphuhlisayo.
- Ukukhubazeka kokufunda, nakwiimeko ezinzima, ukulibala. Oku kungabonakali iminyaka.
- Umvakalelo yokitazo.
- Ingxaki zo mbono.
- Ukulahleka kokuva.
Ukuzalwa kwangaphambi kokuqala kusenzima kubazali, abahamba noxinzelelo lokuba neentsana kwiNICU iintsuku, iiveki, okanye iinyanga, kuxhomekeke kwindlela ekuzalweni ngayo iintsana kwaye ziphi iingxaki ezenzekayo. Ukungakwazi ukuthatha umntwana wakho ekhaya kungakucasula kakhulu, kwaye ukubona umntwana wakho enamathele kwisixhobo se-NICU kunokukhathazeka.
Imithombo:
UDavid B. Schwartz, Yahya Daoud, uPauline Zazula, uGregory Goyert, uRichard Bronsteen, uDebra Wright, uJoanna Copes. Isifo sikashukela sesifo sesifo sikashukela: Iimpawu zegazi zamathambo kunye negazi. I-American Journal ye-Obstetrics ne-Gynecology . Umqulu 181, iNdaba 4, ngoOktobha 1999, iphepha 912-914.
Croft ML, Morgan V, Funda i-AW, uJablensky AS. "Imbali yokukhulelwa yabomama bama-singleton kunye noomama bamawele: ukuthelekiswa kwexesha elide." I-Twin Research kunye ne-Human Genetics. 2010 Dec; 13 (6): 595-603.
I-Chittacharoen A, i-Wetchapruekpitak S, i-Suthutvoravut S. "Ukukhulelwa kwengqondo-kubangela ukuba uxinzelelo lweengcinezelo lwamaqondo ngama-twin pregnancy". Umbhalo we-Medical Association of Thailand. 2005 I-Oct; 88 I-Suppl 2: S69-74.
Ukuzama Ukukhulelwa. Matshi weDimes. Kufumaneka ngoFebruwari 3, 2012. http://www.marchofdimes.com/pregnancy/trying_multiples.html
UMcMullan PF, uNorman RJ, uMarivate M. "Ukukhulelwa kwengqondo-kubangela ukuba uxinzelelo lweengcinezelo lwamaqondo ngama-twin pregnancy". I-British Journal ye-Obstetrics kunye ne-Gynecology. 1984 uMar; 91 (3): 240-3.
Ukuzalwa kwangaphambili. Isiko soLawulo lweZifo. Kufumaneka ngoFebruwari 3, 2012. http://www.cdc.gov/IziFundo/IsiXhosaBirth/
Usana olungaphambi kokusasa. MedlinePlus. Kufumaneka ngoFebhuwari 3, 2012. http://www.nlm.nih.gov/medlineplus/ency/article/001562.htm