Isifo sesifo sokumpontshelwa kwe-twwin-to-twin yimeko ye- placenta echaphazela ukukhulelwa kwamanye amawele afanayo. Kwii-TTTS, ukudibanisa okungavumelekanga phakathi kwemithambo yegazi kwi-placenta kuvumela igazi ukusuka kwelinye iwele ukuba liphumelele kwenye iwele. Kwamanye amaxesha, amawele athetha ipalacenta eqhelekileyo, kwaye elinye iwele lingenaso isabelo esikhulu ngokwaneleyo ukuba sithole izondlo eziyimfuneko ukuze zikhule ngokuqhelekileyo okanye ziphile.
Xa i-TTTS ivele nini?
I-twin-to-twin transfusion syndrome iyenzeka kuphela xa amawele afanayo ahlanganyela kwi-placenta. I-TTTS iyakwenzeka kwi-triplet okanye ukukhulelwa okuphezulu xa ezimbini zintsana zifana kwaye zikwabelana nge-placenta. Amawele omzalwana kunye namawele afanayo aneepalcenta ahlukeneyo asemngciphekweni we-TTTS.
Ziziphi iimpawu zeTTTS?
Amawele e-TTTS anempawu ezahlukileyo ngokusekelwe ekubeni ngaba ngabaxhasi okanye abafumanayo .
Amawele e-TTTS amawele athola igazi elingaphantsi kwi-placenta kwaye alahlekelwe igazi ukuya kwelinye iwele. Amawele azinikeleyo amancinci, kokubili ngaphambi nangemva kokuzalwa. Zizophaphaza kunye ne-anemic, ziye zanciphisa umkhiqizo we-urine kwi-utero, kunye neyona mincinci-kune-average bladders. Ukuba amawele aneesibini ze-amniotic, i-twin donor iya kunciphisa i-amniotic fluid ( oligohydramnios ).
Amawele alamkeli afumana igazi elininzi, zombini ukusuka kwi-placenta nakwezinye iwele. Ezi zintsana zikhulu kwaye zinamanzi amniotic ngokweqile (i- polyhydramnios ).
Ngenxa yokuba le ntsana inamanzi amaninzi emzimbeni, iinkqubo zabo zogxininiso zingatyala, zenze iingxaki zentliziyo.
Zibuhlungu kangakanani i-TTTS?
I-twwin ukuya kwi-twin-syndrome i-transfusion i-syndrome ingabonakalisa imbeko okanye imbi kakhulu, kuxhomekeke kwindlela igazi elingafanelanga ngayo yabantwana. Xa i-TTTS ifumaneka, oogqirha baya kulandela ukukhulelwa ngokukhawuleza ukuba babone ukuba iimpawu ziyaqhubeka okanye cha.
Izigaba zeTTTS zi:
- Isigaba I: I-twin donor iye yanciphisa i-amniotic fluid; i-twin ye-receptor ine-amniotic fluid excessively.
- Isigaba II: Okufanayo ngentla. I-twin bladder ye-donor ayibonakali kwi-ultrasound - uphawu lokunciphisa umchamo we-urine kwi-utero.
- Isigaba III: Zonke iimpawu ezingentla zikhoyo; Ukuhamba kwegazi kwiinkambo zomzimba akuqhelekanga.
- Isigaba IV: Zonke iimpawu ezingentla zikhoyo; i-twin ye-recept is edematous kwaye ibonisa iimpawu zentliziyo yokuhluleka.
- Isigaba V: Zonke iimpawu ezingentla zikhoyo kwaye elinye iwele lifile.
I-TTTS ithathwa njani?
Xa oogqirha bebona ukuba amawele afanayo afana ne-placenta, umama uya kulandelwa ngokulandelelana ukuze abe nemiqondiso yeTTTS. Ukuba i-TTTS ifumaneka, umama uya kuhlolisiswa kuphela. Emva kokuba i-TTTS iqhubela phambili kwisigaba II okanye III, oogqirha banokuzama ukuhlinzwa okanye ukunciphisa i-amniotic fluid. Utyando lunokuzama ukuvalelwa kwesi sifo, kodwa amathuba okuphumelela aphantsi.
Ngophenyo lwe-laser fetal , unyango lwe-laser isetyenziselwa ukwahlula imithana yegazi kwi-placenta evumela igazi ukuba liphume ukusuka kwelinye iwele ukuya kwelinye. Ukuhlinzwa ngokuqhelekileyo kuthathwa njengempumelelo kakhulu kunokunciphisa i-amniotic fluid. Amawele azalwe emva kokuhlinzwa ngethambo lomntwana anethuba eliphezulu lokuphila kunye nethuba eliphantsi lokuba nefuthe elide lexesha elide leTTTS.
Ukuhlinzwa ngamanye amaxesha kunzima, nangona kunjalo, kwaye i-TTTS iya kuqhubeka iqhubela phambili.
Kwi- serial amniotic fluid ukunciphisa , i-amniotic fluid igxothwe kwisangxo ejikeleze i-twin. Inqubo ingenziwa kuphela kanye okanye amaxesha amaninzi. Inkolelo emva kokunciphisa i-amniotic fluid kukuba ukunciphisa uketshezi kunciphisa intlungu kwintliziyo yomntu oyisiphene kunye nokuthintela umsebenzi we-preterm ukuba kwenzeke xa i-amniotic fluid excessive ibeka ingxaki emlonyeni wesibeleko.
Ziziphi iimpembelelo zexesha elide zeTTTS?
Uninzi lweempawu ze-TTTS ezincinci, kubandakanya i-anemia kunye ne-polycythemia (isibalo esiphezulu se-cell cell), singaphathwa ngempumelelo emva kokuzalwa.
Ngenxa yokuba ezininzi ze-TTTS zokukhulelwa kwezibini azihambi ukuya kwikota, imiphumo yexesha elide le-TTTS ifana nefuthe elide lexesha lokuqala .
Kwiimeko eziphambili ze-TTTS, iintsana ezibandakanyekayo zingenokuba nefuthe elide kwixesha elide ngaphaya kweengxaki zokuqala kwangaphambili. Ukunyuka kwesisu kunye nezinye izilonda zobuchopho ziqhelekileyo kwiintsana ze-TTTS, nangona emva kokunyanga kwamayeza okanye i-amnioreduction. Ukuba eso sifo singakhange siphundulwe kwaye singalandelwa ngokusondeleyo, iimiphumo zexesha elide zingabandakanya ukungaphumeleli kwentliziyo nokufa kwesinye okanye amawele.
Imithombo:
Lenclen, MD, uRichard, Paupe, MD, Alain, Ciarlo, MD, Giuseppina, Castela, MD, Sophie, Castela, MD, Florence, Ortqvist, MD, uLisa, Ville, MD, Yves. Isiphumo se-Neonatal kwi-Preterm I-Monochorionic Twins kunye ne-Twin-to-Twin Transfusion Syndrome Emva kokunyanga kwe-Intrauterine Treatment kunye ne-Amnioreduction okanye i-Fetoscopic Laser Surgery: Ukuthelekiswa nama-Dichorionic Twins. "I- American Journal ye-Obstetrics kunye ne-Gynecology Meyi 2007: 450e1-450e7.
Norton, MD, Mary. "Ukuphonononga nokuLawula i-Twin-Twin Transfusion Syndrome: Isengumngeni" I- American Journal ye-Obstetrics ne-Gynecology Meyi 2007. 196: iphe 419-420.
I-Twin ukuya kwiTwin Transfusion Syndrome Foundation. "Kwizonyango."
I-USC yeZiko lezeMpilo laseSan Diego. "Ukuqonda iiNqanaba zeTTTS."