Isifo sokutofelwa kwamawele ngamawele

Isifo sokudluliselwa kwewele ngamawele ngamawele yimeko enqabileyo eyenzeka kuphela kumawele afanayo ngelixa besesibelekweni.

I-twin-to-twin syndrome (i-TTTS) ye-twin (i-TTTS) ivela xa ukunikezelwa kwegazi kwelinye iwele kuhamba kwelinye kwi-placenta eyabelwe. Iwele eliphulukana negazi libizwa ngokuba liwele lomnikeli. Iwele elifumana igazi libizwa ngokuba liwele lomamkeli.

Zombini iintsana zinokuba neengxaki, kuxhomekeke ekubeni lingakanani igazi elidluliswayo ukusuka kwelinye ukuya kwelinye. Iwele elinikelayo linokuba negazi elincinci, kwaye elinye linokuba negazi elininzi.

Uninzi lwexesha, iwele lomnikeli lincinci kunelinye iwele xa kuzalwa. Usana ludla ngokuba ne-anemia, luphelelwe ngamanzi emzimbeni, kwaye lubukeka luthuthu.

Iwele elamkelayo lizalwa likhulu, libomvu esikhumbeni, ligazi elininzi, kwaye kukho uxinzelelo lwegazi oluphezulu. Amawele afumana igazi elininzi kakhulu anokuhlakulela ukusilela kwentliziyo ngenxa yevolumu ephezulu yegazi. Usana lusenokufuna amayeza ukomeleza ukusebenza kwentliziyo.

Ubungakanani obungalinganiyo bamawele afanayo kubhekiswa kuwo njengamawele angahambelaniyo.

Le meko ihlala ifunyaniswa yi-ultrasound ngexesha lokukhulelwa.

Emva kokuzalwa, abantwana baya kufumana ezi mvavanyo zilandelayo:

• Izifundo zokunqanda igazi, kubandakanya ixesha leprothrombin (PT) kunye nexesha le-thromboplastin (PTT)
• Iphaneli yemetaboli egqibeleleyo yokumisela ibhalansi ye-electrolyte
• Gcwalisa ubalo lwegazi
• I-x-ray yesifuba

Unyango lunokufuna i-amniocentesis ephindaphindiweyo ngexesha lokukhulelwa. Utyando lwe-laser lwe-Fetal lunokwenziwa ukumisa ukuhamba kwegazi ukusuka kwelinye iwele ukuya kwelinye ngexesha lokukhulelwa.

Emva kokuzalwa, unyango luxhomekeke kwiimpawu zosana. Iwele lomnikeli lingadinga ukutofelwa igazi ukunyanga i-anemia.

Ummkeli wewele unokufuna ukuba umthamo wamanzi omzimba uncitshiswe. Oku kunokubandakanya utofelo-gazi.

Iwele elamkelayo lisenokufuna ukuthatha iyeza ukunqanda ukusilela kwentliziyo.

Ukuba utofelo-gazi kumawele lincinci, zombini iintsana zihlala ziphila ngokupheleleyo. Iimeko ezinzima zingakhokelela ekufeni kwewele.

TTTS; Isifo sokufakwa kwegazi esiswini

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INewman RB, i-Unal ER. Ukukhulelwa okuninzi. Ku: Gabbe SG, Niebyl JR, Simpson JL, et al, ii-eds. I-Obstetrics: Ukukhulelwa okuqhelekileyo kunye neengxaki. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 32.

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