Twin-to-twin kuwedzerwa chirwere ndechimwe chepentecenta inokanganisa zvimwe zvakafanana nemaviri pamuviri. MuchiTTTS, kushamwaridzana kusingawanzoitiki pakati pemidziyo yeropa mumapentecenta kubvumira ropa kubva kune rimwe jaya richiyerera kune rimwe divi. Mune zvimwe zviitiko, mapatya anowanzobatanidza placenta zvakafanana, uye rimwe rimwe ringave risina mugove mukuru zvakakwana kuti uwane michina inodiwa kuti ikure kazhinji kana kuti igare.
Apo TTTS Inobvepi?
Twin-to-twin kuwedzerwa chirwere chinongoitika bedzi apo mapavi akafanana anowanika pasi. TTTS inogona kuitika muutatu kana kuti kukwirira kwakanyanya kana vaviri vecheche vachifanana uye vachigovera placenta. Vakadzi vemapatya uye mapatya akafanana ane placenta akasiyana haasi pangozi yeTTTS.
Ndezvipi zviratidzo zveTTTS?
TTTS mapatya ane zviratidzo zvakasiyana-siyana zvichienderana nokuti ivo vapei kana vanogamuchira .
Vanopa TTTS mapatya vanogamuchira ropa shoma kubva pamaketeni uye vanorasikirwa neropa kune rimwe divi. Mapa mapapiro mashoma, zvose zvisati zvaitika uye mushure mokuberekwa. Izvo zvakanyatsojeka uye zvinopera simba, zvakaderedza urine zvakakosha muUtero, uye zviduku-kudarika-chiyero chezvipfeko. Kana mapatya ane zvikwama zviviri zveamniotic, twinopipa rupiro ichave yakaderedza amniotic fluid ( oligohydramnios ).
Vakagamuchira mapatya vanowana ropa rakawandisa, zvose kubva pamaketeni uye kubva kune mamwe mapatya. Idzi idzi dzinokosha uye dzine anniotic fluid yakawanda ( polyhydramnios ).
Nemhaka yokuti vana ava vane ropa rakawanda mumitumbi yavo, maitiro avo epakati pemvura anogona kuwandiswa, zvichikonzera matambudziko emwoyo.
Ndezvipi Zvakanyanya TTTS?
Twin to twin kuwedzerwa ropa kunogona kunge yakanyorova kana kuti yakakomba zvikuru, zvichienderana nekusava neropa iro rakagoverwa nevana. Pane imwe nguva TTTS inowanikwa, vanachiremba vanotevera kutevedza pedyo kuti vaone kana zviratidzo zviri kufambira mberi kana kwete.
Zvikamu zveTTTS ndezvi:
- Nhanho I: Mapatya anopa vakaderedza amniotic fluid; uyo anogamuchira twin ane zvakanyanya amniotic fluid.
- Nhanho II: Samwe sepamusoro. Mucherechedzo wemapapiro emakumbo haana kuonekwa pane ultrasound - chiratidzo chekuderedza urine zvakabuda muUtero.
- Nhanho III: Zvose zvinotevera zviripo; ropa rinoyerera mumakumbo embilical harisi.
- Nhanho IV: Zvose zviri pamusoro apa zviratidzo; uyo anogamuchira mapatya ari edematous uye ari kuratidza zviratidzo zvekushaya mwoyo.
- Chikamu V: Zvose zviratidzo zviri kumusoro zviripo uye rimwe jaya rakafa.
TTTS Inotorwa Sei?
Apo vanachiremba vanoziva kuti mafa maviri akafanana anowanika pasi, amai vachabatwa zvakanyatsotevera nekuda kwezviratidzo zveTTTS. Kana shanho I TTTS ichionekwa, amai ndivo vachangonyatsoongororwa. Pane imwe nguva TTTS inofambira mberi muchigamba II kana III, vanachiremba vanogona kuedza kuberekera chirwere chemalasi kana kuti amniotic fluid kuderedza. Kurapa kunogona kunge kuchiri kuedzwa gare gare muchirwere, asi mikana yekubudirira yakaderera.
Mukuvhiya kwema fetal laser , laser therapy inoshandiswa kuparadzanisa mitsipa yeropa mumapatenta anobvumira ropa kuti riyerere kubva kune rimwe mapatya kune rimwe. Kuvhiyiwa kwacho kunowanzobudirira kubudirira kupfuura amniotic fluid kuderedza. Mapatya akaberekwa mushure mekuvhiyiwa kwemaserta emaserta ane mukana wakakura wekupona uye mukana wepasi wekuva nemigumisiro yakareba kwenguva refu yeTTTS.
Kuvhiyiwa dzimwe nguva kunokundikana, zvisinei, uye TTTS icharamba ichifambira mberi.
Mu serial amniotic fluid kuderedza , amniotic fluid inodururwa kubva muchikwata chakakomberedza mapapiro maviri. Iyo nzira inogona kuitwa kamwe chete kana kazhinji. Dzidziso yeamniotic fluid kuderedza ndeyokuti kuderedza kusvibiswa kunoderedza kunetseka kwomunhu anogamuchira mapatya maviri uye kunodzivirira kutanga kwebasa kubva pakuitika apo zvakanyanya amniotic fluid inowedzera maronda pamuviri.
Ndeipi Migumisiro Yenguva refu YeTTTS?
Zvizhinji zvezviratidzo zveTTTS zvinyoro, kusanganisira anemia uye polycythemia (yakakwirira yakasvipa masero eropa), inogona kubudirira kurapwa mushure mokuberekwa.
Nemhaka yokuti vazhinji veTTTS vane pamuviri havasi kuenda kune imwe nguva, kwenguva yakareba migumisiro yeTTTS yakafanana nemigumisiro yenguva refu yekutangira .
Mumatambudziko akakwirira eTTTS, vacheche vanobatanidzwa vanogona kuva nemigumisiro yenguva refu kudarika matambudziko ehutachiona. Intraventricular hemorrhage nezvimwe zvipembenene zveuropi zvakajairika muvana veTTTS, kunyange mushure mekurapa kwerasi kana amnioreduction. Kana chirwere ichi chisina kutorwa uye chisina kuteverwa zvakasimba, kwenguva yakareba migumisiro inogona kusanganisira mwoyo kusakona uye kufa kweimwe kana mbiri mbiri.
Sources:
Lenclen, MD, Richard, Paupe, MD, Alain, Ciarlo, MD, Giuseppina, Castela, MD, Sophie, Castela, MD, Florence, Ortqvist, MD, Lisa, City, MD, Yves. "Chibereko cheNononatal mu Preterm Monochorionic Twins neTwin-to-Twin Transfusion Syndrome Mushure meIntrauterine Treatment neAmnioreduction kana Fetoscopic Laser Kuvhiya: Kuenzanisa neDichorionic Twins." American Journal of Obstetrics uye Gynecology May 2007: 450e1-450e7.
Norton, MD, Mary. "Kuongorora uye Kutungamirirwa kweTwin-Twin Transfusion Syndrome: Chiri Chinhu Chinetso" American Journal of Obstetrics uye Gynecology May 2007. 196: p 419-420.
Twin to Twin Transfusion Syndrome Foundation. "Kune Vezvokurapa."
USC San Diego Medical Centre. "Kunzwisisa Matanho eTTTS."