Twin-to-twin kuwedzerwa chirwere

Twin-to-twin kuwedzerwa chirwere chirwere chinhu chisingawanzoitika chinowanikwa chete mumapatya akafanana pavanenge vari mudumbu.

Twin-to-twin kuwedzerwa chirwere (TTTS) kunoitika kana ropa rerimwe mapatya richienda kune rimwe kuburikidza neyakagovaniswa placenta. Mapatya anorasikirwa neropa anonzi mupi wemapatya. Mapatya anogamuchira ropa anonzi anonzi anogamuchira mapatya.

Vacheche vese vanogona kuve nezvinetso, zvinoenderana nekuti yakawanda sei ropa rinotamirwa kubva kune rimwe kuenda kune rimwe. Mupiro mapatya anogona kunge ane ropa rakawandisa, uye mumwe wacho angave neropa rakawandisa.

Kazhinji yenguva, mupiro mapatya madiki pane mamwe mapatya pakuzvarwa. Mucheche anowanzove neanemia, akashaya mvura, uye anotaridzika kuchena.

Anogamuchira mapatya anozvarwa akakura, aine hutsvuku paganda, rakawandisa ropa, uye rakakwira BP. Mapatya anowana ropa rakawandisa anogona kukundikana nemoyo nekuda kweropa rakakura. Mucheche anogona zvakare kuda mushonga wekusimbisa moyo kushanda.

Hakaenzana saizi yemapatya akafanana anonzi mapfumo asina kufanira.

Iyi mamiriro inowanzoonekwa ne ultrasound panguva yekuzvitakura.

Mushure mekuzvarwa, vacheche vanogashira bvunzo dzinotevera:

• Dzidzo yekuvhara ropa, kusanganisira prothrombin nguva (PT) uye yakasarudzika thromboplastin nguva (PTT)
• Yakakwana metabolic pani kuona electrolyte chiyero
• Yakazara kuverenga ropa
• Chest x-ray

Kurapa kunogona kuda kudzokorora amniocentesis panguva yekuzvitakura. Fetal laser kuvhiyiwa kunogona kuitwa kumisa kuyerera kweropa kubva kune rimwe mapatya kuenda kune rimwe panguva yepamuviri.

Mushure mokuberekwa, kurapwa kunoenderana nezviratidzo zvemucheche. Mupiro mapatya angangoda kuwedzerwa ropa kuti arape kupererwa neropa.

Anogamuchira mapatya angangoda kuve neuwandu hwemvura yemuviri yakaderedzwa. Izvi zvinogona kusanganisira kuwedzerwa kuwedzerwa ropa.

Anogamuchira mapatya anogona zvakare kuda kutora mushonga kudzivirira moyo kutadza.

Kana mapatya-ku-mapatya kuwedzerwa kuri nyore, vese vacheche vanowanzo kupora zvizere. Mhosva dzakakomba dzinogona kukonzera kufa kwemupatya.

TTTS; Fetal kuwedzerwa chirwere

Malone FD, D'alton ME. Akawanda gestation: kiriniki hunhu uye manejimendi. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Sirivha RM, eds. Creasy uye Resnik's Maternal-Fetal Mushonga: Misimboti uye Dzidzira. 8th ed. Philadelphia, PA: Elsevier; 2019: chitsuwa 40.

Newman RB, Unal ER. Akawanda ekubata. Mune: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Yakajairwa uye Dambudziko Pamuviri. 7th ed. Philadelphia, PA: Elsevier; 2017: chits. 32.

Obican SG, Odibo AO. Inopisa fetal therapy. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Sirivha RM, eds. Creasy uye Resnik's Maternal-Fetal Mushonga: Misimboti uye Dzidzira. 8th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 37.