I-twin-to-twin transfusion syndrome

I-twin-to-twin transfusion syndrome yisimo esingajwayelekile esenzeka kuphela kumawele afanayo ngenkathi esesibelethweni.

I-twin-to-twin transfusion syndrome (i-TTTS) yenzeka lapho ukunikezwa kwegazi lewele elilodwa kudlulela kolunye nge-placenta eyabiwe. Iwele elilahlekelwa yigazi libizwa ngewele elinikelayo. Iwele elamukela igazi libizwa ngokuthi iwele elamukelayo.

Zombili izingane zingaba nezinkinga, kuya ngokuthi kudluliswa igazi elingakanani lisuka kwelinye liye komunye. Iwele lomnikeli lingaba negazi elincane kakhulu, kanti elinye lingaba negazi eliningi kakhulu.

Isikhathi esiningi, iwele lomnikeli lincane kunelinye iwele lapho lizalwa. Usana luvame ukuba ne-anemia, luphelelwe amanzi emzimbeni, futhi lubukeka luphaphathekile.

Iwele elamukelayo lizalwa likhudlwana, linokubomvu esikhunjeni, igazi eliningi, nomfutho wegazi ophakeme. Iwele elithola igazi eliningi kakhulu lingaqala ukuhluleka kwenhliziyo ngenxa yevolumu ephezulu yegazi. Ingane nayo ingadinga umuthi wokuqinisa ukusebenza kwenhliziyo.

Ubukhulu obungalingani bamawele afanayo kubhekiselwa kuwo njengamawele angavumelani.

Lesi simo sivame ukutholakala nge-ultrasound ngesikhathi sokukhulelwa.

Ngemuva kokuzalwa, izingane zizothola izivivinyo ezilandelayo:

• Izifundo zokuvala igazi, kufaka phakathi isikhathi seprothrombin (PT) nesikhathi esinqunyelwe se-thromboplastin (PTT)
• Iphaneli yemethodi ephelele yokunquma ibhalansi ye-electrolyte
• Qedela ukubalwa kwegazi
• I-x-ray yesifuba

Ukwelashwa kungadinga ama-amniocentesis aphindaphindiwe ngesikhathi sokukhulelwa. Ukuhlinzwa kwe-fetal laser kungenziwa ukumisa ukugeleza kwegazi kusuka kwelinye iwele kuya kwelinye ngesikhathi sokukhulelwa.

Ngemuva kokuzalwa, ukwelashwa kuya ngezimpawu zosana. Iwele lomnikeli lingadinga ukumpontshelwa igazi ukwelapha i-anemia.

Iwele lomamukeli lingadinga ukunciphisa ivolumu yomzimba. Lokhu kungabandakanya ukumpontshelwa igazi.

Iwele elamukelayo lingadinga futhi ukuphuza umuthi ukuvimbela ukwehluleka kwenhliziyo.

Uma ukumpontshelwa kwamawele namawele kumnene, zombili izingane zivame ukululama ngokuphelele. Amacala abucayi angaholela ekufeni kwewele.

TTTS; Isifo sokumpontshelwa kwengane

IMalone FD, iD'alton ME. Ukukhulelwa okuningi: izici zokwelashwa nokuphathwa. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, abahleli. ICreasy neResnik's Maternal-Fetal Medicine: Izimiso kanye Nokuzijwayeza. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 40.

INewman RB, i-Unal ER. Ukukhulelwa okuningi. Ku: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Ama-Obstetrics: Ukukhulelwa Okujwayelekile Nenkinga. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 32.

I-Obican SG, i-Odibo AO. Ukwelashwa kombungu okuhlaselayo. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, abahleli. ICreasy neResnik's Maternal-Fetal Medicine: Izimiso kanye Nokuzijwayeza. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 37.