An kiyasta cewa rabin hawaye an haife shi ne da wuri, kafin zuwan makonni 36, wanda kusan wata daya kafin zauren zinare na yara 40 na babyletleton. Triplets da sauran magunguna masu yawa suna da mahimmancin damar haifar da su da wuri. A wasu lokuta, ba za a iya dakatar da aiki na farko ba, yayin da a wasu lokuta, hadarin ga mahaifiyar ko jarirai na buƙatar ƙaddamar da ƙarshen ciki. Ga wasu dalilan da suka fi dacewa da yasa aka haife ma'aurata da wuri.
Labarin farfadowa
Farawa na farko ba aiki ba ne a cikin yawan ciki. Yin ɗauke da jarirai da yawa yana ƙara haɗarin aikin aiki, don haka yana da mahimmanci cewa mahaifiyar mahaifiyar ma'aurata ko fiye da sanin sanannun cututtuka da kuma neman magani mai dacewa. Wasu daga cikin rikice-rikice da yanayin da aka bayyana a kasa za su iya faɗakar da aikin, amma wani lokaci ma'anar ainihin ba a bayyana ba. Amma ba tare da dalilin dalili ba, lokacin da mahaifa ya fara kwangila da / ko cervix fara farawa a shirye-shiryen haihuwar haihuwa, sakamakon shine aiki na farko. A wasu lokuta, za'a iya dakatar da shi, amma idan baza a iya ba, za a ba da jariran da ba a daɗe ba kuma an haife shi da wuri.
Kara
Preeclampsia
Yawancin mahaifiyar mahaifa zasu haɗu da hawan jini (cutar hawan jini) da ke faruwa a lokacin da take ciki, daya daga cikin matsalolin da ake ciki na ciki. Preeclampsia wata cuta ce da ke dauke da cutar hawan jini wanda aka hade shi tare da wani nauyin gina jiki mai girma a cikin fitsari. Ba a kulle shi ba, zai iya haifar da matsalolin lafiya ga mahaifiyar, ciki har da ciwo, bugun jini, da hanta hanta. Za a iya gudanar da maganin ƙwayar cuta, amma babu magani sai dai don ceton jariran. Lokacin da lokuta da suka dace da matsala masu iyaye, za'a ba da shawarar jima'i na farko.
Matsalar Matsala
Tare da tagwaye, za a iya zama ɗaya ko biyu placentas , wanda shine kwayoyin da ke kula da jarirai a lokacin da suke cikin mahaifa. An haɗa shi cikin ciki na mahaifa mahaifa kuma an haɗa shi da 'ya'yan jari ta igiyoyin umbilicaI. Tare da mahaifa (s) a cikin hawan ciki da yawa da ke rufe babban rabo daga bango na uterine, akwai matsala mafi girma na rikitarwa wanda zai iya zama haɗari ga mahaifi ko jariran. Rushewar zubar da ciki , inda 'yan ƙananan mahaifa, ko ƙaddarar rigakafin previa, inda aka sanya shi a matsayin mahaifa a cikin cikin mahaifa, yana rufe murfin mahaifa, wasu yanayi ne da zasu iya kawo saurin bayarwa.
Yayinda matsalolin ƙwayar cuta kamar wadannan zasu iya tasiri da magunguna, Twin-to-Twin Transfusion Syndrome (TTTS) wata cuta ce ga ma'aurata. Yana faruwa a yayin da jini ya kamu da shi a cikin guda daya, wanda aka raba shi, wanda ya haifar da canji na jini. A cikin lokuta masu tsanani da suke daidaitawa da jariri, aikawa zai iya zama wani zaɓi.
Ruptured Amniotic Membranes
A lokacin yin ciki, tayin - ko a cikin yanayin jima'i, tayi - an haɗa shi cikin jakar ruwa, a cikin jakar amniotic. A matsayin wani ɓangare na aiki, zakar za ta buɗe (wanda aka sani da "watsewar ruwa"). Amma wasu lokuta farkon jakar jaka, wanda aka sani da PROM (Farfesa Rukture of Membranes) ko PPROM (Farfesa na Farfesa na Membranes) idan ya faru kafin zuwan makonni 37. Da zarar jakar ruwa ta ragargaje, yana ba da dama ga kamuwa da cuta idan ba a sanarwa ba, kuma zai iya ba da izinin ba da jim kadan.
Mo-Mo Twins
Ƙananan ƙwayoyin ma'aurata guda biyu (ma'anar) an gano su a matsayin ma'aurata monochorionic-monoamniotic (Mo-Mo) . Ba wai kawai suna raba rami ɗaya ba amma an haɗa su a cikin jakar amniotic daya. Akwai haɗari na rikici ko rikitarwa a cikin wannan halin da ake ciki, wani mummunan yanayi wanda zai iya daidaita rayuwar dan jarirai. A wasu lokuta inda wannan ya auku, mafi kyawun zaɓi ga jarirai bai dace ba.
Ƙuntatawar Girma
IUGR - ko ƙuntataccen haɓaka ƙwaƙwalwa - yana da babban rukuni na haruffa da aka yi amfani dasu don bayyana ƙananan matsala tare da babban sakamako. Wannan jariri ne ko kuma jariri biyu da yawa kuma basu girma ba. A wasu haɗuwar juna biyu, IUGR yana cike da tagwaye yayin da ɗayan bai kasance (wanda aka sani da Zaɓin Intrauterine Growth Restriction ko SIUGR). Yayin da ake haifa maimaita kananan yara fiye da singletons, mai tsanani IUGR na iya gabatar da matsala mai tsanani ga jariri. Har zuwa kashi daya cikin rabi na ciki na biyu sun sami IUGR. Akwai dalilai masu yawa don ci gaba da girma; wasu sun haɗa da sauran yanayi da aka ambata a nan, irin su rashin isasshen ƙwayar cuta, rashin ruwa a cikin mahaifa, ko Twin-to-Twin Transfusion Syndrome (TTTS). Idan an ƙaddara cewa yarinya ya daina ci gaba ko girma ko kuma yana cikin wahala, saukarwa na farko yana iya zama zaɓi mafi kyau.
An yi la'akari da lokacin a 37 ko 38 makonni
Ra'ayoyin sun bambanta akan lokaci mafi kyau don ba da tagwaye ko fiye. A lokacin da ake yin aiki na farko ko wasu matsalolin da aka sanya a ciki, burin shine sau da yawa "daga baya mafi kyau." Amma a cikin 'yan makonni na ƙarshe na ciki, likitoci daban-daban na iya samun hanyoyi daban-daban. Ga wasu, haihuwa a zahiri a 37 ko 38 makonni yana da kyau don yin ciki na biyu a cikin rikice-rikice, don haka likitanku na iya tsara lokacin aikawa da makonni biyu da wuri. Wasu sun fi son jira da ganin.
Sources:
Dodd, JM, et al., "Haihuwa a cikin makonni 37 na gestation bisa daidaitattun kulawa da mata tare da daukar ciki na biyu cikin rikice-rikice a cikin lokaci: jaririn Zuciya na Haihuwa Random Trial." British Journal of Obstetrics and Gynecology, Yuni 2012. pg. 964.
Habli, M., et al. "Ciwon sikila guda biyu zuwa biyu: cikakken sabuntawa." Clinicals in Perinatology , Yuni 2009. pg. 391.
Leeman, L. da Fontaine, P., "Magunguna na Harkokin Ciki." Aminiya na Yammacin Amirka , Yuli 2008, pg. 93.
Moh, W., et al.
"Mace-ciki da yawa." Kwalejin Kasuwancin Amurka da Magungunan Kwayoyin Kwayoyin Nahiyar , Samun Fabrairu 27, 2016. http://www.acog.org/Patients/FAQs/Multiple-Pregnancy
Saliva, HM, et al., "Mutuwa mai lalacewa tare da abruptio placenta a singletons da yawa." Jaridar American Journal of Obstetrics da Gynecology , Yuli 2005, pg. 198.
"Ciwon ciki biyu na ciki." UCSF Fetus Treatment Center. An shiga Fabrairu 27, 2016. https://web.archive.org/web/20111221205053/http://fetus.ucsfmedicalcenter.org/twin/