Sashin ciwon sikila guda biyu zuwa biyu shine yanayin mahaifa wanda ke shafar wasu ciki biyu na ciki biyu. A cikin TTTS, haɗuwa marar haɗi tsakanin jini a cikin ƙwayar cuta ya ba da izinin jinin daga ma'aurata zuwa cikin wasu biyu. A wasu lokuta, ma'aurata suna raba ragamar ƙwayar magungunta, kuma ɗayan ɗaya ba zai iya samun raba mai yawa ba don karɓar kayan da ake bukata don yayi girma kullum ko tsira.
Yaushe TTTS ya faru?
Abin ciwon sikila guda biyu zuwa biyu yana faruwa ne kawai lokacin da ma'aurata masu juna biyu ke raba rami. TTTS zai iya faruwa a cikin sau uku ko ciki mafi girma idan biyu daga cikin jariri suna da kuma raba rami. Ma'aurata na waje da ma'aurata masu yawa tare da raguwa masu rarraba basu da hatsari ga TTTS.
Menene alamun TTTS?
Ma'aurata TTTS suna da alamun wariyar launin fata da ke dogara ne akan ko su ne masu bayarwa ko masu karɓa .
Abokan TTTS Donor suna karɓar jinin daga jini kuma sun rasa jini ga wasu ma'aurata. Abokan jinsuna sun fi ƙanƙanta, kafin kafin haihuwa. Su ne kodadde da anemic, sun rage fitattun fitsari a cikin utero, da ƙananan magunguna. Idan ma'aurata suna da jaka biyu na amniotic, mahaifiyar mai ba da kyauta zai rage ruwan hawan amniotic ( oligohydramnios ).
Ma'aurata masu karɓa suna karɓar jini mai yawa, duka daga cikin mahaifa da kuma daga wasu ma'aurata. Wadannan jariran sun fi girma kuma suna da ruwa mai haɗari ( polyhydramnios ).
Saboda wadannan jariran suna da jini mai yawa a cikin jikinsu, za a iya ƙaddamar da tsarin ƙwayoyin su, don haifar da matsalolin zuciya.
Ta yaya TTTS yake da muhimmanci?
Twin zuwa ciwon sikila na jini yana iya kasancewa mai sauƙi ko mai tsananin gaske, dangane da yadda yara ke rabawa. Da zarar an gano TTTS, likitoci zasu bi ciki don ganin idan bayyanar cututtuka na ci gaba ko a'a.
Yanayin TTTS sune:
- Sashe na I: Yara mai bayarwa ya rage ruwa mai amniotic; ma'aurata masu karɓa suna da ruwa mai haɗari.
- Stage II: Same kamar yadda a sama. Ba'a iya ganin mahaifiyar mahaifa ba a bayyane a kan duban dan tayi - alamar rage yawan fitattun fitsari a utero.
- Sashe na III: Dukkanin alamun bayyanar suna samuwa; Hanyoyin jini a cikin igiya na wucin gadi abu ne maras kyau.
- Mataki na IV: Dukkanin alamun bayyanar suna samuwa; Mai karɓa mai karɓa yana da ladabi kuma yana nuna alamun rashin nasara na zuciya.
- Sashe na V: Dukkanin bayyanar cututtuka a sama suna bayarwa kuma ɗayan macce ya mutu.
Yaya aka yi TTTS?
Lokacin da likitoci suka gane cewa ma'aurata biyu suna raba rami, uwar za ta biyo bayan alamun TTTS. Idan mataki na TTTS aka gano, mahaifiyar kawai za a kula da shi kawai. Da zarar TTTS ya ci gaba zuwa mataki na II ko III, likitoci zasu iya gwada tayar da lasisin tayi ko yaduwar ruwa na amniotic. Ana iya yuwuwar magani a baya a cikin cutar, amma chances of success are lower.
A tilasta laser tayi , ana amfani da maganin laser don raba sassan jini a cikin tudun da ke bada izinin jini ya gudana daga ɗima biyu zuwa ɗayan. An yi amfani da tiyata a mafi yawan nasara fiye da rage yawan hawan mahaifa. Jimagin da aka haifa bayan hawan taya na laser yana da damar da za su iya rayuwa da kuma ƙananan damar yin tasiri mai tsanani na TTTS.
Tiyata na wani lokaci ya kasa, duk da haka, kuma TTTS za su cigaba da ci gaba.
A cikin saurin hawan mahaifa , ruwa mai tsabta yana kwance daga jakar da ke kewaye da mahaifa mai karɓa. Za'a iya aiwatar da wannan hanya sau ɗaya ko sau da yawa. Ka'idar a baya bayan rage hawan mahaifa shine rage rage ruwa ya rage nauyin zuciya a kan zuciya mai maimaitawa kuma ya hana aiki na farko kafin ya faru yayin da ruwan sama mai ɗimbin ruwa ya sanya mummunan rauni a kan cervix.
Mene ne tasirin TTTS?
Da yawa daga cikin alamun bayyanar TTTS, ciki har da anemia da polycythemia (ƙananan jinin jini), za a iya samun nasarar magance su bayan haihuwa.
Saboda yawancin matakan TTTS masu ciki ba su zuwa lokaci, ƙayyadaddun sakamako na TTTS suna kama da fargaba na tsawon lokaci .
A cikin lokutta masu tasowa na TTTS, yara masu ciki zasu iya samun sakamako mai tsawo lokacin da suke fuskantar matsaloli. Cutar da ke cikin kwakwalwa da sauran ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa sun fi kowa a cikin jaririn TTTS, ko da bayan magani na laser ko amnioreduction. Idan cutar ba ta da kyau kuma ba a biye da hankali ba, hadarin lokaci na iya hada da rashin zuciya da mutuwar daya ko biyu biyu.
Sources:
Lenclen, MD, Richard, Paupe, MD, Alain, Ciarlo, MD, Giuseppina, Castela, MD, Sofia, Castela, MD, Florence, Ortqvist, MD, Lisa, Ville, MD, Yves. "Neonatal Sakamako a cikin Jirgin Ƙwararrun Masarar Monochorionic tare da Twin-to-Twin Transfusion Syndrome Bayan Narkar da Intrauterine tare da Amnioreduction ko Laser Train Laser Fetoscopic: Daidaita da Twhor na Dichorionic." American Journal of Obstetrics and Gynecology May 2007: 450e1-450e7.
Norton, MD, Maryamu. "Bincike da Gudanar da Ciwo na Twin-Twin Transfusion: Duk da haka wata Kalubale" Littafin Ƙididdigar Harkokin Harkokin Kiwon Lafiyar Jama'ar Amirka da Gynecology Mayu 2007. 196: p 419-420.
Twin zuwa Twin Transfusion Foundation. "Ga Ma'aikatan Lafiya."
USC San Diego Medical Center. "Fahimtar Sakamakon TTTS."