Matenda opatsirana a mapasa ndi mapasa

Matenda opatsirana mwa mapasa ndi mapasa ndi omwe amapezeka kawirikawiri m'mapasa ofanana ali m'mimba.

Matenda opatsirana mwa mapasa amapasa (TTTS) amapezeka pomwe magazi amapasa amapita amapita kwinako kudzera m'chigawo chogawana. Mapasa omwe amataya magazi amatchedwa mapasa opereka. Mapasa omwe amalandira magazi amatchedwa mapasa olandila.

Ana onse atha kukhala ndi mavuto, kutengera kuchuluka kwa magazi omwe amaperekedwa kuchokera kwa wina kupita wina. Mapasa operekayo atha kukhala ndi magazi ochepa, ndipo winayo akhoza kukhala ndi magazi ochulukirapo.

Nthawi zambiri, amapasa opereka amakhala ocheperako kuposa amapasa ena pakubadwa. Khanda nthawi zambiri limakhala ndi kuchepa kwa magazi, limasowa madzi, ndipo limawoneka lotuwa.

Mapasa olandirayo amabadwa okulirapo, ofiira pakhungu, magazi ochulukirapo, komanso kuthamanga kwambiri kwa magazi. Mapasa omwe amalandira magazi ochulukirapo amatha kudwala mtima chifukwa cha kuchuluka kwamagazi ambiri. Khanda lingafunenso mankhwala kuti lilimbikitse kugwira ntchito kwa mtima.

Kukula kosalingana kwa mapasa ofanana kumatchedwa mapasa osagwirizana.

Matendawa amapezeka ndi ultrasound nthawi yapakati.

Atabadwa, makanda adzalandira mayeso otsatirawa:

• Kafukufuku wopanga magazi, kuphatikiza nthawi ya prothrombin (PT) ndi nthawi yapadera ya thromboplastin (PTT)
• Zowonjezera zamagetsi zamagulu kuti mudziwe kuchuluka kwa ma electrolyte
• Kuwerengera kwathunthu kwa magazi
• X-ray pachifuwa

Chithandizo chingafune mobwerezabwereza amniocentesis panthawi yapakati. Kuchita opaleshoni ya fetal laser kumachitika kuti athetse magazi kuchokera kumapasa awiri kupita kwina pamene ali ndi pakati.

Pambuyo pobadwa, chithandizo chimadalira zizindikiro za khanda. Mapasa opereka angafunike kuthiridwa magazi kuti athetse kuchepa kwa magazi.

Amapasa olandila angafunikire kuti achepetse kuchuluka kwa madzi amthupi. Izi zitha kuphatikizira kuthiridwa magazi.

Mapasa omwe amalandila angafunikenso kumwa mankhwala kuti ateteze mtima.

Ngati kuthiridwa mapasa kwa mapasa kuli kochepa, ana onse awiri nthawi zambiri amachira kwathunthu. Milandu yayikulu imatha kupha mapasa.

TTTS; Matenda a fetus

Malone FD, D'alton INE. Ma gestation angapo: mawonekedwe azachipatala ndi kasamalidwe. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, olemba. Creasy ndi Resnik's Maternal-Fetal Medicine: Mfundo ndi Kuchita. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 40.

Newman RB, Unal ER. Ma gestation angapo. Mu: Gabbe SG, Niebyl JR, Simpson JL, et al, olemba. Obstetrics: Mimba Yachibadwa ndi Mavuto. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 32.

Obican SG, Odibo AO. Mankhwala owopsa a fetus. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, olemba. Creasy ndi Resnik's Maternal-Fetal Medicine: Mfundo ndi Kuchita. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 37.