Kuberekwa kwevana vaviri kana kupfuura kamwe kamwe munguva yedu haisi isiri. Kubata pamuviri kunowanzoitika kakawanda gore negore. Twine nekatatu hazvisati zvichitadzisa dutu rakadaro, sekutanga. Zvisinei, kuberekwa kwavo hachiri kunyatsonzwisiswa chiitiko. Saka, chii chinowanikwa pamuviri: mapatya, mapatya - musoro wekukurukurirana nhasi.
Mune pamuviri akawanda, vaviri kana kupfuura fetus inowanikwa panguva imwechete mubereki. Zvichienderana nehuwandu hwavo, gare gare vanoberekwa: mapatya, katatu, zvigaro nezvimwe zvakadaro. Nzira yakakurumbira yekuwanda pamuviri mumunhu ndeyekuvhara-mazai kamwechete. Inogona kubuda kubva kune imwe chete yezai uye kubva kune imwe spermatozoon. Kukura mumimba yakadaro, mapatya, sezvaunoziva, akafanana zvakakwana. Vanogara vachiita zvepabonde imwechete uye vane mazita edziini.
Kubata pamuviri kunogonawo kuva mugumisiro wekudyisa mazai maviri akasiyana nema spermatozoa maviri akasiyana. Somugumisiro, maviri emucheche anowedzera, anokwanisa kuva ega kana kuti akasiyana zvepabonde, uye mazita avo emagetsi haana kufanana. Asi zvakadaro, ivo, semuenzaniso wokutanga, vanonziwo mapatya. Ivo kune mumwe nemumwe hama nehanzvadzi mune imwe nharo sehama nehanzvadzi kubva pamuviri akazvitakura zvakasiyana.
Kubata pamuviri mune chokwadi uye nhamba
Iko kufungidzirwa kuti kufungira apo mapatya anoberekwa ndiyo ngozi yakachena. Ichokwadi ichi hachina simba kune hutano kana zvimwe mukati kana kunze kwezvinhu. Nhamba yavo inogara isingagumi uye inenge 0.4% yehuwandu hwevanhu vanozvarwa. Maererano nevamwe vanotsvakurudza, kune vose vana makumi mapfumbamwe nemasere ekuberekwa kune kuberekwa kwemapatya.
Zvisinei, mumakore emakore ekutsvakurudza, mamwe maitiro akaratidzwa. Saka, mimba yemapatya inobva pane zvinhu zvakawanda. Zvinonyanya kukosha ndezvekuti: hutano, dzinza, nzvimbo, nguva yeamai uye chirwere chake chekubereka, pamwe nehutoni huno.
Iyo yakaderera muzana yehuwandu hwepamuviri inowanikwa munyika dzekumabvazuva, yepamusoro muAfrica, uye inowanikwa muCaucasians. MuChina, chiyero ichi chinowanikwa kubva ku 0.33 kusvika ku 0.4%, uye kuWestern Nigeria iri kusvika 4,5%. MuCaucasians, chiyero chekuberekwa kwemababa maererano nehuwandu hwekuberekwa kunobva kubva ku 0.9 kusvika ku4%.
Kakawanda kacho kazhinji kamuviri kaviri kunobva pane nguva yeamai. Iyo yakaderera muzana (0.3%) yakawanika kuvakadzi vasati vava nemakore makumi maviri uye makumi mana, uye yakakwirira (1.2-1.8%) pazera remakore 31-39. Mikana yekuberekwa kwemawere inowedzerawo nenhamba yekuberekwa. Yakawanikwa kuti mukana wekutora mimba yakawanda ndiyo yakakura kupfuura yechitatu kana kuti inotevera.
Amai vemapatya kakawanda kazhinji vakadzi vasina kuroorwa, vakadzi vane urema hwakawandisa, uye avo avo vakanonoka vakatanga kutungamirira hupenyu hwepabonde. Kuumbwa kwehuwandu hwekuzvimba kunowanzova nehuwandu hwepabonde. Kazhinji kacho, mapatya anoberekwa kubva pamuviri wakatanga mumwedzi yezhizha. Izvo zvinoenderana nemwedzi wekuberekwa kweamai - pakati pevakadzi vakaberekerwa kubva panguva yaJanuary kusvika munaMei, kazhinji pane kuve nepamuviri yakawanda.
Kazhinji, zvinofungidzirwa kuti vazhinji vane pamuviri vanotora kudzokorora. Yakafungidzirwa kuti mushure mokuberekwa kwemawere, mikana yekuita pamuviri yakawanda inowedzera ka3-10 nguva! Pano panewo mukana wekugara nhaka. Izvi zvinoreva kuti kune mikana yakawanda yekuberekera mapatya mune avo vane mhuri dzakange dzine maitiro akawanda ekuzvitakura.
Kubva kutanga kwema1970, kwakave nekuwedzera kwakanyanya kwenhamba yematambudziko evanhu vakawanda vane pamuviri munyika. Zvimwe zvinokonzera izvi zvinotendwa kuti zvinogara zvichiwedzera nekushandiswa zvakanakisisa nzira dzekudzivirira maitiro uye mahomoni ekushaya vana. Nzira dzekuita zvekuberekwa dzakatungamirira kumamiriro ezvinhu umo nyika dzakabudirira yakawedzera kuberekwa kwemafa ne 50%. Zvose izvi ndezvikonzero zvekupindira mune zvehutano.
Ngozi dzeKubata pamuviri
Odnoyaytsovye mapatya anowanzoita maduku muhukuru, kazhinji kazhinji ane hutano husina kunaka uye kakawanda anofa mudumbu muduku kupfuura maronda. Mamiriro ezvinhu akaipa kune intrauterine kukura, kusagadzikana kwezvokudya zvinovaka muviri, kazhinji umbilical cord loops, uyewo nhamba yakawanda yekuberekwa kusati yasvika kunowedzera kukanganisa kwehuwandu hwepamuviri.
Zvidzidzo zvezvipembenene zvevascular zvakaratidza kuvapo kwechirwere chisingawanzogadziriswa (vascular anastomoses), kunyanya mumapatya akafanana. Izvi zvinogona kukonzera embryonic-fetal transfusion, iyo inotungamirira kukuremara kana kufa kwekufa.
Iyo michero yakawanda mukati mechiberekero, yakawanda kuwanda kwechiropa, kuwedzera kwehutano, kuwedzera, kuwedzera kwemoyo, chiropa, itsvo. Somugumisiro, polyhydramnios inogona kukura. Kukura kwema fetus kunoderera, iyo inopera, kukura kwayo kunomira. Ichi chiitiko chinoratidzirwa nehutachiona hwehutachiwana, kuderera kwemazipa, kuderera kwemvura. Mune mamiriro ezvinhu, zvose fetusi zviri pahuwandu hwekukanganisa kwemwoyo. Kushungurudzika kwekupararira kwepascental kunogona kukonzera kukanganisa kana kuora mwoyo kwezvokudya zvekuberekwa (chimwe kana zvose).
Matambudziko aamai
Gestosis uye eclampsia inoitika katatu kakawanda kanowanzova nemitambo yakawanda pane kutora pamuviri. Muna 75% yezviitiko, kutora mimba yakawanda kunoguma nekuberekwa nguva isati yasvika. Iyo systolic mamiriro emubereki inenge isina simba uye isina kugoverwa. Placenta previa inowanzoitika. Muchiitiko ichi, ukuru hwepentecenta ine huwandu hwekuzvidzivirira huwandu hwakanyanya kudarika mukurara kwepamuviri. Izvi zvinokonzera njodzi yekubuda mukati uye kukanganisa. Somugumisiro wekupera kwemuviri we amniotic wemukomana wekutanga kana kusimba kwakasimba kwechibereko mushure mokuberekwa kwemawere ekutanga, musungwa wekutanga wepentecenta unowanzoitika. Chibereko chinenge chichirambidzwa panguva yekudzivirira, kazhinji pasina kukwanisa kugara chibvumirano mushure mokuberekwa. Uye kunyange zvazvo postpartum atony inowanzoitika, uye kuwanda kwepamuviri kunogona kukonzera kubuda ropa kwakanyanya.
Matambudziko e fetus (rimwe kana kupfuura)
Zvinetso zvepabonde zvinowanzoitika kakawanda kupfuura nekugara kwepamuviri. Izvi zvingave zvakakonzerwa nekunyorwa kwembilical kwehuropi, kushungurudzwa kwekudya kana kuberekwa kusagadzikana. Dambudziko guru rekumanikidzika kwemutsipa wembambo yembilical inowanikwa munyaya yemasonuclear twine ane amniotic cavity imwe chete. Inenge kaviri semapapiro akawanda evannoyaytsovyh uye mapatya anofa panguva yekuzvimba uye pakarepo asati aberekwa. Iyo ngozi kune mwana akaberekwa yakakwirira, maererano nenhamba yavo yose.
Dambudziko rezvakatipoteredza ndicho chikonzero chinowanzokonzera kufa kwekuberekwa mumatambudziko akawanda. Kuberekwa kwekutanga mwedzi mumwe chete isati yasvika iyo inokonzerwa nokusunungurwa kusati kwasara kwomwana kubva kumamitiotic fluid uye kusati kwasvika contract contractive basa rechibereko.
Zviitiko zvinowedzera huwandu hwekufa uye fetal malformations zvinotarisana nenzvimbo yavo. Izvi zvinokanganisa kupararira kweropa uye chiitiko chekupindira kwekupindira. Kupera kwemuviri wechimbichi kunowanikwa pakuberekwa kwevakawanda kanomwe kanowanzopfuura neyekugara. Chikonzero chekupera kufema uye kufa kwechecheche inogona kuva, somuenzaniso, kuvhara musoro wake munzvimbo isina kunaka asati aberekwa. Chinhu chakakosha ndiyo iyo inonzi zvinetso zveSaamese twins, umo kuberekwa nenzira yechisikigo hakugoneki.
Zvinetso zvePostpartum - kupona kwevana vachangobva kuberekwa mukutora mimba yakawanda kunoenderana nemhando dzose dzezvinetso zvinokanganisa uye mamiriro emucheche, kuchengetwa kwechecheche nezvimwe zvinhu zvakawanda.
Ndeipi mikana?
Chigumisiro chakanaka ndechekuti apo zvose fetusi zviri mu "musoro pasi" nzvimbo, apo kuberekwa kunogona kuitika zvakangoitika.
Maternal morbidity mumakamukamu akawanda anowanzoita 4-8 zvakapfuura kudarika pamuviri. Kufa kwevanaamai kwakawedzera zvishoma. Kana mwana wacho akaberekwa ari mupenyu, chikonzero chakanakisisa chekupona ndechezera remakore. Mune zviitiko zvakawanda, kufungidzira kwemapatya kana katatu zvinorema anopfuura 2500 g zviri nani kudarika michero imwechete yekuberekwa kwakafanana. Izvi zvinotevera kubva kunekuti zvibereko zvekudzivirirwa kwevakawanda zvakanyanya kukura.
Yechipiri yemapatya, sekutonga, iri mune ngozi huru kupfuura yekutanga. Inowanzova duku kuduku uye ine hutano hwepfungwa uye kukuvadzwa kwepinatal zvinogona kuita kuti zvikuvadze.
Same kana kwete?
Nekudzivirira pamuviri, mapatya, mapatya, katatu nezvimwe zvinogona kuva zvakaoma kusiyanisa. Kune dzimwe nguva mamiriro ezvinhu apo vabereki vane mapatya akafanana havagoni kusiyanisa vana vavo pachavo. Mumamiriro ekuberekwa kwemawere, anenge 10 muzana yevabereki vanoziva chokwadi chokuti havakwanisi kutumidza mwana zita, sezvo vakangovhiringidza kuti ndiani.
Kufanana kwemawele mupfungwa yekukurukurirana kwepedyo dzimwe nguva ndicho chinokonzera kushungurudzika kwemukati mukati kunobatanidza kusakwana kwakakwana kweruzivo rwevanhu. Mark Twain mubhuku rake roupenyu anotaura kuti mushure mekurasikirwa kwehama yake mapatya, kazhinji aishungurudzwa nemubvunzo uyu: "Ndeipi mumwe wedu ari mupenyu: iye kana ini."
Siamese twins
Siamese twins, kunyange munguva yedu, achiri chiitiko chisina kujairika chisingazivikanwi. Nokuda kwechikonzero chisingazivikanwi, vaviri bhumusi vanokura pamwe chete vasati vaberekwa nemativi akasiyana emuviri. Kupatsana kwekutanga kwemajaya eSiamese kwakaitika muThailand muna 1951 uye basa iri rakaitwa apo mapatya aiva nemakore maviri. Thailand yakanga ichizivikanwa seSiam. Nokudaro mapatya akadai, akabatana, uye akatanga kunzi "Siamese." Nhasi, nekubatanidzwa kwemichina yekuongororwa, zvinogona kugumiswa kuti kwete zvimwe zvikamu uye nhengo dzinowanikwa mumapatya, asiwo hukama hwepedyo hwemashure pakati pavo. Dzimwe nguva, nerufaro, mapatya eSiyaam anogona kugoverwa. Zvisinei, mushonga uchiri kuziva zvishoma nezvedambudziko iri.