Mimba yambiri ndi njira yowonongeka yomwe ma fetusi awiri kapena awiri amayamba panthawi yomweyo. Zimapezeka pa 1-1.6% ya mimba yonse. Tsopano pali kuwonjezeka kwa chiwerengero cha mimba yambirimbiri, yomwe ikukhudzana ndi ntchito yogwiritsira ntchito njira zothandizira kubereka.
Zifukwa za mimba zambiri
Poganizira zochitika za mimba yambiri, madokotala nthawi zambiri amazindikira zomwe zimayambitsa zochitika zawo. Malingana ndi maphunziro awo ndi zochitika, izi sizikhoza kuchitika kwa mayi aliyense angathe. Zina mwa zinthu zomwe zimayambitsa mimba yambiri, madokotala amadziwa izi:
- Zosintha zamoyo. Malingana ndi kafukufuku wa geneticists, amayi omwe ali ndi pakati ambiri pa amayi (kuchokera kwa agogo aakazi, agogo-aakazi) amakhala oposa 6-8 kuposa ena kuti akhale amphongo.
- Zaka. Chifukwa cha kusintha kwa mahomoni pamapeto kwa zaka 35 kwa amayi, mazira angapo amatha kupsa pa nthawi ya kusamba, zomwe zimapangitsa mpata kubereka mapasa.
- Kulandira mankhwala. Kawirikawiri, motsutsana ndi kumwa mankhwala omwe amachititsa kuti mankhwala a mahomoni asamalidwe.
- Kukhalapo kwa obadwa angapo mu anamnesis. Mimba zambiri zimakhala zolembedwa ndi madokotala amayi omwe ali ndi pakati.
- IVF. Mu njira ya feteleza ya extracorporal , maselo angapo a kugonana amasampulidwa mwakamodzi, omwe, pambuyo pa umuna, amaikidwa mu chiberekero. Mpata wa mazira angapo amamangirira nthawi yomweyo.
Mimba mapasa
Pogonana ndi mapasa a dizygotic, mapasa amawonekera. Kawirikawiri majeremusi amawatcha kuti raznoyaytsevye. Kukula kwa zipatso zotero kumachitika ndi feteleza imodzi imodzi ya ma oocyte osiyana. Pachifukwa ichi, kusasitsa kwa maselo amtunduwu kumapezeka mu ovary imodzi komanso m'mimba mwake. Kuwonetsera kwa kukula kwa ma dizygotic mapasa kungapangidwe pa mzere wa amayi. Ana obadwa chifukwa cha mimba imeneyi akhoza kukhala osagonana kapena amuna kapena akazi okhaokha.
Pofotokoza za mimba ya mapasa, zozizwitsa za njirayi, madokotala amadziŵa kuti ngati raznoyaytseva kawiri m'mimba mwa amayi, ma pulasitiki awiri amakhala opangidwa nthawi zonse. Kawirikawiri amakhala pafupi, ngakhale akhudza, koma nthawi zonse amagawidwa. Mimba iliyonse imayikidwa mu fetus (fetus) yosiyana, yomwe imasiyanitsidwa ndi seveni. Mu mapangidwe oterewa muli 2 chorionic ndi 2 amniotic nembanemba.
Mimba ndi mapasa
Pankhani imeneyi, kukula kwa mimba zambiri kumabwera chifukwa cha kupatulidwa kwa dzira limodzi la fetal m'zigawo zosiyanasiyana za kukula kwake. Nthawi zambiri kubadwa kwa ana otere sikudutsa maulendo 3-5 pa kubadwa kwa 1000. Kugawanika kwa dzira la feteleza mu magawo awiri ofanana pa gawo limodzi kungayambidwe chifukwa cha kuchedwa kwa kukhazikitsidwa, kuswa kwa acidity ndi maonekedwe a ionic a chilengedwe, ndi zotsatira za zinthu zakunja pa thupi.
Kukula kwa monozygotic mapasa kungakhale chifukwa cha umuna wa ovum, womwe unali ndi nuclei 2 kamodzi. Pamene kulekana kwa dzira la feteleza kumachitika mkati mwa masiku atatu pambuyo pa umuna - zipatso zimakhala ndi placenta ndi amniotic cavity. Pakagawanika masiku 4-8 kuchokera ku selo la chiwerewere, mazira awiri amapangidwa, omwe ali ndi sachesi yamadzi, koma ndi placenta yofanana.
Pamene kupatulidwa kumachitika pa tsiku la 9 mpaka 10 mutatha umuna, mazirawo amalandira sachesi ya amniotic ndi pulasitiki imodzi. Kupatukana kwa dzira pa tsiku 13-15 kungayambitse matenda - kusagwirizana kwathunthu, komwe kumabweretsa chitukuko cha mapasa a Siamese. Pali zovuta kwambiri - 1:50 000-100 000 mimba za mimba.
Mwamwambo wa mimba zambiri
Ndi kulengedwa kwa chibadwidwe, kukhala ndi ana angapo kamodzi ndi kochepa - 1.5-2%. Mu ma 99% awa ndi mapasa, ndipo katatu ndi zipatso zambiri sichidziwikiratu - zosakwana 1% za kugonana. Pa nthawi yomweyi, madokotala anapeza nthawi zonse - nthawi zambiri pali mimba yambiri ndi IVF. Izi zathandizira zipangizo zamakono zokhudzana ndi kubereka zimaphatikizapo kuikidwa mu chiberekero cha mazira angapo kamodzi, omwe angathe kuikidwa bwino. Pankhani ya kubadwa kwa chibadwidwe, mwayi wa kubadwa kwa mapasa ukuwonjezeka patatha zaka 35.
Zizindikiro za mimba zambiri
Pamene mimba yambiri imayamba, zizindikiro zomwe zimayambidwa poyamba sizimasiyana ndi zomwe zimalembedwa ndi mayi atatenga mwana mmodzi. Izi zimapangitsanso funso lobwerezabwereza la amayi omwe amayembekezera omwe amadwala madokotala, panthawi yanji mimba yambiri ingathe kutsimikiziridwa. Kugwira ntchito muyiyi ndi ultrasound, yomwe imapereka zotsatira zowonjezereka kwambiri ndipo ikhoza kuchitidwa mwamsanga masabata 4-5.
Kuthamanga kwa mimba zambiri
Musanayambe kutenga mimba yambiri mothandizidwa ndi ultrasound, dokotala amapenda kukayezetsa amayi oyembekezera. Lingaliro lakuti mkazi akumanyamula mapasa, akatswiri a ma gynecologists amatha kukula kukula kwa chiberekero, chomwe chimakhala choposa nthawiyi. Zizindikiro zina za mimba zambiri sizilipo. Pokhapokha ngati mukupanga ultrasound mu uterine cavity, mazira angapo amadziwika. Potero, tcherani khutu ku zinthu zofunika zomwe zingakhudzepo njira zowonjezera:
- kuchuluka kwa placenta (choriality);
- chiwerengero cha ziwalo za fetus (amniotic).
HCG m'mimba yambiri
Mlingo wa hCG pakupezeka kwa mimba yambiri imakhala yochepa kwambiri. Kuwonjezeka kwa chizindikiro ichi kungawonedwe kuti ndi chizindikiro cha matenda, kuphwanya kakulidwe ka fetal. Njirayi silingamvetsetse bwino zomwe zimachitika mimba yapadera - sizingatheke kudziwa momwe mkazi alili ndi pakati. Mmene hCG imasinthira pafupifupi mimba yambiri pamimba, mukhoza kuwona mu tebulo ili m'munsiyi.
Mimba yambiri - zoopsa
Mimba yambiri imakhudza thupi kwambiri. Chotsatira chake, mwayi wokhala ndi matenda okhudzana ndi thanzi la mkazi kapena panthawi ya mimba ndipamwamba. Kaŵirikaŵiri pakuchita, zotsatira zotsatizana za mimba zambiri zimachitika:
- kutaya padera ali wamng'ono;
- kubereka msanga ;
- kufa kwa intrauterine kamodzi mwa fetus;
- late gestosis;
- kupweteka kwa chiberekero;
- hypoxia wa mmodzi kapena ana onse;
- kuchedwa pa chitukuko;
- Kusakanikirana ndi mapangidwe a mapasa a Siamese.
Kubereka ndi kutenga mimba zambiri
Pamene mimba yambiri imapezeka nthawi zambiri, tizilombo tomwe timapezeka nthawi yayitali, kubereka kungatheke mwachibadwa. Poganizira zodziwika bwino zogwira ntchito panthawi yoyembekezera, madokotala amatha kuwonjezeka mwayi wokhala ndi zofunikira zowonongeka kwa odwala matendawa. Masabata 3-4 isanakwane tsiku loti abwerere, mayi ali kuchipatala, akuyesa ndi kuyesa vutoli. Kukula kungatheke malinga ndi zochitika izi:
- Ngati pangakhale zovuta pa nthawi yomwe ali ndi mimba, imodzi mwa fetus imapezeka pang'onopang'ono, zonsezi zimakhala ndi pathupi kapena pali chiberekero pachiberekero cha mimba yapitalo - zimayambitsa gawo lokonzekera.
- Mimba ya mimba ndi yokhutiritsa, makanda ali pamtunda wautali - amapanga kubadwa kwachirengedwe.