Ukukhulelwa okuphindaphindiweyo yinkqubo yokuzinyantya apho i-fetus 2 okanye ngaphezulu ikhula ngokukodwa ngexesha lesisu. Kwenzeka kwi-1-1.6% yokhuseleko lonke. Ngoku kukho ukunyuka kweziganeko zokukhulelwa okubanzi, okuhambelana nokusetyenziswa okusebenzayo kwezobuchwepheshe bokuzala.
Izizathu zokukhulelwa ezininzi
Ngokuqwalasela iimpawu zokukhulelwa okuphindaphindiweyo, oogqirha bahlala beqwalasela izizathu zokuvela kwazo. Ngokutsho kwezifundo kunye nokuqwalasela, oku akunakwenzeka kuzo zonke iimama. Phakathi kwezinto ezibangela ukukhulelwa okuphindaphindiweyo, oogqirha bajonga oku kulandelayo:
- I-Genetic predisposition. Ngokutsho kweengcaphephe zengcali ze-geneticists, abafazi abaye bafumana ukukhulelwa okubanzi kwinqanaba lesetyhini (ku-grandgothers, grand-grandmothers) banamathuba ama-6-8 ngaphezu kwamanye ukuba babe ngamama amawele.
- Ubudala. Ngaphantsi kwempembelelo ye-hormones e-foremenopausal emva kweminyaka engama-35 kubasetyhini, amaqanda amaninzi anokuvuthwa ngexesha lomjikelezo wesini, okwandisa amathuba okukhulelwa amawele.
- Ukufumana amayeza. Ngokuqhelekileyo, malunga nemvelaphi yokuthatha izidakamizwa ezichanekileyo ze-hormonal (unyango olungenalo unyango, ukukhuthazwa kwe-ovulation), kukho ukuvuthwa kweeqanda eziliqela ezinokuzaliswa.
- Ubuninzi bokuzalwa kwabaninzi kwi-anamnesis. Ukukhulelwa okuphindaphindiweyo kubhalwa ngokugqithiswa ngamayeza kwabasetyhini abakhulelweyo.
- IVF. Kwinkqubo yokuchumisa i-extracorporal , iiseli ezithandathu zesini zithatyathwa ngokukhawuleza, eziza kufakwa kwisisu. Ikhefu leembrus eziliqela lixhomeke kwangoko liphezulu.
Ukukhulelwa ngamawele
Ekukhulelweni kwamawele angama-dizygotic, amawele avela ekukhanyeni. I-Genetics isoloko ibhekisela kuzo njenge-raznoyaytsevye. Ukuphuhliswa kweziqhamo ezinjalo kwenzeka kunye nokutyalwa kwamanye ama-oocyte ahlukeneyo. Kule meko, ukutshatyalaliswa kwezi ntsholongwane zentsholongwane kuya kwenzeka kwi-ovary enye kunye nakwii-ovari ezahlukeneyo. Ukubonakalisa ukuphuhliswa kwamawele angama-dizygotic kunokufumana ilifa kumgca womama. Abantwana abazalwa ngenxa yolu hlobo lokukhulelwa banokuthi bangabambulana okanye baxhatshaze.
Ukuchaza ukukhulelwa kwamawele, iindawo ezizodwa zolu cwangciso, oogqirha bayaqaphela ukuba xa i-raznoyaytseva kabini kwisibeleko sikamama, ii-placentas zihlala zakha. Ngokuqhelekileyo basondelene, kunye nokuthintela, kodwa banokuhlala behlulwe. I-embryo nganye ifakwe kwi-fetus ehlukeneyo (fetus), eyahlukana ne-septum. Kulo hlobo lwama-anatomiki kukhona i-chorionic ne-2 amniotic membranes.
Ukukhulelwa ngamawele
Kule meko, ukuphuhliswa kokukhulelwa okuninzi kwenzeka ngenxa yokuhlukana kweqanda elilodwa lomntwana kwiindawo ezahlukeneyo zophuhliso lwayo. Ubunzima bokuzalwa kwabantwana abanjalo abugqithisi ama-3 ama-ngalinye ngokuzalwa kwama-1000. Ukwahlula kweqanda elichumisiweyo libe yizingxenye ezilinganayo ezi-2 kwelinye lamanyathelo kungabangelwa ukulibaziseka kokufakelwa, ukuphulwa kwe-asidi kunye nokubunjwa kwe-ion yendalo, kunye nefuthe lezinto zangaphandle emzimbeni.
Ukuphuhliswa kwamawele e-monozygotic kungabikho ngenxa yokuchumisa i-ovum, ene-2 nuclei kanye. Xa ulwahlulo lweqanda oluchumayo lwenzeka emva kweentsuku ezi-3 emva kokuchumisa - iziqhamo zinalo nganye iplascenta kunye ne-amniotic cavity. Xa ukwahlula kwixesha leentsuku ezi-4-8 ukusuka kwisini lesini, ii-embrosi ezi-2 zenziwe, ngasinye sine-sac amniotic yayo, kodwa i-placenta ephakathi ezimbini.
Xa ulwahlulo lubonakala ngomhla we-9-10 emva komhla wokufumba, ama-embrasi afumana isigxoba esisodwa se-amniotic kunye ne-placenta enye. Ukwahlukana kweqanda ngomhla we-13-15 kunokubangela ukukhubazeka okungafaniyo, okukhokelela ekuphuhlisweni kwamawele e-Siam. Kukho inqabileyo kakhulu - 1:50 000-100 000 iimeko zokukhulelwa.
Ukukhulelwa kwamathuba amaninzi okukhulelwa
Ngokuveliswa kwemvelo, amathuba okuba nabantwana abaningana bancinci - 1.5-2%. Kwi-99% yamatyala lawa mawele, kunye nezilwanyana kunye neziqhamo ezingaphezulu aziqhelekanga kakhulu-ngaphantsi kwe-1% yazo zonke izigulane. Ngelo xesha, oogqirha bafumanisa rhoqo - ngokuqhelekileyo kukho ukukhulelwa okubanzi ne-IVF. Oku kuncedisa iteknoloji yokuzala kubandakanya ukufakwa kwisigxina se-uterine yeembrusi eziliqela kanye, okungafakwa ngempumelelo. Kwimeko yokuveliswa kwemvelo, ithuba lokuzalwa kwamawele likhula emva kweminyaka engama-35.
Izibonakaliso zokukhulelwa ezininzi
Xa ukukhulelwa okuninzi kukhula, imiqondiso eboniswe kwinqanaba lokuqala ayifani naleyo erekhodiweyo yowesifazane xa ethwele umntwana omnye. Le nyaniso inokubangela ukuba umama okhuselekileyo onomdla oogqirha, unomdla wokuba ukhulelwe ngamathuba amaninzi. Ukusebenza kule meko yi-ultrasound, enika umphumo ochazayo kwaye ungenziwa emva kweeveki ezi-4-5.
Ukukhulelwa kokukhulelwa okubanzi
Ngaphambi kokugqiba ukukhulelwa okubanzi ngoncedo lwe-ultrasound, ugqirha uqhuba uviwo lomfazi okhulelweyo. Ukucinga ukuba ibhinqa lithwele amawele, abafazi abanamava abanobuchule banokwenza ukwanda okwenyuka kwesibeleko, okungaphezulu kwesiqhelo kweli xesha. Ezinye iimpawu zokukhulelwa ezininzi azikho. Kuphela xa kuqhutywe i-ultrasound kwisibilini se-uterine, iimbumba ezininzi zibonwa ngokubonakalayo. Ngokwenza njalo, khawuqwalasele iimpawu ezibalulekileyo ezingasichaphazela ngakumbi iindlela zokuhambisa:
- isixa seepentecenta (i-choriality);
- inani lama-blister fetal (amniotic).
I-HCG ngokukhulelwa okubanzi
Iqondo le- hCG ekuxilongweni kokukhulelwa okungafaniyo lincinane. Ukwandiswa kwesi sixalathisi kunokuthathwa njengophawu lwe-pathology, ukuphulwa kwenkqubo yokuphuhlisa umntwana. Le ndlela ayiyiqondi ngokupheleleyo iinkalo ezithile zokukhulelwa okuthethileyo-akunakwenzeka ukucacisa ukuba umfazi ukhulelwe kangakanani. Indlela iHCG iguquka ngayo malunga nokukhulelwa okuphindaphindiweyo ngeveki, uyayibona kwitheyibhile elingezantsi.
Ukukhulelwa okuninzi - ingozi
Ukukhulelwa okuninzi kuthintela umzimba kakhulu. Ngenxa yoko, ithuba lokuphuhlisa i-pathologies ehambelana nempilo yowesifazane okanye ngenkqubo yokukhulelwa iphezulu. Ngokuqhelekileyo ekusebenzeni, ezi nkathazo ezilandelayo zokukhulelwa ezininzi zivela:
- ukutshatyalaliswa komzimba kwasebuncinaneni;
- ukuhanjiswa kwangethuba ;
- ukufa kwangaphakathi kwesinye somntwana;
- gestosis ekupheleni;
- isifo semva
- i-hypoxia enye okanye zombini iintsana;
- ukulibaziseka ekuphuhlisweni;
- ukuxuba kunye nokubunjwa kwamawele e-Siam.
Ukuzala ngokukhulelwa okubanzi
Xa ukukhulelwa okuphindaphindiweyo kwenzeka ngokuqhelekileyo, abantwana abaselula bafumaneka ngokude, ukuhanjiswa kunokwenzeka ngendlela yendalo. Ukuqwalasela iimpawu eziqhelekileyo zokuqhuba umsebenzi ngexesha lokukhulelwa okuphezulu, oogqirha banokunyuka kwimiba yokuphuhlisa imfuno yokufumana iimeko zokuphucula iimeko zoxinzelelo. Iiveki ezingama-3-4 phambi komhla wokulindelwa kokunikezelwa, ibhinqa igqirha, lihlola kwaye livavanye imeko yembambano. Uphuhliso lunokwenzeka ngokubhekiselele kwenye yezi zilandelayo:
- Ukuba kwakukho iingxaki ngexesha lokukhulelwa, enye yeemfesane itholakala ngapha nangapha, zombini i-pelvic presentation okanye kukho inqamlezo kwisibeleko ukusuka ekukhulelweni kwangaphambili-baqhuba icandelo elithintelo elicwangcisiweyo.
- Umqathango okhulelwe unelisayo, iintsana zihlala kwindawo ephezulu-zenza ukuzala komzimba.