Ukuzalwa kwabantwana ababini okanye ngaphezulu kwangoko ngexesha lethu akuqhelekanga. Ukukhulelwa okuninzi kwenzeka rhoqo rhoqo ngonyaka. Amawele kunye neentathu azisayi kubangela eso siqhwithi sengqondo, njengangaphambili. Nangona kunjalo, ukuzalwa kwabo akuyiqondi kakuhle into. Ngoko, ukuthini ukukhulelwa okubanzi: amawele, amawele - isihloko sesingxoxo namhlanje.
Xa ukhulelwe ngokuphindaphindiweyo, amabhinqa amabini okanye ngaphezulu aveliswa ngexesha elifanayo kwisibeleko. Ngokuxhomekeke kwinani labo, kamva bazalwa: amawele, ama-triplets, iigumbi kunye nokunye. Ifomu eqhelekileyo yokukhulelwa okuphezulu kumntu kukukhulelwa kweqanda elilodwa. Iyakwazi ukuvela kwiqanda elilodwa elinomhlaza kunye nakwi-spermatozoon eyodwa. Ukukhula ngokukhulelwa okunjalo, amawele, njengoko uyaziyo, afana ngokufanayo. Zisoloko zifana ngesini esinye kwaye zifumana ikhowudi efanayo.
Ukukhulelwa kwamaninzi kungakhokelela ekukhuliseni amaqanda amabini ahlukeneyo kunye ne-spermatozoa ehlukeneyo. Ngenxa yoko, iibhokhwe ezimbini zikhulayo, ezinokuthi zibe nye okanye zesini ezahlukeneyo, kwaye iifowuni zabo zofuzo azifani. Kodwa, kunjalo, kwimeko yokuqala, zibizwa ngokuba ngamawele. Bayabanye abazalwana kunye noodade ngokulinganayo kunye nabazalwana kunye noodade abavela kwiindawo ezimbini zokukhulelwa ezihlukeneyo.
Ukukhulelwa kwamaninzi kumaqiniso kunye namanani
Kucingelwa ukuba ukuchumisa apho amawele azalwayo yingozi engcolileyo. Le nyaniso ayikho mpe mbelelo kwi-heredity okanye nayiphi na into yangaphakathi okanye yangaphandle. Inani labo lisoloko lihlala kwaye li malunga ne-0.4% yenani labazali. Ngokwabanye abaphandi, kubo bonke abantwana abangama-80 bazalwa ngokuzalwa kwamawele.
Nangona kunjalo, kwiminyaka emininzi yophando, iipatheni ezithile zityhilwa. Ngoko, ukukhulelwa kwamawele kuxhomekeke kwizinto ezininzi. Eyona nto ibalulekileyo kukuba: ukuzalwa, ubuhlanga, indawo, ubunzima bomama kunye neqondo lokuzala, kwakunye nezinga le-hormonal.
Ipesenti ephantsi kakhulu yokukhulelwa okuphindaphindiweyo kubonakala kumazwe asempuma, ephezulu kwiAfrika, kunye nomyinge waseCaucasus. E-China, eli nani lisuka kwi-0.33 ukuya kwi-0.4%, kwaye eNtshona Nigeria isondela kwi-4.5%. E-Caucasians, ipesenteji yokuzalwa kwamawele ngokumalunga nenani elipheleleyo lokuzalwa livela kwi-0.9 ukuya ku-1.4%.
Ukuvama kokukhulelwa okuxhomekeke kuncinci kwiminyaka kamama. Ipesenti ephantsi kakhulu (0.3%) yafunyanwa kwabasetyhini abangaphantsi kweminyaka engama-20 nangaphezu kwama-40, kwaye iphezulu (1.2-1.8%) eneminyaka engama-31-39. Ubuhle bokuzalwa kwamawele buya kwanda kunye nenani lokuzalwa. Kwafunyaniswa ukuba ukukhulelwa okuphezulu kunkulu kunikezelo lwesithathu okanye olwalandelayo.
Abaamaamaamawele ngamaxesha amaninzi abafazi abangatshatanga, abafazi abanesisindo esithinteleyo, kunye nabo baye baqala ukukhokela ubomi bokulala ngokwesondo. Ukwakhiwa kokukhulelwa okubanzi kunokwenzeka kakhulu kwinani lezesondo zesondo. Ngokuqhelekileyo, amawele azalwa ngokukhulelwa okwaqala kwiinyanga zasehlobo. Kuxhomekeke kwinyanga yokuzalwa komama - phakathi kwabasetyhini abazalwa ngexesha lokusukela ngoJanuwari ukuya kuMeyi, ngokuqhelekileyo kukho ukukhulelwa okuphindaphindiweyo.
Ngokuqhelekileyo, kukholelwa ukuba ukukhulelwa okuphindaphindiweyo kudla ukuphindaphinda. Kwaqikelelwa ukuba emva kokuzalwa kwamamawele ukukhulelwa okuphindaphindiweyo kwanda ngama-3-10 maxesha! Kukho kwakhona amathuba okuba uzuze ifa. Okokuthi, kunamathuba amaninzi okuzalela amawele kwiiintsapho zabo apho kukho iimeko zokukhulelwa okubanzi.
Ukususela ekuqaleni kwee-1970, kuye kwanda ukwanda kwenani lamatyala okukhulelwa okubanzi kwihlabathi. Iimbangela zeli bakala zikholelwa ukuba zisebenzisana ngokubanzi nangendlela esebenzayo yeendlela zokuchithwa kwempahla kunye nokunyanga kwe-hormonal infertility. Izindlela zokuvelisa ngokubakho zenzeke kwiimeko apho amazwe athuthukile awandise izinga lokuzalwa kwamawele ngama-50%. Yonke le miphumo yongenelelo lwonyango.
Ingozi Yokukhulelwa Kwabaninzi
Odnoyaytsovye iwele zihlala ziyingcinci ngobukhulu, ngokuqhelekileyo zineentsholongwane zesifo sobungqingili kwaye zidla ngokufa kwisibeleko kunokuba isifo segazi. Izimo ezimbi zokuphuhliswa kwamanye amazwe, ukungondleki, iisandi zomnxeba rhoqo, kunye nenani elikhulu lokubeleka kwangaphambi kwexesha elidlulileyo libuhlungu ngakumbi ukukhulelwa kokukhulelwa.
Uphando lwezinto ze-vascular compounds lubonakalisa ubukho bendalo obungavamile (i-anastomoses ye-vascular), ikakhulukazi ngamawele afanayo. Ezi zixhobo zingabangela ukumpontshelwa kwe-embryonic-fetal, ekhokelela ekukhubazekeni okanye ekufeni komntwana.
Iziqhamo ezingakumbi kwisibeletho, esikhulu isixa sokujikeleza kwegazi, uxinzelelo lwegazi, ukukhukhumeza, ukwandisa intliziyo, isibindi, iintso. Ngenxa yoko, i-polyhydramnios iyakhula. Ubungakanani bentsholongwane buyancipha, bubuhlungu, ukukhula kwawo kume. Le meko ibonakaliswa yintsholongwane yegazi, ukujikeleza kwegazi okungaphantsi, ukutyhila kwamanzi. Kule meko, bobabini abathatyayo banomngcipheko wokwanda kweentsilelo zentliziyo. Ukuphazamiseka kwi-circulation circulation kungakhokelela kumonakalo okanye ukuphazamiseka kokutya kwesisu (enye okanye yonke).
Iingxaki zomama
I-Gestosis kunye ne-eclampsia zenzeka kathathu ngokuphindaphindiweyo ngokukhulelwa okuphindaphindiweyo kunokukhulelwa okuqhelekileyo. Kwi-75% yamatyala, ukukhulelwa okubanzi kuphelela ekuzalweni kwangaphambi kokuzalwa. Isimo se-systolic se-uterus sibuthathaka kwaye sidibene. I-Placenta previa inokwenzeka kakhulu. Kule meko, ubungakanani be-placenta kunye nokukhulelwa okuphezulu kuninzi kakhulu kunokukhulelwa okuqhelekileyo. Oku kudala ingozi yokuphuma kwangaphakathi kunye nokuthintela. Njengomphumo wokugqithwa kwimbumba ye-amniotic ye-fetus yokuqala okanye ukuchithwa okuqinileyo kwesibeleko emva kokuzalwa kwe-twin yokuqala, i-detachment yangaphambi kwesikhathi ye-placenta ihlala ikhona. Isibeleko sithinteka kakhulu ngexesha lokukhulelwa, kaninzi singenakho ukuhlala sivumelwano emva kokubeleka. Kwaye nangona i-atony postpartum yinto eqhelekileyo, ngokukhulelwa oku kuninzi kunokubangela ukuphuma kwegazi.
Iingxaki ze-fetus (enye okanye ngaphezulu)
Ukuxhatshazwa kokubeleka kwenzeka ngokuphindaphindiweyo kunokukhulelwa okuqhelekileyo. Oku kungakho ngenxa yokunyanzeliswa kwesimo sengqondo, ukuphazamiseka kokutya okanye ukungabikho komntwana. Umngcipheko omkhulu wokunciphisa intamo yomtya we-umbilical uyabonwa kwimeko yamawele enononuclear kunye nesigidi esisodwa se-amniotic. Phantse kabini amawele angama-odnoyaytsovyh namawele afa ngexesha lokukhulelwa kwaye nangoko ngaphambi kokubeletha. Umngcipheko kumntwana omdala uphezulu, ngokumalunga nenani labo elipheleleyo.
Ingxaki yokusingqongileyo yimbangela ebalulekileyo yokufa komntwana ekukhulelweni ezininzi. Ukuzalwa kwasekuqaleni ubuncinane inyanga enye ngaphambi kokuba i-term isiphumo sokukhululwa kwangaphambi komntwana kwi-amniotic fluid kunye nomsebenzi osesikhatyathwa wokubambisana kwesibeletho.
Izinto eziphakamisa izinga lokufa kunye nokukhubazeka kwentlungu kuxhomekeke kwindawo yazo. Oku kuchaphazela ukujikelezwa ngokubanzi kwegazi kunye nomngcipheko wokungenelela ngoncedo. I-prolapse ye-strings umbilical yenzeke ngokukhulelwa okuphindwe kabili ngaphezu kwesihlandlo esivamile. Isizathu sokuphefumula nokufa komntwana kungumzekelo, ukubetha intloko kwindawo engafanelekanga ngaphambi kokubeletha. Icandelo elikhethekileyo yinto ebizwa ngokuba yimpumelelo yamawele e-Siam, apho ukuzalwa ngokwemvelo kungenakwenzeka.
Iingxaki zePostpartum - ukusinda kweentsana ekukhulelweni ezininzi kuxhomekeke kwimiba yobunzima be-obstetric kunye nemeko yobusana, ukunakekelwa kwintsana kunye nezinye izinto ezininzi.
Ziziphi amathuba?
Isiphumo esona siphumo xa bobabini abantwana befestile "kwindawo ephantsi", apho ukuzalwa kungahle kwenzeke khona ngokwemvelo.
Ukukhulelwa komama ngokukhulelwa okuphindaphindiweyo kunamaxesha angama-4 ukuya phezulu kunokuba ukhulelwe ngokuqhelekileyo. Ukufa kwabamama kwabakho ukukhula kancinci. Ukuba umntwana wazalwa ephilileyo, umlinganiselo ophezulu wokusinda ngumlinganiselo wokunyusa. Kwimiba amaninzi, ukuxeliswa kwamawele okanye ama-triplets anesisindo esingaphezulu kwe-2500 g kungcono kuneziqhamo ezifanayo zesisindo sokuzalwa esifanayo. Oku kulandela kwinto yokuba iziqhamo zokukhulelwa ezininzi zikhulile.
Okwesibini kweamawele, njengommiselo, usemngciphekweni omkhulu kunowokuqala. Ngokuqhelekileyo lincinci ngobukhulu kwaye lunezifo zengqondo kunye nokulimala komzimba kwangoku kubangela ukulimaza.
Ngokufanayo okanye akunjalo?
Ngokukhulelwa okuphindaphindiweyo, amawele, amawele, ama-triplethi njalo njalo kunokuba nzima kakhulu ukwahlula. Kukho amaxesha apho abazali beewele ezifanayo bengakwazi ukwahlula abantwana babo. Kwimeko yokuzalwa kwamawele, malunga ne-10% yabazali bayayibona into yokuba abanako ukubiza igama ngamagama, kuba sele badidekile ngubani.
Ukufana kwamawele ngeendlela zokuthetha ngokukhawuleza ngamanye amaxesha kubangelwa izidumbu ezininzi zangaphakathi ezibandakanya ukungaqondi kakuhle komntu ngamnye. UMarko Twain kwincwadi yakhe yomntu uthi emva kokulahlekelwa ngumzalwana wakhe wamawele, wayehlala ehlushwa ngumbuzo othi: "Ngubani na ophilayo: yena okanye mna."
Amawele aseSiam
Amawele e-siamese, nangethuba lethu, isengumzekelo wezinto eziphilayo ezingachangekiyo. Ngesizathu esingaziwa, iifubus ezimbini zikhula kunye nangaphambi kokuzalwa ngamalungu ahlukeneyo omzimba. Ukwahlukana okuphumelelayo kokuqala kwamawele e-Siam kwenzeka eThailand ngo-1951 kwaye lo msebenzi wenziwa xa amawele ephakathi kweminyaka emibini ubudala. I-Thailand yaziwa ngoko-ke njengeSiam. Ngenxa yoko loo mawele, adibana kunye, kwaye waqala ukubizwa ngokuba ngu "Siamese." Namhlanje, ngokuthatha inxaxheba kwezixhobo zokuxilonga, kunokugqitywa ukuba akukhona nje ezinye iindawo kunye nezitho eziqhelekileyo kumawele, kodwa kunye nezixhamlwane ezisondelene kakhulu phakathi kwazo. Ngamanye amaxesha, ngethamsanqa, amawele e-Siam angabelana. Nangona kunjalo, iyeza lisazi kakhulu ngolu hlobo.