Ukubelethwa kwezingane ezimbili noma ngaphezulu ngesikhathi esisodwa akuvamile. Ukukhulelwa okuphindwe kaningi kwenzeka kaningi njalo ngonyaka. Amawele namathathu ayengasabangeli izimo zomoya, njengangaphambili. Noma kunjalo, ukuzalwa kwabo kusengakacaciswanga ngokugcwele. Ngakho-ke, ukukhulelwa okuningi: amawele, amawele - isihloko sezingxoxo namuhla.
Ngokukhulelwa okuphindwe kabili, izibeletho ezimbili noma ngaphezulu zikhula ngesikhathi esisodwa esibelethweni. Kuye ngenani labo, kamuva bazalwa: amawele, ama-triplets, amakamelo nokunye okunjalo. Ifomu elivame kakhulu lokukhulelwa okuningi kumuntu ukukhulelwa kweqanda elilodwa. Kungabuka iqanda elilodwa elikhulelwe futhi lisuka ku-spermatozoon eyodwa. Ukukhula ekukhulelweni okunjalo, amawele, njengoba uyazi, afana ngokuphelele. Bahlale benesidingo esifanayo futhi banakho ikhodi efanayo.
Ukukhulelwa okuphindaphindiwe kungabuye kube umphumela wokukhulelwa kwamaqanda amabili ahlukene nge spermatozoa ehlukene. Ngenxa yalokho, ama-fetus amabili akhula, okungaba ngobulili owodwa noma obuhlukile, futhi amakhodi abo we-genetic awafani. Kodwa nokho, njengalabo bokuqala, kuthiwa namawele. Ziba nomunye nomunye abazalwane nodade ngendlela efanayo nabazalwane nodade abavela kokukhulelwa okuhlukene okubili.
Ukukhulelwa okuningi emaqinisweni nezinombolo
Kucatshangwa ukuthi ukukhulelwa lapho amawele azalwa khona kuyingozi engcolile. Leli qiniso alinethonya ekufezeni noma kunoma yiziphi izinto zangaphakathi noma zangaphandle. Inombolo yabo ihlale ihlala njalo futhi ingaba ngu-0.4% wezinombolo zokuzalwa. Ngokusho kwabanye abacwaningi, kubo bonke abazalwa abangu-80 kukhona ukuzalwa okulodwa kwamawele.
Kodwa-ke, phakathi neminyaka eminingi yocwaningo, amaphethini athile abonakalisiwe. Ngakho, ukukhulelwa kwamawele kuncike ezintweni eziningi. Okubaluleke nakakhulu yilezi: ubufebe, ubuhlanga, imvelo, ubudala bomama kanye nezinga lakhe lokuzala, kanye nezinga le-hormonal.
Iphesenti eliphansi kakhulu lokukhulelwa okuphindaphindiwe libhekwa emazweni asempumalanga, eliphakeme kunawo wonke e-Afrika, futhi eliphakathi kwamaCaucasian. E-China, lesi sibalo sisuka ku-0.33 kuya ku-0.4%, futhi eNtshonalanga yeNigeria isondela ku-4.5%. E-Caucasians, iphesenti lokuzalwa kwamawele ngokuphathelene nenani eliphelele lokuzalwa livela ku-0.9 kuya ku-1.4%.
Ukuvama kokukhulelwa okuxhomeke kakhulu kuncike eminyakeni yobudala. Amaphesenti aphansi kakhulu (0.3%) atholakale kwabesifazane abaneminyaka engama-20 nangaphezulu kuka-40, futhi abaphakeme kakhulu (1.2-1.8%) baneminyaka engu 31-39. Amathuba okubeletha amawele nawo akhula nenani lokuzalwa. Kutholakale ukuthi kungenzeka ukuthi ukukhulelwa okuningi kubaluleke kakhulu ekuhambisweni kwesithathu noma okulandelayo.
Amama amawele kaningi abesilisa abangashadile, abesifazane abanesisindo esiningi, futhi nalabo abaye baqala ukuhola baqala ukuhola impilo yocansi. Ukubunjwa kokukhulelwa okuphezulu kuningi kakhulu nenani elikhulu kakhulu lobulili. Ngokuvamile, amawele azalwa ngokukhulelwa okwaqala ezinyangeni zasehlobo. Kubuye kuncike enyangeni yokuzalwa komama - phakathi kwabesifazane abazalwa esikhathini kusukela ngoJanuwari kuya kuMeyi, kaningi kukhona ukukhulelwa okuningi.
Ngokuvamile, kukholelwa ukuthi ukukhulelwa okuningi kuvame ukuphinda. Kwacatshangwa ukuthi emva kokuzalwa kwamawele amathuba okukhulelwa okukhudlwana akhula ngezikhathi ezingu-3-10! Kukhona futhi amathuba okuba yizizukulwane zefa. Okusho ukuthi kunamathuba amaningi okubeletha amawele kulabo abahlala emindenini yabo lapho bekhulelwe khona.
Kusukela ekuqaleni kweminyaka yama-1970, kuye kwaba nokwanda okuphawulekayo kwenani lamacala okukhulelwa okuningi emhlabeni. Izimbangela zalesi senzakalo zikholelwa ukuthi ziyindlela eqhubekayo yokwedlula futhi esebenzayo yezindlela zokwelashwa okufakelwayo kanye nokwelashwa kwama-hormonal infertility. Izindlela zokukhiqiza ezenzakalelayo zaholela esimweni lapho amazwe athuthukile akhula izinga lokuzalwa kwamawele ngo-50%. Konke lokhu kungumphumela wokungenelela kwezokwelapha.
Izingozi Zokukhulelwa Okuningi
I-Odnoyaytsovye amawele ngokuvamile ayingcosana ngosayizi, kaningi kaningi abe nezinkinga ezingenasifo sokubeletha futhi kaningi efa esibelethweni kunesifo samathambo. Izimo ezimbi zokuthuthukiswa kwe-intrauterine, ukungondleki, izintambo zomlomo ezivamile, kanye nenani elikhulu lokubeletha ngaphambi kokubeletha likhubaza kakhulu ukukhulelwa kwezikhukhula eziningi.
Izifundo zamakhemikhali ezinama-vascular zibonisa ukuthi kunezinkinga ezingajwayelekile ezingavamile (i-anastomoses ye-vascular), ikakhulukazi ngamawele afanayo. Lezi zinhlanganisela zingabangela ukumpontshelwa kwe-embryonic-fetal, okuholela ekukhubazekeni noma ekufeni komntwana.
Izithelo ezingaphezu kwesibeletho, inani elikhulu lokujikeleza igazi, umfutho wegazi ophakeme, ukuvuvukala, ukwandisa kwenhliziyo, isibindi, izinso. Ngenxa yalokho, ama-polyhydramnios angathuthuka. Ubukhulu be-fetus buyancipha, buyinkimbinkimbi, ukukhula kwayo kuyayeka. Lesi simo sibonakala nge-anemia, ukugeleza kwegazi okungaphansi, ukuphela kwamanzi. Kulesi simo, kokubili izitho zomzimba zitholakala engozini yokwanda kwenhliziyo. Ukuphazamiseka kokusakazwa kwe-placental kungaholela ekulimaleni noma ukungonakali kokudla komntwana (okukodwa noma konke).
Izinkinga zomama
I-gestosis ne-eclampsia kwenzeka kaningi kaningi ngokukhulelwa okuningi kunokukhulelwa okuvamile. Ezingamaphesenti angama-75%, ukukhulelwa okuningi kuphela ekuzalweni okungakafiki. Isimo se-systolic sesibeletho sibuthakathaka futhi sihlanganisiwe. I-Placenta previa kungenzeka kakhulu. Kulesi simo, ubukhulu be-placenta obuningi bokukhulelwa bukhulu kakhulu kunokukhulelwa okujwayelekile. Lokhu kudala ingozi yokuphuma kwangaphakathi nokuqothulwa. Ngenxa yokuqhekeka kwekhanda le-amniotic ye-fetus yokuqala noma ukuphazamiseka okuqinile kwesibeletho ngemuva kokuzalwa kwewele lokuqala, inqwaba yamascenta esheshe ivele. Isibeletho siphelelwe yisikhathi ngesikhathi sokukhulelwa, kaningi ngaphandle kokukwazi ukuvumelanisa njalo ngemva kokubeletha. Futhi nakuba i-postpartum atony yinto evamile, ngokukhulelwa okuningi lokhu kungabangela ukuphaphazeka okukhulu.
Izinkinga ze-fetus (eyodwa noma ngaphezulu)
Ukuhlukunyezwa kokubeletha kwenzeka kakhulu kaningi kunokukhulelwa okujwayelekile. Lokhu kungahle kube ngenxa yokucindezeleka komqondo womqondo, ukuphazamiseka kokudla noma ukukhubazeka kokuzalwa. Ingozi enkulu kakhulu yokucindezela intamo yesigxobo se-umbilical ibonakala esimweni sezinwele ze-mononuclear nge-single amniotic cavity. Cishe kabili amawele angama-odnoyaytsovyh amaningi namawele afa ngesikhathi sokukhulelwa futhi ngokushesha ngaphambi kokubeletha. Ingozi ebusweni iphezulu, ngokuhambisana nenani labo eliphelele.
Izinkinga zemvelo yizona ezibangela kakhulu ukufa komntwana ekukhulelweni okuningi. Ukuzalwa kokuqala okungenani inyanga eyodwa ngaphambi kwesikhashana kungumphumela wokukhululwa ngaphambi kwesikhathi kwengane kusuka kumsebenzi we-amniotic fluid nokusebenza kwesikhathi ngaphambi kwesikhathi.
Izinto ezikhuphula izinga lokufa kanye nokukhubazeka kokubeletha kuncike endaweni yabo. Lokhu kuthinta ukujikeleza jikelele kwegazi kanye nobungozi bokungenelela kokuhlinzwa. I-prolapse ye-umbilical cord iqhutshwa ekukhulelwe okuphindwe kabili izikhathi ezinhlanu kaningi kunokujwayelekile. Isizathu sokuphela kokuphefumula nokufa kwe-fetus kungaba, isibonelo, ukubopha ikhanda lakhe endaweni engafanele ngaphambi kokubeletha. Isimo esikhethekile yizinkinga ezibizwa ngokuthi amawele e-Siamese, lapho ukuzalwa ngokwemvelo kungenakwenzeka.
Izinkinga ze-postpartum - ukusinda kwezinsana ekukhulelweni okuningi kuncike kokubili ukucindezelwa kwezinkinga kanye nesimo se-fetus, ukunakekelwa kwezinsana nezinye izinto eziningi.
Ziyini amathuba?
Umphumela omuhle wukuthi lapho bobabili izitho zangasese zisezingeni "eliphansi," lapho ukubeletha kungenza khona ngokwemvelo.
Ukukhulelwa komama ekukhulelweni okuphindaphindiwe kunamaphesenti angama-4 kuya phezulu kunokukhulelwa okujwayelekile. Ukushona kwababelethi kwanda kancane kancane. Uma umntwana ezalwa ephila, umgomo omuhle wokusinda ungumnyaka wokuthokoza. Ezimweni eziningi, ukuchazwa kwamawele noma ama-triplets anesisindo esingaphezu kuka-2500 g kungcono kunezithelo ezifanayo zesisindo sokuzalwa esifanayo. Lokhu kulandela ukuthi izithelo zokukhulelwa okuningi zivuthiwe.
Owesibini wamawele, njengombuso, usesengozini enkulu kuneyokuqala. Ngokuvamile kuncane kakhulu ngobukhulu futhi kunezifo zenhliziyo kanye nokulimala komuntu ngamunye okungaholela ekulimazeni.
Same noma cha?
Ngokukhulelwa okuningi, amawele, amawele, ama-triple njalonjalo kungaba nzima kakhulu ukuhlukanisa. Kuningi lapho izimo lapho ababelethi bamawele afanayo bengakwazi ukuhlukanisa izingane zabo. Endabeni yokubeletha kwamawele, abazali abangaba ngu-10% bayaqaphela ukuthi abakwazi ukubiza igama ngegama, ngoba nje badidekile ukuthi ngubani.
Ukufanana kwamawele ngomqondo wokukhulumisana okuvamise ngezinye izikhathi kubangelwa ukuhlukunyezwa okuningi kwangaphakathi okuhambisana nokuntula okuphelele komqondo wokuzimela. UMarku Twain emlandweni wakhe uthi emva kokulahlekelwa yiwele lakhe, wayevame ukuhlushwa umbuzo othi: "Ngumuphi kithi ophilayo ngempela: yena noma mina."
Amawele e-Siamese
Amawele e-siamese, ngisho nasesikhathini sethu, namanje isenzo esingenakulinganiswa. Ngesizathu esingaziwa, ama-fetus amabili akhula ndawonye ngaphambi kokuba abelethwe izingxenye ezihlukene zomzimba. Ukuhlukana kokuqala kwamawele aseSaamese kwaphumelela eThailand ngo-1951 futhi lokhu kwenziwa lapho amawele ephakathi kweminyaka emibili ubudala. I-Thailand yaziwa ngaleso sikhathi njengeSiam. Ngakho amawele lawo, ahlangane, futhi aqala ukubizwa ngokuthi "iSiamese." Namuhla, ngokubamba iqhaza kwemishini yokuxilonga, kungaphetha ngokuthi akuzona nje izingxenye nezitho ezijwayelekile kumawele, kodwa futhi zihlanganisa ukuxhumana okuxubile kwamasuli phakathi kwabo. Ngezinye izikhathi, ngenhlanhla, amawele e-Siamese angahlukaniswa. Kodwa-ke, imithi isazi kakhulu ngalokhu.