Māhoe Pili
Nānaina
ʻO nā māhoe pili paha e pili ana ma kekahi o nā wahi he nui. ʻO kēia mau māhoe pili e pili ana i ka umauma (thoracopagus). He naʻau kaʻawale ko lākou akā e kaʻana like ana i nā kino'ē aʻe.
ʻO nā māhoe pili he ʻelua pēpē i hānau ʻia e pili ana i ke kino kekahi i kekahi.
Ke ulu nei nā māhoe pili i ka wā e hoʻokaʻawale iki ʻia ai ka embryo mua e hana i ʻelua kanaka. ʻOiai e ulu ana ʻelua pēpē mai kēia embryo, e noho mau ana lākou i ka pili kino - ʻo ka pinepine loa ma ka umauma, ʻōpū a i ʻole ka pelvis. Hiki i nā māhoe pili ke kaʻana like i hoʻokahi a ʻoi aku paha o nā kino o loko.
ʻOiai he nui nā māhoe pili ʻaʻole ola i ka wā hānau (stillborn) a make paha ma hope koke o ka hānau ʻana, ua hoʻomaikaʻi nā holomua i ka ʻoki kino a me ka ʻenehana i nā helu ola. Hiki ke hoʻokaʻawale ʻia kekahi mau māhoe pili ola ma ke ʻoki kino. Ke hilinaʻi nei ka holomua o ka ʻoki kino i kahi e pili ai nā māhoe a me ka nui a me nā kino i kaʻana like ʻia. Ke hilinaʻi nei ia i ka ʻike a me ka mākaukau o ka hui ʻoki kino.
Nā hōʻailona
ʻAʻohe mau hōʻailona kūikawā e hōʻike ana i ka hāpai ʻana i nā māhoe pili. E like me nā hāpai ʻana ʻē aʻe o nā māhoe, hiki ke ulu wikiwiki ka ʻōpū ma mua o ka ulu ʻana me ka pēpē hoʻokahi. A hiki ke nui aku ka luhi, ka ʻōpū a me ka luaʻi i ka hoʻomaka o ka hāpai ʻana. Hiki ke ʻike ʻia nā māhoe pili i ka hoʻomaka o ka hāpai ʻana me ka hoʻohana ʻana i ka ultrasound.
Hoʻokaʻawale pinepine ʻia nā māhoe pili ma muli o kahi i hoʻopili ʻia ai lākou. Hoʻokahi mau manawa nā māhoe i nā kino a i ʻole nā ʻāpana ʻē aʻe o ko lākou kino. ʻO kēlā me kēia hui o nā māhoe pili he kūikawā.
Hiki ke hoʻopili ʻia nā māhoe pili ma kekahi o kēia mau wahi:
- Umauma. Hoʻopili ʻia nā māhoe Thoracopagus (thor-uh-KOP-uh-gus) i ka maka i ka umauma. Loaʻa pinepine iā lākou ka puʻuwai i kaʻana like ʻia a hiki ke kaʻana like i ke ake a me ka ʻōpū kiʻekiʻe. ʻO kēia kekahi o nā wahi maʻamau loa o nā māhoe pili.
- ʻŌpū. Hoʻopili ʻia nā māhoe Omphalopagus (om-fuh-LOP-uh-gus) kokoke i ka piko. Hoʻokahi pinepine nā māhoe omphalopagus i ke ake a me kekahi ʻāpana o ka ʻōnaehana digestive kiʻekiʻe (gastrointestinal a i ʻole GI). Hoʻokahi kekahi mau māhoe i ka ʻāpana haʻahaʻa o ka ʻōpū liʻiliʻi (ileum) a me ka ʻāpana lōʻihi loa o ka ʻōpū nui (colon). ʻAʻole pinepine lākou e kaʻana like i ka puʻuwai.
- Kumu o ke kua. Hoʻopili pinepine ʻia nā māhoe Pygopagus (pie-GOP-uh-gus) i ke kua i ke kua ma ke kumu o ke kua a me nā hoki. Hoʻokahi kekahi mau māhoe pygopagus i ka ʻōnaehana gastrointestinal (GI) haʻahaʻa. He mau māhoe wale nō kaʻana like i nā kino genital a me ka urinary.
- Lōʻihi o ke kua. Hoʻopili ʻia nā māhoe Rachipagus (ray-KIP-uh-gus), i kapa ʻia hoʻi ʻo rachiopagus (ray-kee-OP-uh-gus), i ke kua i ke kua ma ka lōʻihi o ke kua. He mea maʻamau loa kēia ʻano.
- Pelvis. Hoʻopili ʻia nā māhoe Ischiopagus (is-kee-OP-uh-gus) ma ka pelvis, i ka maka i ka maka a i ʻole ka hopena i ka hopena. Hoʻokahi pinepine nā māhoe ischiopagus i ka ʻōnaehana GI haʻahaʻa, a me ke ake a me nā kino genital a me ka urinary. Hiki i kēlā me kēia māhoe ke loaʻa i ʻelua wāwae a i ʻole, ʻaʻole pinepine, kaʻana like nā māhoe i ʻelua a ʻekolu paha mau wāwae.
- Trunk. Hoʻopili ʻia nā māhoe Parapagus (pa-RAP-uh-gus) ma ka ʻaoʻao ma ka pelvis a me kahi a i ʻole nā ʻāpana a pau o ka ʻōpū (ʻōpū) a me ka umauma, akā me nā poʻo kaʻawale. Hiki i nā māhoe ke loaʻa i ʻelua, ʻekolu a ʻehā paha mau lima a me ʻelua a ʻekolu paha mau wāwae.
- Poʻo. Hoʻopili ʻia nā māhoe Craniopagus (kray-nee-OP-uh-gus) ma ke kua, luna a i ʻole ʻaoʻao o ke poʻo, akā ʻaʻole ka maka. Hoʻokahi nā māhoe Craniopagus i kahi ʻāpana o ka iwi poʻo. Akā, ʻokoʻa pinepine ko lākou lolo, ʻoiai paha lākou e kaʻana like i kekahi ʻiʻo lolo.
- Poʻo a me ka umauma. Hoʻopili ʻia nā māhoe Cephalopagus (sef-uh-LOP-uh-gus) ma ke poʻo a me ke kino luna. Aia nā maka ma nā ʻaoʻao ʻē aʻe o kahi poʻo hoʻokahi i kaʻana like ʻia, a kaʻana like lākou i ka lolo. ʻAʻole pinepine e ola kēia mau māhoe.
I nā hihia maʻamau ʻole, hiki ke hoʻopili ʻia nā māhoe me hoʻokahi māhoe liʻiliʻi a ʻaʻole i hoʻokumu piha ʻia ma mua o kekahi (nā māhoe pili asymmetric). I nā hihia maʻamau loa, hiki ke loaʻa kekahi māhoe i hoʻomohala ʻia ma loko o kekahi māhoe ʻē aʻe (fetus in fetu).
Nā kumu
ʻO nā māhoe hoʻokahi (māhoe monozygotic) ka hanana ke māhele ʻia ke hua manu hoʻokahi fertilized a hoʻomohala i ʻelua kanaka. Mai ʻewalu a ʻumikumamālua mau lā ma hope o ka hāpai ʻana, hoʻomaka nā papa embryonic e māhele ʻia e hana i nā māhoe monozygotic e hoʻomohala i nā ʻōnaehana a me nā ʻano kūikawā. Ua manaʻo ʻia ke māhele ʻia ka embryo ma hope o kēia - maʻamau ma waena o 13 a me 15 mau lā ma hope o ka hāpai ʻana - e pau ka hoʻokaʻawale ʻana ma mua o ka pau ʻana o ke kaʻina hana. ʻO nā māhoe hopena he māhoe pili. Loaʻa kekahi manaʻo ʻē aʻe e hiki paha i ʻelua mau embryo kaʻawale ke hui pū ma ke ʻano maʻalahi i ka hoʻomohala mua. ʻAʻole maopopo ka mea e hiki ai ke hoʻoulu i kekahi o nā kaulahao hanana.
Nā mea pilikia
Ma muli o ka liʻiliʻi loa o nā māhoe pili, a ʻaʻole maopopo ke kumu, ʻaʻole maopopo ka mea e hiki ai ke hoʻonui i ka nui o nā kāne a me nā wahine e loaʻa nā māhoe pili.
Nā pilikia
ʻO ka hāpai keiki me nā māhoe pili he mea paʻakikī ia a hoʻonui nui i ka pilikia o nā pilikia koʻikoʻi. Pono nā pēpē pili i ka hānau ʻana ma ke ʻoki ʻana ma ke ʻano o ka ʻoki ʻana o ka ʻōpū (C-section).
E like me nā māhoe, ua nui ka manawa e hānau mua ʻia ai nā pēpē pili, a hiki paha ke make kekahi a ʻelua paha ma mua o ka hānau ʻana a i ʻole ma hope koke o ka hānau ʻana. Hiki i nā pilikia olakino nui no nā māhoe ke kū koke mai, e like me ka pilikia o ka hanu a i ʻole nā pilikia o ka naʻau. Ma hope mai o ke ola, hiki ke kū mai nā pilikia olakino e like me ka scoliosis, cerebral palsy a i ʻole nā pilikia hoʻonaʻauao.
ʻO nā pilikia hiki ke hilinaʻi i kahi i hoʻopili ʻia ai nā māhoe, i nā ʻāpana a i ʻole nā ʻāpana ʻē aʻe o ke kino a lākou e kaʻana like ai, a me ka akamai a me ka ʻike o ka hui mālama ola. Ke manaʻo ʻia nā māhoe pili, pono ka ʻohana a me ka hui mālama ola e kūkākūkā kikoʻī i nā pilikia hiki ke kū mai a pehea e hoʻomākaukau ai no lākou.
ʻImi ʻike
Hiki ke ʻike ʻia nā māhoe pili i ka hoʻohana ʻana i ka ultrasound maʻamau i ka wā hāpai mai 7 a 12 mau pule. Hiki ke hoʻohana ʻia nā ultrasound kikoʻī a me nā hoʻokolohua e hoʻohana ana i nā leo e hana i nā kiʻi o nā naʻau o nā pēpē (echocardiograms) ma kahi o ka hapalua o ka wā hāpai. Hiki i kēia mau hoʻokolohua ke hoʻomaopopo maikaʻi aku i ka nui o ka pili ʻana o nā māhoe a me ka hana ʻana o ko lākou mau kino.
Inā ʻike ka ultrasound i nā māhoe pili, hiki ke hana ʻia kahi scan magnetic resonance imaging (MRI). Hiki i ka MRI ke hāʻawi i nā kikoʻī hou aku e pili ana i kahi e pili ai nā māhoe pili a me nā kino e kaʻana like ai lākou. Kūkulu ka Fetal MRI a me ka fetal echocardiography i ka hoʻolālā ʻana no ka mālama ʻana i ka wā hāpai a ma hope o ka hānau ʻana. Ma hope o ka hānau ʻana, hana ʻia nā hoʻokolohua ʻē aʻe e kōkua i ka ʻike ʻana i ke ʻano o ke kino a me ka hana o nā kino o kēlā me kēia māhoe a me nā mea i kaʻana like ʻia.
Ka mālama ʻana
ʻO ke ʻano o ka mālama ʻana i nā māhoe pili e pili ana i ko lākou kūlana kūikawā - ko lākou mau pilikia olakino, kahi i pili ai lākou, inā paha e kaʻana like ana lākou i nā loko a i ʻole nā mea nui ʻē aʻe, a me nā pilikia ʻē aʻe.
Inā ʻoe e hāpai ana i nā māhoe pili, e nānā pono ʻia ʻoe i loko o kou hāpai ʻana. E kuhikuhi ʻia paha ʻoe i kahi loea lapaʻau makuahine a me ke keiki i ka hāpai ʻana i ka pilikia kiʻekiʻe. Ke pono ai, hiki ke kuhikuhi ʻia ʻoe i nā loea keiki ʻē aʻe ma:
- Ka ʻoki kino (ka mea ʻoki kino keiki)
- ʻŌnaehana mimi, e like me nā puʻupaʻa a me ka ʻōpū (ka mea urologist keiki)
- Ka ʻoki kino iwi a me ka hui (ka mea ʻoki kino orthopedic keiki)
- Ka hoʻoponopono ʻoki kino a me ka hoʻoponopono (ka mea ʻoki kino plastik a me ka hoʻoponopono hou)
- Na puʻuwai a me nā kīʻaha koko (ka mea cardiologist keiki)
- Ka ʻoki kino puʻuwai a me nā kīʻaha koko (ka mea ʻoki kino cardiovascular keiki)
- Ka mālama ʻana i nā pēpē hou (neonatologist)
E aʻo kāu mau loea a me nā poʻe ʻē aʻe ma kāu hui mālama ola i ka nui e hiki ai e pili ana i kāu mau māhoe. ʻO kēia ka aʻo ʻana e pili ana i ko lākou mau ʻano kino, ko lākou hiki ke hana i kekahi mau hana (nā hiki hana) a me ka hopena kūpono (prognosis) e hana i kahi hoʻolālā mālama no kāu mau māhoe.
Hoʻolālā ʻia kahi ʻoki C ma mua o ka manawa, pinepine he 3 a 4 mau pule ma mua o kou lā hānau.
Ma hope o ka hānau ʻana o kāu mau māhoe pili, e loiloi piha ʻia lākou. Me kēia ʻike, hiki iā ʻoe a me kāu hui mālama ola ke hoʻoholo e pili ana i ko lākou mālama a inā kūpono ka ʻoki hoʻokaʻawale.
Inā hoʻoholo ʻia e hoʻokaʻawale i nā māhoe, hana pinepine ʻia ka ʻoki hoʻokaʻawale ma kahi o 6 a 12 mau mahina ma hope o ka hānau ʻana e hāʻawi i ka manawa no ka hoʻolālā a me ka hoʻomākaukau. I kekahi manawa, pono paha ka hoʻokaʻawale ʻana i ka pōpilikia inā make kekahi o nā māhoe, hoʻomohala i kahi kūlana weliweli i ke ola a hoʻoweliweli paha i ke ola o kekahi māhoe.
He nui nā mea paʻakikī e pono ai ke noʻonoʻo ʻia ma ke ʻano he ʻāpana o ka hoʻoholo e hana i ka ʻoki hoʻokaʻawale. Hāʻawi kēlā me kēia hui o nā māhoe pili i kahi hui kūikawā o nā pilikia ma muli o nā ʻokoʻa i ke ʻano kino a me ka hana. ʻO nā pilikia e komo pū ana:
- Inā paha e kaʻana like ana nā māhoe i nā loko nui, e like me ka puʻuwai
- Inā paha ua lawa ke olakino o nā māhoe e kū i ka ʻoki hoʻokaʻawale
- Nā manawa o ka hoʻokaʻawale holomua
- ʻAno a me ka nui o ka ʻoki kino hoʻoponopono hou e pono ai no kēlā me kēia māhoe ma hope o ka hoʻokaʻawale
- ʻAno a me ka nui o ke kākoʻo hana e pono ai ma hope o ka hoʻokaʻawale
- He aha nā pilikia e kū nei i nā māhoe inā noho pū lākou
Ua hoʻomaikaʻi nā holomua hou i ka kiʻi ʻana ma mua o ka hānau ʻana, ka mālama koʻikoʻi a me ka mālama anesthetic i nā hopena i ka ʻoki hoʻokaʻawale. Ma hope o ka ʻoki hoʻokaʻawale, he mea nui nā lawelawe hoʻōla keiki e kōkua i nā māhoe e ulu pono. Hiki i nā lawelawe ke komo pū me nā therapies kino, hana a me ka ʻōlelo a me nā kōkua ʻē aʻe e like me ka pono.
Inā ʻaʻole hiki ke hana ʻia ka ʻoki hoʻokaʻawale a i ʻole inā hoʻoholo ʻoe ʻaʻole e hana i ka ʻoki kino, hiki i kāu hui ke kōkua iā ʻoe e hoʻokō i nā pono mālama ola o kāu mau māhoe.
Inā koʻikoʻi nā kūlana, hāʻawi ʻia ka mālama ʻoluʻolu lapaʻau - e like me ka meaʻai, nā wai, ka pā ʻana o ke kanaka a me ka hōʻoluʻolu ʻeha.
Hiki ke hōʻino ka ʻike ʻana i kāu mau māhoe hāpai ʻana i kahi pilikia lapaʻau nui a i ʻole kahi kūlana weliweli i ke ola. Ma ke ʻano he mākua, e hakakā ʻoe me nā hoʻoholo paʻakikī no kāu mau māhoe pili a me ka wā e hiki mai paha. Hiki ke paʻakikī ke hoʻoholo i nā hopena, a ʻo nā māhoe pili e ola ana i kekahi manawa e kū i nā pilikia nui.
No ka mea he mea maʻamau ʻole nā māhoe pili, hiki ke paʻakikī ke loaʻa nā kumuwaiwai kākoʻo. E nīnau i kāu hui mālama ola inā loaʻa nā limahana hanauna lapaʻau a i ʻole nā kākāʻōlelo e kōkua. Ma muli o kāu mau pono, e noi i ka ʻike e pili ana i nā hui e kākoʻo ana i nā mākua i loaʻa nā keiki me nā kūlana kino e kaupalena ana i ko lākou mau hiki a i ʻole i nalowale nā keiki.
Hōʻole: He kahua ʻike olakino ʻo ʻAukake a ʻaʻole hōʻike kāna mau pane i ka ʻōlelo aʻoaʻo lapaʻau. E kūkākūkā mau me kahi ʻoihana lapaʻau laikini kokoke iā ʻoe ma mua o ka hana ʻana i nā hoʻololi.
Hana ʻia i India, no ka honua