He aha ngā Tohunga Whāngai? Ngā Tohutohu, Ngā Take, me te Maimoatanga

Ko ngā tohunga whāngai he tohunga takirua rite e hono ana te tinana i te wā whānau, e tu ana te wāhi o te tinana, te whekau rānei. He āhuatanga onge tenei e puta ana i te wā e tīmata ana te ira ki te wehewehe hei tohunga takirua rite, engari ka mutu te mahi i waenganui, ka waiho te tohunga takirua e hono ana.

Ka puta tēnei i te 1 noa iho i te 50,000 ki te 1 i te 200,000 whānau puta noa te ao. Ahakoa he wero motuhake te āhuatanga, he tokomaha ngā tohunga whāngai e ora ana i ngā oranga tino pai, whai kiko me te tiaki hauora tika me te tautoko whānau.

He aha ngā tohunga whāngai?

Ka whanake ngā tohunga whāngai ina tīmata te hua manu kotahi ki te wehewehe hei pēpi rua motuhake, engari kāore i te whakaoti i te mahi. Ki te kore e hanga e rua ngā tangata motuhake, ka noho tonu te ira e whanake ana e hono ana i ngā wāhi maha o te tinana.

Ka taea te hononga i tetahi wāhi o te tinana, mai i te ulu me te uma ki te kopu, te upoko, te tua rānei. Ko ētahi tohunga takirua e tu ana te kiri me te uaua, ko ētahi atu ka taea te whakamahi i ngā whekau nui penei i te ngakau, te ate, te roro rānei.

Ko te nuinga o ngā tohunga whāngai he wāhine, ā, he rite tonu rātou, nā te mea i puta mai rātou i te ira taketake kotahi. He mea tino rongoa te āhuatanga, kāore i te puta mai i tetahi mea i mahi ai ngā mātua i mua atu rānei i te wā hapu.

He aha ngā momo tohunga whāngai?

Ka whakarōpūhia e ngā tākuta ngā tohunga whāngai i runga i te wāhi e hono ana rātou ki te tinana. Ka āwhina te wāhi hononga ki te whakatau he aha ngā whekau, ngā pūnaha tinana rānei e taea ai e ngā tohunga takirua te whakamahi.

Ko ēnei ngā momo matua ka kitea pea e koe:

• Ngā tohunga Thoracopagus - E hono ana ki te uma me te kopu o runga, e whakamahi pinepine ana i te ngakau, te ate, ētahi atu whekau rānei i tēnei wāhi
• Ngā tohunga Omphalopagus - E hono ana ki te uma o raro me te kopu, e whakamahi pinepine ana i te ate, ā, i ētahi wā i ngā whekau
• Ngā tohunga Pygopagus - E hono ana ki ngā hope me te tuā o raro, e whakamahi pinepine ana i te tuā o raro me te tūāhu
• Ngā tohunga Ischiopagus - E hono ana ki te upoko, e whakamahi pinepine ana i ngā whekau whakaputa uri, te putea mimi, me ngā wāhi o te pūnaha kai
• Ngā tohunga Craniopagus - E hono ana ki te ulu, he mea tino onge tēnei, ā, ka uru pea ki te kōeke roro, ki ngā oko toto rānei
• Ngā tohunga Parapagus - E hono ana ki te taha ki te taha ki te upoko, ā, i ētahi wā ki te kopu

Ka puta mai ia momo i ngā wero me ngā wāhi rerekē mō te wehenga, i runga i ngā whekau me ngā pūnaha tinana e whakamahia ana e ngā tohunga takirua.

He aha ngā take o ngā tohunga whāngai?

Ko te take tika o ngā tohunga whāngai he mea ngaro tonu ki te putaiao hauora. Ko te mea e mōhio ana tātou, ka puta tēnei i ngā wā tino tīmata o te hapu ina hangaia ngā tohunga takirua rite.

I te nuinga, ina whanake ngā tohunga takirua rite, ka wehewehe te ira kotahi ki ngā ira rua motuhake i waenga i ngā rā 13-15 i muri i te whakaotinga. Ki ngā tohunga whāngai, ka tīmata tēnei mahi wehewehe, engari kāore i te whakaoti rawa, ka waiho te tohunga takirua e hono ana.

He mea tino rongoa, he mea noa tēnei wehenga kore rawa. Kāore i te puta mai i tetahi mea i mahi ai ngā mātua, kāore rānei i mahi, i kai rānei, i whakatārewatia rānei i te wā hapu. Kāore he take ira, rongoā, ā, he pānga taiao kua whakamāramahia kia piki ake te tūponotanga.

E whakapono ana etahi kairangahau ko te wā e ngana ana te ira ki te wehewehe he wāhi nui ki te wāhi e hono ana ngā tohunga takirua, engari kei te ako tonu tēnei.

He aha ngā tohu me ngā tohu i te wā hapu?

Ko te nuinga o ngā take o ngā tohunga whāngai ka kitea i ngā whakamātau ultrasound i te wā hapu, i te nuinga i waenga i ngā wiki 18-20 o te hapu. Ka kite pea tō tākuta kei te tata rawa ngā pēpi, kei te whakamahi rānei i ngā wāhi o te tinana.

Ko ngā tohu o mua ka tohu pea i ngā tohunga whāngai ko te kite i ngā ulu e rua, engari kotahi te tinana i runga i te ultrasound, te kite rānei kei te kore ngā pēpi e neke motuhake tetahi i tetahi. Ka puta pea ngā tohunga takirua ki te anga atu tetahi ki tetahi i te huarahi tino rereke.

I ētahi wā, kāore te āhuatanga e kitea tae noa ki muri i te wā hapu ina mahia he whakaahua taipitopito ake. Ka taea e ngā ultrasound matatau, ngā tātaritanga MRI, ngā tātaritanga CT rānei te awhina i ngā tākuta ki te mohio tika ki te wāhi e hono ana ngā tohunga takirua me ngā whekau e taea ai e rātou te whakamahi.

Mēnā ka whakapaehia ngā tohunga whāngai, ka tūtohu pea tō rōpū hauora ki te whakamātau atu me ngā uiui ki ngā tohunga hei whakamārama pai ake i tō āhuatanga motuhake.

Nōhea koe me haere ki te tākuta?

Mēnā kei te hapu koe, ā, kei te whakaatu ngā whakamātau ultrasound i ngā tohunga whāngai, ka tono tonu tō tākuta ki ngā tohunga he wheako ki tēnei āhuatanga. Ko te tikanga tenei ko ngā tohunga hauora whaea-pēpi me ngā tākuta pokanga tamariki.

Ka hiahia koe ki te rapu i te tiaki i te pokapū hauora nui he wheako ki ngā tohunga whāngai. Kei ēnei wāhi ngā rōpū me ngā taputapu motuhake e hiahiatia ana hei whakarato i te tiaki pai i te wā hapu me muri i te whānau.

Kaua e whakaroa ki te tono i ngā whakaaro tuarua, ki ngā uiui atu rānei. He āhuatanga uaua tēnei, ā, ka taea e te maha o ngā tirohanga tohunga te awhina i a koe ki te whakatau i ngā whakatau mō tō tiaki me te heke mai o ō pēpi.

He aha ngā take morearea mō ngā tohunga whāngai?

Kāore he take morearea e mohiotia ana e piki ake ai ō tūponotanga ki te whānau i ngā tohunga whāngai. Ka puta mai tēnei āhuatanga i te waimarie, ahakoa tō tau, hauora, hītori whānau, tetahi mea rānei e mahi ana koe i te wā hapu.

Kāore i rite ki ētahi atu āhuatanga hapu, kāore ngā tohunga whāngai e rere i roto i ngā whānau, kāore hoki e tino noa i roto i tētahi rōpū iwi motuhake, i tētahi rohe whenua rānei. Ko te whānau i ngā tohunga whāngai i tētahi hapu kāore e piki ake ō tūponotanga ki te whānau i a rātou i ngā hapu e heke mai ana.

Ka puta te āhuatanga puta noa i ngā taupori puta noa te ao, e tautoko ana i te whakaaro he mahi whanaketanga rongoa tēnei, kāore i te mea e pā ana ki ngā take o waho.

He aha ngā raruraru pea?

He maha ngā wero pea e pa ana ki ngā tohunga whāngai, i te wā hapu me muri i te whānau. Ko ngā raruraru motuhake e whakawhirinaki ana ki te wāhi e hono ana ngā tohunga takirua me ngā whekau, ngā pūnaha tinana rānei e whakamahi ana rātou.

I te wā hapu, ko ngā raruraru pea ko:

• Te whānau wawe, e puta ana i te nuinga o ngā take o ngā tohunga whāngai
• Te wai o te amniotic nui (polyhydramnios) i te taha o ngā pēpi
• Te uaua ki te wāhi o te pēpi mō te whānau
• Te piki o te morearea o te ngaronga hapu, ina koa i te wā tīmata o te hapu

Muri i te whānau, ko ngā raruraru pea ko ngā raruraru manawa mēnā e whakamahi ana ngā tohunga takirua i te wāhi uma, ngā raruraru ngakau mēnā e whakamahi ana rātou i ngā hanganga ngakau, me ngā raruraru kai mēnā e whakamahi ana rātou i ngā whekau, ētahi atu whekau kopu rānei.

Ko ētahi tohunga takirua pea he whakaroa whanaketanga, he ngoikoretanga rānei, ko ētahi atu ka whanake noa. Ka rereke te tirohanga i runga i te āhuatanga motuhake me ngā wāhi o te tinana e whakamahia ana.

Me pēhea te whakamātau i ngā tohunga whāngai?

Ko te whakamātau e tīmata ana i ngā whakamātau ultrasound i te wā hapu e whakaatu ana i tetahi mea tino rereke mo te wāhi, te hononga rānei o ngā tohunga takirua. Ka kite pea tō tākuta kei te kore rātou e neke motuhake, kei te whakamahi rānei i ngā wāhi o te tinana.

Ina whakapaehia ngā tohunga whāngai, ka āwhina ngā whakamātau whakaahua taipitopito ake ki te hanga i te pikitia tino pai. Ka uru pea ēnei ki ngā whakamātau ultrasound teitei, ngā tātaritanga MRI, ngā whakaahua 3D motuhake rānei e taea ai te whakaatu tika ki te wāhi e puta mai ana te hononga.

Ka whakamahi hoki tō rōpū hauora i ēnei whakamātau hei whakamārama i ngā whekau, ngā oko toto, ētahi atu hanganga rānei e whakamahi ana ngā tohunga takirua. He mea nui tēnei mō te whakarite i ō rātou tiaki i mua atu me muri i te whānau.

I ētahi wā, ko ētahi atu whakamātau penei i ngā echocardiograms (ultrasounds ngakau) ētahi atu whakamātau motuhake rānei e āwhina ana ki te aromatawai i ngā pūnaha whekau motuhake ka pā pea.

He aha te maimoatanga mō ngā tohunga whāngai?

Ko te maimoatanga mō ngā tohunga whāngai he mea motuhake, ā, e whakawhirinaki ana ki te wāhi e hono ana rātou me te mea e whakamahi ana rātou. Ko te whakawhitinga e whakauru ana i tētahi rōpū o ngā tohunga e mahi tahi ana hei whakarato i te tiaki pai rawa.

Ko ētahi tohunga whāngai ka taea te wehe angitu mā te pokanga, ko ētahi atu ka ora tonu ngā oranga tino pai e noho ana e hono ana. Ko te whakatau mō te wehenga e whakawhirinaki ana ki ngā take maha, tae atu ki ngā whekau e whakamahia ana me te mea he haumaru te wehenga mō ngā tohunga takirua.

Mō ngā tohunga takirua ka taea te wehe, ko te mahi e hiahia pinepine ana ki ngā pokanga maha i te wā. Ko te rōpū pokanga pea ko ngā tākuta pokanga tamariki, ngā tākuta pokanga kiri, ngā neurologists, ngā cardiologists, me ētahi atu tohunga i runga i te mea e hiahiatia ana kia hanga hou.

Mō ngā tohunga takirua e noho ana e hono ana, ko te maimoatanga e aro ana ki te awhina i a rātou ki te ora motuhake, ngāwari hoki. Ka uru pea tēnei ki te rongoā tinana, te rongoā mahi, me ngā whakarerekētanga hei awhina i ngā mahi o ia rā.

Puta noa i ō rātou oranga, he tokomaha ngā tohunga whāngai e hiahia ana ki te tiaki hauora haere tonu hei tirotiro i ngā whekau e whakamahia ana me te whakaoti i ngā take hauora e puta mai ana.

Me pēhea te whakarite mō te whānau me te tiaki o mua?

Ko te whakarite whānau mō ngā tohunga whāngai e hiahia ana ki te whakahaere tika i waenga i ngā rōpū hauora maha. Ko te nuinga o ngā tohunga whāngai ka whānau mā te wahi ke i te whare hauora he wāhi motuhake mō ngā tamariki.

Ka whakarite tō rōpū hauora i te wā whānau i runga i te whanaketanga o ngā tohunga takirua me ētahi atu raruraru. He tokomaha ngā tohunga whāngai e whānau wawe ana, na, ka rite te rōpū tiaki hauora pēpi ki te whakarato i te tiaki motuhake tonu.

Muri i te whānau, ka hiahia pea ngā tohunga takirua ki te wā i te wāhi tiaki hauora pēpi i te wā e aromatawai ana ngā tākuta i ō rātou āhuatanga me te whakarite i ō rātou tiaki haere tonu. Ka āwhina tēnei wā i te rōpū hauora ki te mohio tika ki te mea e whakamahi ana ngā tohunga takirua me ngā hiahia motuhake o rātou.

I tēnei wā, ka mahi tahi koe me ngā kaimahi hapori, ngā kaiāwhina, me ētahi atu kaimahi tautoko ka taea te awhina i a koe ki te whakatere i ngā āhuatanga hinengaro me ngā mahi o te tiaki i ngā tohunga whāngai.

Me pēhea te whakarite mō ngā whakaritenga hauora?

Haere mai me te rārangi o ngā pūrongo mō tō āhuatanga motuhake. He motuhake ia take o ngā tohunga whāngai, na, arotahi ki te whakamārama i te mea e pā ana ki ō pēpi motuhake, kāore i te mōhio whānui.

Kawe mai tētahi tangata tautoko ki ngā whakaritenga mēnā ka taea. Ka taea te awhina i te whakarongo me te tuhi i tetahi atu i te wā e tukatuka ana i ngā mōhiohio hauora uaua i te wā o te ngakau.

Pātaihia te hono atu ki ētahi atu whānau he wheako ki ngā tohunga whāngai. Ka taea e ngā whare hauora te hono atu ki ngā rōpū tautoko, ki ētahi atu whānau rānei ka taea te whakapuaki i ō rātou wheako.

Kaua e whakaroa ki te tono i tō rōpū hauora ki te whakahoki, ki te whakamārama rānei i ngā mōhiohio. He nui tēnei ki te tukatuka, ā, he mea noa te hiahia ki ngā mea e whakamāramahia ana i ngā wā maha, i ngā huarahi rerekē rānei.

He aha te mea nui mō ngā tohunga whāngai?

Ko ngā tohunga whāngai he rerekētanga onge, he mea noa i te whanaketanga tangata. Ahakoa he wero motuhake te āhuatanga, he tokomaha ngā tohunga whāngai e ora ana i ngā oranga whai hua me te tiaki hauora tika me te tautoko whānau.

Ko te mea nui rawa ki te mahara ko ia āhuatanga he rerekē. Ko te mea e pā ana ki tētahi rōpū o ngā tohunga whāngai pea kāore e pā ana ki tētahi atu, na, arotahi ki te whakamārama i ō āhuatanga motuhake, kāore i te whakataurite ki ētahi atu take.

Kua whai wāhi nui te rongoā hou ki te tiaki i ngā tohunga whāngai, ahakoa mā te pokanga wehewehe, mā te awhina rānei i ngā tohunga takirua ki te ora pai i te wā e hono ana. Me te rōpū hauora tika me te pūnaha tautoko, ka taea e ngā whānau te whakatere i tēnei haerenga angitu.

Ngā pūrongo e ui pinepinetia ana mō ngā tohunga whāngai

U: Ka taea te aukati i ngā tohunga whāngai?

Kāo, kāore he huarahi ki te aukati i ngā tohunga whāngai, nā te mea he mahi whanaketanga rongoa tēnei e puta mai ana i te wā tīmata o te hapu. Kāore i te puta mai i tetahi mea e mahi ana ngā mātua, kāore rānei e mahi, ā, kāore he take morearea e mohiotia ana e piki ake ai te tūponotanga.

U: Me wehewehe katoa ngā tohunga whāngai?

Kāore rawa. Ko te wehenga anake e whakaarohia ana ina taea te mahi hauora, ā, he haumaru mō ngā tohunga takirua. He tokomaha ngā tohunga whāngai e ora ana i ngā oranga tino pai, harikoa i te wā e hono ana. Ko te whakatau e whakawhirinaki ana ki ngā whekau me ngā hanganga e whakamahia ana me te mea ka pai te wehenga mō ngā tamariki e rua.

U: He rite tonu ngā tohunga whāngai?

Ae, he rite tonu ngā tohunga whāngai, nā te mea i whanake mai rātou i te ira kotahi e tīmata ana ki te wehewehe, engari kāore i te whakaoti i te mahi. E whakamahi ana rātou i te ira kotahi, ā, he rite tonu te ira tangata.

U: He aha te reiti ora mō ngā tohunga whāngai?

Ka rereke ngā reiti ora i runga i te wāhi e hono ana ngā tohunga takirua me ngā whekau e whakamahi ana rātou. Ko ngā tohunga takirua e hono ana ki te uma, ki te ulu rānei e pa ana ki ngā wero atu, ko ētahi e hono ana ki ngā wāhi iti ake te nui o te hua pai. I te nuinga, ko te 40-60% o ngā tohunga whāngai e ora ana ki te whānau, ā, he tokomaha o rātou e ora tonu ana i ngā oranga tino pai.

U: Ka taea e ngā tohunga whāngai te whanaketanga hinengaro noa?

He tokomaha ngā tohunga whāngai he whanaketanga hinengaro tino noa, ina koa ki te kore te roro e pā ana ki to rātou hononga. Ā, ko ngā tohunga takirua e whakamahi ana i ētahi kōeke roro ka taea te whanaketanga noa, ahakoa ka rereke tēnei take i te take.