Tuakana-Teina Hono

Ka taea te hono o ngā māngai takirua i tētahi o ngā wāhi maha. Ko ēnei māngai takirua kua honoa ki te uma (thoracopagus). He ngākau motuhake ō rāua, engari e tuawhaitia ana ētahi atu whekau.

Ko ngā māngai takirua he pēpi rua i whānau mai e hono ana ki te tinana.

Ka whānau mai ngā māngai takirua ina wehe noa te pēpi iti i te tīmatanga hei hanga i ngā tangata tokorua. Ahakoa ka whānau mai ngā pēpi rua i tēnei pēpi iti, ka noho tonu rāua e hono ana ki te tinana—te nuinga ki te uma, te kopu, te riu rānei. Ka taea hoki e ngā māngai takirua te tuawhaitia tētahi whekau tinana o roto, atu rānei.

Ahakoa he tokomaha ngā māngai takirua kāore i ora i te wā i whānau mai ai (mate i te kopu) kāore rānei i mate i muri i te whānau, kua pai ake ngā reiti ora nā te whakahaere i te pokanga me te hangarau. Ka taea te wehewehe i ētahi māngai takirua ora mā te pokanga. Ko te angitu o te pokanga e whakahaeretia ana e te wāhi i honoa ai ngā māngai, me te maha o ngā whekau e tuawhaitia ana, me ēhea ngā whekau. Kei te whakawhirinaki hoki ki te wheako me te pūkenga o te rōpū pokanga.

Kāore he tohu motuhake e tohu ana i te haputanga o te whānau tokorua kōtui. Pēnei i ētahi atu haputanga tokorua, ka tere ake te tipu o te kopu i te mea kotahi te pēpi. Ā, pea ka nui ake te ngenge, te ruaki, me te ruaki i te tīmatanga o te haputanga. Ka taea te whakamātautau i ngā māngai tokorua i te tīmatanga o te haputanga mā te whakamahi i te ultrasound.

E whakarōpūtia ana ngā māngai tokorua i te nuinga ki te wāhi e hono atu ai rātou. I etahi wā ka tutaki ngā māngai i ngā whekau, i ētahi atu wāhanga rānei o o rātou tinana. He motuhake ia takirua o ngā māngai tokorua.

Ka taea te hono o ngā māngai tokorua ki tetahi o ēnei wāhi:

• Uma. Ko ngā māngai Thoracopagus (thor-uh-KOP-uh-gus) e hono ana te kanohi ki te kanohi ki te uma. He ngakau whānui te nuinga o rātou, ā, pea ka tutaki hoki te ate me te kopu o runga. Koinei tetahi o ngā wāhi tino noa o ngā māngai tokorua.
• Puku. Ko ngā māngai Omphalopagus (om-fuh-LOP-uh-gus) e hono ana i te taha o te pito puku. He maha ngā māngai omphalopagus e tutaki ana i te ate me tetahi wāhanga o te ara kai o runga (gastrointestinal, GI rānei). Ko ētahi māngai e tutaki ana i te wāhanga raro o te kopu iti (ileum) me te wāhanga roa o te kopu nui (colon). Kāore rātou e tutaki i te ngakau i te nuinga.
• Te turanga o te tuara. Ko ngā māngai Pygopagus (pie-GOP-uh-gus) e hono ana i te nuinga o te tuara ki te tuara i te turanga o te tuara me ngā hope. Ko ētahi māngai pygopagus e tutaki ana i te ara kai o raro (GI). Ko ētahi tokoiti o ngā māngai e tutaki ana i ngā whekau ira tangata me ngā whekau mimi.
• Te roa o te tuara. Ko ngā māngai Rachipagus (ray-KIP-uh-gus), e kiia ana hoki ko te rachiopagus (ray-kee-OP-uh-gus), e hono ana te tuara ki te tuara i te roa o te tuara. He tino onge tenei momo.
• Upoko. Ko ngā māngai Ischiopagus (is-kee-OP-uh-gus) e hono ana ki te upoko, te kanohi ki te kanohi, te mutunga rānei ki te mutunga. He maha ngā māngai ischiopagus e tutaki ana i te ara kai o raro (GI), me te ate me ngā whekau ira tangata me ngā whekau mimi. Pea ka rua ngā waewae o ia māngai, te iti rānei, ka tutaki ngā māngai i ngā waewae e rua, e toru rānei.
• Te tinana. Ko ngā māngai Parapagus (pa-RAP-uh-gus) e hono ana te taha ki te taha ki te upoko me tetahi wāhanga, te katoa rānei o te puku (puku) me te uma, engari he upoko motuhake. Ka rua, toru, e whā rānei ngā ringa o ngā māngai, me ngā waewae e rua, e toru rānei.
• Upoko. Ko ngā māngai Craniopagus (kray-nee-OP-uh-gus) e hono ana i te tuara, te tihi, te taha rānei o te upoko, engari ehara i te kanohi. Ka tutaki ngā māngai Craniopagus i tetahi wāhanga o te angaanga. Engari he motuhake te nuinga o o rātou roro, ahakoa pea ka tutaki rātou i ētahi kiko roro.
• Upoko me te uma. Ko ngā māngai Cephalopagus (sef-uh-LOP-uh-gus) e hono ana ki te upoko me te tinana o runga. Kei ngā taha rerekē o te upoko kotahi te kanohi, ā, ka tutaki rātou i te roro. Kāore ngā māngai nei e ora i te nuinga.

I etahi wā onge, ka taea te hono o ngā māngai me tetahi māngai iti ake, te iti ake rānei te hanga i tetahi atu (ngā māngai tokorua kore-rite). I etahi wā tino onge, ka kitea pea tetahi māngai i whakawhanakehia i roto i tetahi atu māngai (fetus in fetu).

Kaore he uauatanga

Ko ngā māngai kotahi (ngā māngai monozygotic) ka puta mai ina wehe te hua manu kotahi kua whakaotingia, ka whanake hei ngā tangata tokorua. I waenganui i te waru ki te tekau mā rua rā i muri i te whakaotinga, ka tīmata te whanaketanga o ngā paparanga embryonic e wehewehe ana hei hanga i ngā māngai monozygotic hei ngā whekau me ngā hanganga motuhake.

E whakaponotia ana, ina wehe te ira i muri iho i tēnei – i te nuinga i waenganui i te tekau mā toru ki te tekau mā rima rā i muri i te whakaotinga – ka mutu te wehenga i mua i te otinga o te tukanga. Ko ngā māngai e puta mai ko ngā māngai hono.

He whakaaro rerekē e kī ana pea ka hono tahi ngā ira e rua motuhake i te tīmatanga o te whanaketanga.

He aha te take o tetahi rānei o ngā kaupapa e rua nei kaore e mōhiotia.

Nō te rerenga o ngā māngai whakawhāngai, ā, kāore i te mārama te take, kāore e mōhiotia he aha e āhei ai te whakawhānui ake i ētahi tokorua ki te whānau i ngā māngai whakawhāngai.

Ko te hapu me nga peepi toua he mea uaua, a he nui te piki o te tupono o nga raruraru kino. Me mahi te waha o te peepi toua ma te waha keti (C-waha).

Ka rite ki nga peepi mahanga, he tino pea ka whanau wawe nga peepi toua, a ka mate ranei tetahi, te rua ranei i te wa e whanau ana, i muri i te whanautanga ranei. Ka taea e nga raruraru hauora nui mo nga peepi mahanga te puta tonu, penei i te raruraru o te manawa, te raruraru o te ngakau ranei. I muri iho, ka puta mai nga raruraru hauora penei i te scoliosis, te cerebral palsy, te raru o te ako ranei.

Ko nga raruraru pea ka whakawhirinaki ki te waahi e hono ana nga peepi toua, ko tehea o nga whekau, etahi atu wahi ranei o te tinana e tuwhaina ana e raua, me te mohio me te wheako o te ropu tiaki hauora. Ki te tumanakohia nga peepi toua, me korerorero nga whanau me te ropu tiaki hauora mo nga raruraru pea me pehea te whakarite mo enei.

Kaore he uara (NaN)

Ka taea te whakatau i ngā māngai whāngai mā te whakamahi i te ultrasound noa i te tīmatanga o te 7 ki te 12 wiki o te haputanga. Ka taea te whakamahi i ngā ultrasound taipitopito ake me ngā whakamātautau e whakamahi ana i ngā ngaru oro hei whakaputa i ngā whakaahua o ngā ngākau o ngā pepeke (echocardiograms) i te wā tata ki te haurua o te haputanga. Ka taea e ēnei whakamātautau te whakatau pai ake i te whānui o te hononga o ngā māngai whāngai me te mahi o ō rātou whekau. Ki te kitea e te ultrasound ngā māngai whāngai, ka taea te mahi i te tātaritanga whakaata pūkaha (MRI). Ka taea e te MRI te whakarato i ngā kōrero taipitopito ake mō te wāhi e hono atu ai ngā māngai whāngai me ngā whekau e tuwhaina ana e rāua. Ka āwhina te MRI whānau me te echocardiography whānau ki te whakarite mō te tiaki i te wā o te haputanga me muri iho. I muri i te whānau, ka mahia ētahi atu whakamātautau hei awhina i te tautuhi i te hanganga tinana me te mahi whekau o ia māngai whāngai me ngā mea e tuwhaina ana.

Ko te rongoā i ngā māngai e hono ana e whakawhāngaitia ana ki o rātou āhuatanga ahurei—ō rātou raruraru hauora, te wāhi e hono atu ana rātou, te whakawhāiti rānei i ngā whekau, i ētahi atu hanganga nui rānei, me ētahi atu raruraru pea.

Ki te hapai koe i ngā māngai e hono ana, ka ata tirotirohia pea koe i te wa o tō haputanga. Ka tohua pea koe ki te tohunga hauora whaea me te peepi i roto i te haputanga morearea. Ki te hiahiatia, ka tohua pea koe ki ētahi atu tohunga tamariki i roto i:

• Te pokanga (tohunga pokanga tamariki)
• Pūnaha mimi, pēnei i ngā whatukuhu me te putea mimi (tohunga urology tamariki)
• Pokanga wheua me te hononga (tohunga pokanga wheua tamariki)
• Te whakatikatika me te whakatika pokanga (tohunga pokanga kiri me te whakahou)
• Ngā ngākau me ngā oko toto (tohunga ngākau tamariki)
• Pokanga ngākau me ngā oko toto (tohunga pokanga ngākau tamariki)
• Te tiaki i ngā pēpi hou (neonatologist)

Ka ako o tohunga me ētahi atu i roto i tō rōpū hauora i te mea ka taea mō ō māngai. Kei roto i ēnei te ako mō ō rātou hanganga tinana, ō rātou kaha ki te mahi i ētahi mahi (ngā kaha mahi) me te hua pea (whakaaro) hei hanga i te mahere rongoā mō ō māngai.

Ka whakaritea he wahi C i mua, i te nuinga o te wā 3 ki te 4 wiki i mua i tō rā whānau.

I muri i te whānau o ō māngai e hono ana, ka whakatauhia rātou katoa. Ma tēnei mōhiohio, ka taea e koe me tō rōpū hauora te whakatau i ngā mea e pā ana ki ō rātou tiaki me te tika rānei o te pokanga wehewehe.

Ki te whakatauhia te wehewehe i ngā māngai, ka mahia te pokanga wehewehe i te wā 6 ki te 12 marama i muri i te whānau kia tukua ai te wā mō te whakarite me te whakarite. I etahi wa, ka hiahiatia pea he wehewehe ohorere ki te mate tetahi o ngā māngai, ki te whānau rānei i tetahi āhuatanga morearea, ki te whakawehi rānei i te ora o tetahi atu māngai.

He maha ngā take uaua me whakaarohia hei wāhanga o te whakatau ki te mahi i te pokanga wehewehe. Ka whakaatu ia huinga o ngā māngai e hono ana i tetahi huinga take motuhake na te rerekētanga o te hanganga tinana me te mahi. Kei roto i ngā take:

• Te whakawhāiti rānei i ngā whekau nui a ngā māngai, pēnei i te ngākau
• Te hauora rānei o ngā māngai ki te tūpato i te pokanga wehewehe
• Ngā tūponotanga o te wehewehe angitu
• Momo me te nui o te pokanga whakahou e hiahiatia ana mō ia māngai i muri i te wehewehe
• Momo me te nui o te tautoko mahi e hiahiatia ana i muri i te wehewehe
• Ngā wero e tūtaki ana ki ngā māngai ki te noho tahi rātou

Kua pai ake ngā hua i roto i te pokanga wehewehe na ngā ahuatanga hou o te whakaahua i mua i te whānau, te tiaki matū me te tiaki anesthetic. I muri i te pokanga wehewehe, he mea nui ngā ratonga whakaora tamariki hei āwhina i ngā māngai kia whāngaia tika. Ka uru pea ngā ratonga ki ngā rongoā tinana, mahi me te kōrero me ētahi atu āwhina e hiahiatia ana.

Ki te kore e taea te pokanga wehewehe, ki te whakatau rānei koe ki te kore e mahi i te pokanga, ka taea e tō rōpū te āwhina i a koe ki te whakatutuki i ngā hiahia tiaki hauora o ō māngai.

Ki te kino te āhuatanga, ka whakaratohia te tiaki whakamarie hauora—pēnei i te kai, ngā wai, te pa atu tangata me te whakaora mamae.

Ka raru pea te ako kei a ō māngai kaore i whānau he take hauora nui, he āhuatanga morearea rānei. Hei mātua, ka whawhai koe ki ngā whakatau uaua mō ō māngai e hono ana me te heke mai kore e tino mōhiotia. Ka uaua pea te whakatau i ngā hua, ā, ko ngā māngai e hono ana e ora ana i etahi wā ka tūtaki ki ngā raruraru nui.

Na te mea he onge ngā māngai e hono ana, ka uaua pea te kimi i ngā rauemi tautoko. Pātai atu ki tō rōpū hauora mena kei te wātea ngā kaimahi pāpori hauora, ngā kaiāwhina rānei hei āwhina. I runga i ō hiahia, uiuihia mō ngā korero i runga i ngā whakahaere e tautoko ana i ngā mātua he tamariki ō rātou he āhuatanga tinana e āhei ana i ō rātou kaha, i ngā tamariki rānei kua ngaro.

Kaore he uauatanga