Kembar episod 5 :: TTS - Twin Transfusion Syndrome

Ketika disahkan mengandung kembar satu uri....mama telah dimaklumkan doctor untuk bersedia...bersedia mental dan fizikal.....bersedia untuk kehilangan...kehilangan satu atau keduanya.....Ya Allah...dugaan apakah ini...sesungguhnya aku lemah.......mohon permudahkan segalanya...

Menurut doktor, kehamilan kembar satu uri atau berkongsi uri akan terdedah dengan risiko TTS atau Twin transfusion syndrome...apa itu TTS?

Twin to twin transfusion syndrome (TTTS) is a disease of the placenta (or afterbirth) that affects identical twin pregnancies.Twin-to-twin transfusion syndrome (TTTS) is the result of an intrauterine blood transfusion from one twin (donor) to another twin (recipient). TTTS only occurs in monozygotic (identical) twins with a monochorionic placenta. The donor twin is often smaller with a birth weight 20% less than the recipient's birth weight. The donor twin is often anemic and the recipient twin is often plethoric with hemoglobin differences greater than 5 g/dL.

TTTS affects identical twins (or higher multiple gestations), who share a common monochorionic placenta.

The shared placenta contains abnormal blood vessels, which connect the umbilical cords and circulations of the twins.

The common placenta may also be shared unequally by the twins, and one twin may have a share too small to provide the necessary nutrients to grow normally or even survive.

The events in pregnancy that lead to TTTS - the timing of the twinning event, the number and type of connecting vessels, and the way the placenta is shared by the twins are all random events that have no primary prevention (see section on The Monochorionic Placenta), is not hereditary or genetic, nor is it caused by anything the parents did or did not do. TTTS can happen to anyone.

The placenta is the only biologic structure that can cause the death or injury of more than one person at the same time.

Depending on the number, type and direction of the connecting vessels, blood can be transfused disproportionately from one twin (the donor) to the other twin (the recipient).

The transfusion causes the donor twin to have decreased blood volume. This in turn leads to slower than normal growth than its co-twin, and poor urinary output causing little to no amniotic fluid or oligohydramnios (the source of most of the amniotic fluid is urine from the baby).

The recipient twin becomes overloaded with blood. This excess blood puts a strain on this baby’s heart to the point that it may develop heart failure, and also causes this baby to have too much amniotic fluid (polyhydramnios) from a greater than normal production of urine.

TTTS can occur at any time during pregnancy, even while a mother is in labor at term. The placental abnormalities determine when and to what degree a transfusion occurs between the twins.

Chronic TTTS describes those cases that appear early in pregnancy (12-26 weeks’ gestation). These cases are the most serious because the babies are immature and cannot be delivered. In addition, the twins will have a longer time during their development in the womb to be affected by the TTTS abnormalities. Without treatment, most of these babies would not survive and of the survivors, most would have handicaps or birth defects.

Acute TTTS describes those cases that occur suddenly, whenever there is a major difference in the blood pressures between the twins. This may occur in labor at term, or during the last third of pregnancy whenever one twin becomes gravely ill or even passes away as a result of the abnormalities in their shared placenta. Acute TTTS twins may have a better chance to survive based on their gestational age, but may have a greater chance of surviving with handicaps.


sumber : tttsfoundation.org

 

 

namun sepanjang kehamilan....doktor hanya nampak tanda2 TTS pada bulan yang ke 6 melalui scan tapi  kemudian tanda2 tersebut hilang...jadi prof hasyim yakinkan yang twinnies sihat tanpa sebarang komplikasi sehingga la pada hari mereka dilahirkan....sufi lahir dengan berat 1.9 kg (donor) manakala suci 2.78 (recipient).Kata prof lagi TTS terjadi di akhir menjelang kelahiran...

Kata prof hasyim...kerana suci menerima lebih maka darahnya menjadi pekat menyebabkan jantungnya yg belum cukup matang tak mampu untuk mengepam darah yang pekat tu.....sebab itu suci ditahan di NICU satu malam bagi doktor monitor pernafasan dan nadinya....sebab corak nadi dan pernafasannya tak cantik...kata doktor la...taktau la camana cantik or tak cantiknya......

memula mama ingatkan suci yang ok sebab dia lebih berat dan sufi yang mungkin ditahan sebab sufi lebih kecil (takut tak cukup zat...heheheh)....rupanya yang terjadi di sebaliknya pula....Allah itu Maha Kuasa....dan setiap yang berlaku itu ada hikmahnya.

 

 

tapi Alhamdullillah.....beza sufi dan suci tidak ketara sangat...hanya dari segi saiz...tu pon kalau perhati betul2...kalau tidak...macam lebih kurang sahaja...

 

kalau nak bandingkan TTS bayi kembar di luar Negara......

 

 

  

syukur kepadamu Ya Allah......terima kasih atas kurniaan yang indah dan sihat tubuh badan buat anak anak mama dan papa...sufi dan suci...