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Višeplodna trudnoća jest razvoj više od jednog ploda u maternici žene. Blizanci se mogu razviti iz jedne ili dvije oplođene jajne stanice. Višeplodne trudnoće spadaju u rizične trudnoće zbog učestalosti komplikacija posebno kod jednojajčanih blizanaca. Dijagnoza višeplodnih trudnoća postavlja se na temelju anamneze, kliničkog pregleda, a od neprocjenjive vrijednosti je ultrazvučni pregled. Tijelo trudnice prilagođava se na višeplodnu trunoću kao i na jednoplodnu, samo su promjene izraženije. Postoje karakteristične komplikacije kao što su povećana smrtnost, diskordantni blizanci, krvožilne anastomoze i akardijus. Važnost antenatalne skrbi jest velika i njena svrha je spriječiti prijevremeno rađanje, prepoznati intrauterine poremećaje rasta, pravovremeni porođaj u slučaju indikacije, smanjena mogućnost oštećenja ploda tijekom porođaja i osigurana skrb za novorođenčad. Najčešći položaj blizanaca jest oba glavom ili prvi glavom drugi zadak kod kojih je vaginalni porod moguć ako nema drugih komplikacija. Uloga primalje jest velika. Od zaprimanja trudnice na odjel, educiranja rodilje tehnikama pravilnog disanja i tiskanja, primjene propisane terapije, stlanog nadzora i pravovremenog uočavanja eventualnih komplikacija, do porađanja i prve opskrbe djece. Development more than one fetus in woman uterus is called multiple pregnancy. Twins can develop from one or more fertilised egg cells. Multiple pregnancy is considered as high risk pragnancy because of it's higher percentage of complications, specially with one egg twins. Diagnostic is based on anamnesis, clinical exams and most important ultrasound exams. The body of pregnant woman in multiple pregnancy is adjusting the same way as it does for one fetus, but changes are more prominent. There are typical complications such as increased mortality, discordant twins, anastomosis and acardium. The importance of antenatal care is great and it's purpose is to prevent premature birth, recognize intrauterine growth disorders, timely delivery in case of indications, reduced risk of birth defects during childbirth and nursing care for newborn. The most common presentation of twins is both with head or first twin head and second pelvis. In that case vaginal birth is possible if there is no other complications. The role of midwife is very important for woman in labor. From receiving woman to delivery room, educating her about right techniques for breathing and pushing, aplly prescribed therapy, constant monitoring and timely detection of complications, to delivery and first supply of the newborn. |
