Araştırma Makalesi
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İdiopatik İntrauterin Gelişme Geriliği İle Komplike Gebeliklerde Mikroalbuminüri Düzeyinin Araştırılması

Yıl 2020, Cilt: 15 Sayı: 1, 22 - 27, 26.03.2020
https://doi.org/10.17517/ksutfd.580043

Öz

Düşük doğum ağırlığı (<2500 g), perinatal mortaliteye, kısa ve uzun dönemde çocukluk çağı morbidite ve mortaliteye ve daha sonraki hayatta ise bir takım kardiyovasküler ve metabolik hastalılara neden olur. Eğer mümkünse Fetal Büyüme sınırlılığı (Fetal Growth Restriction FGR) 'nin ve düşük doğum ağırlığının önlenmesi klinik ve ekonomik açıdan çok önemlidir. Korunmanın ilk basamağı ise etiyolojiyi anlamaktır. Bu bağlamda etiyopatogeneze yönelik endotel disfonksiyonu ve bunun getirdiği sonuçlarda yetersiz trofoblastik invazyonu anlamak için Ekim 2002 ile Temmuz 2004 tarihleri arasındaki Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim dalı Obstetrik polikliniğinde antenatal takiplerinde FGR saptanan 38 gebe, risk faktörünü bulundurmayıp kontrol grubunu oluşturan rastgele seçilmiş 50 normal gebe olmak üzere toplam 88 olgu çalışmaya dahil edildi. Hastalarda gerek olgu gerekse kontrol grubunda 24 saatlik idrarda mikroalbüminüri düzeyleri karşılaştırıldı. Bu olguların aynı zamanda perinatal sonuçlan da mikroalbüminüri düzeyleri ile karşılaştırıldı. Çalışmanın sonunda her iki grup karşılaştırıldığında antenatal dönemlerinde mikroalbüminüri açısından gruplar arasında istatiksel bir anlam farkı bulunmadı (p>0.05). Her grupta mikroalbüminüri ile yenidoğan ağırlıkları ile anlamlı bir ilişki bulunmamıştır (p>0.05). Sonuç olarak FGR etiyopatogenezinden yetersiz trofoblastik invazyonun değişik mekanizmaların sorumlu olabileceği nedeniyle daha geniş ve kapsamlı araştırmalara gereksinim vardır.

Kaynakça

  • 1- Ghidini A. : Idiopathic fetal growth restriction: a pathophysiılogic approach. Obstet Gynecol Surv 51(6) :376-382, 19962- Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu 1972; 1: 177–1913- Kaufman Et Al. Endovascular Trophoblast Invasion: Implications for the Pathogenesis of Intrauterine Growth Retardation and Preeclampsia Bıology Of Reproductıon 69, 1–7 (2003)4- Dekker GA. Sibai BM. Low- dose apirin in the prevention of pre-eclampsia and fetal growth retardation: rationale, mechanisms and clinical trials. Am J Obstet Gynecol 1993; 168:214-2275- Renkin EM. Capillary transport of macromolecules: pores and other endothelial pathways. J Appl Physiol 985;58:315–3256- Pober JS, Cotran RS. Cytokines and endothelial cell biology. Physiol Rev 1990;70:427–4517- van Hinsbergh VWM, ed. Vascular Control of Hemostasis. Ad-vances in Vascular Biology_Vadas MA, Harlan J, series eds.., Vol1. Amsterdam: Harwood Academic Publishers, 19968- Stehouwer CDA. Von Willebrand factor, dysfunction of the vascular endothelium, and the development of renal and vascular complications in diabetes. In: Mogensen CE, ed. The Kidney and Hypertension in Diabetes Mellitus, 3rd edn. Boston: Kluwer, 1997:155– 1639- Stehouwer CDA, Donker AJM. Urinary albumin excretion and cardiovascular disease risk in diabetes mellitus: Is endothelial dysfunction the missing link? J Nephrol 1993;6:72–9210- Vane JR, A° ngg°ard EE, Botting RM. Mechanisms of disease: regulatory functions of the vascular endothelium. N Engl J Med 1990;323:27–36.11- Hamsten A. Hemostatic function and coronary artery disease. N Engl J Med 1995;332:677–67812- Jansson JH, Nilsson TK, Johnson O. von Willebrand factor in plasma: a novel risk factor for recurrent myocardial infarction and death. Br Heart J 1991;66:351–35513- Ridker PM, Vaughan DE, Stampfer MJ, Manson JE, Hennekens CH. Endogenous tissue-type plasminogen activator and risk of myocardial infarction. Lancet 1993;341:1165–116814- Omland T, Lie RT, Aakvaag A, Aarsland T, Dickstein K. Plasma endothelin determination as a prognostic indicator of 1-year mortality after acute myocardial infarction. Circulation 1994;89:1573–157915- Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Engl J Med 1995;332:635–64116- Blann AD, Taberner DA. A reliable marker of endothelial dysfunction: does it exist? Br J Haematol 1995;90:244–24817- Waldron JS et al Urine microalbumin excretion in relation to exercise-induced electrocardiographic myocardial ischaemia .Med Sci Monit, 2002; 8(11): CR725-72718- Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature 1993;362:801–80919- Stehouwer CDA, Donker AJM: Clinical usefulness of measurement of urinary albumin excretion in diabetes mellitus. Neth J Med 42: 175-186, 199320- Severi FM, Bocchi C, Visentin A, Falco P, Cobellis L, Florio P, Zagonari S, Pilu G: Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol 19: 225-228, 200221- Kaufmann P, Black S, Huppertz B: Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod 69: 1-7, 200322- Pober JS, Cotran RS: Cytokines and endothelial cell biology. Physiol Rev 70: 427-451, 199023- Lapillonne A, Peretti N, Ho PS, Claris O, Salle BL: Aetiology, morphology and body composition of infants born small for gestational age. Acta Paediatr Suppl 423: 173-173, 1997 24- Masse J, Forest JC, Moutquin JM: Microalbumin as a marker of premature delivery. Obstet Gynecol 87: 661-663, 199625- Singh H, Samal S, Mahapatro A, Ghose S. Comparison of obstetric outcome in pregnant women with and without microalbuminuria. J Nat Sci Biol Med. 2015 ;6(1):120-426- Ekbom P, Damm P, Feldt-Rasmussen B, Feldt-Rasmussen U, Molvig J, Mathiesen ER: Pregnancy outcome in type 1 diabetic women with microalbuminuria.Diabetes Care 24: 1739-1744, 2001 27- Schroder W, Heyl W, Hill-Grasshoff B, Rath W: Clinical value of detecting microalbuminuria as a risk factor for pregnancy-induced hypertension in insulin-treated diabetic pregnancies European Journal of Obstetrics & Gynecology and Reproductive Biology 91: 155-158, 200028- Masse J, Forest JC, Moutquin JM: Microalbumin as a marker of premature delivery. Obstet Gynecol 87: 661-663, 199629- Smith GC, Pell JP, Walsh D: Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births.Lancet 357: 2002-2006, 2001
Yıl 2020, Cilt: 15 Sayı: 1, 22 - 27, 26.03.2020
https://doi.org/10.17517/ksutfd.580043

Öz

Kaynakça

  • 1- Ghidini A. : Idiopathic fetal growth restriction: a pathophysiılogic approach. Obstet Gynecol Surv 51(6) :376-382, 19962- Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu 1972; 1: 177–1913- Kaufman Et Al. Endovascular Trophoblast Invasion: Implications for the Pathogenesis of Intrauterine Growth Retardation and Preeclampsia Bıology Of Reproductıon 69, 1–7 (2003)4- Dekker GA. Sibai BM. Low- dose apirin in the prevention of pre-eclampsia and fetal growth retardation: rationale, mechanisms and clinical trials. Am J Obstet Gynecol 1993; 168:214-2275- Renkin EM. Capillary transport of macromolecules: pores and other endothelial pathways. J Appl Physiol 985;58:315–3256- Pober JS, Cotran RS. Cytokines and endothelial cell biology. Physiol Rev 1990;70:427–4517- van Hinsbergh VWM, ed. Vascular Control of Hemostasis. Ad-vances in Vascular Biology_Vadas MA, Harlan J, series eds.., Vol1. Amsterdam: Harwood Academic Publishers, 19968- Stehouwer CDA. Von Willebrand factor, dysfunction of the vascular endothelium, and the development of renal and vascular complications in diabetes. In: Mogensen CE, ed. The Kidney and Hypertension in Diabetes Mellitus, 3rd edn. Boston: Kluwer, 1997:155– 1639- Stehouwer CDA, Donker AJM. Urinary albumin excretion and cardiovascular disease risk in diabetes mellitus: Is endothelial dysfunction the missing link? J Nephrol 1993;6:72–9210- Vane JR, A° ngg°ard EE, Botting RM. Mechanisms of disease: regulatory functions of the vascular endothelium. N Engl J Med 1990;323:27–36.11- Hamsten A. Hemostatic function and coronary artery disease. N Engl J Med 1995;332:677–67812- Jansson JH, Nilsson TK, Johnson O. von Willebrand factor in plasma: a novel risk factor for recurrent myocardial infarction and death. Br Heart J 1991;66:351–35513- Ridker PM, Vaughan DE, Stampfer MJ, Manson JE, Hennekens CH. Endogenous tissue-type plasminogen activator and risk of myocardial infarction. Lancet 1993;341:1165–116814- Omland T, Lie RT, Aakvaag A, Aarsland T, Dickstein K. Plasma endothelin determination as a prognostic indicator of 1-year mortality after acute myocardial infarction. Circulation 1994;89:1573–157915- Thompson SG, Kienast J, Pyke SD, Haverkate F, van de Loo JC. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Engl J Med 1995;332:635–64116- Blann AD, Taberner DA. A reliable marker of endothelial dysfunction: does it exist? Br J Haematol 1995;90:244–24817- Waldron JS et al Urine microalbumin excretion in relation to exercise-induced electrocardiographic myocardial ischaemia .Med Sci Monit, 2002; 8(11): CR725-72718- Ross R. The pathogenesis of atherosclerosis: A perspective for the 1990s. Nature 1993;362:801–80919- Stehouwer CDA, Donker AJM: Clinical usefulness of measurement of urinary albumin excretion in diabetes mellitus. Neth J Med 42: 175-186, 199320- Severi FM, Bocchi C, Visentin A, Falco P, Cobellis L, Florio P, Zagonari S, Pilu G: Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol 19: 225-228, 200221- Kaufmann P, Black S, Huppertz B: Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod 69: 1-7, 200322- Pober JS, Cotran RS: Cytokines and endothelial cell biology. Physiol Rev 70: 427-451, 199023- Lapillonne A, Peretti N, Ho PS, Claris O, Salle BL: Aetiology, morphology and body composition of infants born small for gestational age. Acta Paediatr Suppl 423: 173-173, 1997 24- Masse J, Forest JC, Moutquin JM: Microalbumin as a marker of premature delivery. Obstet Gynecol 87: 661-663, 199625- Singh H, Samal S, Mahapatro A, Ghose S. Comparison of obstetric outcome in pregnant women with and without microalbuminuria. J Nat Sci Biol Med. 2015 ;6(1):120-426- Ekbom P, Damm P, Feldt-Rasmussen B, Feldt-Rasmussen U, Molvig J, Mathiesen ER: Pregnancy outcome in type 1 diabetic women with microalbuminuria.Diabetes Care 24: 1739-1744, 2001 27- Schroder W, Heyl W, Hill-Grasshoff B, Rath W: Clinical value of detecting microalbuminuria as a risk factor for pregnancy-induced hypertension in insulin-treated diabetic pregnancies European Journal of Obstetrics & Gynecology and Reproductive Biology 91: 155-158, 200028- Masse J, Forest JC, Moutquin JM: Microalbumin as a marker of premature delivery. Obstet Gynecol 87: 661-663, 199629- Smith GC, Pell JP, Walsh D: Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births.Lancet 357: 2002-2006, 2001
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Ahmet Turp 0000-0003-2981-1096

Yayımlanma Tarihi 26 Mart 2020
Gönderilme Tarihi 19 Haziran 2019
Kabul Tarihi 26 Ocak 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 15 Sayı: 1

Kaynak Göster

AMA Turp A. İdiopatik İntrauterin Gelişme Geriliği İle Komplike Gebeliklerde Mikroalbuminüri Düzeyinin Araştırılması. KSÜ Tıp Fak Der. Mart 2020;15(1):22-27. doi:10.17517/ksutfd.580043