YARDIMCI ÜREME TEKNİKLERİNİN NEONATAL KARDİYAK ANOMALİ SIKLIĞI VE SOL VENTRİKÜL FONKSİYONLARI ÜZERİNE ETKİSİ

Year 2020, , 6 - 11, 31.03.2020

Ahmet Öktem , Fatih Atik

https://doi.org/10.20492/aeahtd.670514

Abstract

Türkçe Özet:
Amaç:
Doğal üreme yöntemleriyle bebek sahibi olamayan aileler yardımcı üreme tekniklerine (IVF) başvurmaktadırlar. Bu çalışmada IVF ile doğan bebeklerle, spontan gebelik sonucu doğan bebeklerin kardiyak fonksiyon ve anomali açısından iki grup arasındaki farklılıklar araştırılmıştır.

Gereç ve Yöntem:
Çalışmaya Ufuk Üniversitesi Çocuk Kardiyoloji Bilim Dalı’nda takip edilen, IVF ile doğan 50 olgu ve spontan gebelik ile doğan 77 olgu olmak üzere toplam 127 olgu alınmıştır. Ekokakardiyografi ile tüm olgular konjenital anomali ve sol ventrikül fonksiyonları açısından değerlendirildi. Sol ventrikül duvar kalınlıkları, ventrikül çapı, ejeksiyon ve kısalma fraksiyonları hesaplandı.

Bulgular:
Çalışmaya alınan 127 hastada; IVF bebeklerin yaş ortalaması 14,46±14,8 ay; spontan gebelik ile doğan bebeklerin yaş ortalaması 4,42 ±5,7 aydı. IVF bebeklerin 25’i kız (%50), 25’i erkek (%50); spontan gebelik ile doğan bebeklerin 36’sı kız (%46,7), 41’i erkek (%53,3) idi.
Çalışmada; spontan gebelik ile doğanların 18’inde (% 23) , IVF ile doğanların ise 10’unda (%25) kardiyak anomali saptandı.
Sol ventrikül duvar kalınlıkları değerlendirildiğinde spontan gebelik ile doğan olgularla IVF ile doğan olgular arasında fark bulunmamıştır (p>0,05). Sol ventrikül sistol sonu çapı IVF ile doğan olgularda, EF ve FS değerleri spontan gebelik ile doğan olgularda tüm yaş gruplarında istatistiksel anlamlı yüksek bulunmuştur (p<0,05).

Sonuç:
Son yıllarda IVF ile doğan bebeklerde doğumsal anomali prevelansının spontan gebelik sonucu doğan bebeklerle benzer olduğunu destekleyen yayınlar mevcuttur. Bizim çalışmamızda doğumsal kardiyak anomali açısından bu verileri destekler niteliktedir. Ancak sol kalp fonksiyonları yardımcı üreme teknikleri ile doğan bebeklerde daha düşük tespit edilmiş olmakla birlikte bu bebeklerin belirli aralıklarla daha uzun süre izlenmesi gerektiğini ortaya koymuştur.

İngilizce Özet:
Purpose:
Families who cannot have babies with spontaneous pregnancy resort to assisted reproductive techniques (ART).The aim of this study was to investigate the differences of cardiac function and anomaly between babies born with ART and babies born as a result of spontaneous pregnancy.

Material and Method:
A total of 127 cases examined in Ufuk University Department of Pediatric Cardiology, including 50 cases born with ART and 77 cases born with spontaneous pregnancy, were included in the study.All patients were evaluated for congenital anomaly and left ventricular function by echocardiography.Left ventricular wall thickness, ventricular diameter, ejection and shortening fractions were calculated.

Results:
127 patients included in the study; The mean age of ART babies was 14.46 ± 14.8 months; The mean age of the babies born with spontaneous pregnancy was 4.42 ± 5.7 months.
25 were female (50%) and 25 were male (50%) in ART group; 36 were female (46.7%) and 41 were male (53.3%) in spontaneous pregnancy group.18 (23%) cardiac anomalieswere detected in spontaneous pregnancy group and 10 (25%)cardiac anomalieswere detectedin ART group.
When the left ventricular wall thicknesses were evaluated, no difference was found between the cases born with spontaneous pregnancy and ART (p> 0.05).
In all age groups, left ventricular end-systolic diameter was found to be significantly higher in ART group, EF and FS values were found to be significantly higher in spontaneous pregnancy group (p <0.05).

Conclusion:
Recent studies suggest that the prevalence of congenital anomaly in infants born with ART is similar to those born with spontaneous pregnancy.Our study supports these data about congenital cardiac anomaly.However, although left heart functions were found to be lower in babies born with ART, it was shown that these babies should be monitored for longer periods at regular intervals.

Keywords

IVF Gebelik, Spontan gebelik, Sol kalp fonksiyonları, Kardiyak anomali

Supporting Institution

yok

Project Number

yok

Thanks

Bu çalışmanın önerisi ve planlanması sürecinde tüm desteği için merhum Sayın Prof. Dr. Enver Ekici'ye teşekkür ederiz.

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