İntrauterin Resüsitasyon Manevraları ve Yönetimi
Year 2024,
Volume: 8 Issue: 2, 107 - 115, 31.08.2024
Seray Gerey
,
Hülya Türkmen
,
Pelin Palas Karaca
Abstract
ÖZ
Amaç: Bu derleme maternal pozisyon değişikliği, maternal oksijen uygulaması, intravenöz sıvı uygulaması, uterotonik ajanların kesilmesi, vazopresör kullanımı, amniyoinfüzyon ve tokoliz uygulaması gibi intrauterin resüsitasyon tekniklerinin etki durumlarını, her birinin uygulanma şekillerini ve bu tekniklerle ilgili yapılan çalışmalardaki önerileri açıklamak amacıyla yazılmıştır.
Gereç ve Yöntemler: Bu çalışma genel bir derleme olup literatür özetlemesi yapılarak yazılmıştır.
Bulgular: İntrapartum dönem normal bir süreç olmasına rağmen, bu süreçte hem anne hem fetüs açısından riskli durumlar gelişebilmektedir. Bu riskli durumların saptanmasında, doğumun güvenli bir şekilde sürdürülmesinde ve fetal iyilik halinin bilinmesinde Elektronik Fetal Monitörizasyon (EFM) gibi çeşitli uygulamalar önemlidir. Ebelerin doğum esnasında fetal kalp atımlarını sürekli takip etmeleri doğumun sonuçları açısından gereklidir. Doğum eyleminde fetal kalp atımında normalden sapma söz konusu olduğunda fetüsün oksijenlenmesinde azalma yaşanabilmektedir. Fetal oksijenlenmenin artırılması açısından intrauterin resisütasyon manevraları uygulanmakta olup, fetüsün oksijen yetersizliğinden kaynaklanan hipoksik iskemik ensefalopati, serebral palsi ve ölüm gibi sonuçları önleyebilmektedir. Sağlık profesyonelleri tarafından fetal sağlığın tehdit altında olduğu durumlarda intrauterin resisütasyon manevralarına derhal başlanmalıdır.
Sonuç: İntrapartum dönemde uygulanan intrauterin resüsitasyon manevraları intrapartum ve postpartum dönemdeki mortalite ve morbiditeyi büyük oranda önleyebilmektedir. Bu sebeple ebelerin de fetal distresi tanıma, yönetme ve intrauterin resüsitasyon manevraları hakkında bilgi sahibi olması gereklidir.
Ethical Statement
Çalışma derleme çalışması olduğu için etik izni yoktur.
Supporting Institution
Bu makale kamu, ticari veya kar amacı gütmeyen sektörlerdeki finansman kuruluşlarından herhangi bir özel hibe almamıştır.
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Year 2024,
Volume: 8 Issue: 2, 107 - 115, 31.08.2024
Seray Gerey
,
Hülya Türkmen
,
Pelin Palas Karaca
References
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- Acar, A., Ercan, F., & Sayal, B. (2016). Fetal Kan Örneklemesi: Derleme. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 13(2), 68-74.
- Afolayan, J., Olajumoke, T., Esangbedo, S., & Edomwonyi, N. (2014). Spinal anaesthesia for caesarean section in pregnant women with fetal distress: time for reappraisal. International Journal of Biomedical Science: IJBS, 10(2), 103.
- Aktaş, S., & Osmanağaoğlu, M. A. (2017). İntrapartum Elektronık Fetal Monıtorızasyon Uygulaması Ve Sağlık Profesyonellerının Sorumlulukları. Life Sciences, 12(1), 14-29.
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- Azarkish, F., Janghorban, R., Bozorgzadeh, S., Arzani, A., Balouchi, R., & Didehvar, M. (2022). The effect of maternal intravenous hydration on amniotic fluid index in oligohydramnios. BMC research notes, 15(1), 95.
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- De Ruigh, A. A., Simons, N. E., Van Der Windt, L. I., Breuking, S. H., van ‘t Hooft, J., Van Teeffelen, A. S., Alfirevic, Z., Roberts, D., Mol, B. W., & Pajkrt, E. (2022). Amnioinfusion versus usual care in women with prelabor rupture of membranes in midtrimester: a systematic review and meta-analysis of short-and long-term outcomes. Fetal Diagnosis and Therapy, 49(7-8), 321-332.
- Dongare, P. A., & Nataraj, M. S. (2018). Anaesthetic management of obstetric emergencies. Indian journal of anaesthesia, 62(9), 704-709.
- East, C. E., Begg, L., Colditz, P. B., & Lau, R. (2014). Fetal pulse oximetry for fetal assessment in labour. Cochrane database of systematic reviews(10).
- Erenel, A. Ş., & Çiçek, S. (2018). Doğum şeklinin anne ve yenidoğan sağlığına etkisi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi, 9(2), 123-129.
- Erol, S. A., Kırbaş, A., & Ustun, Y. (2020). Preterm doğum yönetiminde tokolitik ajanlar ve kalsiyum kanal blokerlerinin (nifedipin) yeri. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 17(4), 621-628.
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- Gwanzura, C., Gavi, S., Mangiza, M., Moyo, F. V., Lohman, M. C., Nhemachena, T., & Chipato, T. (2023). Effect of anesthesia administration method on apgar scores of infants born to women undergoing elective cesarean section. BMC anesthesiology, 23(1), 142.
- Hamel, M. S., Anderson, B. L., & Rouse, D. J. (2014). Oxygen for intrauterine resuscitation: of unproved benefit and potentially harmful. American journal of obstetrics and gynecology, 211(2), 124-127.
- Hamel, M. S., Hughes, B. L., & Rouse, D. J. (2015). Whither oxygen for intrauterine resuscitation? American journal of obstetrics and gynecology, 212(4), p461-463.
- Hofmeyr, G. J., & Lawrie, T. A. (2012). Amnioinfusion for potential or suspected umbilical cord compression in labour. Cochrane database of systematic reviews(1).
- Huang, J., Zang, Y., Ren, L.-H., Li, F.-J., & Lu, H. (2019). A review and comparison of common maternal positions during the second-stage of labor. International journal of nursing sciences, 6(4), 460-467.
- Hughes, O., & Murphy, D. (2022). Comparing second-line tests to assess fetal wellbeing in Labor: a feasibility study and pilot randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 35(1), 91-99.
- James, S., Maduna, N. E., & Morton, D. G. (2019). Knowledge levels of midwives regarding the interpretation of cardiotocographs at labour units in KwaZulu-Natal public hospitals. Curationis, 42(1), 1-7.
- Johnson, M. J. (2020). Intrauterine Fetal Resuscitation, A Midwife’s RolE. Editorial Board, 9(8).
- Karadeniz, M., & Öztürk, A. C. (2023). Fetal and Maternal Effects of Amnioinfusion Applied during Delivery in Oligohydramniotic Meconium-Stained Pregnancies. Bosphorus Medical Journal, 10(3), 168.
- Kiratli, D., Yavan, T., Karsahin, K. E., & Yenen, M. C. (2018). The effect of different maternal positions on reactivity of the nonstress test, maternal blood pressure and heart rate. Izmır Dr Behcet Uz Cocuk Hastanesı Dergısı.
- Kitaw, T. M., Limenh, S. K., Chekole, F. A., Getie, S. A., Gemeda, B. N., & Engda, A. S. (2021). Decision to delivery interval and associated factors for emergency cesarean section: a cross-sectional study. BMC Pregnancy and Childbirth, 21, 1-7.
- Leathersich, S. J., Vogel, J. P., Tran, T. S., & Hofmeyr, G. J. (2018). Acute tocolysis for uterine tachysystole or suspected fetal distress. Cochrane database of systematic reviews(7).
- Magawa, S., Nii, M., Sakakura, Y., Enomoto, N., Takakura, S., Maki, S., Tanaka, H., Kondo, E., & Ikeda, T. (2022).
Appropriate Method of Administering Vasopressors for Maternal Hypotension Associated with Combined Spinal Epidural Anesthesia in Elective Cesarean Section: Impact on Postnatal Respiratory Support for Newborns. Medicina, 58(3), 403.
- Mayer, C., & Apodaca-Ramos, I. (2023). Tocolysis. In StatPearls [Internet]. StatPearls Publishing.
- Metogo, J. A. M., Nana, T. N., Ngongheh, B. A., Nyuydzefon, E. B., Adjahoung, C. A., Tochie, J. N., & Minkande, J. Z. (2021). General versus regional anaesthesia for caesarean section indicated for acute foetal distress: a retrospective cohort study. BMC anesthesiology, 21, 1-10.
- Miremberg, H., Grinstein, E., Herman, H. G., Marelly, C., Barber, E., Schreiber, L., Bar, J., Kovo, M., & Weiner, E. (2020). The association between isolated oligohydramnios at term and placental pathology in correlation with pregnancy outcomes. Placenta, 90, 37-41.
- Murphy, D., Shahabuddin, Y., Yambasu, S., O’Donoghue, K., Devane, D., Cotter, A., Gaffney, G., Burke, L., Molloy, E., & Boland, F. (2022). Digital fetal scalp stimulation (dFSS) versus fetal blood sampling (FBS) to assess fetal wellbeing in labour—a multi-centre randomised controlled trial: Fetal Intrapartum Randomised Scalp Stimulation Trial (FIRSST NCT05306756). Trials, 23(1), 848.
- Nag, D. S., Samaddar, D. P., Chatterjee, A., Kumar, H., & Dembla, A. (2015). Vasopressors in obstetric anesthesia: A current perspective. World Journal of Clinical Cases: WJCC, 3(1), 58.
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