GEBELİK SIRASINDA GEÇİRİLEN NON-OBSTETRİK CERRAHİ SONRASI MATERNAL VE FETAL SONUÇLAR

Year 2023, Volume: 7 Issue: 2, 97 - 105, 30.08.2023

Asya Özcan , Semra Yüksel , Zeynep Gedik Özköse , İsmail Özdemir

https://doi.org/10.34084/bshr.1278592

Abstract

Amaç: Gebelik sırasında yapılan non-obstetrik cerrahilerde gebeliğin devamı ve neonatal sürecin nasıl etkileyeceği hem gebe hem cerrah tarafından önem arz etmektedir. Non-obstetrik cerrahiler ile ilgili çalışmalar sınırlı sayıdadır. Bu çalışmamızın amacı non-obstetrik cerrahi sonrası maternal ve fetal sonuçların değerlendirilmesidir.
Yöntem: Çalışmamız tersiyer bir merkez olan hastanemizin obstetri kliniğimizde Ocak 2015-Ağustos 2020 tarihleri arasındaki non-obstetrik cerrahi yapılan 60 gebe hastanın retrospektif değerlendirilmesini içermektedir. Hasta bilgilerine elektronik sistem ve arşiv dosyalarından ulaşıldı. Hastaların demografik özellikleri, cerrahi yapılan hafta, takipleri, gebelik ve neonatal sonuçları değerlendirildi.
Bulgular: Hastaların ortalama yaşı 27,9±4,42 cerrahi yapılan gebelik haftası ortalama
17,7±11,3 idi. Cerrahi endikasyonlar arasında en sık neden 45 hasta ile (%75) apandisittir.
Gebelerin %88,3’üne acil cerrahi yapıldı. Ortalama hastanede kalış süresi 3,3±3,2 gün, doğuma kadar geçen ortalama hafta 21,1±8,6 idi. Gebelerin ortalama doğum haftası 37,8±2,8 idi. Acil cerrahi yapılan hastalarda laparotomi tercihi laparoskopiye göre anlamlı olarak yüksek bulundu (P=0.007). Laparotomi(LT) ve laparoskopi(LSK) grubunda gebelik sonuçları ve neonatal sonuçlar açısından fark saptanmadı.
Sonuç: Gebelikte geçirilen non-obstetrik cerrahi olumsuz gebelik ve neonatal sonuçlarda artışa yol açtığına dair bir sonuca ulaşılamamıştır. Ayrıca cerrahi şeklini değerlendirdiğimizde; laparotomi ve laparoskopi yapılan gruplar arasında gebelik ve neonatal sonuçlar açısından anlamlı bir fark bulunmadı. Bu konuda daha geniş çaplı çalışmalara ihtiyaç vardır.

Keywords

gebelikte cerrahi, non-obstetrik cerrahi, gebelikte laparoskopi

MATERNAL AND FETAL RESULTS AFTER NON-OBSTETRIC SURGERY DURING PREGNANCY

Abstract

Objectives: In non-obstetric surgeries performed during pregnancy, the continuation of pregnancy and how it will affect the neonatal process are important for both the pregnant and the surgeon. Studies on non-obstetric surgeries are limited. The aim of this study is to evaluate maternal and fetal outcomes after non-obstetric surgery.
Methods: Our study includes the retrospective evaluation of 60 pregnant patients who underwent non-obstetric surgery between January 2015 and August 2020 in our obstetrics clinic, which is a tertiary center. Patient information was obtained from electronic system and archive files. Demographic characteristics of the patients, week of surgery, follow-up, pregnancy and neonatal outcomes were evaluated.
Results: The mean age of the patients was 27.9±4.42, and the mean gestational week at which surgery was performed was 17.7±11.3. Among the surgical indications, the most common cause is appendicitis with 45 patients (75%). Emergency surgery was performed in 88.3% of the pregnant women. The mean hospital stay was 3.3±3.2 days, and the mean week to delivery was 21.1±8.6. The mean delivery week of the pregnant women was 37.8±2.8. Laparotomy preference was found to be significantly higher than laparoscopy in patients who underwent emergency surgery (P=0.007). There was no difference in pregnancy outcomes and neonatal outcomes in the laparotomy (LT) and laparoscopy (LSK) groups.
Conclusions: There was no conclusion that non-obstetric surgery during pregnancy led to an increase in adverse pregnancy and neonatal outcomes. In addition, when we evaluate the type of surgery; There was no significant difference between the laparotomy and laparoscopy groups in terms of pregnancy and neonatal outcomes. More extensive studies are needed on this subject.

Keywords

surgery in pregnancy, non-obstetric surgery, laparoscopy in pregnancy

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