İhmal Edilen Bir Alan: Gebelikte Huzursuz Bacak Sendromu ve Kadın Sağlığı Hemşiresinin Rolü

Abstract

Huzursuz bacak sendromu gebelikte en fazla görülen hareket bozukluğu olup gebelerde sağlıklı kadınlara ve erkeklere göre daha sık görülmektedir. Buna karşın doğum uzmanları tarafından yeterince tanınmamaktadır. Benzer şekilde gebelerin de huzursuz bacak sendromuna ilişkin farkındalıkları düşüktür. Hastalığın gebelikteki patofizyolojisinde genetik, beyin dopamin sistemi ve demir metabolizmasının etkili olduğu düşünülmektedir. Semptomlar genellikle doğumdan sonra kaybolmaktadır ancak hastalık tedavi edilmezse uyku bozukluğu, psikolojik sorunlar, yaşam kalitesinde azalmanın yanında preeklampsi, düşük tehdidi, erken doğum, zor doğum, sezeryan doğum ve intrauterin büyüme geriliği gibi gebelik ve doğumla ilgili komplikasyonlar yaşanabilmektedir. Gebelikte tanı, Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu'nun temel kriterleri kullanılarak konulmaktadır. Tedavide primer olarak non-farmakolojik yöntemler önerilmektedir. Ancak semptomlar şiddetli ise daha güvenilir olan ilaçlar düşünülmelidir. Semptom yönetiminde öncelikle anemi, uyku apnesi, huzursuz bacak sendromunu şiddetlendiren ilaç kullanımı gibi faktörlerin kontrol altına alınması önemlidir. Gebelikte huzursuz bacak sendromu şiddetini azaltmaya yönelik orta derecede egzersiz, yoga, sıcak/soğuk su uygulamaları, progresif gevşeme egzersizi, gevşeme fon müziği dinlenmesi, uyku hijyeni gibi farmakolojik olmayan tedaviler önerilebilmektedir. Gebe takibinde önemli rol ve sorumluluğu olan kadın sağlığı hemşirelerinin kadınlara prepartum, peripartum, intrapartum ve postpartum dönemde bütüncül bir yaklaşımla kanıta dayalı uygulamalar doğrultusunda etkili ve kaliteli bir bakım verebilmesi gerekmektedir.

Keywords

• Gebelik
• huzursuz bacak sendromu
• kadın hastalıkları ve doğum hemşireliği
• hemşirelik bakımı

A Neglected Area: Restless Leg Syndrome in Pregnancy and The Role of the Obstetric and Gynecology Nurse

Abstract

Restless legs syndrome is the most common movement disorder in pregnancy and is more common in pregnant women than in healthy women and men. However, it is not well known among obstetricians. Similarly, the awareness of pregnant women about restless legs syndrome is also low. Genetics, the brain’s dopamine system and iron metabolism are thought to be effective in the pathophysiology of the disease in pregnancy. The disease usually disappears after delivery, but if not treated, sleep disorders, psychological problems, decreased quality of life, as well as symptoms of pregnancy and birth-related complications such as preeclampsia, the threat of miscarriage, premature birth, difficult birth, cesarean delivery and intrauterine growth retardation may occur. Diagnosis in pregnancy is made using the basic criteria of the International Restless Legs Syndrome Working Group. Non-pharmacological methods are primarily recommended for treatment. However, if symptoms are severe, more reliable drugs should be considered. In symptom management, it is essential to control anemia, sleep apnoea, and drug use that exacerbate restless legs syndrome. To reduce the severity of restless legs syndrome during pregnancy, non-pharmacological treatments such as moderate exercise, yoga, hot/cold water applications, relaxation exercise, relaxing background music, and sleep hygiene can be recommended. Obstetrics and gynecology nurses, who have a crucial role and responsibility in pregnancy follow-up, should be able to provide effective and quality care to women in the prepartum, peripartum, intrapartum, and postpartum periods with a comprehensive approach in line with evidence-based practices.

Keywords

• Pregnancy
• restless legs syndrome
• obstetrics and gynecology nursing
• nursing care.

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