Risk Factors, Maternal and Perinatal Results Concerning Placental Detachment; 5 Year-Experience of a Single Center

Abstract

Aim: The aim of this study is to determine the risk factors for placental detachment, and to evaluate its maternal and perinatal results. Materials and Methods: Between 2014 and 2019, birth records at Ümraniye Training and Research Hospital were scanned retrospectively. The study was planned with single pregnancies and 5 patients were excluded from the study because of multiple pregnancies. 137 patients were included in the study. Results: The reason for applying to the hospital, was recorded as follows; 49.6% (n = 68) bleeding, 28.5% (n = 39) pain, 10.9% (n = 15) water breaking, 0.7% (n = 1) falling down, 1.5% (n = 2) exhaustion, 3.6% (n = 5) nausea and headache, while it was observed that 5.1% (n = 7) applied for control purposes only. Blood replacements were performed in 31.4% (n = 43) of the cases. While 32.8% (n = 45) of the babies did not need newborn intensive care unit (NICU) hospitalization, 42.3% (n = 58) of the babies were discharged after the NICU hospitalization, and it was observed that 9.5% (n = 13) were ex during the NICU hospitalization, and 15.3% (n = 21) of them were intrauterine ex fetus. Conclusion: Placental detachment significantly increases maternal and perinatal morbidity and mortality. Compared with the rates in the normal pregnant population in the literature, it was found that hypertensive diseases, intrauterine growth retardation, proteinuria and placenta previa cases were significantly higher in placental detachment within our study. Knowing the risk factors causing placental detachment will be helpful in managing pregnant women and reducing birth complications.

Keywords

• plasental detachment,intrapartum bleeding

Plasenta Dekolmanı İçin Risk Faktörleri, Maternal ve Perinatal Sonuçlar; Tek Merkezin 5 Yıllık Deneyimi

Abstract

ÖZET Amaç: Çalışmamızda plasenta dekolmanı için risk faktörlerini tespit etmek, doğum haftasına göre maternal ve perinatal sonuçlarını değerlendirmek. Gereçler ve Yöntem: Ocak 2014 ve Ocak 2019 yılları arasında Ümraniye Eğitim ve Araştırma Hastanesi’ndeki doğum kayıtları retrospetif olarak tarandı. 20. gebelik haftasından sonra sezaryene alınan ve klinik olarak plasenta dekolmanı tanısı alan 142 hasta değerlendirmeye alındı. Plasenta dekolmanı tanısı operasyon esnasında retroplasental veya intraplasental hematomun izlenmesiyle konulmuştur. Çalışma tekil gebeliklerle planlanmış ve 5 hasta çoğul gebelik nedeniyle çalışma dışı bırakılmış, toplam 137 hasta çalışmaya dahil edildi. Bulgular ve Sonuç : Çalışmaya alınan olguların %49,6’sının (n=68) hastaneye başvuru sebebi kanama, %28,5’inin (n=39) sancı, %10,9’unun (n=15) su gelişi, %0,7’sinin (n=1) düşme, %1,5’inin (n=2) miad aşımı, %3,6’sının (n=5) mide bulantısı, baş ağrısı olduğu gözlenirken %5,1’inin (n=7) sadece kontrol amaçlı başvurduğu gözlenmiştir. Olguların %31,4’ünde (n=43) kan ve kan ürünleri replasmanı uygulanmıştır. Bebeklerin %32,8’inde (n=45) YDYBÜ yatışı gerekmezken, %42,3’ünün (n=58) yeni doğan yoğun bakım ünitesi (YDYBÜ) yatışı sonrasında taburcu olduğu, %9,5’inin (n=13) YDYBÜ yatışı esnasında ex olduğu izlenmiştir. %15,3’ünün (n=21) ise intrauterin ex fetüs (IUEF) olduğu gözlenmiştir. Plasenta dekolmanı maternal ve perinatal morbidite ve mortaliteyi aşikâr biçimde artırmaktadır. Literatürde normal gebe popülasyonundaki oranları ile kıyaslandığında çalışmamızda hipertansif hastalıklar, intrauterin gelişme geriliği, proteinüri ve plasenta previa olgularının plasenta dekolmanında anlamlı şekilde yüksek olduğu tespit edilmiştir. Plasenta dekolmanına neden olan risk faktörlerinin bilinmesi, gebelerin yönetiminde ve doğum komplikasyonlarının azaltılmasında yarar sağlayacaktır.

Keywords

• plasenta dekolmanı,kanama

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