Tedavi sonrası vajinismus hastalarının gebelik sonuçları, obstetrik ve perinatal sonuçlarının değerlendirilmesi

Year 2021, Volume: 18 Issue: 4, 1023 - 1027, 31.12.2021

Tunay Kiremitli Sevil Kiremitli

https://doi.org/10.38136/jgon.943264

Abstract

Amaç: Bu çalışmanın amacı; vajinismus tedavisi sonrası spontan gebe kalabilmiş primer vajinismus hastalarının obstetrik ve perinatal sonuçlarını irdeleyerek, tedavi edilmiş primer vajinismusun obstetrik ve perinatal komplikasyonlar için halen bir risk faktörü olup olmadığını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya, 1 Ocak 2018-1 Ağustos 2020 tarihleri arasında, 8 haftayı geçmemiş gebeliği bulunan, 18-35 yaş arasında, daha önceden primer vajinismus tedavisi almış, nullipar, spontan gebe kalmış 50 hasta dahil edildi. Kontrol grubunda ise 56 nullipar gebe bulunmaktaydı. Hastaların dosyaları retrospektif taranarak, demografik verileri, karakteristik özellikleri, doğum haftaları, doğum indüksiyonu gerekliliği, doğum şekilleri, sezaryen endikasyonları, fetüslerin doğum kiloları, apgar skorları ve yenidoğan yoğun bakım ünitesi ihtiyaçları kaydedildi ve gruplar arasında karşılaştırıldı.
Bulgular: Vajinismus grubunda 31 (%68.9) hasta, kontrol gurunda ise 16 (%31.4) hasta sezaryen doğum yaptı(p<0.01). Vaginal doğum yapan hastalar arasında, vajinismus grubunda 14 hastanın 1’i, kontrol grubunda ise 35 gebenin 2’si epizyotomisiz doğum yaptı(p=0.6). Vajinismus grubunda en sık görülen sezaryen endikasyonları; vaginal muayede güçlük ve hasta isteğiydi, kontrol grubu ile fark istatistiksel olarak anlamlıydı(sırasıyla, p=0.04, p= 0.03).
Sonuç: Tedavi sonrası spontan gebe kalan vaginismus hastalarında vaginismus öyküsü sezaryen için risk faktörüdür. Bu hastalar tedavi almış olmalarına rağmen, doğumu yaptıran obstetrik ekibin hastanın vaginal muayeneye uyum göstermede güçlük çekebileceğini ve bu hastaların sezaryen beklentisinin fazla olabileceğini bilmeleri önemlidir.

Keywords

Primer vajinismus, vajinismus obstetrik sonuçlar, vajinismus sezaryen endikasyonları

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Examination of pregnancy outcomes, obstetric and perinatal outcomes of vaginismus patients after treatment

Abstract

Aim: The aim of this study is; to evaluate whether treated primary vaginismus (PV) is still a risk factor for obstetric&perinatal complications by examining the obstetric&perinatal outcomes of PV patients who could conceive spontaneously after vaginismus treatment.
Materials and Methods: Fifty nulliparous and spontaneous pregnancies between the ages of 18-35, who had previously received PV treatment between January 1, 2018 and August 1, 2020, were included in the study. There were 56 nulliparous pregnant women in the control group. The patients' files were scanned retrospectively, and their demographic data, characteristics, delivery weeks, labor induction requirement, delivery types, cesarean indications, birth weights of fetuses, apgar scores and neonatal intensive care unit needs were recorded and compared between the groups.
Results: Caesarean delivery was performed by 31 patients (68.9%) in the vaginismus-group and 16 (31.4%) patients in the control-group (p<0.01). Among the patients who delivered vaginally, 1 of 14 patients in the vaginismus-group and 2 of 35 patients in the control-group gave birth without episiotomy (p=0.6). The most common cesarean indications in the vaginismus-group are; the difficulty in vaginal examination, and the patient's request, the difference in the control-group was statistically significant (p=0.04, p=0.03, respectively).
Conclusion: In PV patients who conceive spontaneously after treatment, the history of vaginismus is a risk factor for cesarean delivery. Although these patients have received treatment, it is important for the obstetric team to know that the patient may have difficulty in adapting to the vaginal examination and that these patients may have a high expectation of cesarean section.

Keywords

Primary vaginismus, obstetric consequences of vaginismus, cesarean indications of vaginismus

Project Number

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