PRETERM ERKEN MEMBRAN RÜPTÜRÜ OLGULARINDA MATERNAL VE NEONATAL SONUÇLARIN DEĞERLENDİRİLMESİ

Year 2015, Volume: 2 Issue: 2, 13 - 25, 29.11.2015

Abdül Güler , Yüksel Sayın

Abstract

Amaç: Preterm Erken Membran Rüptürü(PEMR) olgularında maternal ve neonatal sonuçların araştırılmasını amaçladık.

Gereç ve yöntemler: PEMR tanısı alan 145 tekiz gebelik geriye dönük incelendi. Maternal ve fetal etkileri incelenmesinde gebelik haftasına göre üç gruba ayrıldı. I. Grup: 29 gebelik haftası ve altı, 13 hasta. II. Grup: 30-34 gebelik haftası, 46 hasta. III. Grup: 34 gebelik haftası ve üzeri, 86 hasta olarak belirlendi. Grupların maternal ve neonatal sonuçları analiz edildi.

Bulgular: Çalışmaya katılan olguların yaş ortalaması 28,20±5,53 yıl olarak bulundu. Gestasyonel hafta ayrımına göre, olguların yaş, gravida, parite dağılımı, eğitim durumu, USG’ de AFI dağılımı, idrar kültürü dağılımı, tokoliz durumu, latent süre dağılımı arasında anlamlı fark bulunamamıştır(p>0.05). Gestasyonel hafta ayrımına göre olguların CRP, WBC ve ateş durumu dağılımında istatistiksel olarak anlamlı farklılık tespit edildi(p<0.05). Gestasyonel hafta ayrımına göre olguların doğum şekli dağılımında da anlamlı farklılık vardı(p<0,05).

Sonuç: Çalışmamızda morbidite ve mortalite oranını gebelik yaşına göre irdelediğimizde yenidoğan açısından en önemli morbidite nedeni olan RDS’ un 29. gebelik haftası ile başlayarak giderek azaldığı, her hafta için yaklaşık %10-15 lik azalma saptandığı belirlenmiştir. 29. gebelik haftası ile birlikte PEMR olgularında neonatal mortalite %50’ nin altına inerken, 32. gebelik haftası ile %10’ un altına inmektedir. PEMR olgularının 29. gebelik haftası ile birlikte ”bekle ve gör” yaklaşımı ile izlenmesinin neonatal morbidite ve mortalite açısından çok faydalı sonuçlar sağlayacağı kanaatindeyiz. 29. gebelik haftası altındaki olgularda neonatal prognoz ‘‘bekle ve gör” yaklaşımını desteklemeyecek kadar düşüktür.

 

Anahtar kelimeler: Preterm Erken Membran Rüptürü, Respiratuar Distres Sendromu

 

 

                                                                                                          

 

ABSTRACT

 

Objective: We aimed to investigate the cases of maternal and neonatal outcomes of Preterm premature rupture of membranes(PEMR).

Material and Methods: PEMR diagnosis of 145 singleton pregnancies were surveyed retrospectively. The examining of maternal and fetal effects were divided into three groups according to the study weeks of pregnancy. Group I: 29 weeks of pregnancy or less, 13 patients. Group II : 30-34 weeks of pregnancy, 46 patients. Group III : 34 weeks of pregnancy and more, were identified as 86 patients. Maternal and neonatal results of the two groups were analyzed.

Results: The average of the patients that are participated into this study has found 28,20±5,53. According to gestational week discrimination, the case of age, gravida, parity distribution, education level, USG of AFI distribution, urine culture distribution, tocolysis situation, latency time distribution have no significant difference with each other (p>0.05). According to gestational week discrimination was a significant difference in the distribution mode of delivery of the patients (p <0.05).

Conclusion: In our study when we examine gestational age of morbidity and mortality rate of the most important causes of morbidity in terms of the new born RDS’s 29th week of pregnancy as beginning with diminishing, It was determined that there was approximate reduction about %10-%15 per week. During the 29th week of pregnancy, neonatal mortality of Pemr event reduced more than %50 percetange, during the 32th week of gestation with %10 of it is below. With 29 weeks of pregnancy "wait and see" approach to monitoring and neonatal morbidity and we believe will provide very useful results in terms of mortality. Underlying 29th weeks pregnancy events neonatal prognosis wait and see approach is too low to support.

Keywords: Preterm labor, early membrane rupture, respiratory distress syndrome 

Keywords

Preterm Erken Membran Rüptürü, Respiratuar Distres Sendromu

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