Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi

Year 2019, Volume: 17 Issue: 3, 374 - 386, 02.12.2019

Meltem Yazıcı Ayşe Livanelioglu

Abstract

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, Sezaryen (S) doğum sırasında
kullanılan anestezik maddelerin doğum sonrası ilk 48 saat içinde sağlıklı, tam
zamanlı doğan bebeklerin genel hareket (GMs) kaliteleri üzerine olan etkisini
araştırmaktır. Ayrıca doğum şekline göre anne ve bebeğe ait peri-prenatal
koşulları, bu koşullarla GMs motor Optimalite Skorları arasındaki ilişkiyi
incelemektir.

YÖNTEM ve GEREÇLER: Çalışmaya
herhangi bir risk içermeyen gebelik ve intrauterin sürecinin ardından 37- 40
haftayı tamamlayarak komplikasyonsuz bir doğum sonucunda doğan 60 tam zamanlı
doğan bebek ve anneleri dahil edildi. Bebekler doğum şekillerine göre 30 Normal
Spontan Vajinal Yol (NSVY) ve 30 elektif S ile doğan bebekler olarak
sınıflandırıldı. GMs motor Optimalite Skorları bebeklerin video görüntüleri
üzerinden spontan hareketlerinin GMs Detaylandırılmış Motor Optimalite Analizi
ile puanlandırılmasıyla belirlendi. Ayrıca, doğum şekline göre bebeklerin GMs
motor optimalite skorları ile gebelik, doğum ve yeni doğana ait optimalite
değerlendirmeleri arasındaki ilişki incelendi. Pre-perinatal koşullar doğum
şekline göre karşılaştırıldı.

BULGULAR: NSVY ile doğan bebeklerin
ilk 48 saat içindeki motor optimalite skorlarının S ile doğan bebeklerden daha
yüksek olduğu bulundu (p<0.05). NSVY ve S grubundaki annelerin gebelik
koşulları ve yenidoğanın fizyolojik sağlık hali açısından optimaliteleri
arasında fark olmadığı görüldü (p>0.05). Doğum optimalitesi NSVY ile doğumda
S dan daha yüksek bulundu (p<0.05). Doğum şekline göre bebeklerin motor
optimaliteleri ile peri-prenatal koşulları arasında ilişki görülmedi.

TARTIŞMA ve SONUÇ: Sezeryan doğum
sırasında kullanılan anestezik maddeler doğumdan sonraki ilk 48 saatte yeni
doğanın nörodavranışsal durumunu etkilemektedir.

Keywords

Yeni doğan nörodavranış, Prechtl, genel hareketler, anestezi, sezeryan, vajinal doğum

Investigation of the Effects of Cesarean Section on General Movements of the Newborn

Abstract

INTRODUCTION: This study aimed to
analyse the effect of anaesthetics used during Caesarean Section (CS) on the
General Movements (GMs),quality of healthy full-term infants in the postnatal
first 48 hours, the peri-prenatal conditions of mothers and infants, and the
relationship between these conditions and GMs motor Optimality Scores (OS)
according to type of birth.

METHODS: This study included 60 term
infants born without any birth complications after completing 37–40 weeks of
non-risky pregnancy and intrauterine process, along with their mothers. The
infants were allocated as 30 of them born by Normal Spontaneous Vaginal
Delivery (NSVD) and 30 of them born by elective CS. Infants’ GMs were assessed
in detail in the first 48 hours using Prechtl’s Method; this assessment yielded
their OS. The relationship between infants' GMs motor OS and pregnancy, birth,
and infants' optimality assessments was examined, and pre-perinatal conditions
were compared according to type of birth.

RESULTS: Motor OS in the first 48
hours were higher for infants born by NSDV than for those born by CS
(p<0.05). No difference was found between mothers’ pregnancy conditions and
neonates’ physiological health optimality in the two groups (p>0.05). Birth
optimality was higher in NSVD group than in CS group (p<0.05). No relationship
was found between infants' motor optimality and peri-prenatal conditions
according to type of birth.

DISCUSSION and CONCLUSION:
Anaesthetics used during CS affect infants' neurobehavioral status in the
postnatal first 48 hours.

 

Keywords

: Infant neurobehavior, Prechtl, general movements, anaesthesia, caesarean, vaginal delivery

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