Plasenta previalı gebelerde acil müdahalenin risk faktörleri ve sonuçları: gözlemsel bir çalışma

Öz

Amaç: Plasenta previalı (PP) gebelerde acil müdahalenin risk faktörlerini ve sonuçlarını araştırmak. Gereç ve yöntem: Bu retrospektif çalışma Haziran 2015 ile Ocak 2021 tarihleri arasında yapıldı. PP'li gebeler cerrahi planlamaya göre acil ve planlı müdahale gruplarına ayrıldı. Gruplar demografik özellikler, antepartum kanama (AK) varlığı, operasyon özellikleri, anne ve yenidoğan sonuçları açısından karşılaştırıldı. Bulgular: PP'li toplam 434 hasta analiz edildi. Çalışma süresince PP sıklığı %0,52 idi. 168 (%38,7) gebeye acil müdahale yapılırken, 266 (%61,3) gebeye planlı müdahale yapıldı. PP’lı gebelerin 208 (%47,9)’sinde AK öyküsü vardı. Gebelerde AK öyküsünün olması acil müdahale riskinin 3.026 kat artmasıyla ilişkiliydi [%95 güven aralığı (GA), 1.990–4.603; p = 0.000]. Gebelikte kilo alımı acil müdahale riskinin 0,932 (%95 GA, 0,887–0,987; p = 0,004) kat azalmasıyla ilişkilendirildi. Acil müdahale grubunda, operasyon sırasında daha fazla ek cerrahi prosedür gerekti ve daha fazla masif transfüzyon yapıldı (p = 0.000 ve p = 0.000). Acil müdahale, olumsuz maternal sonuçlarda 3.064 (% 95 GA, 1.571-5.975) kat ve olumsuz fetal sonuçlarda 7.5 (%95 GA, 4.841–11.620) kat artışa neden oldu. Sonuç: PP'li gebelerde doğumda acil müdahale sıklığı yüksektir ve bu durum artan olumsuz maternal ve neonatal sonuçlarla ilişkilidir. Acil müdahalenin öngörülmesinde en etkili faktör AK'dir.

Anahtar Kelimeler

• acil müdahale
• antepartum kanama
• maternal ve neonatal sonuçlar
• plasenta previa

Risk factors and outcomes of emergency intervention in pregnant women with placenta previa: an observational study

Öz

Aim: To investigate the risk factors and outcomes of emergency intervention in pregnant women with placenta previa (PP). Material and method: This retrospective study was conducted between June 2015 and January 2021. Pregnant women with PP were divided into emergency and planned intervention groups according to surgical planning. The groups were compared in terms of demographic characteristics, presence of antepartum hemorrhage (APH), operation characteristics, and maternal and neonatal outcomes. Results: A total of 434 patients with PP were analyzed. The frequency of PP was 0.52%. The emergency intervention was performed in 168 (38.7%) pregnant women, whereas planned intervention was performed in 266 (61.3%). APH was present in 208 (47.9%) patients; the presence of APH was associated with increased risk of emergency intervention by 3.026 [95% confidence interval (CI), 1.990–4.603; p = 0.000]-fold. The weight gained during pregnancy was associated with reduced risk of emergency intervention by 0.932 (95% CI, 0.887–0.978; p = 0.004)-fold. In the emergency intervention group, more additional surgical procedures and massive transfusion were performed during the operation (p = 0.000 and p = 0.000) Emergency intervention resulted in an increase in adverse maternal and fetal outcomes by 3.064 (95% CI, 1.571–5.975) and 7.5 (95% CI, 4.841–11.620)-fold, respectively. Conclusion: The frequency of an emergency intervention is high in those with PP and is associated with increased adverse maternal and neonatal outcomes.The most effective factor in the prediction of emergency intervention is APH.

Anahtar Kelimeler

• antepartum hemorrhage
• emergency intervention
• maternal and neonatal outcomes
• placenta previa

Kaynakça

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