Gebelerde Kronik Yorgunluk Sendromu Belirti ve Bulgularının Sıklığının Araştırılması

Yıl 2017, Cilt: 17 Sayı: 3, 160 - 173, 27.09.2017

Mehmet Gölcür Oktay Sarı , Ümit Aydoğan Yaşam Kemal Akpak Uğur Keskin

https://doi.org/10.17098/amj.339335

Öz

Amaç: Kronik yorgunluk sendromu (KYS) istirahat ile düzelmeyen ve en az altı
aydan beri devam eden yorgunluk ile birlikte, ayrıca hafıza ve konsantrasyon
problemleri, miyalji, artralji, başağrısı, uyku bozukluğu, tekrarlayan boğaz
ağrısı ve hassas lenf nodları gibi bulgulardan en az dört tanesinin
bulunmasıyla karakterize bir hastalıktır. Gebelik süreci ise çeşitli hormonal,
metabolik ve anatomik değişiklikler paralelinde benzer yakınmaların
görülebileceği fizyolojik bir süreçtir. Çalışmamızda, gebelerde karışabilen KYS
semptomlarının sıklığını araştırdık.

Materyal ve Metot: Bu çalışma kronik sistemik hastalığı olmayan 224 gebe ile
gerçekleştirildi. Gebelere sosyodemografik özellikleri ve gebelik bilgileri ile
KYS belirti ve bulgularını içeren anket formu uygulandı. Sonuçlar hastalık
koruma ve kontrol merkezi (CDC) ve Bruce M.Carruthers ve ark. nın yayınladığı
tanı ve tedavi kılavuzunda yer alan KYS tanı kriterleri ışığında
değerlendirildi. 
Bulgular: CDC’ye göre 24 (%10,7)
gebe, tanı ve tedavi kılavuzuna göre ise 8 gebe (%3,5) KYS olarak
değerlendirildi. Gebelerde en sık görülen yakınmalar; %75 (n=168) ile egzersiz
sonrası yorgunluk, %58,9 (n=132) ile aşırı uyuma veya az uyuma ve %53,6 (n=120)
ile ışık, ses ve kokulara karşı hassasiyet olarak saptandı. 
Sonuç: KYS ile gebelik arasında pek
çok belirti ve bulgunun ortak olarak bulunması gerçeği gebe takibi yapan hekimlerinin
gebelere ait her yakınmayı dikkatli bir şekilde değerlendirmesini
gerektirmektedir. Gebelik sürecinde ve fizyolojik olarak değerlendirilebilen
bazı yakınmalar, aslında gebelik süreci ile tetiklenmiş bazı patolojilere
işaret ediyor olabilir.

Anahtar Kelimeler

Kronik yorgunluk sendromu (KYS), Gebelik, sistemik hastalık

Evaluation of the Frequency of Symptoms and Signs Related to Chronic Fatigue Syndrome in Pregnant Women

Öz

Objectives: Chronic fatigue syndrome (CFS) is characterized by
fatigue that has not improved with rest and has continued for at least six
months and also by four of the following symptoms; memory and concentration
problems, myalgia, arthralgia, headache, sleep disturbance, recurrent throat
pain and sensitive lymph nodes. The pregnancy period is a physiological process
in which similar complaints can be seen in association with various hormonal,
metabolic and anatomical changes. In our study, we investigated the frequency
of symptoms of CFS that can interfere with pregnancy.
Materials and Methods: This study
was performed with 224 pregnant women without any chronic systemic disease. A survey
form including sociodemographic characteristics and pregnancy information and
symptoms and findings of CFS were applied to the pregnants. The results were evaluated
according to the CFS diagnostic criteria in the guideline for diagnosis and
treatment of CDC and Bruce M. Carruthers et al.

Results: According to CDC 24 (10.7%) pregnant women and
according to the diagnosis and treatment guide, 8 pregnant women (3.5%) were
evaluated as CFS. The most common complaints in pregnancy are; fatigue after
exercise in 75% (n = 168), sensitivity to light, sound and smell in 58.9% (n =
132) and excessive sleep or less sleep in 53.6%(n=120).

Conclusion: The fact that many signs and symptoms are common
between CFS and pregnancy necessitates that doctors following-up pregnant women
should carefully evaluate every complaint belonging to the pregnancy.

Anahtar Kelimeler

Chronic fatigue syndrome (CFS), Pregnancy, Systemic Disease

Kaynakça

• Vergauwen K, Huijnen IP, Kos D, Van de Velde D, van Eupen I, Meeus M. Assessment of activity limitations and participation restrictions with persons with chronic fatigue syndrome: a systematic review. Disabil Rehabil 2015;37(19):1706-16.
• Yancey JR, Thomas SM. Chronic fatigue syndrome: diagnosis and treatment. Am Fam Physician 2012;86(8):741-6.
• Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang CF, Plioplys S. A community-based study of chronic fatigue syndrome. Arch Intern Med 1999;159(18):2129-37.
• Carruthers BM, Jain AK, De Meirleir KL, et al. Myalgic Encephalomyelitis/Chronıc Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. Journal of Chronic Fatigue Syndrome 2003;11(1):7-115.
• Johnston S, Brenu EW, Staines D, Marshall-Gradisnik S. The prevalence of chronic fatigue syndrome/ myalgic encephalomyelitis: a meta-analysis. Clin Epidemiol. 2013;5:105-10.
• Karaduman M, Sarı O, Aydoğan U, Akpak YK, Semiz A, Yılanlıoğlu NC, Keskin U. Evaluation of obstructive sleep apnea symptoms in pregnant women with chronic disease. J Matern Fetal Neonatal Med 2016;29(20):3379-85.
• Okour A, Alkhateeb M, Amarin Z. Awareness of danger signs and symptoms of pregnancy complication among women in Jordan. Int J Gynaecol Obstet 2012;118(1):11-4.
• Werker CL, Nijhof SL, van de Putte EM. Clinical Practice: Chronic fatigue syndrome. Eur J Pediatr 2013;172(10):1293-8.
• Wessely S, Chalder T, Hirsch S, Wallace P, Wright D. The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. Am J Public Health 1997;87(9):1449-55.
• 1Allen PR. Chronic fatigue syndrome: implications for women and their health care providers during the childbearing years. J Midwifery and Womens Health 2008;53(4):289-301.
• Jha RR, Masson EA, Lindow SW. Detailed description of a pregnancy associated with severe chronic fatigue syndrome. J Obstet Gynaecol 1999;19(3):306-7.
• Jason LA, Taylor RR, Kennedy CL, Jordan K, Huang CF, Torres-Harding S, Song S, Johnson D. A factor analysis of chronic fatigue symptoms in a community-based sample. Soc Psychiatry Psychiatr Epidemiol 2002;37(4):183-9.
• Çevik R, Gür A, Nas K, Acar S, Saraç AJ. Kronik yorgunluk sendromlu hastaların klinik özellikleri. Romatizma 2003;18(1):18-22.
• Kroenke K. Gender differences in the reporting of physical and somatoform symptoms. Psychosomatic Medicine 1998;60:150-5.
• Baranuik JN, Clauw DJ, Gaumond E. Rhinitis symptoms in chronic fatigue syndrome. Ann Allergy Asthma Immunol 1998;81(4):359-65.
• Çoban A, Yanıkkerem E. Gebelerde uyku kalitesi ve yorgunluk düzeyi. Ege Tıp Dergisi 2010;49(2):87-94.
• Bansal AS, Bradley AS, Bishop KN, Kiani-Alikhan S, Ford B. Chronic fatigue syndrome, the immune system and viral infection. Brain Behav Immun 2012;26(1):24-31.
• Lewis G, Wesseley S. The epidemiology of fatigue : more questions than answers. J of Epidemiology and Community Health 1992;46(2):92-7.
• Bates DW, Schmitt W, Buchwald D, Ware NC, Lee J, Thoyer E, Kornish RJ, Komaroff AL. Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Arch Intern Med 1993;153(24):2759-65.
• Naud K, Ouellet A, Brown C, Pasquier JC, Moutquin JM. Is sleep disturbed in pregnancy? J Obstet Gynaecol Can 2010;32(1):28-34.
• Allen LH. Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr 2000;71(5):1280-4.
• Demitrack MA, Crofford LJ. Evidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome. Ann N Y Acad Sci 1998;840:684-97.
• Schacterle RS, Komaroff AL. A comparison of pregnancies that occur before and after the onset of chronic fatigue syndrome. Arch Intern Med 2004;164(4):401-4.