Gebeliğe Bağlı İntrahepatik Kolestaz: 48 Vakanın Fetal ve Maternal Sonuçlarının Değerlendirilmesi

Öz

Amaç: Kliniğimizde takip edilen gebeliğe bağlı intrahepatik kolestaz tanılı hastaların fetal - maternal sonuçlarının değerlendirilmesi ve bu hastaların gebelik yönetiminin tartışılması. Gereç ve Yöntem: Çalışmamızda Dicle Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı Obstetri kliniğine Ocak 2011 -Aralık 2015 tarihleri arasında başvuran ve gebeliğe bağlı intrahepatik kolestaz (GBİHK) tanısı alan 48 hasta incelendi. Başvuru esnasındaki bilgiler hastane arşivi ve hasta dosyaları incelenerek toplandı. Bulgular: Gebeliğe bağlı intrahepatik kolestaz tanılı hastaların ortalama yaşları 27.6±6.5 idi.. Gebelerin ortalama doğum haftaları 36.1±3.1 idi. Hastaların %48’i (n=23) otuz yedinci gebelik haftasından önce doğum yaptı. 5. dk ortalama APGAR 8.19±1.73 idi. Sezaryen ile doğum oranı %56.25 (n=27) idi. Yeni doğan yoğun bakıma kabul oranı %10.6 idi. Yenidoğan bebeklerin %76.5’i (n=39) erkek %23.5 ‘i (n=12) kız idi. Perinatal mortalite oranı %3.92 idi. Maternal mortalite izlenmedi. Sonuç: Gebeliğe bağlı intrahepatik kolestaz tanısı klinik bulgu ve laboratuvar sonuçlar ile konur. Hastalığın ayırıcı tanısı dikkatli bir şekilde yapılmalı, ayırıcı tanı üzerinde dikkatle durulmalıdır. Antenatal dönemde fetal ve maternal takip dikkatli bir şekilde yapılmalı, tedavi ve doğum süreci hastaya göre planlanmalıdır. Yüksek prematüre doğum riski nedeniyle yenidoğan yoğun bakım ihtiyacı göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Gebelik
• intrahepatik kolestaz
• yenidoğan yoğun bakım

Due to Pregnancy İntrahepatic Cholestasis: Evaluation of Fetal & Maternal Outcomes of 48 Pregnancies

Öz

Objective: To evaluate fetal-maternal outcomes of the pregnancies complicated by intrahepatic cholestasis and to discuss the pregnancy management in our clinic. Material and methods: In this study, Dicle University Obstetrics and Gynecology, Department of Obstetrics clinic in January 2011 -December 2015 between the applicant and pregnancy induced intrahepatic cholestasis (GBİHK) were evaluated in 48 patients diagnosed. Data were collected on admission and patients by providing hospital archive files. Results: The mean age was 27.6 ± 6.5 diagnosis of intrahepatic cholestasis of pregnancy-induced patients. The average gestational age at delivery of the patients was 36.1 ± 3.1. 48% of patients (n=23) gave birth before the thirty seventh week of pregnancy. 5 min Apgar was 8:19 ± 1.73 average. Cesarean birth rate with 56.25% (n=27), respectively. Acceptance rate was 10.6% in the newborn intensive care unit. 76.5% of newborn infants (n=39) were male and 23.5% 'i (n=12) were monitored girl. Perinatal mortality rate was 3.92%. Maternal mortality was observed. Conclusion: İntrahepatic cholestasis of pregnancy depends on the diagnosis made by clinical signs and laboratory results. The differential diagnosis of the disease must be done carefully, the differential diagnosis should be considered carefully. Antenatal maternal and fetal follow-up should be done carefully, treatment and delivery process should be planned according to the patient. Due to the high risk of premature birth neonatal intensive care needs to be taken into consideration.

Anahtar Kelimeler

• Pregnancy
• intrahepatic cholestasis
• newborn intensive care

Kaynakça

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