Gebelik Döneminde Kanıta Dayalı Yaklaşımların Güncel Rehberler Doğrultusunda İncelenmesi

Öz

Maternal, fetal mortalite ve morbiditeyi azaltmaya yönelik küresel stratejiler, gebelik döneminde kanıta dayalı yaklaşımlar ile sağlık hizmetlerinin standartlaşmasına, tanı, tedavi ve bakım sürecinde karar verirken en iyi kanıtların dikkatli, özenli ve akıllıca kullanılmasına ağırlık vermektedir. Dünya Sağlık Örgütü, perinatal mortalitenin azaltılmasında, güvenli gebelik ve doğum için prekonsepsiyonel dönemden başlayarak antenatal dönemde kullanılan kanıt temelli uygulamaların yaygınlaştırılması gerektiğini vurgulamış ve bu süreçte kadını bir bütün olarak ele alıp, onu devamlı takip etmeyi sağlayan ebe liderliğinde sürekli bakım modelini önermiştir. Bu çalışmada; gebelikte yapılan uygulamaların güncel literatür ve klinik uygulama rehberleri doğrultusunda kanıta dayalı olarak incelenmesi ve gebelere antenatal bakım hizmeti veren ebe ve diğer sağlık profesyonellerine yol göstermesi amaçlanmıştır.

Anahtar Kelimeler

• Ebelik
• Gebelik
• Kanıta Dayalı Uygulamalar
• Klinik uygulama rehberleri

Investigation of Evidence-based Approaches in the Pregnancy Period According to Current Guidelines

Öz

Global strategies to reduce maternal and fetal mortality and morbidity focus on the standardization of healthcare services with evidence-based approaches during pregnancy, the best evidence to be used carefully, attentively and wisely when making decisions in the diagnosis, treatment and care process. The World Health Organization emphasized that the evidence-based practices used in the antenatal period should be expanded to reduce perinatal mortality, starting from the preconceptional period for safe pregnancy and childbirth, and proposed a continuous care model under the leadership of a midwife, which takes woman as a whole and follows her constantly. In this study; It is aimed to examine the practices performed during pregnancy in line with the current literature and clinical practice guidelines and to guide midwives and other healthcare professionals who provide antenatal care services to pregnant women.

Anahtar Kelimeler

• Midwifery
• Pregnancy
• Evidence-Based Practices
• Clinical Practice Guidelines

Kaynakça

1. Akarsu, S., Akbıyık, F., Karaismailoglu, E., Dikmen, Z. G. 2016. Gestation specific reference intervals for thyroid function tests in pregnancy. Clin Chem Lab Med; 54: 1377-83.
2. Alexander, E. K., Pearce, E. N., Brent, G. A., et al. 2017. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid; 27: 315-89.
3. American College of Obstetricians and Gynecologists (ACOG). 2012. Guidelines for perinatal care. Available at: https://www.buckeyehealthplan.com/content/dam/centene/Buckeye/medicaid/pdfs/ACOG-Guidelines-for-Perinatal-Care.pdf, (Accessed 2019 November 14).
4. American College of Obstetricians and Gynecologists (ACOG). 2017. Nutrition during pregnancy. Available at: https://www.acog.org/-/media/Womens-Health/nutrition-in-pregnancy.pdf?dmc=1&ts=20171126T1444446640, (Accessed 2020 April 06).
5. American College of Obstetricians and Gynecologists (ACOG). 2018. Nausea And Vomiting of Pregnancy. Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/01/nausea-and-vomiting-of-pregnancy. (Accessed 2019 November 12).
6. American College of Obstetricians and Gynecologists (ACOG). Intimate partner violence.Available at: https://www.acog.org/clinical/clinical-guidance/committee opinion/articles/2012/02/intimate-partner-violence. (Accessed 2019 December 14).
7. American College of Obstetricians and Gynecology (ACOG). Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Available at: http://www.spog.org.pe/web/phocadownloadpap/HypertensioninPregnancy.pdf,(Accessed 2019 December 02).
8. Anderson, C. M., Schmella, M. J. 2017. Preeclampsia: Current Approaches to Nursing Management. Am J Nurs 2017; 117: 30-8.

9. Ashrafi R., Curtis S. L. 2017. Heart Disease and Pregnancy. Cardiol Ther 2017 Dec; 6(2): 157-73. doi: 10.1007/s40119-017-0096-4.
10. Bahadori, B., Riediger, N. D., Farrell, S. M., Uitz, E., Moghadasian, M. F. 2013. Hypothesis: smoking decreases breast feeding duration by suppressing prolactin secretion. Med Hypotheses.;81(4)582-6.
11. Balık, G., Şentürk, Ş., Güvendağ, G. E. S., Kağıtçı, M., Kır, Ş. F. 2015. Doğu Karadeniz bölgesindeki miadında gebe kadınlarda anemi sıklığı ve bazı hematolojik parametrelerin analizi. Medeniyet Medical Journal; 30(1)8-12.
12. Behrooz, L., Balekian, D. S., Faridi, M. K., Espinola, J. A., Townley, L. P., Camargo, C. A. 2018. Prenatal and postnatal tobacco smoke exposure and risk of severe bronchiolitis during infancy. Respir Med.;140:21-6.
13. Branson, B. M., Handsfield, H. H., Lampe, M. A., Janssen, R. S., Taylor, A. W., Lyss, S. B., Clark, J. E. Centers for Disease Control and Prevention (CDC) revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep;55(RR14)1-17.
14. Bruner, J. P., Forouzan, I. 1991. Smoking and buccally administered nicotine. Acute effect on uterine and umbilical artery Doppler flow velocity waveforms. J Reprod Med.;36(6)435-40.
15. Caleyachetty, R., Tait, C. A., Kengne, A. P., Corvalan, C., Uauy, R. 2014. Tobacco use in pregnant women: analysis of data from demographic and health surveys from 54 low-income and middle-income countries. Lancet Glob Health; 2: 513–520.
16. Centers for Disease Control and Prevention (CDC). Fact sheets About HIV/AIDS. Available at: https://www.cdc.gov/hiv/basics/whatishiv.html, (Accessed 2020 April 06).
17. Centers for Disease Control and Prevention (CDC). Global tobacco control. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6313a1.htm. (Accessed 2020 April 04).
18. Drew, L. B., Mittal, M., Marie E., Cynthia, C., Harper, R., Steinberg, R. J. 2019. Intimate Partner Violence and Effectiveness Level of Contraceptive Selection Post-Abortion. JOURNAL OF WOMEN’S HEALTH; Vol: 00;00; 2019 DOI:10.1089/jwh.2018.7612.
19. Ellsberg, M. C. 2006. Violence against women: a global public health crisis. Scand J Public Health;34(1)1–4.
20. European Society of Cardiology (ESC) [Online]. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy: The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Available at: https://academic.oup.com/eurheartj/article/39/34/3165/5078465 , (Accessed 2019 November 12).
21. Ferrara, A. 2007. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care;30(2)141–S6.
22. Fletcher, T. R, Clements, A. D., Bailey B. 2016. Identifying intimate partner violence during pregnancy in prenatal care settings. Int J Health Sci Educ;3(1).
23. Gardner B, Wardle J, Poston L, Croker H. 2011. Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev;12(7)e60220.
24. Ghendon, Y. 1990. WHO strategy for the global elimination of new cases of hepatitis B. Vaccine;8(Suppl)S129-33.
25. Goonewardena, M., Shehata. M., Hamad, A. 2012. Anemia in pregnancy. Best Pract Res Clinical Obstetrics Gynaecology;26(1)3-24.
26. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. (2019). 2018 Türkiye Nüfus ve Sağlık Araştırması (TNSA). Hacettepe Üniversitesi Nüfus Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara.
27. Hakeem, G. F., Oddy, L., Holcroft, C. A., Abenhaim, H. A. 2014. Incidence and determinants of sudden infant death syndrome: a population-based study on 37 million births. World J Pediatr;1-7.
28. International Council of Nursing (ICN) [Online]. 2012. Closing the gap: from evidence to action, Available at: https://www.nursingworld.org/~4aff6a/globalassets/practiceandpolicy/innovation--evidence/ind-kit-2012-for-nnas.pdf. (Accessed 2019 December 01).
29. Kabaran, S., Ayaz, A. 2013. Maternal ve fetal sağlık üzerinde b12, folik asit, a, d, e ve c vitaminlerinin etkileri. Turk Hijyen ve Deneysel Biyoloji Dergisi; 70(2):103-12. doi:10.5505/TurkHijyen.2013.48039.
30. Karcaaltincaba, D., Kandemir, Ö., Yalvac, S., Güvendağ, G, E. S., Yildirim, B. A,, Haberal, A. 2009. Cigarette smoking and pregnancy: results of a survey at a turkish women's hospital in 1,020 patients. J Obstet Gynaecol;29(6)480- 486.
31. Koenig, M. D. 2017. Nutrient intake during pregnancy. Journal of Obstetric, Gynecologic & Neonatal Nursing; 46 (3):120-2. doi: 10.1016/j.jogn.2016.11.004.
32. Küçükceran, H., Ayhan, B. D., Ağadayı, E., Demir, A. A., Kahveci, R. 2018. Ankara ili Akyurt bölgesindeki gebelerde demir eksikliği anemisi prevalansı ve demir eksikliğine sebep olan faktörler. Konuralp Tıp Dergisi; 10(1)13-19.
33. Levy, A., Fraser, D., Katz, M., Mazor, M., Sheiner, E. 2005. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol; 122(2)182-186.
34. Ludermir, A. B., Araújo, T. B., Valongueiro, S. A., Muniz, M. C., Silva, E. P. 2017. Previous experience of family violence and intimate partner violence in pregnancy. Rev Saude Publica.;51:85.
35. McDonald, S. D., Pullenayegum, E., Taylor, V. H., Lutsiv, O., Bracken, K., Good, C., et al. 2011. Despite 2009 guidelines, few women report being counseled correctly about weight gain during pregnancy. Am J Obstet Gynecol; 205(4):333.e1-6.
36. National Institute for Health and Care Excellence (NICE). 2015. Diabetes in Pregnancy: Management from preconception to the postnatal period. NICE Guideline 2015. Available at: https://www.nice.org.uk/guidance/ng3, (Accessed 2020 April 06).
37. National Institute for Health and Care Excellence (NICE). Guideline for Hypertension in pregnancy: diagnosis and management. Available at: https://www.nice.org.uk/guidance/ng133, (Accessed 2020 April 06).
38. Perinatoloji Uzmanları Derneği (PUDER). Gebelik ve Diyabet Kılavuzu. Avaliable at: http://puder.org.tr/kilavuzlar/, (Accessed 2020 April 06).
39. Pineles, B. L., Park, E., Samet, J. M. 2014. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol; 179:807–23.
40. Primo, C. C., Ruela, P. B., Brotto, L. D., Garcia, T. R., Lima, E. F. 2013. Effects of maternal nicotine on breastfeeding infants. Rev Paul Pediatr.;31(3)392-7.
41. Qui, J., He, X., Cui, H., Zhang, C., et al. 2014. Passive Smoking and Preterm Birth in Urban China. Am J Epidemiol;180(1)94–102.
42. Roos-Hesselink, J. W., Budts, W., Walker, F., De Backer J. F. A., Swan, L., Stones, W., Kranke, P., Sliwa-Hahnle, K., Johnson, M. R. 2017. Organisation of care for pregnancy in patients with congenital heart disease. Heart 2017 Dec ;103(23)1854-1859. doi:10.1136/heartjnl-2017-311758.
43. Sanhal, C. Y., Ataman, Ç., Özel, Ş., Üstün, Y., E. 2018. Gebelikte HIV Enfeksiyonu. HIV Infection In Pregnancy. Jinekoloji- Obstetrik ve Neonatoloji Tıp Dergisi;15(2)87-89. Saranac, L., Zivanovic, S., Bjelakovic, B., Stamenkovic, H., Novak, M., Kamenov, B. 2011. Why is the thyroid so prone to autoimmune disease? Horm Res Paediatr;75(3)157- 65.
44. Setty, N,, Kumar, V., Srinivas, B. C., Reddy, B. N, et al. 2016. Approach to hypertensive disorders in pregnancy. Ann Clin Exp Hypertension 2016; 4: 1039. 27.
45. Singh, J. K., Evans-Lacko, S., Acharya, D., Kadel, R., Gautam, S. 2018. Intimate partner violence during pregnancy and use of antenatal care among rural women in southern Terai of Nepal. Women and Birth;31: 96–102.
46. Smith, M., Martin, F. 1995. Domestic violence: recognition, intervention, and prevention. Medsurg Nurs;4(1)21–5.
47. T.C. Aile ve Sosyal Politikalar Başbakanlığı Kadının Statüsü Genel Müdürlüğü. 2015. Türkiye’ de Kadına Yönelik Aile İçi Şiddet. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Ankara: Elma Teknik Basım.
48. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Kadın ve Üreme Sağlığı Dairesi Başkanlığı. 2018. Doğum Öncesi Bakım Yönetim Rehberi. Yayın No:925. pp. 6, Ankara. T.C. Sağlık Bakanlığı.
49. Taşkın, L. 2016. Riskli gebelikler. Doğum ve kadın sağlığı hemşireliği. 13. Baskı. pp. 50 -243 Ankara. Akademisyen Yayınevi,
50. Townsend R, Brien, P. O., Khalil, A. 2016. Current best practice in the management of hypertensive disorders in pregnancy. Integr Blood Press Control. 2016; 9:79-94. Tran, T. T. 2016. Hepatitis B and pregnancy. Clin Infect Dis.;62(Suppl 4)S314-7.
51. Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Tiroid hastalıkları tanı ve tedavi kılavuzu.http://temd.org.tr/admin/uploads/tbl_kilavuz/201904261653402019tbl_kilavuze72e4ddf38.pdf (Erişim Tarihi: 02.04.2020).
52. Türkiye İstatistik Kurumu (TÜİK). Sağlık İstatistikleri haber bülteni. http://www.tuik.gov.tr/PreTablo.do?alt_id=1095, (Erişim Tarihi: 04.04.2020).
53. U.S. National Library of Medicine (NIH). 2020. Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Transmission in the United States. Available at: https://aidsinfo.nih.gov/guidelines/html/3/perinatal/224/whats-new-in-the guidelines, (Accessed 2020 April 02).
54. United Nations International Children's Emergency Fund (UNICEF) (2019). Antenatal care. Available at: https://data.unicef.org/topic/maternal-health/antenatal-care/, (Accessed 2020 April 10).
55. United Nations Population Fund (UNFPA) [Online]. The state of the world’s midwifery 2014. A Universal Pathway. A Woman’s Right to Health Cairo. Available at:https://www.unfpa.org/sites/default/files/pub-pdf/EN_SoWMy2014_complete.pdf, (Accessed 2019 November 09).
56. World Health Organisations (WHO). 2011. Intimate Partner Violence during Pregnancy. Available at: https://www.who.int/reproductivehealth/publications/violence/rhr_11_35/en/. (Accessed 2019 December 02).
57. World Health Organisations (WHO). World Health Organisations Sexually transmitted infections (STIs) Fact Sheets. (Erişim Tarihi: 02.04.2020). Available at: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). (Accessed 2019 November 10).
58. World Health Organization (WHO) [Online]. 2015. Multiple micronutrient supplements in pregnancy: implementation considerations for successful integration into existing programmes. Available at: https://www.who.int/nutrition/callforauthors_multiple_microsupp_pregnancy/en/index1.html, (Accessed 2019 November 10).
59. World Health Organization (WHO) [Online]. 2016. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Available at: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/, (Accessed 2019 November 10).
60. World Health Organization (WHO) [Online]. 2019. Maternal Mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality, (Accessed on 2019 November 12).
61. World Health Organization (WHO) [Online]. 2019. World Health Organisations HIV/AİDS Fact Sheets. Available at: ttps://www.who.int/news-room/fact-sheets/detail/hiv-aids .(Accessed 2020 April 02).
62. World Health Organization (WHO). 2018. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience: Summary. https://apps.who.int/iris/bitstream/handle/10665/259947/WHO-RHR-18.02 eng.pdf?sequence=1.(Accessed on 2020 April 9).
63. World Health Organization (WHO). Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy. Available at: https://www.who.int/diabetes/publications/Hyperglycaemia_In_Pregnancy/en/, (Accessed 2019 November 10).
64. World Health Organization (WHO). Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Available at: https://apps.who.int/iris/bitstream/handle/10665/154590/9789241549059_eng.pdf?sequence, (Accessed 2020 April 04).
65. Yılmaz, E., Çöl, M. 2014. Kanıta Dayalı Tıp. J Clin Anal Med; 5(6), 537-542.
66. Yi, P., Chen, R., Huang, Y., Zhou, R. R., Fan, X. G. 2016. Management of mother-to-child transmission of hepatitis B virus: Propositions and challenges. J Clin Virol; 77:32-9.
67. Zhang, K., Wang, X. 2013. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Leg Med (Tokyo);15(3):115-121.