Öz
Objective: To evaluate the effectiveness of cervical length in predicting prepartum bleeding and emergency caesarean section in cases of complete placenta previa
Materials and Methods: Between June 2009 and August 2011, cervical length was measured by transvaginal ultrasound in women with complete placenta previa persisting into the third trimester of pregnancy and correlated this to clinical outcome with regards to, emergency cesarean section due to massive hemorrhage
Results: Overall, 65 women were included in the study group. The mean gestational age at ultrasound was 31.7
± 2.9 weeks and the cervical length was 35.9 ±7.8 mm. Cesarean delivery was performed in all cases, at a mean gestational age of 34.5 ± 2.6 weeks. 26 (40 %) women presented prepartum bleeding and 12 (18,4 %) required an emergency cesarean section prior to 34 completed weeks due to massive haemorrhage. Cervical length was significantly shorter among patients who underwent emergency caesarean section <34 weeks due to massive hemorrhage compared with patients who underwent elective caesarean section (29.4 ± 5.7 mm , 36.1 ± 6.5 mm; p = 0.005).
Conclusion: Transvaginal sonographic cervical length predicts the risk of emergency cesarean section <34 weeks in women with complete placenta previa.
Kaynakça
- Ghourap S. Third-trimester transvaginal ultrasonography in placenta previa: does the shape of the lower placental edge predict clinical outcome? Ultrasound Obstet Gynecol 2001;18(2):103-8.
- Saitoh M, Ishihara K, Sekiya T, Araki T. Anticipation of uterine bleeding in placenta previa based on vaginal sonographic evalution. Gynecol Obstet Invest 2002;54(1):37-42.
- Sumigama S, Itakura A, Ota T, Okada M, Kotani T, Hayakawa H, et al. Placenta praevia increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. J Obstet Gynaecol Res 2007; 33(6): 606–11.
- Şener T. Servikal serklaj gerekli midir? Ultrasonografi Obstetrik ve jinekoloji 2003;7(3- 4):17
- Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, et al. The length of the cervix and the risk of spontaneous preterm delivery. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. N Engl J Med 1996; 334(9):567-72.
- Gramellini D, Fieni S, Molina E, Berretta R, Vadora E. Transvaginal sonographic cervical length changes during normal pregnancy. J Ultrasound Med 2002;21(3):227-32.
- Hibbard JU, Tart M, Moawad AH. Cervical length at 16–22 weeks’ gestation and risk for preterm delivery. Obstet Gynecol 2000;96(6):972–8.
- Stafford IA, Dashe JS, Shivvers SA, Alexander JM, McIntire DD, Leveno KJ. Ultrasonographic cervical length and risk of hemorrhage in pregnancies with placenta previa. Obstet Gynecol 2010;116(3):595-600.
Öz
Amaç: Total plasenta previalı olgularda serviks uzunluğunun etkinliğini değerlendirerek acil sezeryan ve prepartum kanamayı öngörmek.
Gereç ve Yöntemler: Haziran 2009 ile Ağustos 2011 tarihleri arasında üçüncü trimester- daki, total plasenta previa tanılı gebelerin transvajinal ultrasonografi ile servikal uzunluk ölçümleri yapılarak şiddetli kanama nedeniyle acil sezeryan olan gebelerin klinik sonuç- larıyla karşılaştırıldı.
Bulgular: Çalışma grubuna 65 kadın dahil edildi. Ultrasonografiye göre ortalama gebelik haftası 31.7 ± 2.9 hafta ve servikal uzunluk 35.9 ±7.8 mm olarak bulundu. Hastaların tamamına ortalama 34.5 ± 2.6 gestasyonel haftada sezeryan yapıldı. Hastaların yirmi altısı (%40) kanama ile geldi. Bunlarda on ikisi (%18,4) 34. haftayı tamamlamadan masif kanama nedeniyle acil sezeryana alındı. 34. haftadan önce masif kanama nedeniyle acil sezeryana aldığımız hastaların servikal kanal uzunlukları elektif sezeryana aldığımız has- talara kıyasla önemli derecede kısa saptandı (29.4 ± 5.7 mm, 36.1 ± 6.5 mm; p = 0.005).
Sonuç: 34. haftadan küçük plasenta previa totalis bulunan gebelerde transvainal sonog- rafi ile servikal uzunluk ölçümü, acil sezeryan riskini saptayabilir.
Kaynakça
- Ghourap S. Third-trimester transvaginal ultrasonography in placenta previa: does the shape of the lower placental edge predict clinical outcome? Ultrasound Obstet Gynecol 2001;18(2):103-8.
- Saitoh M, Ishihara K, Sekiya T, Araki T. Anticipation of uterine bleeding in placenta previa based on vaginal sonographic evalution. Gynecol Obstet Invest 2002;54(1):37-42.
- Sumigama S, Itakura A, Ota T, Okada M, Kotani T, Hayakawa H, et al. Placenta praevia increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course. J Obstet Gynaecol Res 2007; 33(6): 606–11.
- Şener T. Servikal serklaj gerekli midir? Ultrasonografi Obstetrik ve jinekoloji 2003;7(3- 4):17
- Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, et al. The length of the cervix and the risk of spontaneous preterm delivery. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. N Engl J Med 1996; 334(9):567-72.
- Gramellini D, Fieni S, Molina E, Berretta R, Vadora E. Transvaginal sonographic cervical length changes during normal pregnancy. J Ultrasound Med 2002;21(3):227-32.
- Hibbard JU, Tart M, Moawad AH. Cervical length at 16–22 weeks’ gestation and risk for preterm delivery. Obstet Gynecol 2000;96(6):972–8.
- Stafford IA, Dashe JS, Shivvers SA, Alexander JM, McIntire DD, Leveno KJ. Ultrasonographic cervical length and risk of hemorrhage in pregnancies with placenta previa. Obstet Gynecol 2010;116(3):595-600.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Orjinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2013 |
| Yayımlandığı Sayı | Yıl 2013 Cilt: 3 Sayı: 3 |
