GEBELİK SIRASINDA GEÇİRİLEN NON-OBSTETRİK CERRAHİ SONRASI MATERNAL VE FETAL SONUÇLAR

Öz

Amaç: Gebelik sırasında yapılan non-obstetrik cerrahilerde gebeliğin devamı ve neonatal sürecin nasıl etkileyeceği hem gebe hem cerrah tarafından önem arz etmektedir. Non-obstetrik cerrahiler ile ilgili çalışmalar sınırlı sayıdadır. Bu çalışmamızın amacı non-obstetrik cerrahi sonrası maternal ve fetal sonuçların değerlendirilmesidir. Yöntem: Çalışmamız tersiyer bir merkez olan hastanemizin obstetri kliniğimizde Ocak 2015-Ağustos 2020 tarihleri arasındaki non-obstetrik cerrahi yapılan 60 gebe hastanın retrospektif değerlendirilmesini içermektedir. Hasta bilgilerine elektronik sistem ve arşiv dosyalarından ulaşıldı. Hastaların demografik özellikleri, cerrahi yapılan hafta, takipleri, gebelik ve neonatal sonuçları değerlendirildi. Bulgular: Hastaların ortalama yaşı 27,9±4,42 cerrahi yapılan gebelik haftası ortalama 17,7±11,3 idi. Cerrahi endikasyonlar arasında en sık neden 45 hasta ile (%75) apandisittir. Gebelerin %88,3’üne acil cerrahi yapıldı. Ortalama hastanede kalış süresi 3,3±3,2 gün, doğuma kadar geçen ortalama hafta 21,1±8,6 idi. Gebelerin ortalama doğum haftası 37,8±2,8 idi. Acil cerrahi yapılan hastalarda laparotomi tercihi laparoskopiye göre anlamlı olarak yüksek bulundu (P=0.007). Laparotomi(LT) ve laparoskopi(LSK) grubunda gebelik sonuçları ve neonatal sonuçlar açısından fark saptanmadı. Sonuç: Gebelikte geçirilen non-obstetrik cerrahi olumsuz gebelik ve neonatal sonuçlarda artışa yol açtığına dair bir sonuca ulaşılamamıştır. Ayrıca cerrahi şeklini değerlendirdiğimizde; laparotomi ve laparoskopi yapılan gruplar arasında gebelik ve neonatal sonuçlar açısından anlamlı bir fark bulunmadı. Bu konuda daha geniş çaplı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• gebelikte cerrahi
• non-obstetrik cerrahi
• gebelikte laparoskopi

MATERNAL AND FETAL RESULTS AFTER NON-OBSTETRIC SURGERY DURING PREGNANCY

Öz

Objectives: In non-obstetric surgeries performed during pregnancy, the continuation of pregnancy and how it will affect the neonatal process are important for both the pregnant and the surgeon. Studies on non-obstetric surgeries are limited. The aim of this study is to evaluate maternal and fetal outcomes after non-obstetric surgery. Methods: Our study includes the retrospective evaluation of 60 pregnant patients who underwent non-obstetric surgery between January 2015 and August 2020 in our obstetrics clinic, which is a tertiary center. Patient information was obtained from electronic system and archive files. Demographic characteristics of the patients, week of surgery, follow-up, pregnancy and neonatal outcomes were evaluated. Results: The mean age of the patients was 27.9±4.42, and the mean gestational week at which surgery was performed was 17.7±11.3. Among the surgical indications, the most common cause is appendicitis with 45 patients (75%). Emergency surgery was performed in 88.3% of the pregnant women. The mean hospital stay was 3.3±3.2 days, and the mean week to delivery was 21.1±8.6. The mean delivery week of the pregnant women was 37.8±2.8. Laparotomy preference was found to be significantly higher than laparoscopy in patients who underwent emergency surgery (P=0.007). There was no difference in pregnancy outcomes and neonatal outcomes in the laparotomy (LT) and laparoscopy (LSK) groups. Conclusions: There was no conclusion that non-obstetric surgery during pregnancy led to an increase in adverse pregnancy and neonatal outcomes. In addition, when we evaluate the type of surgery; There was no significant difference between the laparotomy and laparoscopy groups in terms of pregnancy and neonatal outcomes. More extensive studies are needed on this subject.

Anahtar Kelimeler

• surgery in pregnancy
• non-obstetric surgery
• laparoscopy in pregnancy

Kaynakça

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