İlk trimester tarama testindeki biyokimyasal parametrelerin maternal ve fetal morbiditeyi öngörmedeki değerinin araştırılması–Retrospektif Vaka-Kontrol Çalışması

Yıl 2023, , 28 - 35, 31.08.2023

İsa Kaplan

https://doi.org/10.33713/egetbd.1139461

Öz

AMAÇ: Bu araştırma maternal serum gebelikle ilişkili plazma protein A, serbest beta human koryonik gonadotropin düzeylerinin obstetrik komplikasyonlar ile ilişkisini incelemek amacıyla yapılmıştır.
MATERYAL-METOD: Bu araştırma retrospektif vaka-kontrol çalışmasıdır. Araştırma Aydın Adnan Menderes Üniversitesi Hastanesi’nde Ocak 2015 ve Kasım 2016 tarihleri arasında yapılmıştır. Down sendromu taraması için 1. Trimester tarama belirteçleri ve ense kalınlığına bakılmıştır. Çalışma doğum sonrası down sendromu olmayan tekil 250 gebe ile yapılmıştır. Çoğul gebeliği olan ve fetal kromozomal anomalileri olan kadınlar çalışma dışı bırakılmıştır. Verilerin değerlendirilmesinde Ki-Kare testi, Fisher’s Exact test ve Continuity Correction (Yates) test kullanılmıştır.
BULGULAR: Gebelerin yaş ortalaması 29,52±6,17, gebelik haftası ortalaması 12,2±0,8’dir. Olguların pregnancy associated plasma protein A (PAPP-A) düzeyleri ortalaması 0,92±0,40 multiples of the median (MoM), Beta human chorionic gonadotrophin (ß-hCG) düzeyleri ortalaması 1,36±0,98 MoM nukal translüsensi (NT) MoM değerleri ortalaması 0,92±0,31 MoM’dir. Olguların %28,8’inde erken doğum tehdidi (EDT), %20’sinde gebelik yaşına göre küçük bebek (SGA), %18,8’inde gestasyonel diabetes mellitus (GDM), %15,6’sında fetal distress, %15,6’sında erken doğum eylemi, %14,4’sında intrauterin gelişme geriliği (IUGR), %12,8’inde oligohidramnios ve %12’sinde erken membran rüptürü (EMR) komplikasyonu geliştiği saptanmıştır. Maternal serum PAPP-A≤0,5 MoM değeri ile GDM, EDT, erken doğum, EMR, oligohidramnios, polihidramnios, IUGR, SGA ve preterm doğum gelişimi arasında istatiksel olarak anlamlı bir ilişki tespit edilmiştir. Çalışmamızda serbest ß-hCG için düzeltilmiş sınır değer ≥2,5 MoM olarak alınmış olup irdelediğimiz gebelik sonuçları ile anlamlı birliktelik saptanmamıştır.
SONUÇ: Birinci trimester tarama testi sonuçları kromozomal anomaliler ile birlikte birçok istenmeyen gebelik sonucu için erken dönemde uyarıcı ölçüt olarak kullanılarak hastaların erken tanı ve uygun yönetimi planlamak için yararlanılabilir.

Anahtar Kelimeler

papp-a, ß-hcg, gebelik kompikasyonu, birinci trimester tarama testi

Value of first trimester screening test biochemichal parameters in predicting maternal and fetal morbidity-Retrospektif Case-Control Study

Öz

OBJECTIVE: Our study was conducted to examine the relationship between maternal serum pregnancy-related plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (ß-hCG) levels and obstetric complications.
MATERIAL-METHOD: This research is a retrospective case-control study. The research was carried out at Aydın Adnan Menderes University Hospital between January 2015 and November 2016. The study was conducted with 250 singleton pregnant women who did not have postpartum Down syndrome. Women with multiple pregnancies and fetal chromosomal abnormalities were excluded from the study. SPSS Statistics 22.0 program was used for statistical analysis.
RESULTS: The mean age of the pregnant women was 29.52±6.17, and the mean week of gestation was 12.2±0.8. The mean PAPP-A of the cases was 0.92±0.40 multiples of the median (MoM), the mean of ß-hCG was 1.36±0.98 MoM, and the mean nuchal translucency (NT) was 0.92±0.31 MoM. In the patients, 28.8% threatened preterm birth (TPL), 20% small for gestational age (SGA), 18.8% gestational diabetes mellitus (GDM), 15.6% fetal distress, 15.6% preterm labor, % 14.4% intrauterine fetal growth retardation (IUGR), 12.8% oligohydramnios and 12% premature rupture of membranes (EMR) were detected. A statistically significant correlation was found between maternal serum PAPP-A≤0.5 MoM and the development of GDM, TPL, preterm birth, PROM, oligohydramnios, polyhydramnios, IUGR, SGA, and preterm birth. In our study, the corrected cut-off value for free ß-hCG was taken as ≥2.5 MoM, and no significant association was found with the pregnancy outcomes we examined.
CONCLUSION: First-trimester screening test results can be a warning for unwanted pregnancy results.

Anahtar Kelimeler

papp-a, ß-hcg, pregnancy complication, first trimester screening test

Kaynakça

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