Previabl membran rüptürünün maternal ve perinatal sonuçları

Yıl 2023, Cilt: 62 Sayı: 2, 205 - 210, 12.06.2023

Fırat Ökmen Hüseyin Ekici Merih Oğur Ghaıth Hejazı Osman Ökmen Gulsum Uysal

https://doi.org/10.19161/etd.1310425

Öz

Amaç: Fetal viabilite öncesinde membran rüptürü meydana gelen olguların maternal ve perinatal sonuçlarını değerlendirmektir.
Gereç ve yöntem: Çalışmaya Mart 2020 ile Mart 2022 tarihleri arasında, gebelik haftası 14+0 ile 22+0 arasında olan ve membran rüptürü tanısı konulan gebeler dahil edildi. Olguların maternal ve perinatal sonuçları gebeliğin yönetim şekline göre demografik ve klinik özellikler açısından karşılaştırıldı.
Bulgular: Çalışmaya 42 olgu dahil edildi. Bu 42 olgudan 12/42 (%28.6) tanesi gebeliğinin terminasyonunu isterken, 30/42 (%71.4 ) olgu bekleme yönetimini tercih etmiştir. Bekleme yönetimini tercih eden 30 olgudan 19’unda spontan düşük meydana gelirken, 11 olguda canlı doğum gerçekleşmiştir. Yenidoğan döneminde altı bebek öldü ve genel neonatal sağ kalım % 45.5 (5/11) idi. Bekleme yönetimi ile spontan düşük olguları karşılaştırıldığında membran rüptürün meydana geldiği gebelik haftası (p>0.001), spontan düşük/doğumun gerçekleştiği gebelik haftası (p>0.001) ve latent süresi (p>0.001) açısından anlamlı fark saptandı.
Sonuç: Viabilite öncesi gebeliklerde meydana gelen membran rüptürü, hastaları ve klinisyenleri, bekleme yönetimini seçme veya gebeliği sonlandırma konusunda zorlu bir karar verme süreci ile karşı karşıya bırakır. Bekleme yönetimini tercih eden olgulardaki nihai amaç olan neonatal sağkalım oranları ise çok düşüktür.

Anahtar Kelimeler

Erken membran rüptürü, erken doğum, viabilite öncesi, maternal sonuçlar

The maternal and perinatal outcomes of previable rupture of membranes

Öz

Aim: To evaluate the maternal and perinatal outcomes of cases with rupture of membranes before fetal viability.
Materials and Methods: Between March 2020 and March 2022, pregnant women with a gestational age between 14+0 and 22+0, who diagnosed with rupture of membranes were included in the study. Maternal and perinatal outcomes of the cases were compared in terms of demographic and clinical characteristics according to the management type of pregnancy.
Results: 42 cases were included in the study. 12/42 (28.6%) of these cases have wanted the termination of their pregnancy, 30/42 (71.4%) cases have preferred the expectant management. Spontaneous abortion occurred in 19 of 30 cases who preferred the expectant management, while live birth accured in 11 cases. Six infants died during the neonatal period and overall neonatal survival was 45.5 %(5/11). When expectant management and miscarriage cases were compared, there was a statistically significant difference for the gestational week at membrane rupture occurred (p>0.001), gestational week at spontaneous abortion/delivery occurred (p>0.001) and latency period(p>0.001).
Conclusion: Rupture of membranes in pre-viable pregnancies presents patients and clinicians with a difficult decision-making process to choose between expectant management or termination of pregnancy. The neonatal survival rate, which is the ultimate goal in patients who prefer expectant management, is very low.

Anahtar Kelimeler

premature rupture of membrane, preterm birth, previable, maternal outcomes

Kaynakça

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