ENDOMETRİOZİSTE EBELERİN ROL VE SORUMLULUKLARI

Yıl 2022, Cilt: 2 Sayı: 1, 345 - 358, 26.04.2022

Ayşenur Turan Cihan Kaya

Öz

Endometriozis, uterin kavite dışında endometriyal gland ve stromanın varlığı olarak tanımlanır. Kadınları menarş öncesi, üreme ve menopoz sonrası hormonal evrelerde etkileyen östrojene bağımlı, iyi huylu ve inflamatuar bir hastalıktır. Endometriozis üreme çağındaki kadınların yaklaşık %10'unda görülmektedir. Ülkemizde yaklaşık 2,4 milyon kadında endometriozis olduğu düşünülmektedir. Lezyonlar tipik olarak pelviste bulunur, ancak bağırsak, diyafram ve plevral boşluk dahil olmak üzere birçok bölgede ortaya çıkabilir. Endometriozis yaygın ve malign olmayan bir süreç olmakla birlikte, ektopik endometriyal doku ve bunun sonucunda oluşan inflamasyon, menoraji, disparoni, infertilite ve kronik pelvik ağrıya neden olabilir. Hastalığa ilişkin bu semptomlar, kadınların günlük yaşam aktivitelerini ve yaşam kalitelerini olumsuz yönde etkilemektedir. Endometriozisli kadınlarda yaşam kalitesinin artırılması ve endometriozis semptomlarının azaltılması amacıyla bireylere multidisipliner bir ekip yaklaşımı uygulanmalıdır. Kadın sağlığıyla her yönden ilgilenen ebelere bu noktada önemli rol ve sorumluluklar düşmektedir. Ebelik faaliyetleri, endometriozis ile ilişkili belirti ve semptomların tanımlanmasını ve yönetimini, diğer sağlık profesyonellerine veya servislerine sevk edilmesini, doğrudan hasta bakımını, tedavinin uygulanmasını, bakımın koordinasyonunu, ağrı yönetimini, sağlık eğitimini, tedavi uygulanmasını, tedavi sonuçlarının değerlendirilmesini ve hasta savunuculuğunu içerir. Endometriozis tanısında ve yönetiminde ebelerin aktif rol alabilmesi için hastalığın belirti, bulgularını, risk faktörlerini tanıyabilmesi ve bakım-tedavi konularında kanıta dayalı bilgiler ışığında hizmet sunması gerekmektedir. Bu derlemede, endometrioziste ebelerin rol ve sorumluluklarının açıklanması amaçlanmıştır.

Anahtar Kelimeler

Endometriozis, kadın sağlığı, yaşam kalitesi, ebelik, sağlık eğitimi

Destekleyen Kurum

Yoktur.

Proje Numarası

Yoktur.

Teşekkür

Yoktur.

THE ROLE AND RESPONSIBILITIES OF MIDWIVES IN ENDOMETRIOSIS

Öz

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity. It is an estrogen-dependent, benign and inflammatory disease that affects women during the premenarche, reproductive and postmenopausal hormonal phases. Endometriosis is seen in approximately 10% of women of reproductive age. It is thought that approximately 2.4 million women in our country have endometriosis. Lesions are typically found in the pelvis, but can occur in many areas, including the bowel, diaphragm, and pleural cavity. Although endometriosis is a common and non-malignant process, ectopic endometrial tissue and consequent inflammation can cause menorrhagia, dyspareunia, infertility, and chronic pelvic pain. These symptoms related to the disease negatively affect women's daily life activities and quality of life. In order to increase the quality of life in women with endometriosis and to reduce the symptoms of endometriosis, a multidisciplinary team approach should be applied to individuals. Midwives, who are interested in women's health in every aspect, have important roles and responsibilities at this point. Midwifery activities include identification and management of signs and symptoms associated with endometriosis, referral to other healthcare professionals or services, direct patient care, administration of treatment, coordination of care, pain management, health education, administration of treatment, evaluation of treatment outcomes, and patient advocacy. In order for midwives to take an active role in the diagnosis and management of endometriosis, they should be able to recognize the signs, symptoms and risk factors of the disease and provide services in the light of evidence-based information on care and treatment. In this review, it is aimed to explain the roles and responsibilities of midwives in endometriosis.

Anahtar Kelimeler

Endometriosis, women, quality of life, midwifery, health education

Proje Numarası

Yoktur.

Kaynakça

• Abercrombie, P.D., Learman, L.A. (2012). Providing holistic care for women withchronic pelvic pain. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(5),668–679. https://doi.org/10.1111/j.1552-6909.2012.01403.x
• Altman, G., Wolcyzk, M. (2010). Overview And Recommendations For Primary Care Nurse Practitioners. The Journal for Nurse Practitioners, 6(6), 427-434. https://doi.org/10.1016/j.nurpra.2009.07.022
• American Society of Anesthesiologists Committee. (2011). Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures. Anesthesiology, 114:495–511 doi: https://doi.org/10.1097/ALN.0b013e3181fcbfd9
• Anglesio, M.S., Papadopoulos, N., Ayhan, A., Nazeran, T.M., Noë, M., Horlings, H.M., et al. (2017). Cancer-Associated Mutations in Endometriosis without Cancer. N Engl J Med, 376:1835. doi: 10.1056/NEJMoa1614814.
• Arnold, J., Barcena de Arellano, M.L., Rüster, C., et al. (2012). Imbalance between sympathetic and sensory innervation in peritoneal endometriosis. Brain Behav Immun, 26(1):132-41. doi: 10.1016/j.bbi.2011.08.004.
• Arnold, J., Vercellino, G.F., Chiantera, V., et al. (2013). Neuroimmunomodulatory alterations in non-lesional peritoneum close to peritoneal endometriosis. Neuroimmunomodulation, 20(1):9-18. doi: 10.1159/000342163.
• As-Sanie, S., Harris, R.E., Napadow, V., et al. (2012). Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. Pain, 153(5):1006-1014. doi: 10.1016/j.pain.2012.01.032.
• Ban, K.A., Minei, J.P., Laronga, C., Harbrecht, B.G., Jensen, E.H., Fry, D.E., et al. (2016). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, Update. J Am Coll Surg, 224(1):59-74. doi: 10.1016/j.jamcollsurg.2016.10.029.
• Barber, E.L., Clarke-Pearson, D.L. (2017). Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecol Oncol, 144(2):420-427. doi: 10.1016/j.ygyno.2016.11.036.
• Barcellos, M.B., Lasmar, B., Lasmar, R. (2016). Agreement between the preoperative findings and the operative diagnosis in patients with deep endometriosis. Arch Gynecol Obstet, 293(4):845-50. doi: 10.1007/s00404-015-3892-x.
• Bratzler, D.W., Dellinger, E.P., Olsen, K.M., Perl, T.M., Auwaerter, P.G., Bolon, M.K., et al. (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery, National Guideline Clearinghouse. Am J Health Syst Pharm, 70(3):195-283. doi: 10.2146/ajhp120568.
• Brosens, I., Puttemans, P., Benagiano, G. (2013). Endometriosis: a life cycle approach? Am J Obstet Gynecol, 209(4):307-16. doi: 10.1016/j.ajog.2013.03.009.
• Browning, R.M., Trentino, K., Nathan, E.A., Hashemi, N., Western Australian Patient Blood Management Program. (2017). Preoperative anaemia is common in patients undergoing major gynaecological surgery and is associated with a fivefold increased risk of transfusion. Aust N Z J Obstet Gynaecol, 52(5):455-9. doi: 10.1111/j.1479-828X.2012.01478.x.
• Buckley, T., Brown, D., Edwards, H.E., Aitken, R.L., Harding, M. (2020). Theimportance of nursing. In D. Brown, H. Edwards, T. Buckley, & R. L. Aitken(Eds.), Lewis’s medical-surgical nursing: Assessment and management of clinical problems (Fifth Edition, Australia and New Zealand edition, pp. 2–19).Chatswood NSW, Australia: Elsevier Australia, Retrieved from. https://www.clinicalkey.com.au/nursing/#!/content/book/3-s2.0-B9780729542920000017Cockerham.
• Burney, R.O., Giudice, L.C. (2012). Pathogenesis and pathophysiology of endometriosis. Fertil Steril, 98(3):511-9. doi: 10.1016/j.fertnstert.2012.06.029.
• Card, R., Sawyer, M., Degnan, B., Harder, K., Kemper, J., Marshall, M., et al. (2014). Perioperative protocol, Health care protocol. National Guideline Clearinghouse. https://www.icsi.org/wp-content/uploads/2019/01/Periop.pdf Accessed: 04/01/2022.
• Cox, H., Henderson, L., Wood, R., Cagliarini, G. (2003). Learning To Take Charge: Women’s Experiences Of Living With Endometriosis. Complementary Therapies In Nursing and Midwifery. 9(2):62-8. doi: 10.1016/S1353-6117(02)00138-5.
• Dovey, S., Sanfilippo, J. (2010). Endometriosis and the adolescent. Clin Obstet Gynecol, 53(2):420-8. doi: 10.1097/GRF.0b013e3181dbdc61.
• Dunselman, G.A., Vermeulen, N., Becker, C., et al. (2014). ESHRE guideline: management of women with endometriosis. Hum Reprod, 29(3):400-12. doi: 10.1093/humrep/det457.
• Eltorai, A.E.M., Szabo, A.L., Antoci, V Jr., Ventetuolo, C.E., Elias, J.A., Daniels, A.H., et al. (2018). Clinical Effectiveness of Incentive Spirometry for the Prevention of Postoperative Pulmonary Complications, Respir Care, 63(3):347-352. doi: 10.4187/respcare.05679.
• Endometriosis: diagnosis and management. (2017). NICE guideline [NG73] Published: 06 September 2017. https://www.nice.org.uk/guidance/ng73, Accessed: 02/10/2021
• ERAS Türkiye Derneği. (2021). ERAS protokolünün temel öğeleri. http://eras.org.tr/page.php?id=10&saglikCalisani=true, Erişim Tarihi: 02/10/2021
• Exacoustos, C., Malzoni, M., Di Giovanni, A., et al. (2014). Ultrasound mapping system for the surgical management of deep infiltrating endometriosis. Fertil Steril, 102(1):143-150.e2. doi: 10.1016/j.fertnstert.2014.03.043. Epub 2014 Apr 29.
• Farland, L.V., Eliassen, A.H., Tamimi, R.M., et al. (2017). History of breast feeding and risk of incident endometriosis: prospective cohort study. BMJ, 2358:j3778. doi: https://doi.org/10.1136/bmj.j3778
• Figueira, P.G., Abrão, M.S., Krikun, G., Taylor, H.S. (2011). Stem cells in endometrium and their role in the pathogenesis of endometriosis. Ann N Y Acad Sci, 1221(1):10-7. doi: 10.1111/j.1749-6632.2011.05969.x.
• Giudice, L.C. (2010). Clinical practice. Endometriosis. N Engl J Med, 362(25):2389-98. doi: 10.1056/NEJMcp1000274.
• Goodenough, C.J., Liang, M.K., Nguyen, M.T., Nguyen, D.H., Holihan, J.L., Alawadi, Z.M., et al. (2015). Preoperative glycosylated hemoglobin and postoperative glucose together predict major complications after abdominal surgery. J Am Coll Surg, 221(4):854-61.e1. doi: 10.1016/j.jamcollsurg.2015.07.013.
• Gökyıldız, S., Beji, N.K. (2012). Chronic pelvic pain: Gynaecological and non-gynaecological causes and considerations for nursing care. International Journal of Urological Nursing. 6(1), 3–10. https://doi.org/10.1111/j.1749-771X.2011.01137.x
• Grønkjær, M., Eliasen, M., Skov-Ettrup, L.S., Tolstrup, J.S., Christiansen, A.H., Mikkelsen, S.S., et al. (2014). Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg, 259(1):52-71. doi: 10.1097/SLA.0b013e3182911913.
• Harris, H.R., Wieser, F., Vitonis, A.F., et al. (2018). Early life abuse and risk of endometriosis. Hum Reprod, 33(9):1657-1668. doi: 10.1093/humrep/dey248.
• Huang, F., Chia, Y.Y., Eng, C.L., Lim, Y.K., Yam, K.L., Tan, S.C., Hockenberry, M. (2015). Evaluation of a preoperative clinic for women with gynecologic cancer. Clinical Journal of Oncology Nursing, 19(6):769-72. doi: 10.1188/15.CJON.769-772.
• Hudelist, G., English, J., Thomas, A.E., et al. (2011). Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol, 37(3):257-63. doi: 10.1002/uog.8858.
• Johnson, K., Razo, S., Smith, J., Cain, A., Soper, K. (2019). Optimize patient outcomes among females undergoing gynecological surgery: A randomized controlled trial. Applied Nursing Research, 45:39-44. doi: 10.1016/j.apnr.2018.12.005.
• Kalogera, E., Dowdy, S.C. (2016). Enhanced recovery pathway in gynecologic surgery. Obstet Gynecol Clin North Am, 43(3):551-73. doi: 10.1016/j.ogc.2016.04.006.
• Kavoussi, S.K., Odenwald, K.C., As-Sanie, S., Lebovic, D.I. (2017). Incidence of ovarian endometrioma among women with peritoneal endometriosis with and without a history of hormonal contraceptive use. Eur J Obstet Gynecol Reprod Biol, 215:220-223. doi: 10.1016/j.ejogrb.2017.06.028.
• Kelly-Weeder, S. (2012). Helping patients through the pain of infertility. The NursePractitioner, 37(2), 47–52. https://doi.org/10.1097/01.NPR.0000410279.52492.3d
• Laurion, S., Fetzer, S.J. (2003). The effect of two nursing interventions on the postoperative outcomes of gynecologic laparoscopic patients. J Perianesth Nurs, 18(4):254-61. doi: 10.1016/s1089-9472(03)00131-x.
• Lemaire, G.S. (2004). More Than Just Menstrual Cramps: Symptoms And Uncertainty Among Women With Endometriosis. Journal of Obstetric, Gynecologic and Neonatal Nursing, 33(1):71-9. doi: 10.1177/0884217503261085.
• Liang, Y., Yao, S. (2016). Potential role of estrogen in maintaining the imbalanced sympathetic and sensory innervation in endometriosis. Mol Cell Endocrinol, 424:42-9. doi: 10.1016/j.mce.2016.01.012.
• Matsuzaki, S., Darcha, C. (2013). Involvement of the Wnt/β-catenin signaling pathway in the cellular and molecular mechanisms of fibrosis in endometriosis. PLoS One, 8(10):e76808. doi: 10.1371/journal.pone.0076808.
• McKinnon, B.D., Bertschi, D., Bersinger, N.A., Mueller, M.D. (2015). Inflammation and nerve fiber interaction in endometriotic pain. Trends Endocrinol Metab, 26(1):1-10. doi: 10.1016/j.tem.2014.10.003.
• Missmer, S.A., Chavarro, J.E., Malspeis, S., et al. (2010). A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod, 25(6):1528-35. doi: 10.1093/humrep/deq044.
• Mowers, E.L., Lim, C.S., Skinner, B., et al. (2016). Prevalence of Endometriosis During Abdominal or Laparoscopic Hysterectomy for Chronic Pelvic Pain. Obstet Gynecol, 127(6):1045-1053. doi: 10.1097/AOG.0000000000001422.
• Nelson, G., Altman, A.D., Nick, A., Meyer, L.A., Ramirez, P.T., Achtari, C., et al. (2016). Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations--Part I, Gynecol Oncol, 140(2):313-22. doi: 10.1016/j.ygyno.2015.11.015.
• Oliveira, F.R., Dela Cruz, C., Del Puerto, H.L., et al. (2012). Stem cells: are they the answer to the puzzling etiology of endometriosis? Histol Histopathol, 27(1):23-9. doi: 10.14670/HH-27.23.
• Oral, E., Kumbak Aygün, B. (2018). Kronik Pelvik Ağrı ve Endometriozis. İçinde: Kronik Pelvik Ağrı. Ed. Oral E, Usta A.T. Ayrıntı Basım Yayın ve Matbaacılık, Ankara.
• Papari, E., Noruzinia, M., Kashani, L., Foster, W.G. (2020). Identification of candidate microRNA markers of endometriosis with the use of next-generation sequencing and quantitative real-time polymerase chain reaction. Fertil Steril, 113(6):1232-1241. doi: 10.1016/j.fertnstert.2020.01.026.
• Rahmioglu, N., Nyholt, D.R., Morris, A.P., Missmer, S.A., Montgomery, G.W., Zondervan, K.T. (2014). Genetic variants underlying risk of endometriosis: insights from meta-analysis of eight genome-wide association and replication datasets. Hum Reprod Update, 20(5):702-16. doi: 10.1093/humupd/dmu015.
• Revised American Society for Reproductive Medicine (1997). Classification of endometriosis: 1996. Fertil Steril, 67(5):817-21. doi: 10.1016/s0015-0282(97)81391-x.
• Sampson, J.A. (1927). Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol, 14, 442-469. http://dx.doi.org/10.1016/S0002-9378(15)30003-X
• Staal, A.H., van der Zanden, M., Nap, A.W. (2016). Diagnostic Delay of Endometriosis in the Netherlands. Gynecol Obstet Invest, 81(4):321-4. doi: 10.1159/000441911.
• Treloar, S.A., Bell, T.A., Nagle, C.M., et al. (2010). Early menstrual characteristics associated with subsequent diagnosis of endometriosis. Am J Obstet Gynecol, 202(6):534.e1-6. doi: 10.1016/j.ajog.2009.10.857.
• Unutkan, A., Kukulu, K. (2014). Endometiozisle ilişkili ağrının yönetimi ve ve ağrının yönetiminde hemşirenin rolü. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 3(2):804-814.
• Vercellini, P., Bracco, B., Mosconi, P., et al. (2016). Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study. Fertil Steril, 105(3):734-743.e3. doi: 10.1016/j.fertnstert.2015.11.016.
• Vercellini, P., Somigliana, E., Consonni, D., et al. (2012). Surgical versus medical treatment for endometriosis-associated severe deep dyspareunia: I. Effect on pain during intercourse and patient satisfaction. Hum Reprod, 27(12):3450-9. doi: 10.1093/humrep/des313.
• Vercellini, P., Viganò, P., Somigliana, E., Fedele, L. (2014). Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol, 10(5):261-75. doi: 10.1038/nrendo.2013.255. Epub 2013 Dec 24.
• Wheeler, M.A., Heffner, D.L., Kim, S., et al. (2014). TNF-α/TNFR1 signaling is required for the development and function of primary nociceptors. Neuron, 82(3):587-602. doi: 10.1016/j.neuron.2014.04.009.
• Wilson, C., Leese, B. (2013). Do nurses and midwives have a role in promoting thewell-being of patients during their fertility journey? A review of the literature. Human Fertility. 16(1):2-7. doi: 10.3109/14647273.2013.781687.
• Yaribakht, S., Malartic, C., Grange, G., Morel, O. (2014). Operative risk related to tobacco in gynecology, Gynecol Obstet Fertil, 42(5):343-7. doi: 10.1016/j.gyobfe.2014.01.022. Epub 2014 Apr 29.