IS AMNIOTIC FLUID ANALYSIS DURING THE SECOND TRIMESTER A PREDICTOR FOR THE DETECTION OF PRETERM LABOR?

Öz

Objective: Premature activation of the hypothalamic-pituitary- adrenal axis due to stress can initiate preterm labor. Many mechanisms have been proposed to explain etiopathogenesis. The most important one is clinical and subclinical chorioamnionitis. We aimed to assess the possibility of early detection and prevention of preterm labor based on second trimester amniotic fluid analysis. Materials and Methods: One hundred and twenty-five pregnant women with singleton pregnancies who underwent amniocentesis were included. The first 2 cm3 of the amniotic fluid obtained during the amniocentesis was used for glucose, interleukin- 1, interleukin-6, high sensitivity C-reactive protein, electrolytes, progesterone/estrogen analysis, and cell counts. Results: Sixteen women (13.8%) went into labor prior to 37 weeks of gestation. The mean age of the study population was 33.2±6.25 years. Ages were similar between the preterm and term groups (36.06±3.91 vs 32.77±6.43). Furthermore, the analysis of all parameters in the amniotic fluid did not show any statistical significant difference between the groups. Conclusion: The possible effects of subclinical infection and steroid hormonal changes that are implied in the etiology of preterm labor were investigated in our study, and no evidence was found to support that these factors played a role in the etiology of preterm labor.

Anahtar Kelimeler

• Amniocentesis
• preterm labor
• glucose
• interleukin
• high sensitivity C-reactive protein
• leukocyte count

İKİNCİ TRİMESTIRDA BAKILAN AMNİOTİK SIVI ANALİZİ PRETERM DOĞUM ÖNGÖRÜSÜNDE BİR PREDİKTÖR MÜDÜR?

Öz

Amaç: Strese bağlı hipotalamik-pitüiter-adrenal aksın prematür aktivasyonu preterm doğumu başlatır. Etyopatogenezi açıklamak üzere pek çok mekanizma ileri sürülmüştür. En önemlisi klinik ve subklinik koryoamniyonittir. Preterm eylem riski taşıyan hastaların daha erken dönemde belirlenmesi, önlenmesi ve hastaların yanlış tanı nedeni ile gereksiz yere tokoliz tedavisi almasının önlenmesini amaçladık. Gereç ve Yöntem: Çalışmamızda 16-26 gebelik haftalarında 125 tekiz gebe, onamı alınarak çalışmaya dahil edildi. Hastalardan 3’ünde karyotip anomalisi (Trizomi 21) saptandı, 1 hastanın gebeliği şiddetli preeklampsi nedeni ile 32. haftada sonlandırıldı, 5 hastaya da ulaşılamadı. 116 hasta ile çalışmaya devam edildi. Amniosentez işlemi alınan ilk 2 cc’lik amniyon mayisi kullanılarak glukoz, IL-1, IL-6, HsCRP, hücre sayımı, elektrolit ve Progesteron/ Estrojen oranı çalışıldı. Bulgular: Gebelerin 16 tanesi 37. haftasını doldurmadan doğum yaptı (%13,8). Çalışma poülasyonunun ortalama yaşı 33,2±6,25 idi. Çalışmamızda preterm doğum yapan grup ile miadında doğum yapan grubun yaş ortalaması istatistiksel olarak benzer bulundu (36,06±3,91 vs 32,77±6,43). Ayrıca her iki grupta hastaların amnion mayisindeki glukoz, IL-1, IL-6, HsCRP, hücre sayımı, elektrolit ve Progesteron/Estrojen oranı istatiksel olarak anlamlı farklı bulunmadı. Sonuç: Çalışmamızda preterm eylemin etyolojisinde suçlanan subklinik enfeksiyon ve steroid hormon değişimleri incelenmiş ve bu hipotezleri destekleyen kanıt bulunamamıştır.

Anahtar Kelimeler

• Amniyosentez
• preterm doğum
• glukoz
• nterlökin
• yüksek sensitiviteli C-reaktif protein
• lökosit sayımı

Kaynakça

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