Pregnancy And Bartholin Abscess: Examination Of 47 Cases

Yıl 2016, Cilt: 13 Sayı: 1, 8 - 11, 01.01.2016

Hakan Timur , Kadriye Nilay Özcan Aytekin Tokmak Hasan Ali İnal Esma Sarıkaya Dilek Uygur

Öz

Aim: To examine the clinical characteristics and obstetric outcomes of pregnant women who were hospitalized for Bartholin abscess.Material and Methods: During the study period 47 patients were identified who were hospitalized with a diagnosis of Bartholin abcess and were surgically managed in our perinatology unit. Hospital records of the patients were evaluated retrospectively in terms of their clinical characteristics, laboratory parameters and maternal and perinatal outcomes.Results: The mean age of patients was 27.0 ± 5.9 years, while the median gestational age at referral was 32.3 5.5 to 41.1 weeks. Bartholin abscess were in leftside in 25 53.2% cases and nulliparous cases 53.2% were more common. Median abscess diameter was calculated as 3.5 cm 2 to 6.5 . All patients underwent surgical drainage with antibiotic treatment and it was observed that 21 44.7% cases were treated with silver nitrate application. The cultures of 25 53.2% were negative, while the most common microorganisms isolated was E. Coli with 12 25.5% patients. In follow-up, 17 34% of the cases gave preterm birth and it was seen that cesarean delivery was more frequently applied. 8 16.7% neonates needed intensive care and 2 4.2% of them were found to be lost in early neonatal period.Conclusion: Although Bartholin abcess are not seen commonly during pregnancy, it can lead to important clinical condition that increases fetal and maternal complications of severe infection as a result of physiological changes during pregnancy. Although it is difficult to conclude, it is possible that Bartolin abscess may cause preterm birth.

Anahtar Kelimeler

Bartholin abscess, pregnancy, obstetric outcome, preterm labor

Gebelik ve Bartolin Absesi: 47 Olgunun İncelenmesi

Öz

Giriş: Bartolin absesi nedeniyle hospitalize edilen gebelerin klinik özelliklerini ve obstetrik sonuçlarını incelemek.Gereç ve Yöntemler: Çalışma süresince hastanemiz perinatoloji kliniğine gebelik ve Bartolin absesi tanısıyla yatırılan ve cerrahi müdahale yapılan 47 hasta tanımlandı. Hastane kayıtlarından saptanan ve dosyaları incelenen bu hastalar klinik özellikleri, laboratuar değerleri ile obstetrik ve perinatal sonuçlarına göre retrospektif olarak değerlendirildi.Bulgular: Hastaların ortalama yaşı 27,0±5,9 yıl, başvurudaki gebelik haftası ise 32,3 5,5-41,1 idi. Bartolin absesi, 25 %53.2 olguda solda iken nulliparlarda %53.2 daha yaygındı. 47 olgunun abse çapı 3,5 cm 2–6,5 olarak hesaplandı. Tüm hastalara antibiyotik baskısı altında cerrahi drenaj yapıldığı ve 21 %44.7 olguda gümüş nitrat tedavisi uygulandığı görüldü. Kültürlerin 25 %53.2 ’inde üreme olmazken, izole edilen en sık mikroorganizma 12 %25.5 hasta ile E.Coli idi. İzlemde, 17 %34 olgunun preterm doğum yaptığı ve sezaryen doğumun daha sık uygulandığı görüldü. 8 %16.7 yenidoğanda yoğun bakım ihtiyacı gerektiği ve bunlardan 2 %4.2 tanesinin erken neonatal dönemde kaybedildiği anlaşıldı.Sonuç: Gebelikte Bartolin absesi çok sık görülmese de gebelikte oluşan fizyolojik değişiklikler sonucu ciddi enfeksiyona ve maternal fetal komplikasyonların arttığı önemli klinik durumlara yol açabilir. Bu konuda kesin sonuçlar belirtmek zor olsa da Bartolin absesi preterm doğumu tetikliyor olabilir.

Anahtar Kelimeler

Bartolin absesi, gebelik, obstetrik sonuç, preterm eylem

Kaynakça

• Berger MB, Betschart C, Khandwala N, DeLancey JO, Haefner HK. Incidental bartholin gland cysts identified on pelvic magnetic resonance imaging. Obstetrics and gynecology. 2012;120:798.
• Brook I. Aerobic and anaerobic microbiology of Bartholin’s abscess. Surgery, gynecology & obstetrics. 1989;169:32-4.
• Tanaka K, Mikamo H, Ninomiya M, Tamaya T, Izumi K, Ito K, et al. Microbiology of Bartholin’s gland abscess in Japan. Journal of clinical microbiology. 2005;43:4258-61.
• Kessous R, Aricha-Tamir B, Sheizaf B, Shteiner N, Moran-Gilad J, Weintraub AY. Clinical and microbiological characteristics of Bartholin gland abscesses. Obstetrics & Gynecology. 2013;122:794-9.
• Marzano DA, Haefner HK. The Bartholin gland cyst: past, present, and future. Journal of lower genital tract disease. 2004;8:195-204.
• Sherer DM, Dalloul M, Salameh G, Abulafia O. Methicillin-resistant Staphylococcus aureus bacteremia and chorioamnionitis after recurrent marsupialization of a bartholin abscess. Obstetrics & Gynecology. 2009;114:471-2.
• Kelly JC, Jia X, Vindenes T, Urato AC. Chorioamnionitis and sternoclavicular septic arthritis after drainage of bartholin gland abscess. Obstetrics & Gynecology. 2014;124:436-8.
• Parvathi S, Imara AS, Thoduka TG. Bartholinitis caused by Streptococcus pneumoniae: Case report and review of literature. Indian Journal of Pathology and Microbiology. 2009;52:265.
• Zeger W, Holt K. Gynecologic infections. Emergency medicine clinics of North America. 2003;21:631-48.
• Lopez-Zeno JA, Ross E, O’Grady JP. Septic shock complicating drainage of a Bartholin gland abscess. Obstetrics & Gynecology. 1990;76:915.
• Carson G, Smith L. Escherichia coli endotoxic shock complicating Bartholin’s gland abscess. Canadian Medical Association Journal. 1980;122:1397.
• Kdous M, Hachicha R, Iraqui Y, Jacob D, Piquet P, Truc J. [Necrotizing fasciitis of the perineum secondary to a surgical treatment of Bartholin’s gland abscess]. Gynecologie, obstetrique & fertilite. 2005;33:887-90.
• Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012;379:2162-72.
• Norwitz ER, Robinson JN, Challis JR. The control of labor. New England Journal of Medicine. 1999;341:660-6.
• Naeye RL. Acute bacterial chorioamnionitis. Progress in clinical and biological research. 1987;281:73-86.
• Klein LL, Gibbs RS. Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth. American journal of obstetrics and gynecology. 2004;190:1493-502.