EVALUATION OF MATERNAL AND FETAL OUTCOMES OF PREGNANT WOMEN ADMITTED TO THE DELIVERY UNIT WITH THE DIAGNOSIS OF REDUCED FETAL MOVEMENTS

Yıl 2022, Cilt: 19 Sayı: 3, 1401 - 1405, 30.09.2022

Burak Elmas , Özlem Moraloğlu Tekin

https://doi.org/10.38136/jgon.1064398

Öz

Aim: Decrease in baby movements during pregnancy is a common reason for admission to hospital. In this study, it was aimed to evaluate the perinatal and obstetric outcomes of pregnant women hospitalized in the delivery unit with the diagnosis of reduced fetal movements.
Materials and methods: Between January 2020 and January 2021, 417 pregnant women who were hospitalized in the delivery unit of our hospital with the diagnosis of reduced fetal movements at 37 weeks and above were retrospectively analyzed. High-risk pregnant women were excluded from the study. The patients' age, gravida, parity, body mass index, mode of delivery and neonatal intensive care need results were recorded. The mode of delivery and the need for neonatal intensive care in pregnant women hospitalized in the delivery unit with the diagnosis of reduced fetal movements were compared with the results of 13059 patients hospitalized in the delivery unit during this year.
Results: It was determined that 417 (3.19%) of 13059 patients admitted to the delivery unit were hospitalized with the diagnosis of reduced fetal movements. While the rate of primary cesarean section was 16.54% among all patients, the rate of primary cesarean section was found to be 36.73% in 245 pregnant women who were diagnosed with reduced fetal movements and delivered. It was found to be significantly higher in the study group than in the whole patient group (p=0.023). No statistically significant difference was observed in the comparison of babies born in both groups in terms of need for neonatal intensive care (p=0.744).
Conclusion: Primary cesarean section rates increase in patients hospitalized with the diagnosis of reduced fetal movements.

Anahtar Kelimeler

Fetal movement, cesarean section, neonatal intensive care

FETAL HAREKETLERDE AZALMA TANISIYLA DOĞUM SERVİSİNE KABUL EDİLEN GEBELERİN MATERNAL VE FETAL SONUÇLARININ DEĞERLENDİRİLMESİ

Öz

Amaç: Gebelikte bebek hareketlerinde azalma hissedilmesi hastaneye başvuru sebepleri arasında sık karşılaşılan bir nedendir. Bu çalışmada fetal hareketlerde azalma tanısı ile doğum ünitesine yatırılan gebelerin perinatal ve obstetrik sonuçlarının değerlendirilmesi amaçlanmıştır.
Gereçler ve yöntem: Ocak 2020- Ocak 2021 tarihleri arsında hastanemiz doğum ünitesine fetal hareketlerde azalma tanısıyla yatırılan 37.hafta ve üzeri 417 gebe retrospektif olarak incelendi. Yüksek riskli gebeler çalışma dışı bırakıldı. Hastaların yaşı, gravida, paritesi, vücut kütle indeksi ile doğum şekli ve yenidoğan yoğun bakım ihtiyacı sonuçları kaydedildi. Fetal hareketlerde azalma tanısı ile doğum ünitesine yatırılan gebelerin doğum şekli ve yenidoğan yoğun bakım ihtiyacı durumu bu bir yıl içerisinde doğum ünitesine yatırılan toplam 13059 hastanın sonuçları ile karşılaştırıldı.
Bulgular: Doğum ünitesine yatan 13059 hastanın 417’sinin ( %3.19) fetal hareketlerde azalma tanısıyla yatırıldığı tespit edildi. Tüm hastalar içinde primer sezaryen oranı %16.54 iken, fetal hareketlerde azalma tanısı alıp doğurtulan 245 gebede primer sezaryen oranı % 36.73 olarak tespit edildi. Primer sezaryen oranları açısından karşılaştırıldığında çalışma grubunda tüm hasta grubuna göre primer sezaryen oranı anlamlı olarak yüksek bulundu (p=0.023). Her iki gruptaki doğan bebeklerin yenidoğan yoğun bakım ihtiyacı olması yönünden karşılaştırılmasında da istatistiksel olarak anlamlı fark izlenmemiştir (p=0.744).
Sonuç: Fetal hareketlerde azalma tanısıyla yatırılan hastalarda primer sezaryen oranları yükselmektedir.

Anahtar Kelimeler

Fetal hareket, sezaryen, yenidoğan yoğun bakım

Kaynakça

• 1. Pearson JF, Weaver JB.Fetal activity and fetal wellbeing: an evaluation.Br Med J. 1976 May 29;1(6021):1305-7.
• 2. Efkarpidis S, Alexopoulos E, Kean L, Liu D, Fay T. Casecontrol study of factors associated with intrauterine fetal deaths. Med Gen Med. 2004 May 27;6(2):53.
• 3. Frøen JF, Arnestad M, Frey K, Vege A, Saugstad OD, StrayPedersen B. Risk factors for sudden intrauterine unexplained death: epidemiologic characteristics of singleton cases in Oslo, Norway, 1986-1995. Am J Obstet Gynecol. 2001 Mar;184(4):694-702.
• 4. Warrander LK, Batra G, Bernatavicius G, Greenwood SL, Dutton P, Jones RL, Sibley CP, Heazell AE. Maternal perception of reduced fetal movements is associated with altered placental structure and function. PLoS One. 2012;7(4):e34851.
• 5. Heazell AE, Frøen JF. Methods of fetal movement counting and the detection of fetal compromise. J Obstet Gynaecol. 2008 Feb;28(2):147-54.
• 6. Warrander LK, Heazell AE. Identifying placental dysfunction in women with reduced fetal movements can be used to predict patients at increased risk of pregnancy complications. Med Hypotheses. 2011 Jan;76(1):17-20.
• 7. Mangesi L, Hofmeyr GJ.Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004909.
• 8. Olesen AG, Svare JA. Decreased fetal movements: background, assessment, and clinical management. Acta Obstet Gynecol Scand. 2004 Sep;83(9):818-26.
• 9. Frøen JF, Heazell AE, Tveit JV, Saastad E, Fretts RC, Flenady V. Fetal movement assessment. Semin Perinatol. 2008;32(4):243-6.
• 10. Grant A, Elbourne D, Valentin L, Alexander S. Routine formal fetal movement counting and risk of antepartum late death in normally formed singletons. Lancet. 1989;2(8659):345-9.
• 11. Frøen JF.A kick from within--fetal movement counting and the cancelled progress in antenatal care. J Perinat Med. 2004;32(1):13-24.
• 12. Flenady V, MacPhail J, Gardener G, Chadha Y, Mahomed K, Heazell A, Fretts R, Frøen F. Detection and management of decreased fetal movements in Australia and New Zealand: a survey of obstetric practice. Aust N Z J Obstet Gynaecol. 2009;49(4):358-63.
• 13. Stacey T, Thompson JM, Mitchell EA, Ekeroma A, Zuccollo J, McCowan LM. Maternal perception of fetal activity and late stillbirth risk: findings from the Auckland Stillbirth Study. Birth. 2011;38(4):311-6.
• 14. O’Sullivan O, Stephen G, Martindale E, Heazell AE Predicting poor perinatal outcome in women who present with decreased fetal movements.J Obstet Gynaecol. 2009;29(8):705-10.
• 15. Rådestad I.Fetal movements in the third trimester-- Important information about wellbeing of the fetus.Sex Reprod Healthc. 2010;1(4):119-21.
• 16. Winje BA, Saastad E, Gunnes N, Tveit JV, Stray-Pedersen B, Flenady V, Frøen JF. Analysis of ‘count-to-ten’ fetal movement charts: a prospective cohort study. BJOG. 2011;118(10):1229-38.
• 17. Peat AM, Stacey T, Cronin R, McCowan LM. Maternal knowledge of fetal movements in late pregnancy. Aust N Z J Obstet Gynaecol. 2012;52(5):445-9.