Gecikmiş Umbilikal Kord Klempleme ve Kord Sıvazlama Uygulamalarinin Prematüre Yenidoğanlarda Etkileri

Yıl 2019, , 54 - 59, 01.01.2019

Deniz Batman Ayden Çoban

https://doi.org/10.30934/kusbed.475344

Öz

Prematüre
yenidoğanlar fizyolojik ve yapısal olarak matür yenidoğanlardan farklıdır ve
mortalite ve morbidite açısından yüksek riske sahiptirler. Doğumda gecikmiş kord
klempleme ve göbek kordu sıvazlanması uygulamalarıyla prematürelerde yeterli
kan hacmi ve etkili dolaşımın sağlanmasının yanında birçok fayda
sağlanabilmektedir. Erken doğumun beraberinde getirdiği sağlık sorunlarını
azaltma ve önleme üzerinde geç klempleme ve sıvazlama uygulamalarının etkili
olduğu belirlenmiştir. Mevcut kanıtlar, geç kord klemplemesinin prematüre
yenidoğanlardaki intraventriküler kanama, sepsis, nekrotizan enterokolit, kan transfüzyonu
ihtiyacı, mortalite ve yoğun bakım ünitesinde yatış gibi komplikasyonları
azalttığı yönündedir. Ayrıca prematürelerde kord sıvazlamasının kan
transfüzyonu ihtiyacını azalttığı, morbidite oranını düşürdüğü ve oksijen ihtiyacını
azalttığı bilinmektedir. Tüm bu faydalara rağmen, geç klempleme ve sıvazlama
uygulamalarının klinikte rutin olarak uygulanmasının önünde hala engeller
bulunmaktadır. Acil resüstasyonun gecikme düşüncesi engellerin başında yer
almaktadır. Ayrıca bu iki uygulamadan hangisinin daha etkin olduğu ve klinik
uygulamada hangi durumlarda tercih edileceği de oldukça önemli bir konudur. Bu
derlemenin amacı, prematüre yenidoğanlarda doğum odasında umbilikal kord
klempleme süresi ve kord sıvazlama uygulamaları ve etkileri hakkında literatür
bilgisi kapsamında bilgi vermektir.

Anahtar Kelimeler

Prematüre, yenidoğan, umbilikal kord, kord klempleme

The Effect of Delayed Umbilical Cord Clamping and Cord Milking on Premature Newborn

Öz

Premature newborns
are physiologically and structurally different from mature newborns and have a
high risk of mortality and morbidity. Delayed cord clamping and umbilical cord
milking at birth provide adequate blood volume and effective circulation in the
prematurity as well as many benefits. It has been determined that the
application of delayed clamping and cord milking on reducing and preventing the
health problems brought by early childbirth is effective. Current evidence
suggests that delayed cord clamping reduces complications such as intraventricular
hemorrhage in premature newborns, sepsis, necrotizing enterocolitis, blood
transfusion need, mortality and admission to the intensive care unit. It is
also known that cord milking platelets in prematurity reduce blood transfusion
need, decrease morbidity rate and decrease oxygen demand. Despite all these benefits,
there are still barriers to routine application of late clamping and cord
milking practices in the clinic. Emergency resuscitation is at the head of the
delayed thought blocks. It is also a very important issue as to which of these
two applications is more effective and in which cases clinical applications
will be preferred. The aim of this review is to provide information about the duration
of umbilical cord clamping and cord milking practices in the birth room for
premature newborns as well as their effects on this field.

Anahtar Kelimeler

Premature, newborn, umbilical cord, clamping

Kaynakça

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