Normal Komplikasyonsuz Gebeliklerde ve Mekonyumlu Gebeliklerde PAPP-A Sonuçlarının ve Doğum Parametrelerinin Karşılaştırılması

Öz

Amaç: Bu çalışmada, birinci ve ikinci trimester tarama testi parametreleri, normal komplikasyonsuz gebelikler ile mekonyumla komplike olmuş gebeliklerde karşılaştırılarak bu parametrelerin doğum parametreleri üzerindeki etkilerini değerlendirmek amaçlanmıştır. Bu analiz, maternal serum gebelikle ilişkili plazma proteini A ve alfa-fetoprotein düzeylerinin mekonyumla boyanmış amniyotik sıvı için faydalı belirteçler olma potansiyelini ortaya koyarak klinik stratejilerin ve izlem yaklaşımlarının geliştirilmesine katkı sağlayabilecektir. Gereç ve Yöntemler: Bu çalışma retrospektif olgu-kontrol çalışmasıdır. Çalışma kapsamında 1238 gebe taranmış, ikili ve üçlü tarama testi sonuçları birlikte bulunan 528 gebe çalışmaya dahil edilmiştir. Bulgular: Mekonyumla boyanmış amniyotik sıvıya sahip gebelerde, bu durumu olmayanlara kıyasla biyobelirteç düzeyleri anlamlı olarak farklıydı; gebelikle ilişkili plazma proteini A MoM düzeyleri sırasıyla 0,9±0,1 ve 1,2±0,2 idi (p=0,012), alfa-fetoprotein MoM düzeyleri ise sırasıyla 1,3±0,5 ve 0,9±0,0 idi (p=0,009). Mekonyumla boyanmış amniyotik sıvıya sahip olan ve olmayan gebeler arasında fetal distres oranları anlamlı farklılık göstermekteydi; sırasıyla 11 vaka (%10) ve 10 vaka (%2,4) (p=0,001). Yenidoğan yoğun bakım ihtiyacı ise mekonyumla boyanmış amniyotik sıvı görülen gebeliklerde istatistiksel olarak anlamlı şekilde daha yüksekti (n=30 (27.3%) vs. n=61(14.6%), p=0,02). Sonuç: Çalışmamız, azalmış maternal serum gebelikle ilişkili plazma proteini A MoM düzeylerinin ve artmış maternal serum alfa-fetoprotein MoM düzeylerinin mekonyumla boyanmış amniyotik sıvı ile ilişkili olduğunu göstermektedir.

Anahtar Kelimeler

• Mekonyumla boyanmış amniyotik sıvı
• PAPP-A
• AFP
• fetal distres
• maternal serum tarama testleri

THE COMPARISON OF PAPP-A RESULTS AND BIRTH PARAMETERS IN NORMAL PREGNANCIES WITHOUT COMPLICATIONS AND IN PREGNANCIES WITH MECONIUM

Öz

Objective: In the present study, we compare first and second trimester screening test parameters in uncomplicated pregnancies with those in pregnancies complicated by meconium to assess their impact on birth outcomes. This analysis may uncover the potential of maternal serum pregnancy-associated plasma protein-A and alpha-fetoprotein levels as useful markers for meconium-stained amniotic fluid, thereby enhancing clinical strategies and monitoring approaches. Material and Methods: The current study had a retrospective case-control design. In the study, a total of 1238 pregnant women were screened, and 528 who had both double and triple screening results were included. Results: Pregnant women with meconium-stained amniotic fluid exhibited significantly different biomarker levels compared to those without. Specifically, the pregnancy-associated plasma protein A MoM levels were 0.9±0.1 versus 1.2±0.2 (p=0.012), and the alpha-fetoprotein MoM levels were 1.3±0.5 versus 0.9±0.0 (p=0.009), respectively. Fetal distress rates differed significantly between pregnant women with and without meconium-stained amniotic fluid, with 11 cases (10%) compared to 10 cases (2.4%) respectively (p=0.001). The requirement for neonatal intensive care was statistically significantly higher in pregnancies with meconium-stained amniotic fluid (n=30 (27.3%) vs. n=61 (14.6%), p=0.02). Conclusion: Our study demonstrates that decreased maternal serum pregnancy-associated plasma-protein-A MoM levels, coupled with increased maternal serum alpha fetoprotein MoM levels are associated with meconium-stained amniotic fluid.

Anahtar Kelimeler

• Meconium-stained amniotic fluid
• PAPP-A
• AFP
• fetal distress
• maternal serum screening tests

Kaynakça

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