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Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi

Yıl 2019, Cilt: 17 Sayı: 3, 374 - 386, 02.12.2019

Öz

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, Sezaryen (S) doğum sırasında
kullanılan anestezik maddelerin doğum sonrası ilk 48 saat içinde sağlıklı, tam
zamanlı doğan bebeklerin genel hareket (GMs) kaliteleri üzerine olan etkisini
araştırmaktır. Ayrıca doğum şekline göre anne ve bebeğe ait peri-prenatal
koşulları, bu koşullarla GMs motor Optimalite Skorları arasındaki ilişkiyi
incelemektir.





YÖNTEM ve GEREÇLER: Çalışmaya
herhangi bir risk içermeyen gebelik ve intrauterin sürecinin ardından 37- 40
haftayı tamamlayarak komplikasyonsuz bir doğum sonucunda doğan 60 tam zamanlı
doğan bebek ve anneleri dahil edildi. Bebekler doğum şekillerine göre 30 Normal
Spontan Vajinal Yol (NSVY) ve 30 elektif S ile doğan bebekler olarak
sınıflandırıldı. GMs motor Optimalite Skorları bebeklerin video görüntüleri
üzerinden spontan hareketlerinin GMs Detaylandırılmış Motor Optimalite Analizi
ile puanlandırılmasıyla belirlendi. Ayrıca, doğum şekline göre bebeklerin GMs
motor optimalite skorları ile gebelik, doğum ve yeni doğana ait optimalite
değerlendirmeleri arasındaki ilişki incelendi. Pre-perinatal koşullar doğum
şekline göre karşılaştırıldı.





BULGULAR: NSVY ile doğan bebeklerin
ilk 48 saat içindeki motor optimalite skorlarının S ile doğan bebeklerden daha
yüksek olduğu bulundu (p<0.05). NSVY ve S grubundaki annelerin gebelik
koşulları ve yenidoğanın fizyolojik sağlık hali açısından optimaliteleri
arasında fark olmadığı görüldü (p>0.05). Doğum optimalitesi NSVY ile doğumda
S dan daha yüksek bulundu (p<0.05). Doğum şekline göre bebeklerin motor
optimaliteleri ile peri-prenatal koşulları arasında ilişki görülmedi.





TARTIŞMA ve SONUÇ: Sezeryan doğum
sırasında kullanılan anestezik maddeler doğumdan sonraki ilk 48 saatte yeni
doğanın nörodavranışsal durumunu etkilemektedir.

Kaynakça

  • 1. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization; 2015 (WHO/RHR/15.02).
  • 2. Health at a Glance 2017 Oecd Indicators. Health Care Activities Caesarean Sections. 2017: 180 1.
  • 3. Lagrew DC, Adashek JA. Lowering the cesarean section rate in a private hospital: comparison of individual physicians' rates, risk factors, and outcomes. Am J Obstet Gynecol 1998; 178: 1207-14.
  • 4. Cunningham FG, Leveno KJ, Bloom S, Hauth JC, Rouse DJ. Spong CY, Williams Obstetrics (23rd ed): New York: McGraw-Hill: 2010
  • 5. Capogna G, Camorcia M. Epidural analgesia for childbirth: effects of newer techniques on neonatal outcome. Pediatric Drugs 2004; 6: 375-86.
  • 6. Einspieler C, Prechtl HFR, Bos A, et al. Prechtl's method on the qualitative assessment of general movements in preterm, term and young infants. Clinics in Developmental Medicine London: Mac Keith Press: 2004.
  • 7. Einspieler C, Prechtl HFR. Precthl’s assesment of general movements: a diagnostic tool for the functional assesment of the young nervous system. Ment Retard Dev Disabil Res Rev 2005; 11: 61- 7.
  • 8. Prechtl HFR. The optimality concept. Early Hum Dev 1980; 4: 201-5.
  • 9. Kainer F, Prechtl HFR, Engele H, et al. Assessment of the quality of general movements in fetuses and infants of women with type-I diabetes mellitus. Earl Hum Dev 1997; 50: 13 25.
  • 10. Touwen BCL, Huisjes HJ, Jurgens AD, et al. Obstetrical condition and neonatal neurological morbidity. an analysis with the help of the optimality concept. Earl Hum Dev 1980; 4: 207-28.
  • 11. Einspeiler C, Prechtl HFR, Bos AF, et al. The qualitative assesment of general movements in preterm, term, and young infants- review of the methodology. Earl Hum Dev 1997; 50: 47-60.
  • 12. Ferrari F, Cioni G, Prechtl HFR. Detailed scoring on general movements during preterm, term and early postterm age. Earl Hum Dev 1990; 23: 151- 256.
  • 13. Prechtl HFR. General movement assessment as a method of development neurology: new paradigms and their consequences. Dev Med Child Neurol 2001; 43: 836-42.
  • 14. Ploegstra WM, Bos AF, de Vries NKS. General movements in healthy full term infants during the first week after birth. Earl Hum Dev 2014; 90: 55-60.
  • 15. Buhimschi CS, Buhimschi IA. Advantages of vaginal delivery. Clinical Obstetrics&Gynecology 2006; 49: 167-83.
  • 16. Lilford RJ, De Groot VC, Moore PJ, et al. The relative risks of caesarean section and vaginal delivery: a detailed analysis to exclude the effects of medical disorders and other acute pre-exiting physiological disturbances. BJOG 1990; 97: 883-92.
  • 17. Nielson TF, Hokegard KH. Postoperative cesarean section morbidity: a prospective study. AJOG 1983; 146: 911-16.
  • 18. Lydon-Rochelle M, Holt VL, Martin DP, et al. Association between method of delivery and maternal rehospitalization. JAMA 2000; 283: 2411-6.
  • 19. Kuhnert BR, Harrison MJ, Lınn PL, et al. Effects of maternal epidural anesthesia on neonatal behavior. Anesth Analg 1984; 63: 301-8.
  • 20. Kuhnert BR, Kennard MJ, Lınn PL. Neonatal neurobehavior after epidural anesthesia for cesarean section: a comparison of bupivacaine and chloroprocaine. Anesth Analg 1988; 67: 64-8.
  • 21. Abboud TK, Afrasiabi A, Sarkis F, et al. Continuous infusion epidural analgesia in parturients receiving bupivacaine, chloroprocaine, or lidocaine-maternal, fetal and neonatal effects. Anesth Analg 1984; 63: 421-8.
  • 22. Brockhurst NJ, Littleford JA, Halpern SH. The neurologic and adaptive capacity score. a systematic review of its use in obstetric anesthesia research. Anesthesiology 2000; 92: 237–46.
  • 23. Abboud TK, Kım KC, Noueihed R, et al. Epidural bupivacaine, chloroprocaine or lidocaine for cesarean section-maternal and neonatal effects. Anesth Analg 1983; 62: 914 9.
  • 24. Mantouvalou M, Rallı S, Arnaoutoglou H, et al. Spinal anesthesia: comparison of plain ropivacaine, bupivacaine and levobupivacaine for lower abdominal surgery. Acta Anesth. Belg. 2008; 59: 65-71.
  • 25. Guler G, Cakır G, Ulgey A, et al. A comparison of spinal anesthesia with levobupivacaine and hyperbaric bupivacaine for cesarean sections: a randomized trial. Open Journal Of Anesthesiology 2012; 2: 84-9.
  • 26. Prakash S, Pramanik V, Chellani H, et al. Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. International Journal of Obstetric Anesthesia 2010; 19: 24 30.
  • 27. Roduit C, Scholtens S, de Jongste J C, et al. Asthma at 8 years of age in children born by caesarean section. Thorax 2009; 64: 107–13.
  • 28. Mattingly JE, Alessio JD, Ramanathan J. Effects of obstetric analgesics and anesthetics on the neonate. Pediatr Drugs 2003; 5: 615-27.
  • 29. de Vries NKS, Bos AF. Quality in general movements in the first ten days of life in preterm infants. Earl Hum Dev 2010; 86: 225-9.

Investigation of the Effects of Cesarean Section on General Movements of the Newborn

Yıl 2019, Cilt: 17 Sayı: 3, 374 - 386, 02.12.2019

Öz

INTRODUCTION: This study aimed to
analyse the effect of anaesthetics used during Caesarean Section (CS) on the
General Movements (GMs),quality of healthy full-term infants in the postnatal
first 48 hours, the peri-prenatal conditions of mothers and infants, and the
relationship between these conditions and GMs motor Optimality Scores (OS)
according to type of birth.



METHODS: This study included 60 term
infants born without any birth complications after completing 37–40 weeks of
non-risky pregnancy and intrauterine process, along with their mothers. The
infants were allocated as 30 of them born by Normal Spontaneous Vaginal
Delivery (NSVD) and 30 of them born by elective CS. Infants’ GMs were assessed
in detail in the first 48 hours using Prechtl’s Method; this assessment yielded
their OS. The relationship between infants' GMs motor OS and pregnancy, birth,
and infants' optimality assessments was examined, and pre-perinatal conditions
were compared according to type of birth.



RESULTS: Motor OS in the first 48
hours were higher for infants born by NSDV than for those born by CS
(p<0.05). No difference was found between mothers’ pregnancy conditions and
neonates’ physiological health optimality in the two groups (p>0.05). Birth
optimality was higher in NSVD group than in CS group (p<0.05). No relationship
was found between infants' motor optimality and peri-prenatal conditions
according to type of birth.



DISCUSSION and CONCLUSION:
Anaesthetics used during CS affect infants' neurobehavioral status in the
postnatal first 48 hours.









 

Kaynakça

  • 1. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization; 2015 (WHO/RHR/15.02).
  • 2. Health at a Glance 2017 Oecd Indicators. Health Care Activities Caesarean Sections. 2017: 180 1.
  • 3. Lagrew DC, Adashek JA. Lowering the cesarean section rate in a private hospital: comparison of individual physicians' rates, risk factors, and outcomes. Am J Obstet Gynecol 1998; 178: 1207-14.
  • 4. Cunningham FG, Leveno KJ, Bloom S, Hauth JC, Rouse DJ. Spong CY, Williams Obstetrics (23rd ed): New York: McGraw-Hill: 2010
  • 5. Capogna G, Camorcia M. Epidural analgesia for childbirth: effects of newer techniques on neonatal outcome. Pediatric Drugs 2004; 6: 375-86.
  • 6. Einspieler C, Prechtl HFR, Bos A, et al. Prechtl's method on the qualitative assessment of general movements in preterm, term and young infants. Clinics in Developmental Medicine London: Mac Keith Press: 2004.
  • 7. Einspieler C, Prechtl HFR. Precthl’s assesment of general movements: a diagnostic tool for the functional assesment of the young nervous system. Ment Retard Dev Disabil Res Rev 2005; 11: 61- 7.
  • 8. Prechtl HFR. The optimality concept. Early Hum Dev 1980; 4: 201-5.
  • 9. Kainer F, Prechtl HFR, Engele H, et al. Assessment of the quality of general movements in fetuses and infants of women with type-I diabetes mellitus. Earl Hum Dev 1997; 50: 13 25.
  • 10. Touwen BCL, Huisjes HJ, Jurgens AD, et al. Obstetrical condition and neonatal neurological morbidity. an analysis with the help of the optimality concept. Earl Hum Dev 1980; 4: 207-28.
  • 11. Einspeiler C, Prechtl HFR, Bos AF, et al. The qualitative assesment of general movements in preterm, term, and young infants- review of the methodology. Earl Hum Dev 1997; 50: 47-60.
  • 12. Ferrari F, Cioni G, Prechtl HFR. Detailed scoring on general movements during preterm, term and early postterm age. Earl Hum Dev 1990; 23: 151- 256.
  • 13. Prechtl HFR. General movement assessment as a method of development neurology: new paradigms and their consequences. Dev Med Child Neurol 2001; 43: 836-42.
  • 14. Ploegstra WM, Bos AF, de Vries NKS. General movements in healthy full term infants during the first week after birth. Earl Hum Dev 2014; 90: 55-60.
  • 15. Buhimschi CS, Buhimschi IA. Advantages of vaginal delivery. Clinical Obstetrics&Gynecology 2006; 49: 167-83.
  • 16. Lilford RJ, De Groot VC, Moore PJ, et al. The relative risks of caesarean section and vaginal delivery: a detailed analysis to exclude the effects of medical disorders and other acute pre-exiting physiological disturbances. BJOG 1990; 97: 883-92.
  • 17. Nielson TF, Hokegard KH. Postoperative cesarean section morbidity: a prospective study. AJOG 1983; 146: 911-16.
  • 18. Lydon-Rochelle M, Holt VL, Martin DP, et al. Association between method of delivery and maternal rehospitalization. JAMA 2000; 283: 2411-6.
  • 19. Kuhnert BR, Harrison MJ, Lınn PL, et al. Effects of maternal epidural anesthesia on neonatal behavior. Anesth Analg 1984; 63: 301-8.
  • 20. Kuhnert BR, Kennard MJ, Lınn PL. Neonatal neurobehavior after epidural anesthesia for cesarean section: a comparison of bupivacaine and chloroprocaine. Anesth Analg 1988; 67: 64-8.
  • 21. Abboud TK, Afrasiabi A, Sarkis F, et al. Continuous infusion epidural analgesia in parturients receiving bupivacaine, chloroprocaine, or lidocaine-maternal, fetal and neonatal effects. Anesth Analg 1984; 63: 421-8.
  • 22. Brockhurst NJ, Littleford JA, Halpern SH. The neurologic and adaptive capacity score. a systematic review of its use in obstetric anesthesia research. Anesthesiology 2000; 92: 237–46.
  • 23. Abboud TK, Kım KC, Noueihed R, et al. Epidural bupivacaine, chloroprocaine or lidocaine for cesarean section-maternal and neonatal effects. Anesth Analg 1983; 62: 914 9.
  • 24. Mantouvalou M, Rallı S, Arnaoutoglou H, et al. Spinal anesthesia: comparison of plain ropivacaine, bupivacaine and levobupivacaine for lower abdominal surgery. Acta Anesth. Belg. 2008; 59: 65-71.
  • 25. Guler G, Cakır G, Ulgey A, et al. A comparison of spinal anesthesia with levobupivacaine and hyperbaric bupivacaine for cesarean sections: a randomized trial. Open Journal Of Anesthesiology 2012; 2: 84-9.
  • 26. Prakash S, Pramanik V, Chellani H, et al. Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. International Journal of Obstetric Anesthesia 2010; 19: 24 30.
  • 27. Roduit C, Scholtens S, de Jongste J C, et al. Asthma at 8 years of age in children born by caesarean section. Thorax 2009; 64: 107–13.
  • 28. Mattingly JE, Alessio JD, Ramanathan J. Effects of obstetric analgesics and anesthetics on the neonate. Pediatr Drugs 2003; 5: 615-27.
  • 29. de Vries NKS, Bos AF. Quality in general movements in the first ten days of life in preterm infants. Earl Hum Dev 2010; 86: 225-9.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma
Yazarlar

Meltem Yazıcı 0000-0003-1616-8070

Ayşe Livanelioglu Bu kişi benim 0000-0003-0945-1388

Yayımlanma Tarihi 2 Aralık 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 17 Sayı: 3

Kaynak Göster

APA Yazıcı, M., & Livanelioglu, A. (2019). Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi. Güncel Pediatri, 17(3), 374-386.
AMA Yazıcı M, Livanelioglu A. Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi. Güncel Pediatri. Aralık 2019;17(3):374-386.
Chicago Yazıcı, Meltem, ve Ayşe Livanelioglu. “Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi”. Güncel Pediatri 17, sy. 3 (Aralık 2019): 374-86.
EndNote Yazıcı M, Livanelioglu A (01 Aralık 2019) Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi. Güncel Pediatri 17 3 374–386.
IEEE M. Yazıcı ve A. Livanelioglu, “Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi”, Güncel Pediatri, c. 17, sy. 3, ss. 374–386, 2019.
ISNAD Yazıcı, Meltem - Livanelioglu, Ayşe. “Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi”. Güncel Pediatri 17/3 (Aralık 2019), 374-386.
JAMA Yazıcı M, Livanelioglu A. Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi. Güncel Pediatri. 2019;17:374–386.
MLA Yazıcı, Meltem ve Ayşe Livanelioglu. “Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi”. Güncel Pediatri, c. 17, sy. 3, 2019, ss. 374-86.
Vancouver Yazıcı M, Livanelioglu A. Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi. Güncel Pediatri. 2019;17(3):374-86.