Gestasyonel Diabetes Mellituslu Hastalarda Acil ve Elektif Sezaryen Doğumların Feto-Maternal Sonuçlarının Karşılaştırılması

Öz

Amaç: Gestasyonel diyabetes mellituslu (GDM) hastalarda elektif ve acil sezaryen doğumlar arasındaki fetal ve maternal sonuçları karşılaştırmak. Gereç ve Yöntemler: Ocak 2015-Temmuz 2020 tarihleri arasında sezaryen (C/S) yapılan GDM'li hastaların verileri geriye dönük olarak değerlendirildi. Hastalar C/S'nin elektif (n=129) veya acil (n=158) olmasına göre gruplandırıldı. Bulgular: GDM'li hastaların sezaryen oranı (%31.16) ve GDM'li olmayanlara göre daha yüksekti. Acil sezaryen grubunda elektif sezaryen grubuna göre daha fazla anne bakımına sahip hasta vardı (p=0,003). Elektif grupta bir yenidoğan ve acil C/S grubunda altı yenidoğan öldü, ancak yenidoğan ölüm oranları benzerdi (p=0.198). Acil C/S grubunda yara enfeksiyonu, ateş, kan transfüzyonu ihtiyacı ve anne yoğun bakım ünitesi morbiditesi, doğum asfiksisi, solunum morbiditesi ve yenidoğan yoğun bakım gereksinimi fetal morbidite oranları daha yüksekti (p<0.05). Sonuç: Acil C/S, GDM vakalarında daha yüksek oranda olumsuz fetal ve maternal sonuçlara sahiptir. Yeterli anne bakımı ve sezaryen olması muhtemel GDM gebeliklerinin erken tanınması, iyi fetal ve maternal sonuçları destekleyen elektif sezaryen insidansını artırabilir

Anahtar Kelimeler

• Diabetes mellitus
• Gebelik
• Komplikasyonlar
• Olumsuz doğum sonuçları
• Cerrahi

Comparison of Feto-Maternal Outcomes Between Emergency and Elective Cesarean Deliveries in Patients with Gestational Diabetes

Öz

Aim: To compare fetal and maternal outcomes between elective and emergency cesarean sections in patients with gestational diabetes mellitus (GDM). Material and Methods: Data from patients with GDM delivered by cesarean section between January 2015 and July 2020 were retrospectively reviewed. Patients were grouped according to whether the cesarean section was elective (n=129) or emergency (n=158). Results: The cesarean section rate was higher in patients with GDM (31.16%) than in patients without GDM. There were more patients with inadequate maternal care in the emergency cesarean section group than in the elective cesarean section group (p=0.003). One neonate in the elective group and six in the emergency C/S group died, but the rates of neonatal mortality were similar (p=0.198). Maternal morbidity (wound infection, fever, blood transfusion, and maternal intensive care) and fetal morbidity (birth asphyxia, respiratory morbidity, and neonatal intensive care) were higher in the emergency C/S group (p<0.05). Conclusion: Emergency C/S results in a higher rate of adverse fetal and maternal outcomes in GDM. Adequate maternal care and early identification of GDM pregnancies likely to require cesarean section may increase the frequency of elective cesarean sections, favoring good fetal and maternal outcomes.

Anahtar Kelimeler

• Diabetes mellitus
• Gestational
• Complications
• Adverse birth outcomes
• Surgery

Kaynakça

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