The clinical analyz of pregnancy terminastions with oksitosin/dinoproston (preeclamptic-nonpreeklamptic) term pregnancies

Yıl 2009, Cilt: 40 Sayı: 4, 179 - 185, 01.05.2009

Ali Çıtırke Mehmet Küçükbaş Vedat Dayıcıoğlu

Öz

Objective: The aim of our study is to compare the efficacy, safety and complications of pharmacological agents of Oxytocine and Dinoprostone and oxytocine + dinoprostone combination which are frequently used for cervical ripening and for labor induction in women with a gestational age of 37 weeks and over 37 weeks and an indication for termination of pregnancy. Materials and Methods: A total of 173 pregnant women with a gestational age of 37 weeks-and over 37 weeks were included into this study. First group applied oxytocine, Second group applied dinoprostone, Third group applied dinoprostone+ oxytocine. In our study, we also compared the presence of preeclampsia with the patients not having preeclampsia in regard to bishop score changes and the time from placement until delivery. Results: We determined the average time from placement until delivery in the patients included into the study to be 19.2 hour in oxytocine group, 21.4 hour in dinoprostone group and 18.9 hour in oxytocine + dinoprostone group. Among the groups, rates of vaginal deliveries within the first 24 hours were determined to be 43.1% in oxytocine group, 32,3% in dinoprostone group and 42,8% in oxytocine + dinoprostone group. In our study, durations of vaginal deliveries, rates of vaginal and caesarean- section deliveries, bishop score changes, amounts of meconium, the mean 1st minute and 5th minute Apgar scores were similar in each of three groups except a higher rate of hyperstimulation in dinoprostone group. We also determined that the presence of preeclampsia did not affect bishop score changes and the time from placement until delivery. Conclusion: Each of three agents can be used alternatives of each other for cervical ripening and labor induction.

Anahtar Kelimeler

Dinoprostone, Oxytocin, Term Birth, Gestational Age, Pre-Eclampsia, Pregnancy Complications, Time

Term gebeliklerde (preeklamptik-diğer) oksitosin/dinoproston yardımlı gebelik terminasyonlannın klinik analizi

Öz

Amaç: Çalışmamızın amacı 37 hafta ve üstü gebelik terminasyonu endikasyonu verilen olgularda serviksi olgunlaştırma ve doğum eylemi indüksiyonunda sık kullanılan ajanlardan Oksitosin, Dinoproston veoksitosin+dinoproston 'u; etkinlik, güvenirlilik ve komplikasyonlar açısından karşılaştırmaktır. Materyal ve metod: Bu çalışmaya 3 7 veya daha büyük gebelik haftasında bulunan toplam 173 gebe kadın dahil edildi. 1.gruba oksitosin, 2.gruba dinoposton. 3.gruba dinoposton+oksitosin uygulandı. Çalışmamızda ayrıca preeklampsi varlığını, bishop skoru değişiklikleri ve uygulamadan doğuma kadar geçen süre açımndan preeklamptik olmayan hastalarla karşılaştırdık. Bulgular: Çalışmaya aldığımız hastalarda uygulamadan doğuma kadar geçen süreyi, ortalama olarak oksitosin grubunda 19.2 saat, dinoproston grubunda 21.4 saat, oksitosin+ dinoproston grubunda 18.9 saat olarak bulduk. Gruplar arasında ilk 24 saattteki vajinal doğum oranlarını oksitosin grubunda %43,1, dinoproston grubunda %32,3, oksitosin^dinoproston grubunda ise %42,8 olarak tespit ettik. Çalışmamızda dinoproston grubunda yüksek hiperstimülasyon oranı dışında her üç grupta vajinal doğum süresi, vajinal ve sezeryan doğum oranları, bishop skorundaki değişimler, mekonyum oranları, 1. dakika ve 5. dakika apgar skor ortalamaları benzer bulunmuştur. Preeklampsi varlığının da bishop skoru değişiklikleri ve uygulamadan doğuma kadar geçen süreyi etkilemediğini tespit ettik. Sonuç: Servikal olgunlaşma ve doğum indüksiyonu için her üç ajan birbirinin alternatifi olarak kullanılabilir.

Anahtar Kelimeler

Dinoproston, Oksitosin, Zamanında doğum, Gebelik yaşı, Preeklampsi, Gebelik komplikasyonları, Zaman

Kaynakça

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