Makrozomik Fetuslarda Doğum Şekli Oluşabilecek Komplikasyonları Önler mi?

Yıl 2018, Cilt: 49 Sayı: 4, - , 15.12.2018

Sezin Ertürk Aksakal , Şafak Özdemirci Füsun Bocutoğlu Baran Yeşil Leyla Mollamahmutoğlu Ömer Lütfi Tapısız

https://doi.org/10.16948/zktipb.428857

Öz

Amaç: Bu çalışmada,
4000 gr ve üzerinde bebek doğuran 643 gebenin 
doğum şeklinin  ve doğum
ağırlıklarının maternal ve neonatal komplikasyonlar üzerine  olan etkisinin değerlendirilmesi amaçlanmıştır.

Materyal
metod: 643 hasta doğum
şekline (vajinal veya sezaryen) ve doğum ağırlıklarına (4000-4500 ve ≥4500
gram) göre gruplara ayrıldı. 4000 gramın üzerinde doğum yapan hastalar doğum
şekline göre komplikasyon oranları açısından karşılaştırıldı. Daha sonra
hastalar 4000-4499 gr ve ≥4500 gr doğum yapanlar olarak ayrıldı. Bu iki
grubun  kendi içinde komplikasyon
açısından fark olup olmadığı araştırıldı.

Bulgular: Makrozomik infant öyküsü, neonatal ağırlık ve
eşlik eden DM, sezaryen ile doğum yapan 
grupta yüksek saptandı. Neonatal komplikasyonlar açısından herhangi bir
fark saptanmadı. maternal postpartum Hb 
değeri sezaryen olan grupta anlamlı düşük bulundu. 4500 gramın üzerinde
doğan bebeklerin doğum şekli ile komplikasyon oranları değişmezken, 4000-4499
gram arasında postpartum Hb değeri sezaryen olan grupta anlamlı düşük saptandı.

Sonuç: Rutin sezaryen ile doğumun makrozomik infantlarda
komplikasyonları azaltma açısından belirgin bir üstünlük sağlamadığı
görülmektedir. Makrozomik infant doğurma riski olan hastalar
kişiselleştirilmeli ve doğum komplikasyonu açısından risk taşıyan hastalar
sezaryene yönlendirilmelidir.

Anahtar Kelimeler

Makrozomi, komplikasyon, sezaryen

Does type of delivery prevent complications in macrosomic fetuses?

Öz

Objective: This study aims to
analyze the effect of delivery method and birth weight over maternal and
neonatal complications in 643 women who gave birth to babies weighing 4000 g or
above.

Material method: 643 patients were
divided into groups according to their delivery method (vaginal or caesarean)
and birth weight (4000-4500 g or ≥4500 g). Patients who delivered babies weighing over 4000 g were compared
in terms of complication rates according to their delivery method. Subsequently,
groups of patients were compared according to delivery weighing 4000 – 4499 g
and ≥4500 g, and were analyzed to find out whether there are differences
between in terms of complications.

Results: Macrosomic infant
history, neonatal weight and concomitant DM were observed higher in the group
of caesarean delivery patients. No difference was found in neonatal complications.
Maternal postpartum hemoglobin levels were significantly lower in caesarian
delivery group. No difference was found in terms of complication rates between
both delivery method groups in babies born over 4500 g, whereas postpartum
hemoglobin level was significantly lower in the group of caesarian delivery of
babies weighing 4000 – 4499 g.

Conclusion: It
is observed that routine caesarian delivery does not provide a significant
advantage in reducing complications in macrosomic infants. Women with suspected fetal macrosomia should be individualized  and prophylactic cesarean delivery may be considered
for patients who has the risk of delivery complications.

Anahtar Kelimeler

macrosomia, complication, caesarian

Kaynakça

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