Preterm prematür membran rüptürü olgularında spontan ve indüklenmiş eylemin maternal ve fetal sonuçlara etkisi

Yıl 2019, Cilt: 50 Sayı: 2, 19 - 23, 15.06.2019

Gürcan Türkyılmaz Şebnem Erol Türkyılmaz Mesut Polat Enis Özkaya Murat Api

https://doi.org/10.16948/zktipb.541187

Cited By: 1

Öz

Amaç: Bu çalışmamızda preterm prematür membran rüptürü (PPROM) ile komplike

gebeliklerde spontan travaya giren olgularla çeşitli endikasyonlarla doğum indüksiyonu yapılan

olguların perinatal sonuçlarını ve latent sürenin bu sonuçlara etkisini araştırmayı amaçladık.

Materyel-metod: Ocak 2014-Ocak 2016 yılları arasında kliniğimizde 24-34 gebelik haftalar

arasındaki PPROM tanısı alan gebelerin perinatal sonuçları retrospektif olarak değerlendirildi.

Bulgular: Çalışmaya 93 olgu dahil edildi ve 43 olguda (%46) doğum eylemi takip sırasında

spontan başladı (Grup 1), 50 olguda (%54) ise doğum eylemi indüksiyonla başlatıldı (Grup 2).

PPROM oluşan zamandan doğuma kadar geçen süre grup 1’de 5.8±2.1 gün, grup 2’de 8.3±3.5

gündü (p:0,19). Ortalama doğum haftası grup 1’de 30.4±2.3 hafta iken grup 2’de 30.5±2.5

haftaydı (p: 0.91). Doğum ağırlıkları arasında anlamlı fark saptanmadı. Grup 1’de 19 (%44.1)

olgu sezaryen ile doğum yaptı, grup 2’de ise 37 (%74) olguda sezaryen ihtiyacı görüldü

(p:0.03). Grup 1’de 4 (%9.3), grup2’de 3 (%6) olguda YDYBÜ takibi sırasında exitus

gerçekleşti (p: 0.54). Grup 1’de 14 (%32.5) grup 2’de ise 17 (%34) olguda ciddi morbidite

geliştiği görüldü. Mortalite ve ciddi morbidite üzerine latent sürenin anlamlı etkisi görülmedi

(p:0.54, p:0.67)

Sonuç: PPROM olgularında latent sürenin neonatal sonuçlara anlamlı etkisi gösterilmemiştir

ve maternal veya fetal iyilik hali güven verdiği sürece ekspektan yaklaşım uygun takip

yöntemidir.

Anahtar Kelimeler

eylem, erken doğum

The influence of spontaneous and induced labor in maternal and fetal outcomes in preterm prematüre rupture of membranes

Öz

Aim: We evaluated the effect of spontaneous and induced parturition in maternal and fetal

outcomes in preterm prematüre rupture of membranes (PPROM) and analyzed the influence of

the latent period in these results.

Materials-method: We analyzed the results of patients who were complicated with PPROM in

24-34 weeks of gestation between January 2014-January 2016 in our clinic.

Results: We collected 93 cases and in 43 patients (46%) the labor occurs spontaneously (Group

1) and in 50 cases (54%) we induced the labor due to maternal and fetal indications (Group 2).

The interval between when PPROM occurred, and labor was 5.8±2.1 days in group 1 and

8.3±3.5 days in group 2 (p:0,19). There was no significant difference between birthweights in

two groups. C-section was performed in 19 (%44.1) patients in group 1 and 37 (%74) cases

were delivered by C-section in group 2 (p: 0.03). Neonatal mortality was 9.3% in group 1 and

6% in group 2 (p:0.54). Severe morbidity was detected in 14 (%32.5) patients in group 1 and

17 (%34)in group 2. We did not show a significant effect of latency period into the severe

morbidity and mortality in newborns (p:0.54, p:0.67).

Conclusion: There was no relevant effect of latency period into the neonatal outcomes, and

expectant management should be used in PPROM cases if the maternal and fetal status is

reassuring.

Anahtar Kelimeler

newborn, parturition

Kaynakça

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