Preterm Erken Membran Rüptürü Olan Gebelerde Maternal ve Fetal Sonuçlar
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Dosyalar
Tarih
2010
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Erken membran rüptüründe (EMR) özellikle preterm dönemde neonatal mortalite ve morbidite oranları artar. Bu çalışmada EMR nedeniyle takip edilen 28-35 haftalık gebelerdeki maternal ve fetal sonuçlar incelendi. Gereç ve yöntem: Çalışmaya 54 hasta dahil edildi. Hastaların vajinal kültür, ultrason, lökosit, sedimentasyon, ateş, CRP takipleri yapıldı. Vakalar maternal ve fetal faktörler değerlendirilerek sezaryen yada normal doğumla doğurtuldu. Bulgular: 28-35 hafta arası EMR hastalarının tüm EMR hastalarına oranı %49 olarak tesbit edildi. Vakaların 13 (%24)’ünde enfeksiyon bulguları, 7 (%12,9)’sinde ikiz gebelik, 6 (%11,1)’sında makat prezentasyon, 4 (%7,4)’ünde transvers duruş, 3 (%5,5)’ünde plasenta previa tesbit edildi. 11 (%20,3) hastada yapılan tetkikler ve alınan hikaye ile herhangi bir neden tesbit edilemedi. Vajinal kültürde 4 hastada sırasıyla E. Coli, enterekok, stafilokok aereus ve psödomonas aeroginoza üredi. Hastaların ortalama doğum süresi 32,4 hafta idi. Hastaların 20 (%37)’si ilk 12 saat içinde, 13 (%24)’ü 12- 24 saatte, 16 (%29,6)’sı 24 saat- 1 hafta içinde doğumunu yaptı. 32 (%59,2) hasta normal doğum ile doğurtuldu. Hastaların 10 (%18,5) tanesine indüksiyon uygulandı. 22 (%40,8) hasta sezaryen ile doğurtuldu. Bebeklerin ortalama doğum kilosu 1845 gr idi. Bebeklerden 9 tanesi exitus oldu. Sonuç: Preterm EMR perinatal sonuçları etkileyen bir obstetrik problemdir. Hastaların dikkatli bir şekilde değerlendirilerek, gebelik haftası ve enfeksiyon bulguları başta olmak üzere tüm faktörler dikkate alınmalı ve uygun tedavi yöntemi planlanmalıdır.
Objective: Neonatal mortality and morbidity rates increase in pregnancy with premature rupture of membranes (PROM), especially in preterm period. Perinatal outcomes of women with PROM between 28-35 weeks were examined in this study. Methods: Fifty-four women were included into the study. Patients were monitored carefully by vaginal culture, ultrasound, leukocyte, erythrocyte sedimentation rate (ESR), presence of fever, C- Reactive Protein (CRP). Patients were delivered vaginally or by cesarean section following the evaluation of maternal and fetal factors. Results: Percentage of PROM between 28-35 weeks was found 49 %. Infection was found in 13 (24%) patients, twin pregnancy in 7 (12.9%), breech presentation in 6 (11.1%) cases. Four (7.4%) cases had transverse position, 3 (5.5%) had placenta previa. Although the laboratory examination and patients previous history, definite etiology cannot be found in 11 (20.3%) cases. E. Coli, enterococci, staphylococcus aereus and pseudomonas aeroginosa were grown in vaginal cultures of four cases respectively. Mean delivery week was 32.4 weeks. Delivery was occurred in 12 hours in 20 (37%) cases, in 12-24 hours in 13 (24%) cases and in 24 hours- one week in 16 (29.6%) cases. Thirty-two (59.2%) cases were delivered vaginally. Induction of labour with oxytocin was applied to 10 (18.5%) cases. Twenty-two (40.8 %) patients were delivered by cesarean section. Mean birth-weight was 1845 grams. Nine newborn were died before or during the follow up period. Conclusions: PROM is an obstetric problem effecting perinatal outcome. Appropriate treatment should be applied after patients were evaluated carefully, especially with respect to gestational age and presence of infection.
Objective: Neonatal mortality and morbidity rates increase in pregnancy with premature rupture of membranes (PROM), especially in preterm period. Perinatal outcomes of women with PROM between 28-35 weeks were examined in this study. Methods: Fifty-four women were included into the study. Patients were monitored carefully by vaginal culture, ultrasound, leukocyte, erythrocyte sedimentation rate (ESR), presence of fever, C- Reactive Protein (CRP). Patients were delivered vaginally or by cesarean section following the evaluation of maternal and fetal factors. Results: Percentage of PROM between 28-35 weeks was found 49 %. Infection was found in 13 (24%) patients, twin pregnancy in 7 (12.9%), breech presentation in 6 (11.1%) cases. Four (7.4%) cases had transverse position, 3 (5.5%) had placenta previa. Although the laboratory examination and patients previous history, definite etiology cannot be found in 11 (20.3%) cases. E. Coli, enterococci, staphylococcus aereus and pseudomonas aeroginosa were grown in vaginal cultures of four cases respectively. Mean delivery week was 32.4 weeks. Delivery was occurred in 12 hours in 20 (37%) cases, in 12-24 hours in 13 (24%) cases and in 24 hours- one week in 16 (29.6%) cases. Thirty-two (59.2%) cases were delivered vaginally. Induction of labour with oxytocin was applied to 10 (18.5%) cases. Twenty-two (40.8 %) patients were delivered by cesarean section. Mean birth-weight was 1845 grams. Nine newborn were died before or during the follow up period. Conclusions: PROM is an obstetric problem effecting perinatal outcome. Appropriate treatment should be applied after patients were evaluated carefully, especially with respect to gestational age and presence of infection.
Açıklama
Anahtar Kelimeler
Erken Membran Rüptürü, Maternal ve Fetal Sonuçlar, Premature rupture of membranes, Maternal and Fetal Outcomes
Kaynak
Tıp Araştırmaları Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
2
Künye
Köşüş, A., Köşüş, N., Güler, A., Çapar, M., (2010). Preterm Erken Membran Rüptürü Olan Gebelerde Maternal ve Fetal Sonuçlar. Tıp Araştırmaları Dergisi, 8(2), 69-75.
