Süleyman AKKAYA, Talip GÜL, Sertaç Ayçiçek, Cegerğun Polat, Hüseyin EDE

Kalp Hastalıkları Olan Gebelerin Değerlendirilmesi: Bir Üniversite Hastanesinin Üç Yıllık Deneyimi

Amaç: Bu çalışmanın esas amacı üçüncü basamak referans hastanesindeki kalp hastalığı olan gebeleri incelemek ve bunların fetal ve maternalözelliklerini değerlendirmektir.Gereç ve Yöntem: Retrospektif olarak 2013 ile 2015 yılları arasında daha önce kardiyak hastalığı olan 20 hafta veya daha üstü gebeliği olan gebelerincelendi. Fetal ve maternal klinik veriler uygun biçimde elde edildi.Bulgular: Hastanemizde toplam 6599 doğum gerçekleştirildi. Kardiyak hastalığı olan 120 gebe vardı. Gebeler arasında en sık görüleni romatizmalkalp hastalığı (n=66, %55) idi; ikinci en sık olan kalp ritim bozuklukları idi (n=15, %12,5). On iki hastada konjestif kalp yetmezliği, 12 hastadakonjenital kalp hastalığı, 8 hastada aort kapak veya aort patolojisi, dört hastada pulmoner hipertansiyon, iki hastada koroner arter hastalığı ve birhastada perikardiyal efüzyon vardı. Üç gebenin sol ventrikül ejeksiyon fraksiyonu (LVEF) %35’in altında iken 6 gebenin LVEF değeri %35 ile %50 arası,diğer gebelerin LVEF’si ise >%50 idi. Maternal ölüm görülmedi ancak 22 hasta (%18,3) postoperatif dönemde kardiyoloji yoğun bakım ünitesindetakip edildi. İki olguda (%1,66) neonatal mortalite gelişirken 6 olguda (%5) neonatal morbidite oluştu. En sık doğum yöntemi sezeryan yoluyladoğumdu (n=97, %81). Prematür doğum oranı %37,5 idi (n=45).Sonuç: Kalp hastalığı olan gebeler, bu alanda deneyimli kardiyoloji, anestezi ve doğum uzmanından oluşan bir takımın yakın takibi olduğu sürecematernal veya neonatal riskin azaltılmasıyla sağlıklı doğum yapma şansına sahiptirler.

The Evaluation of the Pregnants with Cardiac Disorders: Three-Year Experience of an University Hospital

Objectives: The main purpose of our study is to examine cases of pregnant patients with heart diseases in our tertiary referral hospital and to evaluate fetal and maternal outcomes. Materials and Methods: Pregnants with gestational age of 20 weeks or more and with any previous cardiac diseases were examined between 2013 and 2015 retrospectively. Fetal and maternal clinical data were collected accordingly. Results: In total, 6599 live births were carried out in our hospital. Of them, there were 120 pregnants with cardiac disease. Rheumatic valvular heart disease was the most common (n=66, 55%) disorder among the pregnants, followed by the heart rhythm disorders respectively (n=15; 12.5%). Twelve patients had congestive heart failure; twelve patients with congenital heart disease, eight patients with aort valve or aorta pathology; four with pulmonary hypertension, two with coronary artery disease and one with pericardial effusion. Three pregnants had left ventricular ejection fraction (LVEF) of less than 35%, six pregnants had LVEF between 35 to 50% and the rest of the pregnants had LVEF of >50%. Maternal death was not encountered, 22 patients (18.3%) were followed in cardiology intensive care unit postoperatively. Neonatal mortality was developed in 2

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