Birinci trimester subkoryonik hematom boyutunun 2B ve 3B ultrason ölçüm tekniği ile ölçümünün olumsuz gebelik sonuçlarına etkisi var mıdır?

Amaç: Subkoryonik hematom (SKH) boyutunun 2B ve 3B ultrason ile ölçülmesinin olumsuz gebelik sonuçlarına etkisini değerlendirmeyi amaçladık.Yöntemler: Yüz elli sekiz SKH olan gebe çalışmaya alındı. SKH tanısı ilk trimesterde, 6. ve 14. gebelik haftaları arasında, 2 ve 3 boyutlu ultra-sonografik yöntemlerle konuldu. SKH olan gebelerin düşük, intrauterin fetal ölüm [IUFÖ] ve preterm doğum [PD] gibi olumsuz gebelik sonuçları belirlendi. SKH ile düşük, intrauterin fetal ölüm ve erken doğum arasındaki ilişkiyi belirlemek için lojistik regresyon analizleri yapıldı.Bulgular: Primipar ve multipar gebeler arasında vücut kitle indexi, 2B ultrasonografik hematom boyutları, 3B ultrasonografik hematom boyutları ve gebelik sonuçları açısından istatistiksel olarak anlamlı bir fark yoktu. SKH olan primiparlarda düşük/ IUFÖ hızı %4,6, PD hızı %6,9 ve miad doğum hızı %88,5 idi. SKH olan multiparlarda ise düşük/ IUFÖ hızı %7, PD hızı %3,5 ve miad doğum hızı %89,5 idi. 2B ve 3B hematom büyüklüğü ile IUFÖ ve PD arasında anlamlı bir ilişki gözlenmedi. Lojistik regresyon modelinde ölçüm tekniğinden bağımsız olarak SKH’un ≥500 cm3 olması erken doğumla ilişkili risk faktörü olarak bulundu (OR:1,008, %95 CI: 1,002-1,012, p=0,006). Sonuç: SKH boyutunun PD riskini artırdığını belirledik. SKH'un teşhis ve takibinin 2B ve 3B ultrasonografik ölçüm ile yapılmasının düşük, IUFÖ ve PD gibi olumsuz gebelik sonuçlarına etkisinin olmadığını gördük.

Anahtar Kelimeler:

Subkoryonik Hematom, 3 boyutlu, 2 boyutlu, ultrason, olumsuz gebelik sonuçları

Does the measurement of the size of the first trimester subchorionic hematoma by 2D and 3D ultrasonographic techniques have any effect on adverse pregnancy outcomes?

Aim: We aimed to evaluate whether the measurement of subchorionic hematoma (SCH) size with 2D and 3D ultrasonography affects adverse pregnancy outcomes. Methods: One hundred fifty-eight pregnant patients having SCH were enrolled in the study. The diagnosis of SCH was made by 2D and 3D ultra-sonographic methods in the first trimester, between 6th and 14th gestational weeks. Patients having SCH were determined with adverse pregnancy outcomes such as miscarriage, intrauterine fetal death (IUFD), and preterm labor (PL). Logistic regression analyses were applied for the relationship of miscarriage, IUFD, PL, and SCH. Results: There were no statistically significant differences for body mass index, 2-D hematoma sizes, 3-D hematoma sizes, and pregnancy outcomes between the groups. Miscarriage/IUFD rate was 4.6%, PL rate was 6.9%, and the term delivery rate was 88.5% in the primiparas having SCH. Miscarriage/IUFD rate was 7%, PL rate was 3.5%, and the term delivery rate was 89.5% in the multiparas having SCH. No significant association was observed between 2D and 3D hematoma sizes and IUFD and PL. In the logistic regression model, SCH ≥ 500 cm3 was found to be a risk factor associated with PL, not regarding the measurement technique (OR:1.008, 95% CI: 1.002-1.012, p=0.006). Conclusion: We determined that SCH size increases the risk of PL. We observed no effect of diagnosis and follow-up of SCH, by 2D and 3D ultrasonography techniques on adverse pregnancy outcomes such as miscarriage, IUFD, and PL.

Keywords:

Subchorionic Hematoma, three dimensional, two dimensional, ultrasound, adverse pregnancy outcome,

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