Erken ve geç başlangıçlı intrauterin gelişme geriliğinin perinatal sonuçları

Amaç: Bu çalışmanın amacı erken ve geç başlangıçlı İntrauterin gelişme geriliği (İUGG) perinatal sonuçlara etkisini ve aradaki farkları gösterilmesidir. Gereç ve Yöntem: Çalışmamız retrospektif bir çalışmadır. Çalışmamızda 01 Ocak 2015- 01 Ocak 2019 tarihleri arasında İUGG tanısıyla takibe 334 hasta erken ve geç başlangıçlı IUGG olmak üzere alt gruplara ayrıldı. Gelişme geriliği tipi, tanı aldığı gebelik haftası, tahmini fetal ağırlığı (TFA), preeklampsi varlığı, Doppler bulguları, doğum kilosu, doğum şekli, doğum haftası, 5.dk Apgar skoru, yenidoğan yoğun bakım ihtiyacı kayıt edildi ve tüm bu parametrelerin yenidoğanın olumsuz sonuçlarıyla ilişkisi ele alındı. Bulgular: Tanı konulan gebelik haftası ortalaması 30,9±4,5 (min-maks:18-39)’dır. Hastaların doğum haftası ortalaması 34,4±4,5 (min-maks:22-41)’dır. Hastalar tanı aldıkları gebelik haftasına göre <27+6, 28-31, 32-36, >37 hafta olarak dört grupta incelendi. Verilerimiz doppler bulgularının şiddeti ile perinatal sonuçların kötüleştiğini ortaya koymaktadır. Yine çalışmamız TFA<%3 persentil olmasının ve erken başlangıçlı IUGG olmasının fetüslerin perinatal sonuçlarını olumsuz etkilediğini gösterdi. Sonuç: Geç başlangıçlı preeklampsi IUGG’li bebeklerin perinatal sonuçlarını olumsuz etkilememektedir fakat erken başlangıçlı preeklampsi yenidoğan morbidite ve mortalitesindeki artışa neden olmaktadır. Bu sebeple erken başlangıçlı preeklampsinin eşlik ettiği erken başlangıçlı IUGG’li hastalar daha yakından takip edilmeli ve perinatal morbidite ve mortalite için uyanık olunmalıdır.

Anahtar Kelimeler:

fetal büyüme, prenatal tanı, fetal ultrasonografi

Perinatal outcomes of early and late onset intrauterine growth retardation

Purpose: The aim of this study was to show the effect of early and late onset intrauterine growth retardation (IUGR) on perinatal outcomes and the differences between them Materials and Methods: Our study is a retrospective study. 334 patients who were followed up with the diagnosis of IUGR between January 1, 2015 and January 1, 2019 were divided into subgroups as early and late onset IUGR. The type of growth retardation, the gestational week at diagnosis, the estimated fetal weight (EFW), the presence of preeclampsia, doppler findings, the birth weight, the delivery type, the birth week, the 5th minute Apgar score, the neonatal intensive care need were recorded and the relationship of all these parameters with the negative consequences of the newborn was discussed. Results: The average of the gestational week at diagnosis was 30.9 ± 4.5 (min-max: 18-39). The average of the gestational week at delivery was 34.4 ± 4.5 (min-max: 22-41). The patients were examined in four groups as <27 + 6, 28-31, 32-36,> 37 weeks according to the diagnosis time. Perinatal outcomes deteriorate with the severity of Doppler findings. Having EFW <3% percentil and early onset IUGR negatively affects the perinatal outcomes of fetuses. Conclusion: Late onset preeclampsia does not adversely affect the perinatal outcomes of fetuses with IUGR, but early onset preeclampsia causes an increase in neonatal morbidity and mortality. For this reason, patients with early onset IUGR accompanied by early-onset preeclampsia should be followed more closely and be aware of perinatal morbidity and mortality.

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