Elif Ganime AYGÜN, Umut SARI, Özlem PATA, Talat Umut KUTLU DİLEK

İkinci Trimester Muayenesinde Tanı Alan İzole Aberran Sağ Subklavian Arter (ARSA): Nasıl Yaklaşalım?

Amaç: İzole ARSA olgularının gebelik takipleri ve postnatalprognozlarını tartışmayı amaçladık. Yöntemler: Hastanenin bilgisayar maternal-fetal tıp veri tabanı gözden geçirildi. 1859 tekil düşük riskli gebelikten toplam 11 ARSA vakası tespit edildi. Bu olguların tarama testleri, gebelik takipleri, doğum şekilleri ve postnatal muayeneleri gözden geçirildi. Sonuç: İzole ARSA'lı olguların medyan anne yaşı 32 idi. Ultrasonografi haftası medyan 21 hafta olup 11 olguda ek sonografik bulgu izlenmedi. Hastaların hiçbiri invaziv işlem kabul etmedi, 7 olguda cf-DNA (cellfree DNA) testi düşük riskli idi. Tüm olguların gebelik seyirleri komplikasyonsuz olup term doğumla sonuçlandı, neonatal muayenede patolojik bulgu ile karşılaşılmadı. Tartışma: İzole ARSA varlığında perinatal sonuçlar iyi olmakla beraber, 2. trimester muayenesinde saptanan ARSA sadece eşlik eden anöploidiler için bir soft marker değil ayrıca beraber olabildiği konotrunkal anomaliler ve 22q11.2 mikrodelesyonu bir uyarı işareti olarak dikkate alınarak hasta yönetiminde göz önünde bulundurulmalıdır. İnvaziv işlemden kaçınmak isteyen, timus, merkezi sinir sistemi ve konotrunkal anatominin optimal değerlendirildiği gebelere kesin tanı yöntemi olmamakla beraber 22q11.2 mikrodelesyonunu da kapsayan bir panel ile maternal kanda hücre dışı DNA testi önerilebilir.

Anahtar Kelimeler:

ARSA, aberran sağ subklavian arter, prenatal ultrason, ikinci trimester, anöploidi

The Measurement of Neutrophil Gelatinase Associated Lipocalin in Umbilical Cord Blood and the Assessment of Its Relationship with Neonatal Results

Objectives: In this study, the relationship of cord blood Neutrophil Gelatinase-Associated Lipocalin (NGAL) with neonatal diseases was investigated. Methods: NGAL levels were measured in the cord blood of 180 babies born between 2015 and 2016. Patients were classified according to maternal diseases, neonatal diseases and demographic characteristics. Obtained data were compared with cord blood NGAL levels. Results: In our study, the mean NGAL levels were 1283.99 ng/mL in boys and 1306.52 ng/mL in girls. Umbilical cord blood NGAL levels of infants diagnosed with intrauterine growth retardation (1913.4±2833.5 ng/mL) and prolonged premature rupture of membranes (2594.2±2037.1 ng/mL) were found to be statistically high (p0.05). Conclusions: Neutrophil Gelatinase-Associated Lipocalin, may be useful as a diagnostic biomarker in the evaluation of maternal and neonatal diseases. However, studies on larger patient populations are needed.

Keywords:

Neutrophil Gelatinase Associated Lipocalin, umbilical cord blood, newborn,

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