Muhammed Sıraç GÜNEŞ, Süleyman Cemil OĞLAK

Geç-term ve post-term gebeliklerin fetal Doppler akım özelliklerinin karşılaştırılması

Amaç: Çalışmanın amacı, 41 hafta ve üzeri komplike olmayan geç-term ve post-term gebeliklerde fetal Doppler akım özelliklerini karşılaştırmak ve bunların doğum sonrası sonuçlara etkisini değerlendirmektir. Gereç ve Yöntem: Ümraniye Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Polikliniği’ne başvuran düşük risk grubundaki toplam 98 geç-term ve post-term tekiz gebe çalışma grubuna alındı. Tüm gebelerin gebelik haftası, son adet tarihi ve erken dönem ultrasonografi verileri ile teyit edilerek hesaplandı. Hastalara sonografik değerlendirme ile tahmini fetal kilo, amniyotik sıvı hacmi, biyofizik profil ve Doppler (fetal umbilikal arter, orta serebral arter ve maternal uterin arter) incelemeleri yapıldı. Orta serebral ve umbilikal arterlerde pulsatilite ve rezistans indeksleri ile serebroplasental oran Doppler ultrasonografi ile günlük olarak değerlendirildi. Bu gebelerin doğum şekli, yenidoğan doğum kilosu, doğumda mekonyumlu amniotik sıvı varlığı, NST’de fetal distres bulgusu varlığı, yenidoğan 5. dakika Apgar skoru, fetal distres varlığında kordon kan gazı pH değeri ve yenidoğan yoğun bakım ünitesi ihtiyacı olup olmadığı kayıt altına alındı. Bulgular: Her iki grubun ortalama uterin arter ve ortalama umbilikal arter pulsatilite indeksleri ile orta serebral arter rezistans indeksi değerleri arasında fark gösterilememiştir. Post-term grupta ortalama umbilikal arter rezistans indeksi ve orta serebral arter pulsatilite indeksi değerleri anlamlı olarak daha düşük bulunmuştur. Geç-term grupta serebroplasental oran daha düşük olsa da bu farklılık istatistiksel olarak anlamlı değildir. Her iki grupta, bebeklerin yeni doğan yoğun bakım ünitesine yatma oranları arasında anlamlı bir fark saptanmadı. Sonuç: Anormal ve normal serebroplasental oran sonucuna göre yenidoğanın iyilik hali ve yoğun bakım ünitesinde yatma ihtiyacı açısından anlamlı ilişki saptanmamasına rağmen daha geniş serili çalışma gruplarına ihtiyaç olduğu düşünülmektedir.

Comparison of fetal Doppler blood flow characteristics of late-term and post-term pregnancies

Aim: The aim of this study was to compare fetal Doppler flow characteristics in uncomplicated lateterm and post-term pregnancies over 41 weeks and to evaluate their effect on postpartum outcomes. Materials and Methods: A total of 98 late-term and post-term singleton pregnant women in the low risk group who were admitted to the Umraniye Education and Research Hospital Obstetrics and Gynecology Polyclinic were included in the study group. The gestational week of all pregnant women was calculated by confirming their last menstrual period and early period ultrasonography data. Estimated fetal weight, amniotic fluid index, biophysical profile and Doppler examinations (fetal umbilical artery, middle cerebral artery and maternal uterine artery) were performed by sonographic evaluation. The pulsatility and resistance indices of the middle cerebral and umbilical arteries and cerebroplacental ratio were evaluated daily by Doppler ultrasonography. Delivery type, birth weight, amniotic fluid with meconium at birth, presence of fetal distress finding in NST, 5th minute Apgar score, cord blood pH value in presence of fetal distress and neonatal intensive care requirement of newborns were recorded. Results: There was no difference between the mean values of uterine artery pulsatility index, umbilical artery pulsatility index and middle cerebral artery resistance index in both groups. In the postterm group, the mean umbilical artery resistance index and middle cerebral artery pulsatility index values were significantly lower. Although cerebroplacental ratio was lower in the late term group, this difference was not statistically significant. In both groups, no significant difference was found between the rate of hospitalization in the intensive care unit of newborns. Conclusion: Although there is no significant relationship between abnormal and normal cerebroplacental ratio results in terms of the well-being of the newborn and need for hospitalization in the intensive care unit, larger series of study groups are needed.

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