Preeklamptik gebelerde sistolik-diyastolik kan basıncı değerleri, idrar protein miktarı ve doppler bulgularının perinatal sonuçlara etkisi

Amaç : Preeklamptik gebelerde, başvuru sistolik- diyastolik kan basıncı değerleri, idrar protein miktarı ve Doppler ultrasonografi bulgularının perinatal sonuçlara etkisinin araştırılması. Gereç ve Yöntem : Ocak 2004–Aralık 2008 tarihleri arasında arasında Ege Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğine başvuran preeklampsi olguları retrospektif olarak değerlendirildi. Çalışmada karşılaştırılan klinik parametreler; gebelik haftası, doğum ağırlığı, Doppler ultrasonografi bulguları, idrar protein miktarları, 1. ve 5. dakika apgar skorları ve amniyon mayi indeksi idi. İstatistiksel analiz için SPSS 13.0 paket programı, korelasyonlar için varyans analizi ve ki kare testi kullanıldı. p< 0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya dahil edilen gebelerin (n=74) yaş ortalaması 29.09 ± 5.52 idi. Başvuru tansiyonlarına bakıldığında 37 gebenin (50%) sistolik tansiyonu 160 mm/Hg ve/veya üstünde iken, diyastolik tansiyonları 110 mm/Hg veya üstünde olan 6 gebe (8.1%) mevcuttu. 24 saatlik idrar protein değeri 300 mg – 1 gr arasında olan gebe sayısı 17 (23%) iken; 1 gr – 2 gr arasındaki gebe sayısı 18 (24%), 2 gr veya üzerinde olan gebe sayısı 39 (52.7%) idi. Doppler akımlarına bakıldığında; kan akımları normal olan gebe sayısı 42 (56.8%) iken, arteriyel kan akımı anormal olan gebe sayısı 28 (37.8%), venöz akımları anormal olan gebe sayısı 4 (5.4%) idi. Yüksek diastolik kan basıncı değerleriyle, venöz Doppler bulguları arasında istatistiksel olarak anlamlı korelasyon mevcut idi (p< 0.05). Yüksek diastolik basınç değerleri ayrıca oligohidramnioz ve doğum kilosu ile de korele idi (p< 0.05). İdrar protein miktarı düşük grup ( 0.05), venöz sistem anormal grup ile diğer iki grup arasında istatistiksel olarak anlamlı bir fark mevcuttu (p< 0.05). Sonuç: Maternal diyastolik basınç değerleri, idrar protein miktarı ve Doppler ultrason bulguları perinatal sonuçları etkilemektedir.

The effects of systolic- diastolic blood pressure, urine protein excretion and doppler findings on perinatal outcome in preeclamptic women

Aim : To evaluate the effects of maternal systolic- diastolic blood pressure at first admission, urine protein excretion and Doppler findings on perinatal outcome in preeclamptic women. Material and Methods: 196 preeclamptic women who admitted to the Ege University School of Medicine Obstetrics and Gynecology Clinic and hospitalized between January 2004 and December 2008 were investigated retrospectively. Investigations included blood pressure values at first admission, urine protein excretion, Doppler findings, intrauterine growth restriction, oligohydramnios and their effects on perinatal outcomes. 74 pregnancies with sufficient data were included in the study. The clinical correlations used in the study were gestational week at birth, birth weight, Doppler sonographic findings, urine protein values, 1 and 5 minute apgar scores, and amniotic fluid index. The SPSS 13.0 programme was used for statistical analysis. Varians analysis and Chi- square test were used for correlations and p< 0.05 value was accepted as statistically significant. Results: The mean age of the pregnant women was 29.09 ± 5.52. Systolic blood pressure for 37 was (50%) ≥ 160 mm/Hg, and 6 had (8.1%) diastolic blood pressure at ≥ 110 mm/Hg. There were 17 (23%) whose urine protein excretion in 24 hours was between 300 mg- 1 gr; 18 (24%) had output between 1 gr- 2 gr and 39 (52.7%) had ≥ 2 gr. There were 42 pregnant women (56.8%) with normal Doppler findings, 28 (37.8%) with abnormal arterial system and 4 (5.4%) with abnormal venous system. There was a statistically significant correlation between high diastolic blood pressure and abnormal venous Doppler findings (p< 0.05). High diastolic blood pressure was also correlated with oligohydramnios and birth weight (p< 0.05). There was a statistically significant difference between the urine protein excretion ≥ 2 gr group and the < 2 gr group in birth weights, birth weeks, as well as 1 and 5 minute apgar scores (p< 0.05). Intrauterine growth restriction and oligohydraminos were significantly higher in the abnormal venous system group than the other (p< 0.05) group. There was no difference in 1 and 5 minute apgar scores between the normal doppler group and the abnormal arterial system group (p> 0.05), however, there was a statistically significant difference between the abnormal venous system group and the other two groups (p< 0.05) Conclusion: Maternal diastolic blood pressure, urine protein values and doppler findings effect perinatal outcome.

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