Kalp hastalığı olan ve olmayan gebelerde maternal ve fetal sonuçlar açısından bir fark var mı?

Amaç: Bu çalışmada kalp hastalığı olan ve olmayan gebelerdeki maternal ve fetal sonuçlar kıyaslandı. Yöntem: Kalp hastalığı olan 54 gebe ile olmayan 57 gebe değerlendirildi. Yaşları, gebelik sayıları, mevcut kardiyak patoloji ve evresi, mevcut olan semptomlar, doğum şekli ve haftası, bebek kiloları ve APGAR skorları incelendi. Toplanan veriler sıklık ve ortalama ± standart deviasyon şeklinde analiz edildi. Bulgular: Kalp hastalığı olan gebelerin 13’ü sezaryen ile doğum yaparken 41’i vajinal yolla doğurtuldu. 10 (% 18,5) hastaya indüksiyon uygulandı. Ortalama doğum ağırlığı 3037 ± 540 (1500-4500) g idi. Kalp hastalığı olmayan gebelerin 40’ı (% 70,2) normal doğum ile doğurtuldu. 17 hastaya sezaryen uygulandı. Hastaların 18’ine (% 31,5) indüksiyon uygulandı. Ortalama doğum kilosu 3250 ± 626 (1800-4300) g idi. Normal doğum, sezaryen, indüksiyon uygulanması ve doğumdaki bebek kiloları açısından gruplar arasında farklılık tesbit edilmedi. Kalp hastalığı olan gebelerin yedisinde obstetrik, birinde medikal komplikasyon gelişti. Anne ölümü oluşmadı. Obstetrik komplikasyonların altı tanesi preterm doğum, birinde erken membran rüptürü şeklinde idi. Hastaların birinde kalp yetmezliği semptomları oluştu. Doğum sonrası bebeklerden hiçbirinde konjenital kalp hastalığı tesbit edilmedi. Kalp hastalığı olmayan gebelerde ise medikal herhangi bir komplikasyon gelişmedi. İki hastada preterm doğum (34 ve 35 hafta), bir hastada inutero fetüs ölümü, bir bebekte mekonyum aspirasyonuna bağlı ölüm görüldü. Erken doğum eylemi, kalp hastalığı olan grupta anlamlı şekilde daha fazla görüldü. Fetal ve neonatal mortalite açısından gruplar arasında anlamlı farklılık tesbit edilmedi. Sonuç: Dikkatli takip ile kardiak hastalığı olan gebelerde maternal ve fetal sonuçlar kardiyak hastalığı olmayan gebelerden farklı değildir.

Is there any difference between pregnancy with cardiac disease and normal pregnancy for maternal and fetal outcomes?

Objective: The aim of this study was to compare pregnant women with and without cardiac disease and evaluate maternal and fetal outcomes. Methods: Fifty-four women with heart disease and fifty-seven healthy pregnant women were evaluated. Age of the patients, previous pregnancies, parity, present cardiac pathology and stage, present symptoms, type of labor, gestational week during labor, birth weight, APGAR scores were examined. All collected data was analyzed in the form of percentages (relative frequencies) and the mean ± Standard Deviation of variables. Results: Forty-one cases delivered vaginally while thirteen cases underwent cesarean section in cardiac disease group. Induction of labor was applied ten cases. Mean birth weight was 3037 ± 540 (1500- 4500) g. In healthy group forty women delivered vaginally and in eighteen women labour started by induction. Seventeen cases were delivered by cesarean section. Mean birth weight was 3250± 626 (1800-4300) g. There was no difference between groups in terms of types of labor and birth weights. In cardiac disease group seven women had obstetric and one woman had medical complications. No maternal mortality was occurred. Obstetric complications included, six preterm labor, one premature rupture of membranes. Medical complication encountered was one cases of cardiac failure. In healthy group there was no medical complication. Two had preterm labour, one had in utero exitus and one perinatal death due to meconium aspiration. Preterm labor was seen significantly higher in cardiac disease group. There was no any significant difference between groups in terms of fetal and neonatal mortality. Conclusion: With careful follow-up maternal and fetal outcomes are not different in pregnant women with cardiac disease from healthy women.

Kaynakça

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