Sevcan SARIKAYA, Emre UYSAL, Abdurrahman MERT, Muslu Kazım KÖREZ, Oğuzhan GÜNENC, Burhan SAVAŞ, Seyran COŞAR, Elif Ceyda SERİN

Plasenta ve Umblikal Kord Özellikleri ile Fetal Distress Arasındaki İlişki

Amaç: Çalışmamızda; plasenta kalınlığı ve ağırlığı, umblikal kord çapı ve uzunluğunun ve plasentanın kord insersiyo bölgesinin fetal distress ile ilişkisini ve bunun bebeğin doğum APGAR skoru ve kord kan gazı üzerindeki etkilerini araştırdık. Gereç ve yöntem: Çalışmamızda hastanemizde doğum yapan, gestasyonel hastası 37+0- 41+6 hafta arasında olan, 18-45 yaş arasındaki hastaların verileri prospektif olarak kayıt altına alındı. Fetal distress nedeni ile sezaryen yapılan 200 hasta (Grup I) ve daha önce sezaryen ile doğum yapması nedeni ile elektif sezaryen planlanan 200 hasta (Grup II) olmak üzere toplam 400 hastanın verileri kayıt altına alındı, 15 hasta çalışma dışı bırakıldı, 385 hasta çalışmaya dahil edildi. Olguların demografik özellikleri, plasenta kalınılığı ve ağırlığı, umblikal kord çapı ve uzunluğu, umblikal kordun plasentaya insersiyo bölgesi, yenidoğanın cinsiyeti, birinci ve beşinci dakika Apgar skoru, ve umblikal kord kan gazı değerleri kaydedildi. Tüm parametreler her iki grup arasında karşılaştırıldı. Bulgular: Her iki grup karşılaştırıldığında Grup I’deki anne yaşının (29.13 ± 5.20 vs. 25.67 ± 5.27, p<.001) ve body mass index (30.10 ± 4.20 vs. 27.15 ± 3.97, p<.001) değerinin Grup II’ den istatistiksel olarak daha düşük olduğu saptandı. Hemoglobin (11.83 ± 1.27 vs. 12.16 ± 1.41, p=.019) ve white blood cell (10.17 ± 2.37 vs. 10.76 ± 2.57, p=.020) değerinin ise Grup I’de Grup II’den daha yüksek olduğu görüldü. Plasenta ağırlığının (515 [IQR, 430 – 582.5] vs. 610 [IQR, 520 – 710], p<.001) ve kalınlığının (2.42 ± 0.91 vs. 2.72 ± 0.91, p<.001) Grup I hastalarda Grup II hastalara göre daha düşük olduğu görüldü. Grup I hastalarda umblikal kord uzunluğunun (24.02 ± 10.02 vs. 57.35 ± 13.95, p=.008) Grup II’den anlamlı olarak kısa olduğu görüldü. Sonuç: Genç anne yaşı, düşük body mass index, kısa umblikal kord, düşük plasental ağırlık ve ince plasentanın fetal distress ile pozitif korelasyon gösterdiği saptanmıştır. Bu özellikleri taşıyan gebelerin fetal distress açısından daha dikkatli takip edilmesi, daha iyi perinatal ve neonatal sonuçlar için önem taşımaktadır.

Anahtar Kelimeler:

: Fetal distress, plasenta kalınlığı, plasenta ağırlığı, umblikal kord uzunluğu, umblikal kord çapı

The Relationship Between Placenta and Umbilical Cord Characteristics and Fetal Distress

Aim: In our study, we investigated the relationship between placental thickness and weight, umbilical cord diameter and length, and placental cord insertion site with fetal distress, and its effects on the baby's APGAR score and cord blood gas. Materials and methods: In our study, the data of the patients who gave birth in our hospital, whose gestational patient was between 37+0- 41+6 weeks, and between the ages of 18-45 were recorded prospectively. 385 patients (196 patients fetal distress and 189 patients elective cesarean section) were included in the study. Demographic characteristics, placental thickness and weight, umbilical cord diameter and length, insertion site of the umbilical cord into the placenta, newborn gender, first- and fifth-minute. Apgar score, and umbilical cord blood gas values were recorded. All parameters were compared between both groups. Results: When both groups are compared, Maternal age (29.13 ± 5.20 vs. 25.67 ± 5.27, p<.001) and body mass index (30.10 ± 4.20 vs. 27.15 ± 3.97, p<.001) were found to be statistically lower in Group I than Group II. Placental weight (515 [IQR, 430 – 582.5] vs. 610 [IQR, 520 – 710], p<.001) and thickness (2.42 ± 0.91 vs. 2.72 ± 0.91, p<.001) were found to be statistically lower in Group I than Group II. In Group I patients, umbilical cord length (24.02 ± 10.02 vs. 57.35 ± 13.95, p=.008) was found to be significantly shorter than Group II. Conclusion: Young maternal age, low body mass index, short umbilical cord, low placental weight and thin placenta were found to be positively correlated with fetal distress. More careful follow-up of pregnant women with these features in terms of fetal distress is important for better perinatal and neonatal outcomes.

Keywords:

Fetal distress, placenta thickness, placenta weight, umbilical cord length, umbilical cord diameter,

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