Sezeryan Doğumun Yenidoğan Genel Hareketleri Üzerine Etkisinin İncelenmesi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, Sezaryen (S) doğum sırasında kullanılan anestezik maddelerin doğum sonrası ilk 48 saat içinde sağlıklı, tam zamanlı doğan bebeklerin genel hareket (GMs) kaliteleri üzerine olan etkisini araştırmaktır. Ayrıca doğum şekline göre anne ve bebeğe ait peri-prenatal koşulları, bu koşullarla GMs motor Optimalite Skorları arasındaki ilişkiyi incelemektir. YÖNTEM ve GEREÇLER: Çalışmaya herhangi bir risk içermeyen gebelik ve intrauterin sürecinin ardından 37- 40 haftayı tamamlayarak komplikasyonsuz bir doğum sonucunda doğan 60 tam zamanlı doğan bebek ve anneleri dahil edildi. Bebekler doğum şekillerine göre 30 Normal Spontan Vajinal Yol (NSVY) ve 30 elektif S ile doğan bebekler olarak sınıflandırıldı. GMs motor Optimalite Skorları bebeklerin video görüntüleri üzerinden spontan hareketlerinin GMs Detaylandırılmış Motor Optimalite Analizi ile puanlandırılmasıyla belirlendi. Ayrıca, doğum şekline göre bebeklerin GMs motor optimalite skorları ile gebelik, doğum ve yeni doğana ait optimalite değerlendirmeleri arasındaki ilişki incelendi. Pre-perinatal koşullar doğum şekline göre karşılaştırıldı. BULGULAR: NSVY ile doğan bebeklerin ilk 48 saat içindeki motor optimalite skorlarının S ile doğan bebeklerden daha yüksek olduğu bulundu (p<0.05). NSVY ve S grubundaki annelerin gebelik koşulları ve yenidoğanın fizyolojik sağlık hali açısından optimaliteleri arasında fark olmadığı görüldü (p>0.05). Doğum optimalitesi NSVY ile doğumda S dan daha yüksek bulundu (p<0.05). Doğum şekline göre bebeklerin motor optimaliteleri ile peri-prenatal koşulları arasında ilişki görülmedi. TARTIŞMA ve SONUÇ: Sezeryan doğum sırasında kullanılan anestezik maddeler doğumdan sonraki ilk 48 saatte yeni doğanın nörodavranışsal durumunu etkilemektedir.

Anahtar Kelimeler:

Yeni doğan nörodavranış, Prechtl, genel hareketler, anestezi, sezeryan, vajinal doğum

Investigation of the Effects of Cesarean Section on General Movements of the Newborn

INTRODUCTION: This study aimed to analyse the effect of anaesthetics used during Caesarean Section (CS) on the General Movements (GMs),quality of healthy full-term infants in the postnatal first 48 hours, the peri-prenatal conditions of mothers and infants, and the relationship between these conditions and GMs motor Optimality Scores (OS) according to type of birth. METHODS: This study included 60 term infants born without any birth complications after completing 37–40 weeks of non-risky pregnancy and intrauterine process, along with their mothers. The infants were allocated as 30 of them born by Normal Spontaneous Vaginal Delivery (NSVD) and 30 of them born by elective CS. Infants’ GMs were assessed in detail in the first 48 hours using Prechtl’s Method; this assessment yielded their OS. The relationship between infants' GMs motor OS and pregnancy, birth, and infants' optimality assessments was examined, and pre-perinatal conditions were compared according to type of birth. RESULTS: Motor OS in the first 48 hours were higher for infants born by NSDV than for those born by CS (p<0.05). No difference was found between mothers’ pregnancy conditions and neonates’ physiological health optimality in the two groups (p>0.05). Birth optimality was higher in NSVD group than in CS group (p<0.05). No relationship was found between infants' motor optimality and peri-prenatal conditions according to type of birth. DISCUSSION and CONCLUSION: Anaesthetics used during CS affect infants' neurobehavioral status in the postnatal first 48 hours.

Keywords:

: Infant neurobehavior, Prechtl, general movements, anaesthesia, caesarean, vaginal delivery,

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