Mustafa BEHRAM, Süleyman Cemil OĞLAK, Gökhan BOLLUK, Salim SEZER, Zeynep GEDİK ÖZKÖSE, Sema SÜZEN ÇAYPINAR, Züat ACAR, Fatma ÖLMEZ

Preeklampsi ile komplike olmuş gebelerde 24 saatlik idrarda proteinüri değerlerinin maternal ve perinatal sonuçlar üzerine etkisi

Amaç: Bu çalışmada, 24 saatlik proteinüri (PU) düzeyinin maternal, perinatal ve fetal sonuçlar ile ilişkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Preeklampsi tanısıyla yatırılan hastalar (n=92) 24 saatlik idrarda PU düzeylerine göre hafif (0,3-2 g), şiddetli (2-5 g) ve masif (≥5 g) PU olarak üç gruba ayrıldı. Hastalara ait bazı tanımlayıcı ve klinik bilgiler, doğum öncesi ve sonrası kan ve idrar biyokimyası sonuçları, doğum haftası ve hastaneye yatışlarına ait bilgiler, yenidoğanlara ait doğum bilgileri hasta dosyalarından elde edildi ve PU grupları arasında karşılaştırma ve ilişki analizleri yapıldı. Bulgular: Hafif, şiddetli ve masif PU gruplarında sırasıyla 41, 17 ve 34 hasta vardı. Hastaların doğum öncesi 24 saatlik PU miktarı ortalaması 4776,4±5616,6 mg/dL idi. Ayrıca, doğum sonrası, annelerde %20 oranında komplikasyon gelişti. Hafif ve şiddetli PU grupları arasında yaş, RDW ve hastaneye yatış ile doğum arasında geçen süre parametrelerinde anlamlı farklar bulundu ve şiddetli PU grubunda her üç parametre de daha düşüktü. Masif PU grubunda, hafif PU grubuna göre AST ve kordon kanı pH’si daha düşük; BUN, kreatinin ve beyaz küre sayısı daha yüksek idi. Şiddetli ve masif PU grupları arasında ise yalnızca kreatinin düzeyinde istatistiksel olarak anlamlı bir yükselme gözlendi. Sonuç: Şiddetli ve masif PU’da BUN, BK ve kreatinin seviyesi daha yüksek, kordon pH’si daha düşüktür. Böbrek fonksiyonlarını gösteren bu biyokimyasal testlerin uzun dönem maternal böbrek fonksiyonlarına etkisinin, ayrıca doğumdaki düşük kordon pH’sinin bebeklerin uzun dönem sonuçlarına etkisinin olup olmadığını belirleyebilmek için daha uzun süreli ve ileri araştırmalara ihtiyaç vardır.

Anahtar Kelimeler:

preeklampsi, proteinüri, maternal sonuçlar, perinatal sonuçlar

The effect of 24-hour urine protein values on maternal and perinatal outcomes in patients complicated with preeclampsia

Aim: This study aimed to evaluate the relation of 24-hour proteinuria (PU) levels with maternal, perinatal, and fetal outcomes. Material and Methods: Patients who were hospitalized with the diagnosis of preeclampsia (n=97) were divided into three groups as mild (0.3-2 g), severe (2-5 g), and massive (≥5 g) PU according to their 24-hour PU levels. Some descriptive and clinical data of the patients, prenatal, and postnatal blood and urine biochemistry results, inputs about the weeks of birth, and hospitalizations, birth information of the newborn were obtained from the patient files, and comparison and relationship analyzes were performed between three PU groups. Results: There were 41, 17, and 34 patients in the mild, severe, and massive PU groups, respectively. The mean 24-hour PU amount of the patients before delivery was 4776.4±5616.6 (mg/dL). Besides, 20% of the mothers developed complications in the postpartum period. Significant differences were found in age, RDW, and duration between hospitalization and birth among mild and severe PU groups, and all three parameters were lower in the severe PU group. In the massive PU group, AST and cord pH were lower than in the mild PU group; but BUN, creatinine, and WBC were higher. A statistically significant increase was observed only in the creatinine level in the massive PU groups, in comparison with the severe PU group. Conclusion: In severe and massive PU’s, BUN, WBC, and creatinine levels are higher, cord pH is lower. Long-term and further studies are needed to determine whether these biochemical tests that show renal function affect long-term maternal renal function, as well as the effect of low cord pH at birth on long-term outcomes of newborns.

Keywords:

preeclamspia, proteinuria, maternal outcomes, perinatal outcomes,

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