Mehmet Şükrü BUDAK, Cihan KAYA, Sedat AKGÖL, Mehmet Baki ŞENTÜRK, Mine KANAT PEKTAŞ, Neval Yaman GÖRÜK, Önder TOSUN

Prostaglandin E2 ile Doğum İndüksiyonu: Kadın Doğum ve Çocuk Hastalıkları Hastanesi Deneyimi

Amaç: Bu çalışma, hastanemizde son iki yılda prostaglandin E2 dinoprostone ile doğum indüksiyonu uygulanan term gebelik olgularını epidemiyolojik ve klinik bakımdan değerlendirmeyi amaçlamaktadır.Gereç ve Yöntemler: Bu çalışmada term gebelikte gebelik haftası ≥ 37 hafta , uygunsuz serviksi olan Bishop skoru ≤ 4 olan, oligohidramnios veya gün aşımı nedeniyle dinoproston ile doğum indüksiyonu almış 1477 gebeyi inceledik.Bulgular: Doğum indüksiyonu uygulanan gebelerde sezaryenle doğum ve taşisistol oranları sırasıyla % 26.4 ve % 5.8 olarak bulundu. Dinoproston indüksiyonu sonrası vajinal doğum yapanlarla dinoproston sonrası sezaryen doğum yapan hastalar kıyaslandı. Sezaryen grubunda anlamlı derecede daha düşük parite sayısı p=0.001 , daha uzun gebelik süresi p=0.001 , daha uzun latent doğum evresi p=0.001 daha fazla hiperstimülasyon riski p=0.02 vajinal doğum grubuna göre saptandı. Fetal distres % 46.7 , ilerlemeyen eylem % 31.3 ve sefalopelvik uyumsuzluk % 15.4 , sezaryenle doğumlar için en sıklıkla kaydedilen endikasyonlardı.Sonuç: Prostaglandin E2, servikal olgunluğu sağlamak için kullanılan etkin ve güvenilir ajandır. Her nekadar dinoproston sezaryenle doğum oranlarını arttırsa da fetal APGAR skorlarını etkilememektedir.

Anahtar Kelimeler:

Doğum indüksiyonu, prostaglandin E2, sezaryen

Labor Induction With Prostaglandin E2- Experience Of A Maternity And Children’s Disease Hospital

Aim: The present study aims to make an epidemiological and clinical assessment of term pregnancies that received labor induction by prostaglandin E2 dinoprostone within the last two years in our hospital.Material and Methods: We evaluated 1477 pregnants who had admitted to our hospital with term pregnancies gestational age ≥ 37 weeks , unfavorable cervix Bishop score ≤ 4 and had labor induction with dinoproston due to oligohydramnios or surmaturation in this study.Results: Cesarean delivery and tachysystole rates were 26.4 % and 5.8 % in pregnants with labor induction, respectively. The patients who delivered vaginally after dinoprostone induction were compared with those who delivered by cesarean section after dinoprostone induction. The cesarean section group had significantly lower parity p=0.001 , longer gestation p=0.001 , longer latent labor phase p=0.001 and higher risk of hyperstimulation p=0.02 than the vaginal delivery group. Fetal distress 46.7 % , failure for labor progression 31.3 % and cephalopelvic disproportion 15.4 % were the most frequent indications for cesarean delivery.Conclusion: Prostaglandin E2 is safe and efficient agent used for cervical maturation. Although dinoprostone increases cesarean delivery rates, it does not affect fetal APGAR scores.

Keywords:

Labor induction, prostaglandin E2, cesarean section,

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