Hastanede Yatan Hiperemezis Gravidarum Tanılı Hastalarda Plasental Disfonksiyon ve Neonatal Sonuçların İncelenmesi

Özet Amaç: Hiperemezis gravidarumun (HG) gebelik sonuçları üzerindeki etkisine ilişkin kanıtlar hala belirsizdir. Bu çalışmada HG ile hastaneye yatırılan hastalarda plasenta ile ilişkili disfonksiyonlar ve neonatal sonuçlar retrospektif olarak incelenmiştir. Yöntemler: Bu çalışma Ocak 2015-Ocak 2020 tarihleri arasında hastanemizde tekil doğum yapan kadınlar arasında retrospektif olarak yapılmıştır. Olgu grubu olarak HG nedeniyle hastaneye yatırılıp doğum yapmış tekil gebeliği olan kadınlar alınmıştır. Kontrol grubu, HG nedeniyle hastaneye yatmadan doğum yapan tekil gebe kadınlardan oluşturuldu. HG nedeniyle hastaneye yatırılan ve HG nedeniyle hastaneye yatırılmayan hastaların yatış dosyaları aracılığıyla, gestasyonel diyabet, gestasyonel hipertansiyon, preeklampsi veya ölü doğum dahil olmak üzere plasenta disfonksiyonu ve gebelik yaşına göre küçük düşük doğum ağırlığı (SGA) gibi yenidoğan sonuçları ), erken doğum (PTB), yenidoğan yoğun bakım gerekliliği, 5 dk Apgar skorları incelendi. Bulgular: Ortalama gebelik yaşı HG grubunda 37,7 ± 1,5 hafta, kontrol grubunda 37,8 ± 1,4 hafta olarak belirlendi. HG nedeniyle hastaneye yatışın ardından ortalama gebelik haftası 10.6 ± 3.6 haftaydı. Gruplar arasında preeklampsi, PTB, doğum sonu kanama, doğum ağırlığı, GDM, yenidoğan yoğun bakım gereksinimi açısından anlamlı fark yoktu. HG nedeniyle hastaneye yatırılan hastaların doğumlarında anormal doğum ağırlığına sahip SGA bebeklerin daha sık görüldüğü saptandı (P=0,022). HG nedeniyle hastaneye yatırılan hastaların doğumlarında 5 dk Apgar skorları kontrol grubuna göre daha yüksekti (P=0.004). Sonuç: HG nedeniyle hastaneye yatışların plasental disfonksiyon riski oluşturmadığı sonucuna varıldı. Yenidoğan sonuçlarından SGA, HG'li annelerin bebeklerinde daha yaygındı. Buradaki beklentinin aksine HG nedeniyle hastanede yatan hastalarda 5 dk Apgar skoru daha yüksekti.

Anahtar Kelimeler:

Hiperemezis gravidarum, Plasenta disfonksiyonu, Neonatal sonuçlar

Examination of Placental Dysfunction and Neonatal Outcomes in Hospitalized Patients who have Hyperemesis Gravidarum Diagnosis

Background: Evidence on the effect of hyperemesis gravidarum (HG) on pregnancy outcomes is still unclear. In this study, placenta-related dysfunctions and neonatal outcomes in patients who were hospitalized with HG were retrospectively analyzed. Methods: This study was conducted retrospectively among women who had singleton deliveries in our hospital between January 2015 and January 2020. As the case group, women with singleton pregnancies who were hospitalized due to HG and delivered were included. The control group consisted of women with singleton pregnancies who delivered without hospitalization due to HG. Through the hospitalization files of the patients who were hospitalized due to HG and not hospitalized due to HG, neonatal outcomes such as placental dysfunction, including gestational diabetes, gestational hypertension, preeclampsia, or stillbirth, and low birth weight, small for gestational age (SGA), preterm birth (PTB), the necessity for neonatal intensive care, 5-min Apgar scores, were examined. Findings: The mean gestational age was determined as 37.7 ± 1.5 weeks in the HG group and 37.8 ± 1.4 weeks in the control group. The mean week of gestation upon hospitalization for HG was 10.6 ± 3.6 weeks. There was no significant difference between the groups regarding preeclampsia, PTB, postpartum hemorrhage, birth weight, GDM, or neonatal intensive care unit requirement. It was found that SGA babies with abnormal birth weights were seen more frequently in the deliveries of patients hospitalized for HG (P = 0.022). The 5-min Apgar scores were higher in the deliveries of patients hospitalized for HG than in the control group (P = 0.004). Conclusion: It was concluded that hospitalizations due to HG do not pose a risk of placental dysfunction. Of the neonatal outcomes, SGA was more common in the infants of mothers with HG. Contrary to the expectations herein, the 5-min Apgar scores were higher in hospitalized patients for HG.

Keywords:

: Hyperemesis gravidarum, Placental dysfunction, Neonatal outcomes,

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