GECİKMİŞ UMBİLİKAL KORD KLEMPLEME VE KORD SIVAZLAMA UYGULAMALARININ PREMATÜRE YENİDOĞANLARDA ETKİLERİ

Prematüre yenidoğanlar fizyolojik ve yapısal olarak matür yenidoğanlardan farklıdır ve mortalite ve morbidite açısından yüksek riske sahiptirler.Doğumda gecikmiş kord klempleme ve göbek kordu sıvazlanması uygulamalarıyla prematürelerde yeterli kan hacmi ve etkili dolaşımınsağlanmasının yanında birçok fayda sağlanabilmektedir. Erken doğumun beraberinde getirdiği sağlık sorunlarını azaltma ve önleme üzerinde geçklempleme ve sıvazlama uygulamalarının etkili olduğu belirlenmiştir. Mevcut kanıtlar, geç kord klemplemesinin prematüre yenidoğanlardakiintraventriküler kanama, sepsis, nekrotizan enterokolit, kan transfüzyonu ihtiyacı, mortalite ve yoğun bakım ünitesinde yatış gibikomplikasyonları azalttığı yönündedir. Ayrıca prematürelerde kord sıvazlamasının kan transfüzyonu ihtiyacını azalttığı, morbidite oranınıdüşürdüğü ve oksijen ihtiyacını azalttığı bilinmektedir. Tüm bu faydalara rağmen, geç klempleme ve sıvazlama uygulamalarının klinikte rutinolarak uygulanmasının önünde hala engeller bulunmaktadır. Acil resüstasyonun gecikme düşüncesi engellerin başında yer almaktadır. Ayrıca buiki uygulamadan hangisinin daha etkin olduğu ve klinik uygulamada hangi durumlarda tercih edileceği de oldukça önemli bir konudur. Buderlemenin amacı, prematüre yenidoğanlarda doğum odasında umbilikal kord klempleme süresi ve kord sıvazlama uygulamaları ve etkilerihakkında literatür bilgisi kapsamında bilgi vermektir.

THE EFFECT OF DELAYED UMBILICAL CORD CLAMPING AND CORD MILKING ON PREMATURE NEWBORNS

Premature newborns are physiologically and structurally different from mature newborns and have a high risk of mortality and morbidity. Delayed cord clamping and umbilical cord milking at birth provide adequate blood volume and effective circulation in the prematurity as well as many benefits. It has been determined that the application of delayed clamping and cord milking on reducing and preventing the health problems brought by early childbirth is effective. Current evidence suggests that delayed cord clamping reduces complications such as intraventricular hemorrhage in premature newborns, sepsis, necrotizing enterocolitis, blood transfusion need, mortality and admission to the intensive care unit. It is also known that cord milking platelets in prematurity reduce blood transfusion need, decrease morbidity rate and decrease oxygen demand. Despite all these benefits, there are still barriers to routine application of late clamping and cord milking practices in the clinic. Emergency resuscitation is at the head of the delayed thought blocks. It is also a very important issue as to which of these two applications is more effective and in which cases clinical applications will be preferred. The aim of this review is to provide information about the duration of umbilical cord clamping and cord milking practices in the birth room for premature newborns as well as their effects on this field.

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