Turhan CAGLARL, Nuri DANİSMA, Dilek UYGURL, Sibel SAYGAN, Sibel ÖZLER, Derya SOLMAZL, Efser OZTASL

[Preterm Prematür Erken Membran Rüptürü (Pprom) Ve Preterm Eylem (Pte)'De Doğuma Kadar Geçen Süreyi Belirleyebilir Miyiz?

PPROM ve PTE olan gebelerin doğum haftasına kadar geçen süreye etki eden klinik, laboratuvar ve ultrasonoğrafik faktörleri belirlemeyi amaçladık. 2012-2014 yılları arasında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Perinatoloji Kliniğine PTE ve PPROM tanısı olan toplam 448 gebe alındı. 237'i PPROM ve 211'i PTE olan gebelerden oluşmaktaydı. PPROM ve PTE gruplarındaki gebeler serviks kültüründe üreme olan ve olmayanlar olarak kendi arasında alt gruplara ayrıldı. Serviks kültüründe üreme olan PPROM ve PTE gruplarında eylem başladıktan sonra doğuma kadar geçen sürelere etki eden risk faktörleri multivariate regresyon analizi ile belirlendi. Serviks kültüründe üreme olan PPROM grubunda; TVUSG ile ölçülen servikal uzunluk için OR=0,907, 95%Cl = 0,823-0,999 ve amniyotik sıvı indexi OR= 0,962, 95%Cl= 0,946-0,980, SK üreme olan PTE grubunda ise ilk gebeliği olanlarda OR= 1,533, %95Cl=1,054-2,230 ve manuel servikal açıklık için OR = 2,802, %95Cl =1,915-4,099 olarak belirlendi. PPROM ve PTE gruplarda sırası ile serviks kültüründe üreyen mikro-organizmalara baktığımızda her iki grupta da en çok üreyen organizma kandida 43 (%40,95) - 38 (%43,67) ve ikinci en sık üreme olan organizma ise E.coli 38 (%36,19) - 33 (%37,93) idi. Gruplar arasında serviks kültüründe üreyen mikro-organizma açısından fark yoktu. PPROM grubunda, servikal uzunluk ve amniyotik sıvı miktarı doğuma kadar geçen süreyi etkileyen faktörleridir. PTE grubunda ise manuel servikal açıklık ve ilk gebeliği olanlar eylem başladıktan sonra doğuma kadar geçen süreyi etkileyen en önemli faktörlerdir.

Can We Determine the Time Elapsed until the Birth in Preterm Premature Rupture of Membranes (Pprom) and Preterm Labor (Pte)?

We aimed to determined; affect of clinical, laboratory, and ultrasonographic factors the time elapsed until the birth in midtrimester PPROM and PTE. Total 448 PPROM and PTE patients were conceived which applicant the Perinatology Department of Zekai Tahir Burak Women's Health Education and Research Hospital between 2012-2014 years. PPROM group consisted of 237 patients; PTE group consisted of 211 patients. PPROM and PTE groups were divided into subgroups as cervical culture positive and negative PPROM and PTE groups. Risk factors of until the time of birth was determined by multivariate regression analysis in cervical culture positive PPROM and PTE groups. Cervical length measured by TVUSG=0,907, 95% Cl = 0,823-0,999 and amniotic fluid index (or= 0,962, 95% Cl= 0,946-0,980. were determined risk factors of until the time of birth in cervical culture positive PPROM group. First pregnancy OR= 1,533, 95%Cl=1,054-2,230 and manual cervical dilation OR = 2,802, 95% Cl =1,915-4,099 were determined risk factors of until the time of birth in cervical culture positive PTE group. When we look at most of reproducing micro-organism; first Candida 43 (40,95%) -38 (43,67%) and second E. Coli 38 (36,19%)- 33 (37,93%), respectively in PPROM and PTE group. Reproducing micro-organism in cervical culture was not different between the groups. Servical lenght and AMI have been affected the the time of birth in PPROM group. Manuel servical space and first pregnancy have been affected the time of birth in PTE group.

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