Tuncay BAL, Selim KARAKÜÇÜK, Seda nida Karaküçük

Amnion Sıvı İndeksi ile Yenidoğan Ağırlığının İlişkisi

Amaç: Bu çalışmanın amacı amniyotik sıvı indeksi (ASİ) değerinin, son adet tarihi, yaş ve parite durumundan etkilenip etkilenmediğini belirlemek ve ASİ, son adet tarihi, yaş ve parite durumu gibi değişkenler ile yeni doğan ağırlığı arasındaki ilişkiyi incelemektir.Gereç ve Yöntem: Necip Fazıl Şehir Hastanesi, Kadın Hastalıkları ve Doğum Kliniğine doğum ağrıları ile miadında ağrılı gebe olarak 01.08.2017-01.11.2017 tarihleri arasında başvuran ardışık 153 sağlıklı gebenin demografik özellikleri ve yeni doğan ağırlıkları kaydedildi. ASİ ≤5 cm (oligohidroamnioz) ve 5.1-24 cm (normal-hidroamnioz) olarak iki gruba ayrıldı. Normal grupta kendi arasında 5.1-10 cm, 10.1-15 cm, 15.1-20 cm ve 20.1-24 cm arası olmak üzere 4 grup olarak sınıflandırıldı. Bu değişkenlerin birbirleri arasındaki ilişki incelendi. Veriler SPSS 22.0 istatistik programı kullanılarak analiz edildi. Yapılan analiz sonucu p<0.05 istatiksel olarak anlamlı kabul edildi.Bulgular: Yaptığımız çalışmanın sonuçlarına göre SAT, yaş ve parite durumlarının oligohidroamnioz oluşumunda etkisinin olmadığı ve ASİ ortalamalarını etkilemediği bulundu. Yeni doğan ağırlığının ise SAT’tan etkilendiği (t/p=-3,002/0.03) ama yaş ve parite durumundan etkilenmediği saptandı. Ayrıca oligohidroamniozu olan gebelerin, normal ASİ değerine sahip gebelere göre daha düşük yeni doğan ağırlığına sahip bebekler doğurduğu (p<0.000) fakat normal ASİ değerine sahip gebelerin kendi içinde ASİ değeri ile yeni doğan bebek ağırlık ortalamaları arasında anlamlı bir ilişkinin olmadığı belirlendi.Sonuç: Yaptığımız çalışmada değerlendirdiğimiz demografik faktörlerin ASİ değerlerini ve yeni doğan ağırlığını etkilemediği ancak oligohidroamniozlu gebelerde yeni doğan ağırlığının anlamlı olarak daha düşük olduğu belirlendi. SAT ile ASİ arasındaki ilişkiyi inceleyen ve farklı bölgelerde yapılan çalışmaların farklı sonuçlara sahip olmasının sebebinin ASİ’nin genetik yapı, sosyoekonomik durum ve coğrafi konum gibi faktörlerden etkilenmesi olduğunu ve bu değişkenleri gözeterek yapılacak yeni nomogramlara ihtiyaç olduğu kanaatindeyiz.

Anahtar Kelimeler:

Amniyotik sıvı, Yeni doğan ağırlığı, Fetal ağırlık

The Correlation Between Amniotic Fluid and Neonatal Weight

Aim:This study focused on determining whether or not amniotic fluid index (AFI) values were affected by last menstruation period (LMP), age and parity and assessing the correlation between such variables as neonatal weight and AFI, last menstruation period, age and parity.Material and Method:The study was prospectively planned and designed in descriptive and cross-sectional model. 153 successive healthy pregnant women who presented to Necip Fazıl City Hospital, Clinic of Obstetrics and Gynecology as full term pregnant women with pain (FTPWP) between the 1st of August and the 1st of November, 2017 and who gave birth between 37th and 42nd weeks were included in the study. Written official permission to undertake this study was gained from the hospital and informed consent was obtained from each participant. Approval of the ethics committee of Elazığ Medicine Faculty was also obtained. Detailed obstetric history of the participants was taken. Whether or not they had a chronic disease history and family disease history was asked. Pregnancy weeks were separately determined according to both LMP and ultrasonography (USG) measurements. Tensions were measured. Following routine vaginal examination; full blood tests, biochemical tests and full urine tests were performed. All the patients received USG assessments following Non-Stress Test. For standardization, USG assessments were performed by the same doctor from radiology unit using Toshiba Aplio 300 ultrasound device and 3.5 mhz abdominal probe. With USG; biparietal circumference (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) were assessed. According to USG; estimated fetal weights were found (16). While performing AFI measurements, uterus was divided into 4 equal quadrants. Ultrasound probe is placedperpendicular to the floor and parallel to the maternal axis. The deepest bags in 4 different areas are separately measured and added (13-15). After labor, neonatal weightings were done with EKS 8006 weighing machine and the data were recorded.To the study, those healthy women who were 37-42 weeks pregnant and were aged between 17 and 35 years were recruited. Those women who had chronic diseases (diabetes, hypertension, renal diseases, collagenous tissue diseases), fetal anomalies, serious anemia, membrane rupture in medical examination and pregnancy history were excluded from the study. AFI values of the participant patients were classified into five groups: AFI values ≤5 cm, 5.1-10 cm, 10.1-15 cm, 15.1-20 cm and 20.1-24 cm. Two pregnant women with an AFI value of ≥25 cm were dropped off the study because one patient had diabetes and the other one had fetal anomaly. After birth, neonatal weights were sorted out four groups: <2800 gr, 2800-3299 gr, 3300-3799 gr and 3800-4500 gr and data were recorded for comparison.Results:In this study; it was explored that demographic factors that we assessed did not AFI values and neonatal weight but among pregnant women with oligohydramniosis, neonatal weights were considerably lower. The reason why studies that investigated the correlation between LMP and AFI and that were done in different geographical regions demonstrated different results may be that AFI is influenced by such factors as genetic structure, socio-economic status and geographical location and we are of the opinion that we need new nomograms that take these variables into consideration.Conclusion:As a conclusion; in this study we found that age and parity status did not affect AFI and neonatal weight. As for LMP, we identified that it increased neonatal weight; which was in line with literature results. On the other side, we found that increase in LMP did not influence AFI. When studies that were undertaken in different regions and that investigated the correlation between AFI and LMP were examined, we understood that there were different studies suggesting that as LMP increases; AFI reduces or increases or does not change. We are of the opinion that the reason behind these outcomes is that AFI may change depending on many factors such as ethnicity, geographical region, socio-economical factors. Therefore; there is a need for new nomograms that take these variables and geographical regions into consideration. Another result of this current study was that pregnant women with oligohidramnios presented lower neonatal weight as compared to those women with normal AFI values. Yet, comparison which was madeafter dividing pregnant women with normal AFI values into groups did not show any statistically significant difference in terms of neonatal weight.There is a need for wide scale and large series studies in which such factors as expanded age ranges, participation of pregnant women with polyhydramnios, socio-economical differences, smoking status are examined.

Keywords:

Amniotic fluid, Neonatal weight, fetal weight,

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