Preeklamptik Olgularda Vücut Kitle İndeksi ve Gebelik Haftasının Magnezyum Tedavisi Üzerine Etkileri

Preeklampsi veya eklampsi nedeni ile Magnezyum sülfat (MgSO4) tedavisi alan hastaların vücut kitle indeksi (VKİ) ve gebelik haftalarının serum magnezyum (Mg) düzeyine etkilerinin araştırılması amaçlanmıştır. Ocak 2015-Temmuz 2017 tarihleri arasında kliniğimizde preeklampsi veya eklampsi nedeni ile magnezyum sülfat (MgSO4) tedavisi alan 28-41. gebelik haftaları arasındaki 130 hasta çalışmaya dahil edildi. Bu hastaların VKİ ve gebelik haftaları hesaplanarak 6., 12., 18. ve 24. saatlerdeki serum Mg düzeyine etkileri araştırıldı. Altı saat ara ile yapılan serum Mg düzeyi takiplerinde, serum Mg düzeyi alt eşik değeri 4.8 mg/dL olarak alındığında, 6. saatte eşik değerin altında kalan hasta sayısının 71 (%54.6), 12. saatte eşik değerin altında kalan hasta sayısının 61 (%46.9), 18. saatte eşik değerin altında kalan hasta sayısının 62 (%47.7), 24. saatte eşik değerin altında kalan hasta sayısının 78 (% 60) olduğu görüldü. Eşik değerin altında kalan gruplarda gebelik haftası anlamlı olarak daha yüksekti. ROC analizinde VKİ, 6. Saatte eşik değerin altında kalan grubu (AUC=0.707, p< 0.001), 12. saatte eşik değerin altında kalan grubu (AUC=0.642, p= 0.005) ve 18. saatte eşik değerin altında kalan grubu anlamlı olarak öngörmekteydi (AUC=0.623, p= 0.015). Vücut kitle indeksi arttıkça ve gebelik haftası ilerledikçe 6., 12., 18. ve 24. saatte bakılan serum Mg düzeylerinin terapötik değerin altında kalma riski artmaktadır.

Anahtar Kelimeler:

Preeklampsi, Magnezyum sülfat, Vücut kitle indeksi, Gestasyonel hafta

The Effects of Body Mass Index and Pregnancy Week on Magnesium Treatment in Preeclamptic Cases

The aim of this study was to investigate the effects of body mass index (BMI) and gestational week on serum Magnesium (Mg) levels in patients who were treated with Magnesium sulphate (MgSO4) due to preeclampsia or eclampsia. Between January 2015 and July 2017, 130 patients between 28-41 weeks of gestation who were treated with magnesium sulfate (MgSO4) for preeclampsia or eclampsia in our clinic were included in the study. The gestational weeks and BMI of this patients were calculated and their effects on serum Mg levels at the 6th, 12th, 18th and 24th hours were investigated. In the follow-up of serum Mg level at six hours intervals, when the Mg threshold was taken as 4.8 mg/dL, the number of patients below the threshold value at the 6th hour was 71 (54.6%), the number of patients below the threshold at the 12th hour was 61 (46.9%), the number of patients below the threshold at the 18th hour was 62 (47.7%), the number of patients below threshold at 24 hours was 78 (60%). Gestational age was significantly higher in the groups below the threshold. In the ROC analysis, the BMI significantly predicted the group below the threshold at the 6th hour (AUC = 0.707, p <0.001), the group below the threshold at the12th hour (AUC= 0.642, p= 0.005) and the group below the threshold at the 18th hour (AUC = 0.623, p= 0.015). As the BMI increased and gestational week progresses, serum Mg levels measured at the 6th, 12th, 18th, 24th hours were below the therapeutically threshold value.

Keywords:

Preeclampsia, Magnesium sulphate, Body mass index, Gestational week,

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