Berkan GÜRAKAN, Aylin TARCAN, Mehmet TEKŞAM, Ayşegül OLALI

Çok düşük doğum ağırlıklı prematüre bebeklerde periventriküler - intraventriküler kanama ve periventriküler lökomalasi risk etkenlerinin incelenmesi

Son yıllarda perinatal bakımda önemli gelişmeler kaydedilmesine karşın periventriküler-intraventriküler kanama (PV-tVK) ve periventriküler lökomalasi (PVL) önlenememiştir. Bu sorunların sıklığının ve risk etkenlerinin belirlenmesi, korunmaya yönelik çalışmalar ve ileriye yönelik planlamalar açısından önemlidir. Bu çalışmada, yefıidoğan yoğun bakım ünitemizde çok düşük doğum ağırlıklı prematür bebeklerde PV-İVK ve PVL sıklığını ve risk etkenlerini belirlemeyi amaçladık. Retrospektif olarak değerlendirilen 93 bebeğin 30'unun (% 32,2) kraniyal ultrasonografisinde hemorajik ya da iskemik lezyon saptandı. Yirmi üç hastada PV-İVK (% 24), 7 hastada PVL (% 7,6) bulundu. Transport ve hipotansiyon hem PV-İVK, hem de PVL için; RDS ise PV-İVK için bağımsız risk etkenleri olarak bulundu. Bu verilere dayanarak, bizim gibi dışarıdan hasta kabul eden merkezler için gebenin doğum öncesi transferinin sağlanması ya da bölge bazında yapılan organizasyonlarla doğmuş olan bebeklerin transport koşullarının düzeltilmesinin, PV-İVK ve PVL oranlarım belirgin azaltacağını söyleyebiliriz. Ayrıca bebeklerin hemodinamik monitorizasyonunun ÎVK'yı önlemede kritik önemi olduğunu düşünmekteyiz.

Analysis of risk factors for periventricular-intraventricular hemorrhage and periventricular leukomalacia in very low birth weight premature newborns

Analysis of risk factors for periventricular-intraventricular hemorrhage and periventricular leukomalacia in very low birth weight premature newborns Despite marked improvement in perinatal care over the past several decades, the premature infant remains at high risk for the development of periventricular-intraventricular hemorrhage (PV-IVH) and periventricular leukomalacia (PVL). In order to develop preventive strategies, it is important to determine the risk factors. The purpose of this retrospective, clinical study is to determine the incidence and risk factors of PV-IVH and PVL in our study group. Out of 93 very low birth weight premature infants, PV-IVH was diagnosed in 23 (24%) and PVL were diagnosed in 7 (7.6%). Transport and hypotension was found to be independent risk factors for both PV-IVH and PVL, and RDS was associated with a high risk of PV-IVH. In-utero transport of high-risk babies and better organization of postnatal transport would decrease the incidence of PV-IVH and PVL. In this population, preventive measures such as strict hemodynamic monitorization and support are also important Key words: periventricular-intraventricular hemorrhage, periventricular leukomalacia, premature newborns, risk factors

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