Zeynep KAMALAK, Serap SİMAVLI, ZEHRA CANDAN İLTEMİR DUVAN, Öztürk Nilgün TURHAN

Preterm eylem yönetimi

Preterm Eylem Yönetimi Otuzyedinci gestasyonel haftadan önce olan doğumlar preterm eylem olarak isimlendirilir. Preterm eylem obs-tetrik mortalitenin ve morbiditenin en önemli nedenidir. Ekonomik ve emosyonel birçok etkisinin olması haricinde respiratuar, gastrointestinal, immünolojik, santral sinir sistemi, duyma ve görme problemleri gibi birçok fetal etkilere ve uzun dönem kognitif ve gelişimsel bozuk-luklara yol açmaktadır. Böyle ciddi sonuçları olan pre-term eylemin insidansı ilerleyen medikal gelişmelere rağmen günden güne artmaktadır. Preterm doğum için risk faktörleri arasında geçirilmiş preterm doğum öyküsü, erken membran rüptürü hikayesi, geçirilmiş servikal cerrahi, yardımcı üreme teknikleri (ART) ile gerçekleşmiş gebelik olması, uterin anomali, kısa servikal uzunluk, kronik uriner traktus infeksiyonu, maternal Body Mass Index (BMI)’ın düşük olması gibi birçok neden suçlan-maktadır. Yapılan birçok araştırma olmasına rağmen halen preterm eylemin önlenmesinde ve yönetiminde kesin kurallar bulunmamaktadır. Gestasyonel haftaya göre kortikosteroid, tokoliz ve antibiyotik tedavileri multidisipliner bir çerçevede uygu-lanmalıdır ancak şüphesiz ciddi komplikasyonlara yol açan preterm eylemi öngörebilmek ve önleyebilmek esas hedef olmalıdır.

Management of preterm labour

Preterm labour is that born at less than 37 completed weeks of gestation which is the most important cause of the obstetric mortality and morbidity. The birth of a preterm infant brings emotional and economic costs to families and also respiratory, gastrointestinal, immu-nologic, central nervous system, hearing, and vision problems, as well as longer term motor, cognitive, visual, hearing, and growth problems. Despitethese gross results the incidance of preterm labour has increased steadily. Previous preterm labour, preterm premature rupture of membranes (PPROM), previous servical surgery, pregnancy with asiste reproductive technology (ART), uterine abnormality, short servical lenght, cronic urinary tractus infection and less maternal BMI are the risk factors for preterm labour. In contravention of many studies there is no consensus for prevention or treatment of preterm labour. According to week of gestation treatment options are corticosteroids, tocolitic theraphies and antibiotics in a multidisipliner way. But surely the principle aim must be prediction and prevention of preterm labour.

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