Prolonged pregnancies: Approaches in clinical management

Uzamış gebeliklere klinik yaklaşımlar Postterm gebelik son adet tarihinden itibaren 42. gebelik haftasını tamamlamış ya da geçmiş (294 gün) ya da tahmini doğum tarihinden 14 gün geçmiş olan gebelikler olarak tanımlanır. Postterm gebelik modern obstetrikte giderek artan tartışmalı bir problem olmaya devam etmektedir ve hem fetus hem de anne için birçok komplikasyonları vardır. Geleneksel olarak postterm antenatal fetal yakın gözetim 42. gebelik haftasında başlar. Ancak yakın zamanda yapılan bazı çalışmalarda perinatal asfiksinin 40. ve 42. gebelik haftaları arasında da belirgin artışı gösterilmiştir. Bazı çalışmalar da perinatal risklerin 41. gebelik hafta-sından itibaren arttığı söylenmektedir. En fazla intra-partum ve neonatal dönemlerde risk artmaktadır. Bunun üçte dördünü oluşturan en çok ölüm nedenleri intrapar- tum asfiksi, ve mekonyum aspirasyonudur. Postterm gebeliklere yaklaşımlar tartışmalıdır. Bunun düşünce ile bu yazımızda, postterm gebeliklerin tanısını, prenatal belirleyici faktörlerini, maternal-fetal sonuçlarını ve antenatal fetal testlere başlangıç zaman-larını tartıştık.

Uzamış gebeliklere klinik yaklaşımlar

Prolonged (postterm) pregnancy is defined as a pregnancy that continues to or beyond 42 weeks (294 d) from the first day of the last normal menstrual period or 14 days beyond the best obstetric estimate of the date of delivery (EDD). Postterm pregnancy remains constantly a difficult and controversial problem in modern obstetrics and have many complications for both fetus and mother. Postterm antenatal fetal surveillance has traditionally begun at 42 completed weeks of gestation. However recent data have shown that a significant percentage of cases of perinatal asphyxia occurs between 40 and 42 weeks of gestation. Some studies reported that the pregnancy risks increase already from gestational week 41. The most significant increase seems to occur in the intrapartum and neonatal periods. The major causes of death are intrapartum asphyxia and meconium aspiration, which are present in almost three quarters of these deaths. Opinions on the management of post-term pregnancy are controversial. With this ida, in this article we have discussed the diagnosis of post-term pregnancy, prenatal indicators and maternal-fetal outcomes of prolonged pregnancy and timing to start the antepartum fetal tests.

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Yeni Tıp Dergisi-Cover
  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2018
  • Yayıncı: -
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