Çiğdem YAYLA ABİDE, İlter YENİDEDE, ENİS ÖZKAYA

BİRİNCİ TRİMESTER TRİZOMİ TARAMA TESTİ BİYOKİMYASAL BELİRTEÇLERİNİN GESTASYONEL DİYABETES MELLİTUS ÖNGÖRÜSÜNDEKİ YERİ

Amaç: Gebelere rutinde bakılan birinci trimester tarama testi biyokimyasal belirteçleri olan PAPP-A (Gebelik ilişkili plazma protein A) ve ßhcg değerlerinin, ilerleyen gebelik haftalarında gelişen gestasyonel diyabetes mellitus (GDM) hastalığının taranmasında ve erken tanısında ek maliyet yaratmadan faydalanabilme potansiyelini araştırmaktır. Materyal ve Metod: Bu çalışma retrospektif kohort bir çalışma olarak planlandı. Çalışmaya Ocak 2014 – Aralık 2016 yılları arasında birinci trimester trizomi taraması hastanemizde yapılan ve rutin gebelik takibine alınıp doğumunu yine hastanemizde gerçekleştirmiş olan tekil gebeler dahil edilmiştir. Gebeler GDM ve kontrol grubu olarak iki gruba ayrılmıştır. Birinci trimester tarama testi biyokimyasal belirteçlerinin ( PAPP-A (MoM), ßhcg (MoM)) ilerleyen gebelik haftalarında ortaya çıkan GDM’nin tanısının daha erken konulmasında rolünün etkisi araştırılmıştır. Bulgular: GDM grubunda, kontrol grubuna göre, anne yaşı, gebelik sayısı, parite, abortus ve yaşayan çocuk sayısı anlamlı olarak yüksek bulunmuştur (p<0.05). GDM grubunda PAPP-A (MoM), ßhcg (MoM), NT (mm) ve NT (MoM), doğumun gerçekleştiği gestasyonel hafta, bebek doğum ağırlığı, APGAR 1.dk ve APGAR 5.dk değerleri arasında istatistiksel olarak anlamlı bir fark gözlenmemiştir. Sonuç: Çalışmada birinci trimester tarama testi biyokimyasal belirteçleri ile GDM arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır. Ancak bu konuda daha çok hasta sayısı ve özenle planlanmış prospektif çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

Birinci trimester tarama, gestasyonel diyabetes mellitus, gebelik ilişkili protein A

THE ROLE OF BIOCHEMICAL MARKERS OF FIRST TRIMESTER TRISOMY SCREENING TEST IN THE PREDICTION OF GESTATIONAL DIABETES MELLITUS

Objective: To investigate the potential advantage of routinely examined biochemical markers; PAPP-A (pregnancy related plasma protein A) and ßHCG values, in the first trimester screening test for the screening and early diagnosis of gestational diabetes mellitus (GDM) disease that occured in the following weeks of pregnancy without bringing any additional cost.Material and Method: This study was designed as a retrospective cohort study. In this study singleton pregnancies were included whose first trimester trisomy screening tests were examined in our hospital and also deliviries of them took place in our hospital with the routine pregnancy follow up between January 2014 – December 2016. The pregnancies were divided into two groups as GDM and control group. The functional role of biochemical markers ( PAPP-A (MoM), ßhcg (MoM)) in the first trimester screening test were investigated for early diagnosis of GDM which appeared in the later gestational weeks of pregnancy. Results: In the GDM group; maternal age, the number of pregnancies, parity, abort and living children were found significantly high, according to the control group (p<0.05). Statistically significant difference was not observed between PAPP-A (MoM), ßhcg (MoM), NT (mm) ve NT (MoM), gestational week of delivery, birth infant weight, APGAR 1.minute and APGAR 5.minute in the GDM group.Conclusion: No statistically significant relationship was established between biochemical markers of first trimester screening test and GDM in this study. However, more patients and carefully planned prospective studies are needed in this subject.

Keywords:

First trimester screening, gestational diabetes mellitus, pregnancy associated protein A,

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