Tayfun KUTLU, Elif BAĞLAM, Zeynep GENÇ, Y. Sadiye EREN

Erken doğum tehditini önceden belirlemede risk puanı, servikal uzunluk ve maternal tükrük östriol seviyesinin rolü

Amaç: Erken doğum tehditini önceden belirlemede risk puanı, servikal uzunluk ölçümü ve spot maternal tükrük östriol değerlerinin rolünü araştırmak. Geraç ve Yöntem: Zeynep Kamil Hastanesi Doğum Kliniğine Haziran 2003 - Ocak 2004 tarihleri arasında erken doğum tehditi belirti ve bulguları ile başvuran, 26 - 34 gebelik haftaları arasında 100 gebe çalışma grubuna alındı. Standart tanı ve tedavi protokollerinin yanı sıra maternal tükrük östriol seviyesi, servikal uzunluk ölçümü ve risk puanlaması yapıldı. Aynı dönemde, gebe izlem polikliniğinde kontrollerine, devam eden, 26 - 34 gebelik haftaları arasında 100 gebe ise kontrol grubu olarak belirlendi ve aynı ölçümler uygulandı. Randomize ve prospektif olarak düzenlenen çalışmada gruplar arasında servikal uzunluk, Creasy risk puanı ve maternal tükrük östriol seviyeleri karşılaştırıldı. Bulgular: Erken doğum tehditi nedeniyle başvuran gebelerin kontrol grubu gebelerine göre risk puanlan anlamlı derecede yüksek (p

Anahtar Kelimeler:

Obstetrik doğum, prematür, Östriol, Tükrük, Serviks uteri

The role of risk scare, cervical length and maternal salivary estriol levels in the prediction of preterm labor

Objective: To determine the role of risk score, cervical length and maternal salivary estriol levels in the prediction of preterm labor. Materials and Methods: 100 pregnant women between 26-34 gestational weeks and who had admitted to the Zeynep Kamil Women's and Children's Hospital with signs and symptoms of preterm labor between June 2003 and January 2004 were included in the study group and their risk scores, cervical lengths and salivary estriol levels were determined besides the standard therapy they received. 100 pregnant women between 26-34 g estational weeks attending to our antenatal clinic in the same period were included in the control group and they had the same measure-ments.In this randomized, prospective study cervical length, Creasy risk scores and maternal salivary estriol levels were compared between the two groups. Results: The patients admitted to our clinic with signs and symptoms of preterm labor had significantly high risk scores (p

Keywords:

Obstetric Labor, Premature, Estriol, Saliva, Cervix Uteri,

PDF

___

1.Creasy RK, Merkatz IR. Prevention of preterm birth: clinical opinion, Obstet Gynecol
1990;76(suppl):2-4
2.Roman AS, Pernoll ML.Late pregnancy complications. DeCherney AH, Nathan L, eds
Current Obstetrics and Gynecology. 9th ed. London: Appleton&Lange, 2003: 286-300
3.King JF, Grant A,Kierse MJNC,Chalmers I.Beta mimetics in preterm labour:an overview of randomized controlled trials.Br J Obstet Gynecol.1988;95:211-222
4.Creasy RK, Gummer BA, Liggins GC.System for predicting spontaneous preterm birth. Obstet Gynecol 1980;55:692-695 5.Iams JD, Jonson FF, Sonek J. Cervical competence as a continuum: A study of ultrasonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995;172:1097-1102
6.Heine RH, McGregor fA, Dullien VK. Accuracy of salivary estriol testing compound to traditional risk factor assessment in predicting preterm birth
Am J Obstet Gynecol 1999;180:214-18
7.Robertson PA, McGregor JA, Varner M, et al.The role of salivary estriol in predicting symptomatic patients.Presented at the 68th American Clinical Meeting of the American College of Obstetricians and Gynecologists
8.Meis PJ, Goldenberg RL, Mercer BM, et al.The preterm prediction study: Significance of vaginal infections 1995;173:1238-1241 9.Klebanoff MA, Shiono PH, SelbyJV, et ah Anemia and spontaneous preterm birth Am J obstet Gynecol 1991; 164:59-63
10.Heinonen PK, Saarikoski S,Pystnen P
Reproductive performance of women with uterin anomalies. Acta Obstet Gynecol Scand 1982; 61: 157-162
cem gokcora 11.Herbst AL, Hubby MM, Blough RR, et al.Acomparison of pregnancy experience in DES- exposed and DES-unexposed daughters.J Reprod Med 1980;24:62-66
12.Iams JD, Goldenberg RL, Meis PJ, et al. The length of the cervix and the risk of spontaneous premature delivery. N Engl J Med 1996; 334:567- 572
13.McGregor JA, Jackson GM, Lachelin GC, et al
Salivary estriol as risk assessment for preterm labor: a prospective trial. Am J Obstet Gynecol
1995 Oct;173(4):1337-42
14.Heine RP, McGregor JA, Goodwin TM, et al
Serial salivary estriol to detect an increased risk of preterm birth. Obstet Gynecol. 2000 Oct;96(4):490-7