Leyla D. KOLSUZ, Bilge DEMİREL, Tuğba GÜRSOY, Güner KARATEKİN, Fahri OVALI

Erken Membran Rüptürünün Preterm Bebeklerde Morbi̇di̇te ve Mortali̇te Üzeri̇ne Etki̇si̇ni̇n Araştırılması

Amaç: Erken membran rüptürü (EMR), fetal zarların gebeliğin herhangi bir zamanından 42. haftaya kadar olan dönemde doğumdan 18-24 saat önce yırtılmasıdır. Membranlar yırtıldığında yenidoğanda enfeksiyon riski artmakta uzun süre oligohidramnios olduğunda ise pulmoner hipoplazi başta olmak üzere fetal gelişim olumsuz etkilenmektedir. Erken membran rüptürü olan anne bebeklerinde perinatal ölümün dört kat, RDS, İVK gibi yenidoğan hastalıklarının üç kat arttığı bildirilmektedir. Amacımız kliniğimize 2012 yılında yatan EMR (+) olan 32 hafta altı bebekleri olmayan 32 hafta altı bebeklerle karşılaştırmak. Gereç ve yöntem: 1/1/2012-31/12/2012 tarihleri arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Yenidoğan Yoğun Bakım Ünitesinde takip edilen 32 hafta altının altında doğan emr (+) olan ve olmayan 295 bebek retrospektif olarak morbidite ve mortalite açısından incelendi. Bulgular: İki yüz doksan beş bebek çalışmaya alındı. Bebeklerin 220si (%74,6) EMR (-), 75i (%25,4) EMR (+) grubu oluşturdu. Her iki gruptaki bebekler arasında gebelik haftası, doğum ağırlığı ve cinsiyet açısından fark saptanmadı. EMR (-) grupta nazokomiyal sepsis (%17,5 p=0,028) ve mortalite (%23,3, p=0,008) daha fazla iken, EMR (+) grupta bronkopulmoner displazi daha fazla (%26,2 p=0.002) saptandı . Sonuç: EMR olan grupta bronkopulmoner displazi fazla görülürken, EMR olmayan grupta prenatal risk faktörlerinin fazla olması nedeniyle nazokomiyal sepsis ve mortalite daha fazla görülmüştür.

Morbidity and Mortality of Premature Rupture of Membranes in Preterm Infants

Objective: Prematüre membrane rupture is the rupture of fetal membranes between any period of gestation and 42nd week, before 18-24 hours of delivery.When the membranes are ruptured, infection risk is higher in newborn, if there is long-term oligohydramnios there is often pulmonary hypoplasia and fetal development is affected negatively.It was reported that newborn diseases like RDS,İVK is seen 3 times higher and perinatal death 4 times higher in babies whose mothers have EMR Early Membran Rupture . Our objective is to compare babies smaller than 32 weeks with EMR with those without EMR in our clinic in 2012. Materials and methods: Between 01/01/2012- 31/12/2012, 295 infants who were born before 32 weeks of gestational age and who were EMR(+) or not, have been examined retrospectively in terms of morbidity and mortality in Zeynep Kamil Women and Children Education and Research Hospital Newborn Intensive Care Unit. Findings: 295 infants were included the study. 220 (%74,6) of the infants formed the EMR(-) and 75 (%25,4) of them formed the EMR(+) group. There was no difference between the infants in both groups in terms of gestational week, birth weight and gender. While nasocomial sepsis (%17,5 p=0,028) and mortality (%25,3, p=0,008) was higher in EMR(-)group, broncopulmonary dsyplasia (%26,2, p=0,002) was found higher in EMR (+) group. Result: While broncopulmonary dsyplasia is usually seen in EMR (+) group , nasocomial sepsis and mortality is seen more often in EMR (-) group due to many prenatal risk factors.

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