Ali Cenk ÖZAY, Özlen EMEKÇİ ÖZAY

Hiperemezis Gravidarumun Gestasyonel Diyabet ve Gebelik Sonuçları Üzerine Etkisi

Giriş: Bulantı ve kusma, gebe kadınların% 50-80'inde görülen en yaygın komplikasyondur. Gebe kadınların yaklaşık% 1'i ilk trimesterde şiddetli bulantı ve kusma yaşarlar ve hiperemezis gravidarum (HG) tanısı alırlar. HG 20. gebelik haftasından önce hastaneye yatışın ana nedenidir. Önceki çalışmalarda, insülin duyarlılığı, HG ve gestasyonel diabetes mellitus (GDM) arasında bir ilişki kurulmuştur. Bu çalışmada, HG’nin, GDM ve gebelik sonuçları üzerindeki etkisini değerlendirmek amaçlanmıştır.Gereç ve yöntem: Bu retrospektif çalışma 1 Mart 2015-30 Eylül 2017 tarihleri arasında Konya Akşehir Devlet Hastanesi'nde yapıldı. Çalışmaya toplam 100 hasta dahil edildi (n: 46 HG, n: 54 kontrol). GDM için tarama gebelik sırasında bir kez gerçekleştirildi. GDM tanısı, ikinci trimesterde, 24-28 gebelik haftasından 75 g OGTT ile konuldu. Başlıca değerlendirilen parametreler; gestasyonel diyabet, gebeliğe bağlı hipertansiyon, fetal doğum ağırlığı, preterm doğum ve fetal cinsiyet idi. İstatistiksel analiz SPSS 15.0 kullanılarak yapıldı. p <0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: İlk muayenede, iki grup arasında maternal yaş ve VKİ açısından anlamlı bir farklılık gözlenmedi. GDM prevalansı, gebeliğe bağlı hipertansiyon, fetal doğum ağırlığı, preterm doğum ve fetal cinsiyet açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmadı. Sonuç: Literatürde hiperemezis gravidarumun maternal ve fetal sonuçlar üzerine olumsuz etkilerini gösteren birçok çalışma vardır. Çalışmamızda hiperemezis gravidarumun olumsuz gebelik sonuçları ile ilişkili olmadığı bulunmuştur. Bu çalışmanın kısıtlılığı hasta sayısının az olmasıdır. Hiperemezis gravidarumun uzun dönem etkilerini tanımlamak için daha kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

hiperemezis gravidarum, gestasyonel diyabet, gebelik sonuçları

The Effect of Hyperemesis Gravidarum on Gestational Diabetes and Pregnancy Outcomes

Objective: Nausea and vomiting in pregnancy is the most common complication that observed in %50-80 of pregnant women. Approximately %1 of pregnant women experience severe nausea and vomiting during the first trimester and are diagnosed with hyperemesis gravidarum (HG). HG is the major reason for hospitalization before 20 gestational weeks. A relationship between insulin sensitivity, HG, and gestational diabetes mellitus (GDM) has been established. In this study, we aimed to assess the impact of HG on GDM and pregnancy outcomes. Method: This retrospective study was conducted at Konya Akşehir State Hospital between 1st March 2015 and 30th September 2017. A total of 100 women included in this study (n:46 hyperemesis, n:54 control). Screening for GDM was performed once during pregnancy. GDM diagnosis was obtained with a 75-g OGTT, during the second trimester, from 24–28 weeks of gestation. Main outcomes were gestational diabetes, pregnancy-induced hypertension, fetal birth weight, preterm birth and fetal sex. Statistical analysis was performed using SPSS 15.0. p < 0.05 was considered as statistically significant.Results: At initial examination, no significant differences in maternal age and BMI were observed between the two groups. We found no statistical difference between the groups in the prevalence of GDM, pregnancy-induced hypertension, fetal birth weight, preterm birth and fetal sex. Conclusion: In the literature, there are many studies that shows negative effects of HG on maternal and fetal outcomes. In our study, it was found that HG is not associated with adverse pregnancy outcomes. The lack of this study is the small number of patients. More extensive studies are needed to define long term effects of HG.

Keywords:

Hyperemesis gravidarum, gestational diabetes, pregnancy outcomes,

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