Mehmet GÜL, OYA DEMİRCİ, Oya PEKİN, Hamdullah SÖZEN, Doğan VATANSEVER, ARİF AKTUĞ ERTEKİN

Makrozomik Gebeliklerin Doğum Şekilleri ve Sonuçları

Amaç: Makrozomik bebeklerin doğum şekli ve sonuçlarının incelenmesi

Makrozomik bebeklerin doğum şekli ve sonuçlarının incelenmesi. Materyal Metod: Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Doğum Kliniği'ndeki 01/01/2006 ve 31/12/2008 tarihleri arasındaki doğum kayıtları retrospektif olarak incelendi. Çalışma grubu, doğum ağırlığı 4

Mode of Deliveries and Consequences of the Pregnancies with Macrosomia Objective: To evaluate the mode of deliveries and consequences of macrosomic pregnancies. Material and methods: The birth records between 1 st of January 2006 and 31 st of december 2008 in Obstetric Clinic of Zeynep Kamil Women's Health and Children Diseases Education and Research Hospital, were rewieved retrospectively. Study group was composed of with bith weight 4000 g and above, and the control group was composed of with birth weight between 2500-3999 g randomly selected pregnancies at the same time period. Results: Total study and the control cases were 2411; 2133 cases were in study group and 300 cases were in control group . Pregnancies under 37 weeks gestation, multiple pregnancy and the cases with IUGR were excluded to control group. Results: According t he birth records between 1 st of January 2006 and 31 st of december 2008 in Obstetric Clinic of Zeynep Kamil Women's Health and Children Diseases Education and Research Hospital, the insidance of macrosomia (>= 4kg) was found as 5,15%. Ultrasound to predict the weight over 4000 grams, compared to normal birth weight infants were less successful. cpd, was the primary risk factor and indication for primary cesarean section. The duration of labour was longer and caeserean section rate was higher viewed in the cases with oxytocin infused and in macrosomic group. Shoulder dystocia was more prevalent in macrosomic infants and cases with diabetes. Uterine atony was only prevalent in macrosomic pregnancies. Fetal trauma, in the cases with shoulder dystocia and who delivered vaginally were more prevalent. The rate of perinatal mortality in the study group was 0.51%,

PDF

___

1. Mark A. Zamorski, Wendy S. Biggs. Management of Suspected Fetal Macrosomia. American Family Physician 2001; 63:302- 6.
2. J. Berard, P. Dufour, D. Vinatier, D. Subtil, S. Vanderstichele, J.C. Monnier, F. Puech. Fetal Macrosomia: risk factors and outcome A study of the outcome concerning 100 cases >4500. European Journal of Obstetrics & Gynecology and Reproductive Biology 1998; 77 : 51-59.
3. Spellacy WN, Miller S, Winegar A, Peterson PQ: Macrosomia maternal characteristics and infant complications. Obstet Gynecol 1985; 66:158.
4. American Collage of Obstetricians and Gynaecologists. Fetal macrosomia. Practice Bulletin No.22 Washington, DC: ACOG, 2000.
5. Chauhan SP, Lutton PM, Bailey KJ, Guerrieri JP, Morrison JC. intrapartum clinical, sonographic, and parous patients estimates of newborn birth weight. Obstet Gynecol 1992; 79:956-8.
6. Suneet P. Chauan, MD, William A. Grobman, MD, Robert A. Gherman, MD, Vidya B. Chauan, BS, Gene Chang, MD, Everett F. Magann, MD, Nancy W. Hendrix, MD.Suspicion and teratment of the macrosomic fetus: A review. Am J Obstet Gynecol 2005;193:332-46.
7. Chauhan SP, Sullivan CA, Lutton TD, et al: Parous patients estimate of birth weight in postterm pregnancy. J Pernatol 1995;15:192-194.
8. Chauhan SP, Cowan BD, Magann EF, et al: Intrapartum detection of a macrosomic fetus: Clinical versus 8 sonographic models. Aust N Z J Obstet Gynaecol 1995;35:3:266-270.
9. Aısulyman OM, Ouzounian JG, Kjos SL: The accuracy of intrapartum ultrasonographic fetal weight estimation in diabetic pregnancies. Am J Obstet Gynecol 1997;177:503-506.
10. Smith GC, Smith MF, McNay MB, Fleming JE: The relation between fetal abdominal circumference and birth weight: Findings in 3512 pregnancies.Br J Obstet Gynaecol 1997;104:186-190.
11. E.K. Srofenyoh, J.D. Seffah: Prenatal, labor and delivery characteristics of mothers with macrosomic babies. İnternational Journal of Gynecology and Obstetrics 2006; 93: 49-50.
12. Stones RW, Paterson CM, Saunders NJ: Risk factors for major obstetric haemorrhage. Eur J Obstet Gynecol Reprod Biol 1993; 48:15-18.
13. Engin Oral, Arzu Çağdaş, Altay Gezer, Semih Kaleli, Kiliç Aydinli, Fahri Öçer. Perinatal and maternal outcomes of fetal macrosomia. European Journal of Obstetrics & Gynecology and Reproductive Biology 2001; 99 : 167-171.
14. N.E. Stotland, A.B. Caughey, E.M. Breed, G.J. Escobar: Risk factors and obstetric complications associated with macrosomia. İnternational Journal of Gynecology and Obstetrics 2004; 87:220- 226.
15. Perlow JH, Wigton T, Hart J, et al: Birth trauma: A five year review of incidence and associated perinatal factors. J Reprod Med 1996; 41:754-760.
16. Ecker JL, Greenberg JA, Norwitz ER, et al: Birth weight as a predictor of brachial plexus injury. Obstet Gynecol 1997; 71:389-392.
17. Royal College of Obstetricians and Gynaecologists. Shoulder dystocia. Guideline no.42. London: RCOG,2005
18. Gherman RB, Goodwin TM, Ouzounian JG, et al: Brachial plexus palsy associated with cesarean section: An in utero injury? Am J Obstet Gynecol 1997; 177:1162-1164.
19. Gherman RB, Ouzounian JG, Satin AJ, et al: A comparison of shoulder dystocia associated transient and permanent brachial plexus palsies. Obstet Gynecol 2003; 102:544-548.
20. Boulet SL, Alexander GR, Salihu HM, Pas M: Macrosomic births in the United States: Determinants, outcomes and proposed grades of risk. Am J Obstet Gynecol 2003;188:1372-1378
21. American College of Obstetricians and Gynecologists. Fetal macrosomia .Practice Bulletin No.22, November 2000b.