Gürcan TÜRKYILMAZ, Şebnem EROL TÜRKYILMAZ, Mesut POLAT, Enis ÖZKAYA, Murat APİ

Preterm prematür membran rüptürü olgularında spontan ve indüklenmiş eylemin maternal ve fetal sonuçlara etkisi

Amaç: Bu çalışmamızda preterm prematür membran rüptürü (PPROM) ile komplikegebeliklerde spontan travaya giren olgularla çeşitli endikasyonlarla doğum indüksiyonu yapılanolguların perinatal sonuçlarını ve latent sürenin bu sonuçlara etkisini araştırmayı amaçladık.Materyel-metod: Ocak 2014-Ocak 2016 yılları arasında kliniğimizde 24-34 gebelik haftalararasındaki PPROM tanısı alan gebelerin perinatal sonuçları retrospektif olarak değerlendirildi.Bulgular: Çalışmaya 93 olgu dahil edildi ve 43 olguda (%46) doğum eylemi takip sırasındaspontan başladı (Grup 1), 50 olguda (%54) ise doğum eylemi indüksiyonla başlatıldı (Grup 2).PPROM oluşan zamandan doğuma kadar geçen süre grup 1’de 5.8±2.1 gün, grup 2’de 8.3±3.5gündü (p:0,19). Ortalama doğum haftası grup 1’de 30.4±2.3 hafta iken grup 2’de 30.5±2.5haftaydı (p: 0.91). Doğum ağırlıkları arasında anlamlı fark saptanmadı. Grup 1’de 19 (%44.1)olgu sezaryen ile doğum yaptı, grup 2’de ise 37 (%74) olguda sezaryen ihtiyacı görüldü(p:0.03). Grup 1’de 4 (%9.3), grup2’de 3 (%6) olguda YDYBÜ takibi sırasında exitusgerçekleşti (p: 0.54). Grup 1’de 14 (%32.5) grup 2’de ise 17 (%34) olguda ciddi morbiditegeliştiği görüldü. Mortalite ve ciddi morbidite üzerine latent sürenin anlamlı etkisi görülmedi(p:0.54, p:0.67)Sonuç: PPROM olgularında latent sürenin neonatal sonuçlara anlamlı etkisi gösterilmemiştirve maternal veya fetal iyilik hali güven verdiği sürece ekspektan yaklaşım uygun takipyöntemidir.

Anahtar Kelimeler:

eylem, erken doğum

The influence of spontaneous and induced labor in maternal and fetal outcomes in preterm prematüre rupture of membranes

Aim: We evaluated the effect of spontaneous and induced parturition in maternal and fetaloutcomes in preterm prematüre rupture of membranes (PPROM) and analyzed the influence ofthe latent period in these results.Materials-method: We analyzed the results of patients who were complicated with PPROM in24-34 weeks of gestation between January 2014-January 2016 in our clinic.Results: We collected 93 cases and in 43 patients (46%) the labor occurs spontaneously (Group1) and in 50 cases (54%) we induced the labor due to maternal and fetal indications (Group 2).The interval between when PPROM occurred, and labor was 5.8±2.1 days in group 1 and8.3±3.5 days in group 2 (p:0,19). There was no significant difference between birthweights intwo groups. C-section was performed in 19 (%44.1) patients in group 1 and 37 (%74) caseswere delivered by C-section in group 2 (p: 0.03). Neonatal mortality was 9.3% in group 1 and6% in group 2 (p:0.54). Severe morbidity was detected in 14 (%32.5) patients in group 1 and17 (%34)in group 2. We did not show a significant effect of latency period into the severemorbidity and mortality in newborns (p:0.54, p:0.67).Conclusion: There was no relevant effect of latency period into the neonatal outcomes, andexpectant management should be used in PPROM cases if the maternal and fetal status isreassuring.

Keywords:

newborn, parturition,

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