Preterm erken membran rüptürü tanısı olan gebelerde tokolizin etkileri (Retrospektif analiz)
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Date
2008
Authors
Uysal, Nebahat
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı; preterm erken membran rüptürü ile komplike olan, 28-34. gestasyonel haftalar arasındaki gebelerde uygulanan tokolitik tedavinin latent periyot, neonatal ve maternal morbidite üzerine olan etkilerini araştırmaktır.Çalışma; Eylül 2002 - Eylül 2007 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı kliniğine erken membran rüptürü tanısı ile yatırılan ve burada doğum yapan, 28 - 34 gestasyonel haftalar arasındaki gebelerin hastane dosya kayıtları incelenerek retrospektif olarak yapıldı. Çalışma kapsamındaki hastaların %48.33'üne tokolilitik tedavi uygulanmış, %51.67'sine ise uygulanmamıştı ve olguların tümü profilaktik antibiyotik almıştı. Tokoliz grubunda %93.1, tokoliz almayan grupta ise %54.83 olguya antenatal steroid tedavisi verilmişti.Tokoliz uygulanan olguların latent periyotları ile tokoliz uygulanmayanların latent periyotları sırasıyla 10.31 ve 8.83 gündü ve tokolizin latent periyodu uzatmadığı görüldü (p>0.05). Prematüritenin neden olduğu neonatal morbidite ve mortalite oranları da her iki grupta benzerdi. Yenidoğan bebeklerin hastanede ortalama yatış süresine, oksijen ve mekanik ventilatör desteğine ihtiyaç duydukları döneme tokolitik tedavinin olumlu bir etkisinin olmadığı gözlendi (p>0.05). Toplam 3 olguda (birisine tokoliz uygulanmış, diğer ikisine uygulanmamıştı) klinik koryoamnionit gelişmişti. Tokolitik tedavinin koryoamnionit sıklığını arttırıcı bir etkisi gözlenmedi.Preterm erken membran rüptürü sonrası gebelere uygulanan tokolitik tedavininin; latent periyodu ve gebelik süresini uzatmadığı, neonatal ve maternal morbiditeyi etkilemediği görülmüştür. Ancak bu konuda daha fazla prospektif, çok merkezli ve vaka kontrollü çalışmalara ihtiyaç duyulmaktadır.
The present study was undertaken to investigate the effects of tocolytic therapy on latency period, neonatal and maternal morbidity in pregnancies of 28-34 gestational week complicated by preterm rupture of membranes.Between September 2002 and September 2007, hospital records of pregnant women who were of 28-24 gestational weeks and admitted to and gave birth at Uludağ University Faculty of Medicine, Department of Gynecology and Obstetrics with the diagnosis of preterm rupture of membranes was retrospectively reviewed. Of the whole study population, tocolysis was performed in %48.33, whilst not performed in %51.67. All cases received prophylactic antibiotics. Rate of antenatal steroid use was %93.1 and %54.83 in tocolysis and non-tocolysis group, respectively.Latency period was 10.31 and 8.33 days in tocolysis and non- tocolysis group respectively and was not significantly different among groups(p>0.05). Neonatal morbidity and mortality rates associated with prematurity was comparable among groups. It was found that tocolytic therapy did not favorably influence the length of hospital stay, period of oxygen and mechanical ventilatory support in newborns(p>0.05). 3 cases(one wiith tocolytic therapy, two without tocolytic therapy) developed chorioamnionitis. Tocolytic therapy was found not to be associated with an increased frequency of chorioamnionitis. In the present study, we showed that tocolytic therapy performed in pregnant women after preterm rupture of membranes neither did not prolong latency period and gestation period nor did not affect neonatal and maternal morbidity; but further prospective, multicenter and case-control studies are needed to confirm these results.
The present study was undertaken to investigate the effects of tocolytic therapy on latency period, neonatal and maternal morbidity in pregnancies of 28-34 gestational week complicated by preterm rupture of membranes.Between September 2002 and September 2007, hospital records of pregnant women who were of 28-24 gestational weeks and admitted to and gave birth at Uludağ University Faculty of Medicine, Department of Gynecology and Obstetrics with the diagnosis of preterm rupture of membranes was retrospectively reviewed. Of the whole study population, tocolysis was performed in %48.33, whilst not performed in %51.67. All cases received prophylactic antibiotics. Rate of antenatal steroid use was %93.1 and %54.83 in tocolysis and non-tocolysis group, respectively.Latency period was 10.31 and 8.33 days in tocolysis and non- tocolysis group respectively and was not significantly different among groups(p>0.05). Neonatal morbidity and mortality rates associated with prematurity was comparable among groups. It was found that tocolytic therapy did not favorably influence the length of hospital stay, period of oxygen and mechanical ventilatory support in newborns(p>0.05). 3 cases(one wiith tocolytic therapy, two without tocolytic therapy) developed chorioamnionitis. Tocolytic therapy was found not to be associated with an increased frequency of chorioamnionitis. In the present study, we showed that tocolytic therapy performed in pregnant women after preterm rupture of membranes neither did not prolong latency period and gestation period nor did not affect neonatal and maternal morbidity; but further prospective, multicenter and case-control studies are needed to confirm these results.
Description
Keywords
Preterm erken membran rüptürü, Tokoliz, Prematürite, Preterm rupture of membranes, Tocolysis, Prematurity
Citation
Uysal, N. (2008). Preterm erken membran rüptürü tanısı olan gebelerde tokolizin etkileri (Retrospektif analiz). Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.