434 makrozomi olgusunda doğum şekli: Perinatal-maternal morbiditeye etki
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Date
1997-01-27
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Uludağ Üniversitesi
Abstract
Makrozomik bebeklerde doğum şeklinin perinatal-maternal morbiditeye etkisini belirlemek amacıyla, Ağustos 1988 ile Aralık 1993 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum A.B.D. 'nda doğum yapan 5044 gebeden, yenidoğan ağırlıkları 4000 gr ve üzerinde olan 434 'ünün (% 8.60) kayıtları retrospektif olarak değerlendirildi. Gebelerin % 74.2 'si vajinal yoldan doğururken, indüksiyon uygulanan gebelerdeki sezaryen hızı (% 38.9), spontan travaya gidenlerden (% 17.2) 2.26 kat yüksek bulundu. Omuz distosisi gelişen 3 olgudan 2 'sinde ve klavikula kırığı (n = 3) ve brakial pleksus zedelenmesi (n = 2) saptanan olgulardan biri hariç tümünde doğum ağırlığı 4500 gr 'ın üzerinde idi. Bu bulgular, doğum öncesinde fetal ağırlığın 4000 ile -1500 gr arasında tahmin edildiği gebelerde indüksiyondan kaçınılarak spontan travayın beklenmesi, 4500 gr'ın üzerinde oldukları tahmin edilen fetusların ise elektif sezaryen ile doğurtulması gerektiği sonucuna varıldı.
Among a total of 5044 pregnant women who delivered at the Department of Obstetrics and Gynecology of Uludağ University Hospital during the period between August 1988 and December 1993, obstetric rewards of those with infant birth weights of 4000 gr and above (n = 434; 8. 60 %) have been reviewed retrospectively, in order to determine the effects of the mode of delivery of macrosomic infants on perinatal maternal morbidity. While 74.2% of the patients have delivered vaginally, induced labor has culminated 2.26 times more commonly in cesarean section than has spontaneous labor (38.9 % vs 17.2 %). The infant birth weight is above 4500 gr in two of three cases with shoulder dystocia, and in all cases except for one with fracture of the clavicle (n = 3) or brachial plexus injury (n = 2). As a result, we suggest that induction of labor should be avoided and spontaneous labor be awaited in cases where the fetal weight is estimated to be between 4000 and 4500 gr, and that fetuses estimated to be over 4500 gr be delivered by elective caesarean section.
Among a total of 5044 pregnant women who delivered at the Department of Obstetrics and Gynecology of Uludağ University Hospital during the period between August 1988 and December 1993, obstetric rewards of those with infant birth weights of 4000 gr and above (n = 434; 8. 60 %) have been reviewed retrospectively, in order to determine the effects of the mode of delivery of macrosomic infants on perinatal maternal morbidity. While 74.2% of the patients have delivered vaginally, induced labor has culminated 2.26 times more commonly in cesarean section than has spontaneous labor (38.9 % vs 17.2 %). The infant birth weight is above 4500 gr in two of three cases with shoulder dystocia, and in all cases except for one with fracture of the clavicle (n = 3) or brachial plexus injury (n = 2). As a result, we suggest that induction of labor should be avoided and spontaneous labor be awaited in cases where the fetal weight is estimated to be between 4000 and 4500 gr, and that fetuses estimated to be over 4500 gr be delivered by elective caesarean section.
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Keywords
Makrozomi, Omuz distozisi, Doğum travması, Macrosomia, Shoulder dystocia, Birth trauma
Citation
Unca, G. vd. (1996). ''434 makrozomi olgusunda doğum şekli: Perinatal-maternal morbiditeye etki''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 23(1-2-3), 87-89.