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Preterm Erken Membran Rüptürü Olan Gebelerde Kliniğimizin Perinatal Sonuçları

Perinatal Outcomes of Pregnant Women with Preterm Premature Rupture of Membranes in Our Clinic

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Abstract (2. Language): 
The aim of this study was to assess perinatal outcomes of pregnant women who had been admitted to our clinic with the diagnosis of preterm premature rupture of membranes.The study was performed retrospectively on 90 pregnant women who were admitted to and gave birth at the Deparment of Obstetrics and Gynecology, Uludag University Faculty of Medicine, with the diagnosis of preterm premature rupture of membranes. Cases who were enrolled in the study were divided into two groups according to gestational age: women whose gestational ages are between 27 and 34 weeks, and less than and equal to 26 weeks. Complications, frequency of chorioamnionitis, incidence of neonatal morbidity and mortality were assessed. Group 1 and Group 2 included 69(%76,7) and 21 (%23,3) cases, respectively. Antibiotherapy had been used in all study population. While, respectively, 48 (%53,3) and 61(%67,8) women received tocolytic therapy and antenatal corticotherapy, 42(%46,7) and 29 (%32,2) did not. 33(%36,6) neonates needed surfactant therapy. Of 33 neonates, 17(%24,6) were in first group and 16(%76,2) were in second group. Mean gestational age and birth weights were 31,86 and 24,88 weeks, and 1804(±663,4 ) and 805(±55,84) grams in Group 1 and 2, respectiely. Duration of supplemental oxygen was 21,49(±0,91) days in Group 1 and 71,60(±14,81) days in Group 2. Length of hospital stay was 35,77 (±3.57) and 93.65(±15.38) days, respectively. 6 neonates (%8,7) in Group 1 and 5 neonates (%23.8) in Group 2 experienced necroziting enterocolitis (NEC). While incidence of bronchopulmonary dyplasia (BPD) was 10(%14,4) in Group 1, the rate was % 19,04 in Group 2. Rate of patent ductus arteriosus (PDA) was % 4,3 and % 14,3 in Group 1 and Group 2. Grade III-IV intraventricular hemorrhage was more common in Group 2 compared to Group 1; %4.3 in Group 1 and %14.3 in Group 2. In conclusion, it is suggested that the preterm premature rupture of membranes is one of the most important obstetric problems, with negative influences on perinatal outcomes.
Abstract (Original Language): 
Bu çalışmanın amacı kliniğimizde preterm erken membran rüptürü nedeniyle takip edilen gebelerde perinatal sonuçların incelenmesidir. Çalışma; Aralık 2004 – Aralık 2007 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı kliniğine preterm erken membran rüptürü tanısı ile yatırılan ve burada doğum yapan 90 olgunun dosya kayıtları incelenerek retrospektif olarak yapıldı. Çalışmaya dahil edilen olgular gebelik haftalarına göre iki gruba ayrıldı. Birinci grubu, 27-34. gebelik haftasında olan olgular ikinci grubu ise 26. gestasyonel hafta ve daha küçük gebelik haftasında olan olgular oluşturuyordu. Bu olgulardaki komplikasyonlar, koryoamnionit sıklığı, yenidoğanlardaki morbidite ve mortalite insidansı incelendi. Olguların 69’u (%76,7) 1. grupta, 21’i (%23,3) 2. grupta yer alıyordu. İncelenen tüm olgulara antibiyoterapi uygulanmış olduğu görüldü. Toplam 48 (%53,3) olguya tokoliz verilmiş, 42 (%46,7) olguya da tokoliz verilmemişti; ayrıca 61 (%67,8) olguya antenatal kortikosteroid uygulanmış, 29 (%32,2) olguya ise uygulanmamıştı. Yenidoğanların 33’üne (%36,6) sürfaktan tedavisi uygulanmıştı. Bunlardan 17’si (%24,6) birinci grupta, 16’sı (%76,2) ikinci grupta yer alıyordu. Birinci gruptaki olguların gebelik yaşı 31,86 hafta, ikinci grupta ise 24,88 idi. Bebek doğum tartıları da sırayla 1 804 (± 663,4) gr ve 805 (± 55,84) gr idi. Yenidoğanların oksijene ihtiyaç duydukları gün sayısı 1. grupta 21,49 gün (± 0,91), 2. grupta ise 71,60 (± 14,81) güdü. Birinci gruptaki olguların hastanede yatış süresi 35,77 gün (± 3.57), ikinci gruptaki olguları ise 93,65 (± 15.38) gündü. Birinci grupta yer alan olgulardan 6’sında (%8.7), ikinci grupta ise 5’inde (%23,8) nekrotizan enterokolit (NEK) gelişmişti. Birinci gruptan 10 olguda (%14,4) bronkopulmoner displazi (BPD) gelişirken 2. grupta bu oran %19,04 idi. Patent duktus arteriozus (PDA) ise birici grupta %4,3 oranında görülürken ikinci grupta %14,3 oranında idi. Grade III-IV intraventriküler kanama (IVK) sıklığı da ikinci grupta birinci gruba göre artmış olup sırasıyla birinci grupta % 4,3, ikinci grupta %14,3 oranında idi. Sonuç olarak preterm erken membran rüptürünün perinatal sonuçları olumsuz etkileyen en önemli obstetrik sorunlardan birisi olduğu düşünüldü.

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