Öz
Amaç: Bu çalışmanın amacı term vajinal makat doğumların maternal ve fetal
sonuçlarını değerlendirmektir.
Yöntem: Bu çalışmada Ocak 2014-Aralık 2017 tarihleri arasında kliniğimize doğum
için başvuran term gebelerden vajinal yolla doğum yapan makat gebelerdeki
maternal ve fetal sonuçlar değerlendirildi. Çalışma süresinde kliniğimizde 45
vajinal makat doğum gerçekleştiği saptandı.
Maternal demografik veriler; yaş, gravida, parite, gestasyonel hafta ve
maternal travma değerlendirildi. Fetal sonuçlar olarak doğum kilosu, 1. ve 5.
dakika APGAR skorları, 5.dakika APGAR skorunun 7 olması, yenidoğan yoğun bakım ihtiyacı
olup olmaması ve fetal travma ve neonatal ölüm varlığı değerlendirildi. Preterm makat doğumlar çalışmaya dahil
edilmedi.
Bulgular: Çalışma süresince
45 term vajinal makat doğum
gerşekleşmiştir. Gebelerin 2(%4) sinde maternal travmaya rastlanmış,
yenidoğanların 3(%7)ünde doğum travması
görülmüştür. 2(%6) yenidoğan da 5.dakika APGAR7 idi. 13(%29) yenidoğana yoğum bakım
ihtiyacı gerekmiştir, bunların 4(%9) ünde fetal anomali mevcuttu. Neonatal ölüm
1(%2) yenidoğanda görülmüştür. Bu olguda fetal anomali nedeniyle
kaybedilmiştir.
Sonuç: Term makat gebelerde planlanmış sezeryanla doğum yapıldığında mortalite
ve morbiditede azalma sağlanabilir. Düşük risk grubuna sahip gebelerde yakın
fetal moniterizasyon ve tecrübeli hekimlerin varlığında vajinal yolla doğum
sezeryanla doğuma alternatif olabilir.
Anahtar Kelimeler
Kaynakça
- 1. Hickok DE, Gordon DC, Milberg JA, et al. The frequency of breech presentation by gestational age at birth: a large population-based study. Am J Obstet Gynecol 1992; 166:851.
- 2. Danielian PJ1, Wang J, Hall MH. Long-term outcome by method of delivery of fetuses in breech presentation at term: population based follow up. BMJ. 1996 Jun 8;312(7044):1451-3.
- 3. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000 Oct 21;356(9239):1375-83.
- 4. Makat Prezentasyon Yönetimi. T.C. Sağlık Bakanlığı AÇSAP Doğum ve Sezeryan Eylemi Yönetim Rehberi, 2010; s18.
- 5. Goffinet F1, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, Bréart G; PREMODA Study Group. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol. 2006 Apr;194(4):1002-11.
- 6. Doyle NM1, Riggs JW, Ramin SM, Sosa MA, Gilstrap LC 3rd. Outcomes of term vaginal breech delivery. Am J Perinatol. 2005 Aug;22(6):325-8.
- 7. Sanchez-Ramos L1, Wells TL, Adair CD, Arcelin G, Kaunitz AM, Wells DS. Route of breech delivery and maternal and neonatal outcomes. Int J Gynaecol Obstet. 2001 Apr;73(1):7-14.
- 8. Gannard-Pechin E1, Ramanah R, Desmarets M, Maillet R, Riethmuller D. [Term breech presentations in singleton pregnancies: a continuous series of 418 cases]. J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):685-92.
- 9. Berhan Y1, Haileamlak A2. The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. BJOG. 2016 Jan;123(1):49-57. doi: 10.1111/1471-0528.13524. Epub 2015 Jul 29.
- 10. Vlemmix F, Bergenhenegouwen L, Schaaf JM, Ensing S, Rosman AN, Ravelli AC, Van Der Post JA, Verhoeven A, Visser GH, Mol BW, Kok M. Term breech deliveries in the Netherlands: did the increased cesarean rate affect neonatal outcome? A population-based cohort study. Acta Obstet Gynecol Scand. 2014 Sep;93(9):888-96.
- 11. Whyte H, Hannah ME, Saigal S, Hannah WJ et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Am J Obstet Gynecol. 2004 Sep;191(3):864-71.
- 12. Borbolla Foster A1, Bagust A, Bisits A, Holland M, Welsh A. Lessons to be learnt in managing the breech presentation at term: an 11-year single-centre retrospective study. Aust N Z J Obstet Gynaecol. 2014 Aug;54(4):333-9.
Öz
Objective: The aim of the study is to consider maternal and
fetal outcome of planned breech delivery.
Matherial and methods: We report data of 45 term breech deliveries between
Janaury 2014-December 2017. Maternal and fetal outcome were considered at term
vaginal breech delivery. Maternal
demographic features;age, gravidy, parity, gestational week and maternal trauma were evaluated. Fetal
outcome; fetal weight, 1. And 5-minute APGAR scores, 5-minute APGAR score 7, neonatal intensive care admission,
fetal trauma and neonatal death were evaluated. Preterm breech deliveries were
excluded.
Results : 45 term breech deliveries were happened in the study
period. There were 2(%4) maternal traumas and 3(%7) neonatal traumas in these
cases. 5-minute APGAR7 was 2(%6) in neonates. 13(%29) neonates
needed neonatal intensive care and 4 (%9) of them had congenital anomalies. There
was 1(%2) neonatal death and this case had multiple congenital anomalies.
Conclusion: Fetal mortality and morbidity can decrease when
performed planned caeseran delivery for breech presentation at term. Planned
vaginal delivery can be an alternative in low risk pregnants with closed fetal
moniterization and experienced clinicians.
Anahtar Kelimeler
Kaynakça
- 1. Hickok DE, Gordon DC, Milberg JA, et al. The frequency of breech presentation by gestational age at birth: a large population-based study. Am J Obstet Gynecol 1992; 166:851.
- 2. Danielian PJ1, Wang J, Hall MH. Long-term outcome by method of delivery of fetuses in breech presentation at term: population based follow up. BMJ. 1996 Jun 8;312(7044):1451-3.
- 3. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000 Oct 21;356(9239):1375-83.
- 4. Makat Prezentasyon Yönetimi. T.C. Sağlık Bakanlığı AÇSAP Doğum ve Sezeryan Eylemi Yönetim Rehberi, 2010; s18.
- 5. Goffinet F1, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, Bréart G; PREMODA Study Group. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol. 2006 Apr;194(4):1002-11.
- 6. Doyle NM1, Riggs JW, Ramin SM, Sosa MA, Gilstrap LC 3rd. Outcomes of term vaginal breech delivery. Am J Perinatol. 2005 Aug;22(6):325-8.
- 7. Sanchez-Ramos L1, Wells TL, Adair CD, Arcelin G, Kaunitz AM, Wells DS. Route of breech delivery and maternal and neonatal outcomes. Int J Gynaecol Obstet. 2001 Apr;73(1):7-14.
- 8. Gannard-Pechin E1, Ramanah R, Desmarets M, Maillet R, Riethmuller D. [Term breech presentations in singleton pregnancies: a continuous series of 418 cases]. J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):685-92.
- 9. Berhan Y1, Haileamlak A2. The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. BJOG. 2016 Jan;123(1):49-57. doi: 10.1111/1471-0528.13524. Epub 2015 Jul 29.
- 10. Vlemmix F, Bergenhenegouwen L, Schaaf JM, Ensing S, Rosman AN, Ravelli AC, Van Der Post JA, Verhoeven A, Visser GH, Mol BW, Kok M. Term breech deliveries in the Netherlands: did the increased cesarean rate affect neonatal outcome? A population-based cohort study. Acta Obstet Gynecol Scand. 2014 Sep;93(9):888-96.
- 11. Whyte H, Hannah ME, Saigal S, Hannah WJ et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Am J Obstet Gynecol. 2004 Sep;191(3):864-71.
- 12. Borbolla Foster A1, Bagust A, Bisits A, Holland M, Welsh A. Lessons to be learnt in managing the breech presentation at term: an 11-year single-centre retrospective study. Aust N Z J Obstet Gynaecol. 2014 Aug;54(4):333-9.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Nisan 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 49 Sayı: 1 |
