Ablatio Placentae in Hypertensive and Normotensive Pregnants: Perinatal and Neonatal Outcomes
Halil Aslan, Gökhan Y›ld›r›m, Aykut Özdemir, Altan Cebeci, Yavuz Ceylan
2006
Perinatal Journal•
unpublished
Objective: To compare the effect of abruptio placentae on the neonatal outcomes of hypertensive and normotensive pregnancies. Methods: 115 cases of placental abruption between January 2002 and February 2004 were reviewed in our study. These cases were grouped as normotensives (n=50) and hypertensives (n=65). The case groups were compared for demographic features, the degree of placental abrup-tion, the type of delivery, intrauterine growth restriction, oligohydramnios, preterm delivery,
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... rine fetal demise, umbilical artery Doppler measurements, birth weight, gender, Apgar scores, necrotizing enterocolitis (NEC), respiratuar distress syndrome (RDS), sepsis, mechanical ventilation , intensive care unit admission (NICU), and neonatal mortality. Results: Incidence of placental abruption was determined as 0,26%. Grade 1 placental abruption was more frequent in the normotensive group while grade 2 abruption was more frequent among hypertensives (p<0.001; p<0.001). The rate of grade 3 placental abruption was not significantly different between the case groups (p=0.64). Intrauterine growth restriction and fetal distress were more frequent in the hypertensive case group (p<0.001, p<0.001 respectively). There was no significant difference between the case groups for either birth weight, oligohy-dramnios, preterm delivery, and stillbirth or the mode of delivery (p=0.26). Conclusion: Among pregnancies complicated with placental abruption, intrauterine growth restriction and fetal distress rate was significantly higher in the hypertensive group when compared with the normotensive group. There was no significant difference between hypertansive and normotensive pregnancies for other perinatal and neonatal parameters. Normotansif ve hipertansif gebelerde plasenta dekolman›: perinatal ve neonatal sonuçlar Amaç: Plasenta dekolman›n›n hipertansif ve normotansif gebelerde perinatal ve neonatal sonuçlara etkisini karfl›laflt›rmak. Yöntem: Ocak 2002-fiubat 2004 y›llar› aras›nda klini¤imizde plasenta dekolman› tan›s› alan 115 olgu çal›flma grubumuzu oluflturdu. Bu olgu-lar normotansif (n=50) ve hipertansif (n=65) olmak üzere iki gruba ayr›ld›. Her iki olgu grubu demografik özellikler, dekolman derecesi, do¤um flekli, intrauterin geliflme gerili¤i, oligohidroamnios, erken do¤um, intrauterin fetal ölüm, umbilikal arter Doppler ölçümleri, do¤um a¤›rl›¤›, cin-siyet, Apgar skorlar›, nekrotizan enterokolit, RDS, sepsis, mekanik ventilasyon, yo¤un bak›m gereksinimi ve neonatal mortalite yönünden karfl›-laflt›r›ld›. Bulgular: Plasenta dekolman insidans› %0.26 olarak hesapland›. Grade 1 plasenta dekolman› normotansif gurupta, grade 2 dekolman ise hi-pertansif grupta daha fazla izlendi (p<0.001; p<0.001). Grade 3 plasenta dekolman› yönünden olgu gruplar› aras›nda anlaml› fark tespit edilme-di (p=0.64). ‹ntrauterin geliflme gerili¤i ve fetal distress, hipertansif olgu grubunda daha fazla tespit edildi.(p<0.001; p<0.001). Gruplar aras›nda do¤um a¤›rl›¤›, oligohidroamnios, erken do¤um ve ölü do¤um yönünden fark tespit edilmedi. Olgu gruplar› aras›nda do¤um flekli yönünden an-laml› fark tespit edilmedi (p=0,26). Sonuç: Plasenta dekolman› ile komplike olmufl gebeliklerde, intrauterin geliflme gerili¤i ve fetal distres hipertansif gebelerde anlaml› olarak yük-sek bulundu; ancak di¤er perinatal ve neonatal parametreler yönünden hipertansif ve normotansif gebeler aras›nda anlaml› bir fark tespit edil-medi. Anahtar Sözcükler: Plasenta dekolman›, hipertansiyon, perinatal, neonatal sonuçlar.
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