Nullipar ve multipar tekiz makat gelişlerde doğum: Kliniğimizin 5 yıllık sonuçları

Singleton term breech deliveries in nulliparous and multiparous women: A 5-years experience at our clinic

Alparslan BAKSU, Nimet GÖKER, Meltem TEKELİOĞLU, Ahmet ŞAŞMAZLAR, Sibel ÖZSOY

Özet

AMAÇ: Tekiz makat prezentasyonlarında doğum yöntemlerinin tartışılması.MATERYAL ve METOD: Şişli Etfal Eğitim ve Araştırma Hastanesi 1. Kadın Hastalıkları ve Doğum Kliniği'ne Ocak 1998-Aralık 2002 yılları arasında 5 yıllık bir sürede başvuran gebelerden tekiz, 500 gr. üzerinde, 214 makat prezentasyonlu hasta çalışma kapsamına alındı.BULGULAR: Makat prezentasyonlu hastaların 136'sı abdominal, 78'i vajinal yolla doğum yapmıştır. Abdominal doğumların % 66.2'si primipar, % 33.8'i multipar, buna karşın vajinal doğumların % 78.2'si multipar, % 21.8'i primipardır. Parite ile doğum şekilleri arasında istatistiksel olarak anlamlı ilişki bulunmuştur (X2=39.29, p

Abstract

OBJECTIVE: To discuss mode of delivery in singleton breech presentation.STUDY DESING: Total of 214 patients with singleton breech presentation and fetal weight over 500 gram who delivered at Şişli Etfal Training and Research Hospital 1.Obstetrics and Gynecology Clinic between January 1998-December 2002 were recruited into study.RESULTS: 136 patients delivered by cesarean section, and 78 delivered spontaneously. Of the abdominal deliveries, 66.2 % was primiparous and 33.8 % was multiparous whereas of the vajinal deliveries, 21.2 % was primiparous and 78.2 % was multiparous. There were significant correlations between parity and mode of delivery, and between gestational week and mode of delivery (respectively; X2=39.29, p< 0.05; X2=39.29, p< 0.05). As gestational week increased, incidence of cesarean section operation increased. When mode of delivery and fifth minute apgar scores were evaluated, a significant correlation was found (X2=44.25, p< 0.05). The Apgar scores in cesarean deliveries were significantly higher than in vajinal deliveries.CONCLUSION: If close folow-up and monitorization is possible, vajinal birth may be tried in selected singleton breech presentations having none of the risk factors. However, for selection of mode of delivery, obstetrician should consider his or her experience, the facilities of the newborn unit having in mind the low apgar scores in vajinal deliveries for these babies.