Journals / Perinatoloji Dergisi / 2019 / Cilt: 27 - Sayı: 1
The analysis of the termination of pregnancies at and after ten weeks of gestation – a monocenter study
- Journal
- Perinatoloji Dergisi
- Pages
- 14–21
- DOI
- —
Abstract
Objective: We aimed to manage the termination of pregnancies, which were performed at and after 10 weeks of gestation in our clinic, better and to develop appropriate approaches for them by investigating the indications and obstetric characteristics of these cases. Methods: The maternal data, obstetric characteristics and indications of 379 cases whose termination procedures were performed in our clinic between January 2012 and January 2019 were evaluated. The indications were grouped as maternal reasons, amniotic fluid anomalies, and isolated structural, multiple congenital and genetic disorders. The groups were classified according to their characteristics and they were compared among each other. Results: The mean age was 30.2±6, the mean week of gestation was 17.4±3.5, and mean termination duration was 16.4±14.5 hours. The most common reason for termination was amniotic fluid anomalies (n=126, 33.2%). Among fetal reasons, the most common one was isolated structural anomalies (n=114, 30.1%). The anomalies of central nervous system were the most common isolated structural anomalies (n=60, 15.8%). Of 379 termination cases, 25 (6.6%) were caused by maternal reasons. The rates of requesting invasive examination for genetic disorders and of performing the examination were 49.6% (n=197) and 31.7% (n=120), respectively. Chromosomal anomalies were found in 69 (18.2%) cases, with trisomy 21 being the most common anomaly (n=39, 55.7%). It was found out that chromosomal anomalies were identified in more advanced maternal ages and at earlier weeks of gestation. On the other hand, isolated structural and multiple congenital anomalies (cardiac and urogenital anomalies in particular) were identified at younger ages and further weeks of gestation (maternal age, p=0.002; week of gestation, p
Özet
Amaç: Klini¤imizde yap›lm›fl olan 10 hafta ve üzeri gebelik terminasyonlar›n›n endikasyonlar›n› ve obstetrik özelliklerini inceleyerek, bu olgular› daha iyi yönetebilmeyi ve do¤ru yaklafl›mlar› gelifltirebilmeyi amaçlad›k. Yöntem: Ocak 2012 – Ocak 2019 aras›nda klini¤imizde gerçekleflmifl 379 terminasyon olgusunun maternal verileri, obstetrik özellikleri ve endikasyonlar› de¤erlendirildi. Endikasyonlar; maternal nedenler, amniyotik s›v› anomalileri, izole yap›sal, çoklu konjenital ve genetik bozukluklar olarak grupland›r›ld›. Gruplar özelliklerine göre s›n›fland›r›ld› ve kendi aralar›nda karfl›laflt›r›ld›. Bulgular: Ortalama yafl 30.2±6, ortalama gebelik haftas› 17.4±3.5, ortalama terminasyon süresi 16.4±14.5 saatti. En s›k amniyotik s›- v› anomalileri nedeniyle terminasyon yap›ld›¤› izlendi (n=126, %33.2). Fetal nedenler içerisinde en s›k izole yap›sal anomaliler (n=114, %30.1) tespit edildi. Santral sinir sistemi anomalileri en çok görülen izole yap›sal anomaliler idi (n=60, %15.8). Terminasyonlar›n 25/379’u (%6.6) maternal nedenli idi. Genetik bozukluklar için invaziv tetkik istenme oran› %49.6 (n=197), yap›lma oran› %31.7 (n=120) idi. En s›k trizomi 21 (n=39, %55.7) olmak üzere kromozomal anomali 69 (%18.2) olguda tespit edildi. Kromozomal anomalilerin daha ileri maternal yafl ve daha erken gebelik haftalar›nda tespit edildi¤i izlendi. ‹zole yap›sal ve çoklu konjenital anomalilerin ise daha genç yaflta ve daha ileri gebelik haftalar›nda saptand›¤› görüldü (özellikle kardiyak ve ürogenital anomaliler) (maternal yafl, p=0.002; gebelik haftas›, p