Preeklamptik anne bebeklerinin klinik sonuçları

Özet

Amaç: Bu çal›flma yenido¤an yo¤un bak›m ünitesinde yatan, maternal preeklampsi/eklampsi tan›s› olan annelerin bebeklerinin özelliklerinin retrospektif olarak literatür eflli¤inde incelenmesi amac›yla planland›. Yöntem: Bir e¤itim ve araflt›rma hastanesinde 1 Ocak – 31 Aral›k 2018 tarihleri aras›nda preeklampsi/eklampsi tan›s›yla do¤umu gerçekleflen, do¤um sonras› ayn› hastanenin yenido¤an yo¤un bak› m ünitesinde yat›r›larak izlem, tetkik ve tedavisi yap›lan bebeklerin hastane bilgi yönetim sisteminden elde edilen epikriz dosyalar›, hastane yönetimi ve etik kurul onay› al›nd›ktan sonra incelenerek retrospektif olarak de¤erlendirildi. Bulgular: Çal›flmaya dahil edilen 51 bebe¤in annelerinin yafl ortalamas› 32.21±6.20, bebeklerin do¤duklar›ndaki gebelik haftas› 34.21± 3.33, ortalama do¤um a¤›rl›klar› 2177±1007 gram olarak bulundu. Annelerin neredeyse tamam›n›n (%98) spontan (kendili¤inden) gebe kald›¤›, %9.8’inin (n=5) ikiz gebelik oldu¤u, %31.4’ünün (n=16) ek hastal›klar›n›n (gestasyonel diyabet, epilepsi, hipotiroidi) oldu¤u saptand›. Klini¤e kabul edilen bebeklerin yat›fll› olduklar› günlerde %58.8’i nazal sürekli pozitif hava yolu bas›nç deste¤i, %5.9’u mekanik ventilatör deste¤i, %51’i aral›kl› fototerapi ald›. Bebeklerin tam enterale geçifl günleri 10.72±13.87 (aral›k: 1–64) olarak belirlendi. Bebeklerinden 3 tanesi yat›fllar›n›n 2. günü, 12. günü ve 23. gününde hayat›n› kaybetmiflti. Bebeklerin %90.2’si sadece anne sütü (anne memesini emerek), %9.8’i hem anne sütü hem de mama alarak taburcu olmufltu. Sonuç: Preeklamptik anne bebeklerine yaklafl›mda; prematürite ve buna sekonder geliflen komplikasyonlar baflta olmak üzere geliflebilecek di¤er sorunlar›n erken dönemde fark edilmesi, yenido¤an yo¤un bak›m ünitesi koflullar›n›n düzenlenmesi ve multidisipliner ekiplerin oluflturulmas› ile preeklampsiye ba¤l› geliflen perinatal mortalite ve morbiditenin azalt›laca¤› kan›s›nday›z.

Abstract

Objective: We planned this study to investigate the characteristics of the newborns retrospectively in company with the literature, who were hospitalized in the neonatal intensive care unit, of the mothers diagnosed with maternal preeclampsia/eclampsia. Methods: The discharge reports received from the hospital information management system for the newborns monitored, examined and treated in the neonatal intensive care unit in the postnatal period after they were delivered with the diagnosis of preeclampsia/eclampsia between January 1 and December 31, 2018 in a training and research hospital were assessed retrospectively after obtaining the approvals of hospital management and ethics committee. Results: Mean age of the mothers of 51 newborns included in the study was 32.21±6.20, the week of gestation during delivery was 34.21± 3.33, and the mean birth weight of the newborns was 2177±1007 g. It was found that almost all women (98%) conceived spontaneously, 9.8% (n=5) of them were twin pregnancies, and 31.4% (n=16) of them had additional diseases (gestational diabetes, epilepsy, and hypothyroid). During the hospitalization in the clinic, 58.8% of the newborns received nasal continuous positive airway pressure (N-CPAP) support, 5.9% of them received mechanical ventilator support, and 51% of them received intermittent phototherapy. The days switching to full enteral of the newborns were 10.72±13.87 (range: 1–64). Three newborns died on 2nd, 12th, and 23rd days of their hospitalization. Of the newborns, 90.2% were fed by only breastfeeding while 9.8% were fed by both breastfeeding and formula before they were discharged. Conclusion: In the approach towards the newborns of preeclamptic women, we believe that perinatal mortality and morbidity associated with preeclampsia will be decreased by noticing all issues early that may develop, such as prematurity and the complications developing secondary to prematurity in particular, improving the conditions of neonatal intensive care unit, and establishing multidisciplinary teams.