Erken gebelik kayıplarında serum homosistein düzeyinin rolü var mıdır?

Fatih ŞANLIKAN,Koray ÖZBAY,Ahmet GOCMEN,Fatma Tufan ALTUNCU,Muhittin Eftal AVCI

Özet

Amaç: Yüksek maternal homosistein düzeyleri ile erken gebelik kay›plar› aras›ndaki iliflkiyi araflt›rmak. Yöntem: 5–12. gebelik haftalar› aras›nda abortus (misssed, inkomplet ve imminens) tan›s› alan 70 hasta, takiplerinde sorun olmayan 54 gebe ile gebe homosistein düzeyleri aç›s›ndan karfl›laflt›r›ld›. Bulgular: Abortus gruplar›nda en yüksek serum homosistein düzeyi ortalamas› abortus imminens grubunda tespit edildi (8.9±3.9 nmol/l), bu ortalama missed abortus ve inkomplet abortus gruplar› nda s›ras›yla 7.8±2.5 ve 8.7±4.2 nmol/l olarak bulundu. Kontrol grubunda serum homosistein düzeyi ortalamas› 4.8±0.9 nmol/l olarak saptand›. Kontrol grubunun homosistein düzeyleri her üç abortus grubundan anlaml› düzeyde düflüktü (p 0.05). Kontrol grubu ile karfl›laflt›r›ld›¤›nda serum homosistein düzeyleri aras›nda en anlaml› fark missed abortus grubunda saptand› (p<0.01). Sonuç: Erken gebelik haftalar›nda tespit edilen yüksek homosistein düzeyleri, abortus riski hakk›nda uyar›c› olabilece¤i gibi ilerleyen haftalarda geliflebilecek olan preeklampsi, plasenta dekolman› ve intrauterin geliflme gerili¤i gibi obstetrik komplikasyonlar hakk› nda da fikir verebilir.

Abstract

Objective: To investigate the relationship between high maternal homocysteine levels and early pregnancy losses. Methods: Seventy patients diagnosed with miscarriage (missed, incomplete and threatened) between 5 and 12 weeks of gestation and 54 pregnant women without any problem during their follow-up were compared in terms of homocysteine levels during pregnancy. Results: The highest mean serum homocysteine level among the miscarriage groups was in the threatened miscarriage group (8.9±3.9 nmol/l), followed by 7.8±2.5 and 8.7±4.2 nmol/l in the missed and incomplete miscarriage groups, respectively. The mean serum homocysteine level in the control group was 4.8±0.9 nmol/l. The homocysteine levels of the control group were significantly lower than all three miscarriage groups (p 0.05). When compared to the control group, the most significant difference among the serum homocysteine levels was found in the missed miscarriage (p<0.01). Conclusion: High homocysteine levels detected during early weeks of gestation can be a warning about the miscarriage risk, and also may provide insight about the obstetric complications that may develop in the further weeks of gestation such as preeclampsia, ablatio placentae and intrauterine growth restriction.