İkinci trimester uterin arter ve fetal orta serebral arter doppler ölçümlerinin intrauterin gelşme geriliği ve preeklampsi gelişiminde prediktif değeri
Küçük Resim Yok
Tarih
2002
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Preeklampsi ve intrauterin gelişme geriliğinin önceden belirlenmesinde, risk gurubundaki gebelerde 2. trimesterde uygulanan uterin arter ve fetal orta serebral arter doppler incelemelerinin prediktif değerini saptamak. GEREÇ VE YÖNTEM: Polikliniğimize Kasım 1997-Ekim 1998 tarihleri arasında başvuran, 18-26. gebelik haftasında, takip ve doğumları kliniğimizde yaptırılan, belirlenen risk faktörlerinden herhangi birini taşıyan, çoğul gebelik ve anomalili fetus olmayan gebeler çalışmamıza alındı. Deneyimli aynı kişi tarafından, aynı cihaz üzerinde (Toshiba SS A-270 A Tokyo-Japan) doppler incelemesi yapıldı. İntrauterin gelişme geriliği tanısı, gebelik haftası ve cinsiyete göre doğum ağırlığının 10. persantil ve altında olması, preeklampsi tanısı ise 'American College of Obstetricians and Gynecologists' kriterlerine göre konuldu. BULGULAR: Gebelikleri normal sonuçlanan 80 kişi grup 1, intrauterin gelişme geriliği olan 12 kişi grup 2, preeklampsi gelişen 8 kişi grup 3'te yer aldı. Uterin arter rezistans indeksi 3 grup arasında farklıydı (p<0.01). Fetal orta serebral arter sistol/diastol oranları, sadece normal ve intrauterin gelişme geriliği olan gruplar arasında anlamlıydı (p<0.05). Tek parametre kullanıldığında, preeklampsi için en yüksek prediktif değer bilateral diastolik çentik, intrauterin gelişme geriliği içinse fetal orta serebral arter sistol/diastol oranının 4'ün altında olmasıydı. SONUÇ: İkinci trimester doppler uygulamalarında birden fazla parametrenin kombine edilmesi daha başarılı olmaktadır. Bu testler pozitif ön tahmin yeteneğinden ziyade, negatif ön tahminde daha başarılıdır.
OBJECTIVE: To determine the predictive value of uterine artery and middle cerebral artery doppler studies in prediction of intrauterine growth retardation and preeclampsia. MATERIAL AND METHOD: Women between 18.-26.gestational weeks with one of the risk factors determined, with singleton pregnancies and without fetal anomalies were recruited into study between November 1996-October 1997. Doppler analysis was done by the same experienced doctor with the same machine (Toshiba SS A-270 A Tokyo, Japan). Fetal weight <10. percentile according to gestational week and sex was accepted as intrauterine growth retardation and preeclampsia was defined by the criteria of 'American College of Obstetricians and Gynecologists'. RESULTS: Eighty women with normal pregnancy outcomes consisted group 1, 12 women with intrauterine growth retardation were in group 2 and 8 women in whom preeclampsia developed were in group 3. Uterine artery resistans index between the 3 groups was significant (p<0.01). Middle cerebral artery systol/diastol ratio was significant only between normal and intrauterine growth retardation groups (p<0.05). When one parameter was used, bilateral diastolic notch had the most highest predictive value for preeclampsia whereas middle cerebral artery systol/diastol ratio less than 4 was most predictive for intrauterine growth retardation CONCLUSION: Combination of more than one parameter in second trimester doppler studies seems to be more promising. These tests are more valuable in negative prediction rather than positive prediction.
OBJECTIVE: To determine the predictive value of uterine artery and middle cerebral artery doppler studies in prediction of intrauterine growth retardation and preeclampsia. MATERIAL AND METHOD: Women between 18.-26.gestational weeks with one of the risk factors determined, with singleton pregnancies and without fetal anomalies were recruited into study between November 1996-October 1997. Doppler analysis was done by the same experienced doctor with the same machine (Toshiba SS A-270 A Tokyo, Japan). Fetal weight <10. percentile according to gestational week and sex was accepted as intrauterine growth retardation and preeclampsia was defined by the criteria of 'American College of Obstetricians and Gynecologists'. RESULTS: Eighty women with normal pregnancy outcomes consisted group 1, 12 women with intrauterine growth retardation were in group 2 and 8 women in whom preeclampsia developed were in group 3. Uterine artery resistans index between the 3 groups was significant (p<0.01). Middle cerebral artery systol/diastol ratio was significant only between normal and intrauterine growth retardation groups (p<0.05). When one parameter was used, bilateral diastolic notch had the most highest predictive value for preeclampsia whereas middle cerebral artery systol/diastol ratio less than 4 was most predictive for intrauterine growth retardation CONCLUSION: Combination of more than one parameter in second trimester doppler studies seems to be more promising. These tests are more valuable in negative prediction rather than positive prediction.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Medical Network Klinik Bilimler ve Doktor
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
6
