2013-2021 Yılları Arasında Kliniğimizde Postpartum Hemoraji Nedeni İle Acar Usulü Sütürüzasyon Uygulanan Hastaların Sonraki Gebelik Sonuçlarının Araştırılması
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Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu tez çalışmasında postpartum hemoraji nedeni ile Acar usulü
sütürüzasyon uygulanan hastaların sonraki gebelik sonuçlarının araştırılması
amaçlanmıştır.
Gereç ve Yöntem : Retrospektif olarak planlanan çalışmaya 18 yaş üzeri ve tekil
gebeliği olan sezeryanla doğum yapmış ve postpartum hemoraji tanısıyla İntrakaviter
Plasental Alan Sütürüzasyonu(İKPAS) uygulanan 75 kadın hastanın sonraki gebelikleri ile
randomize seçilerek sezeryanla doğum yapan ve İKPAS uygulanmayan 75 kadın hastanın
sonraki gebelikleri olmak üzere toplamda 150 hasta dahil edilmiştir. Her hasta çalışmaya
sadece bir kez dahil edilmiştir. Arşiv ve elektronik ortamdaki dosyalardan hastaların
demografik özellikleri ile obstetrik ve perioperatif sonuçları kaydedilmiştir. İstatiksel
analiz için toplanan tüm veriler Statistical Package for the Social Sciences, sürüm 23,
SPSS Inc., Chicago, IL (SPSS) ile analiz edilmiştir.
Bulgular: Çalısmada klinigimizde sezeryanla doğum yapmış ve postpartum
hemoraji tanısı konup İntrakaviter Plasental Alan Sütürüzasyonu(İKPAS) uygulanan 75
kadın hastanın sonraki gebelikleri vaka grubu olarak alınmıştır. Sezeryanla doğum yapan
ve İKPAS uygulanmayan randomize seçilen 75 kadın hastanın sonraki gebelikleri de
kontrol grubu olarak alınmıştır.Gruplar arasında hastaların yaşı , gebelik haftası, gravidası,
paritesi, sezeryan sayısı, sonraki gebeliğe kadar geçen süre , gebeliğinde hiperemezis
gravidarum ve abortus imminens nedeniyle hastaneye başvuru, oligohidroamnios,
gestasyonel diyabet, gestasyonel hipertansiyon, preeklampsi, intrauterin gelişme
geriliği,fetal anomali,erken membran rüptürü , akut fetal distres açısından istatistiksel
olarak anlamlı fark izlenmemiştir. Gruplar arasında preoperatif hemoglobin, preoperatif
hematokrit, postoperatif hemoglobin, postoperatif hematokrit, postoperatif hastanede yatış
süresi, transfüzyon ihtiyacı açısından da istatistiksel olarak anlamlı fark izlenmemiştir.
Çalışmada vaka grubunda postpartum hemoraji sayısı 14(18.7) iken kontrol grubunda
postpartum hemoraji 5(6.7) idi. Postpartum hemorajinin varlığına bakıldığında ise iki grup
arasında anlamlı fark saptanmıştır. (p=0.027).
viii
Sonuç: Retrospektif olarak yürütülen bu çalısmada postpartum hemorajiyi
önlemeye yönelik mevcut klasik tedavi yöntemlerle başarı sağlanamadığında yeni bir
cerrahi teknik olan Acar usulü süturuzasyonun (İKPAS) etkinliğini,güvenilirliğini ve
sonraki gebelikler üzerine obstetrik ve perioperatif sonuçlarını inceledik. Acar usulü
sütüruzasyon(İKPAS) hem etkilidir hem de kolayca uygulanır ve postpartum hemoraji
vakalarında histerektomiyi önlemede yardımcıdır. Bu yöntemde sezaryanda kullanılan
malzeme dışında ek malzemeye de ihtiyaç yoktur.Diğer yöntemlere göre daha az invaziv
olması ve işlem esnasında ya da sonrasında şimdiye kadar herhangi bir kaydedilen
komplikasyonun olmaması da önemli bir avantajdır.
The primary aim of this study is to investigate the subsequent pregnancy outcomes of patients who had Acar-style suturing due to postpartum hemorrhage. Materials and Methods: A total of 150 patients, including 75 female patients over 18 years of age who had a single pregnancy, cesarean delivery, and underwent Intracavitary Placental Field Suturation(ICPFS) due to diagnosis of postpartum hemorrhage, and 75 randomly selected female patients who had a cesarean delivery but were not applied ICPFS, were included in the retrospective study.Each patient was included in the study only once. Demographic characteristics, obstetric and perioperative results of the patients were recorded from archives and electronic files. All data collected for statistical analysis were analyzed with the Statistical Package for the Social Sciences, version 23, SPSS Inc., Chicago, IL (SPSS). Results: The subsequent pregnancies of 75 female patients, who gave birth by cesarean delivery in our clinic, were diagnosed with postpartum hemorrhage and underwent Intracavitary Placental Field Suturation(ICPFS), were taken as the case group in this study. The subsequent pregnancies of 75 randomly selected female patients who gave birth by cesarean delivery and were not applied ICPFS were taken as the control group. Among the groups, no statistically significant difference was observed in terms of patients' age, gestational week, gravida, parity, number of cesarian delivery, time to the next pregnancy, admission to hospital due to hyperemesis gravidarum and abortus imminens during pregnancy, oligohydramnios, gestational diabetes, gestational hypertension, preeclampsia, intrauterine growth retardation, fetal anomaly, premature rupture of membranes, acute fetal distress. Also, no statistically significant difference was observed in terms of preoperative hemoglobin, preoperative hematocrit, postoperative hemoglobin, postoperative hematocrit, postoperative hospital stay, transfusion need. The number of postpartum hemorrhages was 14 (18.7) in the case group, while the postpartum hemorrhage was 5 (6.7) in the control group.When the presence of postpartum hemorrhage was examined, a significant difference was found between the two groups. (p=0.027). x Conclusion: In this retrospective study, we examined the efficacy and safety of a new surgical technique, Acar-style suture (ICPFS), as well as obstetric and perioperative outcomes in subsequent pregnancies, when current conventional treatment methods to prevent postpartum hemorrhage were unsuccessful. Acar-style suturing (ICPFS) is both effective and easy to administer, and is helpful in preventing hysterectomy in cases of postpartum hemorrhage. There is no need for additional material to use this method other than the material used in the cesarean section. Also, another important advantage of this method is that it is less invasive than other methods and there are no recorded complications during or after the procedure.
The primary aim of this study is to investigate the subsequent pregnancy outcomes of patients who had Acar-style suturing due to postpartum hemorrhage. Materials and Methods: A total of 150 patients, including 75 female patients over 18 years of age who had a single pregnancy, cesarean delivery, and underwent Intracavitary Placental Field Suturation(ICPFS) due to diagnosis of postpartum hemorrhage, and 75 randomly selected female patients who had a cesarean delivery but were not applied ICPFS, were included in the retrospective study.Each patient was included in the study only once. Demographic characteristics, obstetric and perioperative results of the patients were recorded from archives and electronic files. All data collected for statistical analysis were analyzed with the Statistical Package for the Social Sciences, version 23, SPSS Inc., Chicago, IL (SPSS). Results: The subsequent pregnancies of 75 female patients, who gave birth by cesarean delivery in our clinic, were diagnosed with postpartum hemorrhage and underwent Intracavitary Placental Field Suturation(ICPFS), were taken as the case group in this study. The subsequent pregnancies of 75 randomly selected female patients who gave birth by cesarean delivery and were not applied ICPFS were taken as the control group. Among the groups, no statistically significant difference was observed in terms of patients' age, gestational week, gravida, parity, number of cesarian delivery, time to the next pregnancy, admission to hospital due to hyperemesis gravidarum and abortus imminens during pregnancy, oligohydramnios, gestational diabetes, gestational hypertension, preeclampsia, intrauterine growth retardation, fetal anomaly, premature rupture of membranes, acute fetal distress. Also, no statistically significant difference was observed in terms of preoperative hemoglobin, preoperative hematocrit, postoperative hemoglobin, postoperative hematocrit, postoperative hospital stay, transfusion need. The number of postpartum hemorrhages was 14 (18.7) in the case group, while the postpartum hemorrhage was 5 (6.7) in the control group.When the presence of postpartum hemorrhage was examined, a significant difference was found between the two groups. (p=0.027). x Conclusion: In this retrospective study, we examined the efficacy and safety of a new surgical technique, Acar-style suture (ICPFS), as well as obstetric and perioperative outcomes in subsequent pregnancies, when current conventional treatment methods to prevent postpartum hemorrhage were unsuccessful. Acar-style suturing (ICPFS) is both effective and easy to administer, and is helpful in preventing hysterectomy in cases of postpartum hemorrhage. There is no need for additional material to use this method other than the material used in the cesarean section. Also, another important advantage of this method is that it is less invasive than other methods and there are no recorded complications during or after the procedure.
Açıklama
Anahtar Kelimeler
Postpartum Hemoraji, Uterin Atoni, Acar Usulü Sütürasyon, Postpartum Hemorrhage, Uterine Atony, Acar-Style Suturing
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özkaya, E. B. (2022). 2013-2021 Yılları Arasında Kliniğimizde Postpartum Hemoraji Nedeni İle Acar Usulü Sütürüzasyon Uygulanan Hastaların Sonraki Gebelik Sonuçlarının Araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kadın Hastalıkları ve Doğum Anabilim Dalı, Konya.
