Preeklampsi ve FGR olgularının 1. trimester tarama testi parametreleri ile ilişkisi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç:
İlk trimester tarama testlerindeki biyokimyasal belirteçlerin kromozomal ve
yapısal anomali riskini belirlemekle birlikte, gebelik komplikasyonlarının öngörüsünde de
faydalı olabileceği anlaşılmıştır. Birinci trimester taramasında serum g ebelikle ilişkili plazma
protein A (PAPP A) serbest i nsan koryoni k gonadotropin β (serbest βhCG) ve fetal nukal
translusensi kalınlığı (NT) ölçülmektedir. Bu çalışma nın amacı, birinci trimester tarama test i
parametrelerinin preeklampsi (PE) ve fetal büyüme kısıtlılığı ( olguları ile ilişkisi ve
öngö rüdeki etkinliğinin araştırılması dır.
Gereç ve Yöntem: Ocak 2020 Eylül 2023 tarihleri arasında Necmettin Erbakan
Üniversitesi Tıp Fakültesi Hastanesinde doğum yapan ve çalışma kriterlerini karşılayan
preeklampsi tanılı 52, fetal büyüme kısıtlılığı tanılı 101 ve sağlıklı gebeliği olan 285 hasta
tespit edildi. H astaların dosyaları retrospektif olarak tarandı. 1. Trimester tarama testi nde
bakılan serum PAPP A, β hCG düzeyleri ve N T ölçümleri karşılaştırılarak PE ve FGR ön
görebilirliği araştırılmıştır
Bulgular:
Grupların demografik verileri (yaş, gravida, abortus, ek hastalıklar, sigara
kullanımı, IVF ile gebelik) benzer izlendi. PE, FGR ve kontrol grupları ortalama NT mm, NT
MoM, ortanca PAPP A(mIU/ml), β hCG (ng/ml) ve CRL mm değerleri arasında anlamlı bir
fark lılık izlenmedi (p> PAPP A MoM değeri gruplar arasında farklılık gösterdi.
(p= Posthoc analize göre s ubgrup karşılaştırmada FGR grubu PAPP A MoM değeri PE
grub una göre istatistiksel anlamlı olarak az izlendi p=0.00 1 FGR grubu PAPP A MoM
değeri kontrol grub una göre de istatistiksel anlamlı olarak az izlendi. (p=0,009) PE ile kontrol
grubu birbirine benzerdi (p= β hCG MoM değeri gruplar arasında farklılık gösterdi
(p= Posthoc analize göre subgrup karşılaştırmada fark FGR ile P E grubu arasında
izlendi (p= 0.013). PE grubunda β hCG MoM değeri FGR grubuna göre anlamlı yüksek
izlendi. FGR ile k ontrol ve PE ile kontrol grupları birbirine benze r izlendi. (sırasıyla p=0.605,
p=0.073).
Sonuç:
İlk trimester maternal serum PAPP A MoM seviyel eri düşüklüğü gebeliğin
ileri haftalarında gelişen FGR ile , β hCG MoM seviyel eri yüksekliği gebeliğin ileri
haftalarında gelişen PE ile ilişkilidir ve tarama testi parametre leri olarak yol gösterici
olabilir ler Ancak FGR ve PE’yi öngörmede tek par ametre olarak kullanım larının yeterli
tanısal değeri yoktur. PAPP A MoM seviyel eri düşük , β hCG MoM seviyel eri yüksek tespit
edilen vakaları gebeliğin ilerleyen zamanlarında yakın dan takip etme k faydalı olacaktır
Objective It has been understood that biochemical markers in first trimester screening tests can be useful in determining the risk of chromosomal and structural anomalies, as well as in predicting pregnancy complications. In the first trimester screening, serum pregnancy associated plasma protein A (PAPP A), free human chorionic gonadotropin β (free βhCG) and fetal nuchal translucency thickness (NT) are measured. The aim of this study is to investigate the relationship of first trimester screening test parameters with preeclampsia (PE) and fetal growth restriction (FGR) cases and their effectiveness in prediction. Materials Methods Between January 2020 and September 2023, 52 patients diagnosed with preeclampsia, 101 patients with fetal growth restriction, and 285 patients with healthy pregnancies who gave birth at Necmettin Erbakan University Faculty of Medicine Hospital and met the study criteria were i dentified. The patients' files were scanned retrospectively. The predictability of PE and FGR was investigated by comparing serum PAPP A, β hCG levels and NT measurements measured in the 1st Trimester screening test. Results: The demographic data of the groups (age, gravida, abortion, comorbidities, smoking, pregnancy with IVF) were similar. No significant difference was observed between the mean NT mm, NT MoM, median PAPP A (mIU/ml), β hCG (ng/ml) and CRL mm values of the PE, FGR and control groups (p> 0.05). PAPP A MoM value differed between groups. (p=0.001) According to posthoc analysis, in the subgroup comparison, the PAPP A MoM value in the FGR group was statistically significantly lower than the PE group (p=0.001). The PAPP A MoM value in the FGR g roup was statistically significantly lower than the control group. (p=0.009) PE and control groups were similar (p=1.00). β hCG MoM value differed between groups (p= 0.017). According to posthoc analysis, the difference in subgroup comparison was observed between the FGR and PE groups (p = 0.013). β hCG MoM value was observed to be significantly higher in the PE group compared to the FGR group. FGR and control and PE and control groups were similar to each other. (p=0.605, p=0.073 respectively). Conclusion Low first trimester maternal serum PAPP A MoM levels are associated with FGR developing in the later weeks of pregnancy, and high β hCG MoM levels are associated with PE developing in the later weeks of pregnancy, and they can be guiding as screening test parameters. However, their use as the only parameter in predicting FGR and PE
Objective It has been understood that biochemical markers in first trimester screening tests can be useful in determining the risk of chromosomal and structural anomalies, as well as in predicting pregnancy complications. In the first trimester screening, serum pregnancy associated plasma protein A (PAPP A), free human chorionic gonadotropin β (free βhCG) and fetal nuchal translucency thickness (NT) are measured. The aim of this study is to investigate the relationship of first trimester screening test parameters with preeclampsia (PE) and fetal growth restriction (FGR) cases and their effectiveness in prediction. Materials Methods Between January 2020 and September 2023, 52 patients diagnosed with preeclampsia, 101 patients with fetal growth restriction, and 285 patients with healthy pregnancies who gave birth at Necmettin Erbakan University Faculty of Medicine Hospital and met the study criteria were i dentified. The patients' files were scanned retrospectively. The predictability of PE and FGR was investigated by comparing serum PAPP A, β hCG levels and NT measurements measured in the 1st Trimester screening test. Results: The demographic data of the groups (age, gravida, abortion, comorbidities, smoking, pregnancy with IVF) were similar. No significant difference was observed between the mean NT mm, NT MoM, median PAPP A (mIU/ml), β hCG (ng/ml) and CRL mm values of the PE, FGR and control groups (p> 0.05). PAPP A MoM value differed between groups. (p=0.001) According to posthoc analysis, in the subgroup comparison, the PAPP A MoM value in the FGR group was statistically significantly lower than the PE group (p=0.001). The PAPP A MoM value in the FGR g roup was statistically significantly lower than the control group. (p=0.009) PE and control groups were similar (p=1.00). β hCG MoM value differed between groups (p= 0.017). According to posthoc analysis, the difference in subgroup comparison was observed between the FGR and PE groups (p = 0.013). β hCG MoM value was observed to be significantly higher in the PE group compared to the FGR group. FGR and control and PE and control groups were similar to each other. (p=0.605, p=0.073 respectively). Conclusion Low first trimester maternal serum PAPP A MoM levels are associated with FGR developing in the later weeks of pregnancy, and high β hCG MoM levels are associated with PE developing in the later weeks of pregnancy, and they can be guiding as screening test parameters. However, their use as the only parameter in predicting FGR and PE
Açıklama
Anahtar Kelimeler
Preeklampsi, Preeclampsia, Fetal büyüme kısıtlılığı, Fetal growth restriction, B irinci trimester tarama testi, First trimester screening test, PAPP A, β hCG, Nukal Translusens i, Nuchal Translucency
Kaynak
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Scopus Q Değeri
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Sayı
Künye
Gümüş, M. (2024). Preeklampsi ve FGR olgularının 1. trimester tarama testi parametreleri ile ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kadın Hastalıkları ve Doğum Anabilim Dalı, Konya.
