İlk trimester anöploidi taraması yapılmış gebelerde plasental volüm ölçümü, uterin arter doppleri, beta hcg ve papp-a değerlerinin preeklampsi ve fetal gelişme geriliğini öngörmedeki yeri
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Tarih
2024
Yazarlar
Dergi Başlığı
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Yayıncı
Çanakkale Onsekiz Mart Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda 11 – 13+6 gebelik haftalarında değerlendirilen gebelerin plasenta volüm ölçümlerinin, bilateral uterin arter doppler pulsalite indekslerinin ve ilk trimester anöploidi taramasında kullanılan beta HCG ve PAPP-A değerlerinin preeklampsi ve fetal gelişme geriliği ile ilişkisini ortaya koymayı amaçladık. Gereç ve Yöntem: Çalışmaya Ekim 2021- Aralık 2022 tarihleri arasında kliniğimizde ilk trimester anöploidi taramasını yapılmış 255 gebe dahil edildi. 11-13+6 gebelik haftalarında Çanakkale Onsekiz Mart Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Yüksek Riskli Gebelik Polikliniğinde plasenta volümü 2D ölçüldü, uterin arter doppler ölçümleri abdominal ultrasonografi ile yapıldı. Gebelik süreçleri tamamlandıktan sonra hasta kayıtları tarandı. 4 gebenin sonuçlarına ulaşılamadığından çalışma dışı bırakıldı.251 gebenin verileri IBM SPSS Statistics 26.0 programı ile değerlendirildi. Bulgular: Çalışmaya alınan 251 gebenin 8'inde preeklampsi gelişti, 29 gebede ise fetal gelişme geriliği (FGG) gelişti. Preeklampsi gelişen grupta ortalama plasenta hacmi 78,05 cm³ olarak hesaplandı. Preeklampsi gelişmeyen grupta ise 86,10 cm³ olarak hesaplandı. FGG gelişen grupta 78,98 cm³ hesaplanan plasenta hacmi FGG gelişmeyen grupta 86,74 cm³ olarak hesapandı. Gruplar arasında plasenta hacminin, preeklampsi ve FGG ile ilişkisi açısından istatistiksel fark bulunamadı (P 0,478; P 0,342). Uterin arter pulsalite indeksi ve biyokimyasal belirteçler açısından da gruplar arasında istatistiksel olarak fark gözlenmedi. Sonuç: Plasenta hacmi preeklampsi ve FGG görülen gruplarda azalma eğiliminde ancak görülmeyen gruplarla karşılaştırıldığında istatistiksel olarak anlamlı fark bulunmadı. Bilateral uterin arter pulsalite indeksleri, beta HCG ve PAPP-A değerleri için de preeklampsi ve FGG gelişen gruplarda da gelişmeyen gruplarla istatistiksel olarak anlamlı bir fark bulunmadı. İlk trimester taramasında preeklampsi ve FGG'yi öngörmek ilerleyen süreçte maternal ve fetal mortbidite-mortalite üzerine fayda sağlayacağından daha büyük gruplarda çalışmalar yapılmasına ihtiyaç vardır. Anahtar Kelimeler: preeklampsi, fetal gelişme geriliği, plasenta volüm
Objective: In our study, we aimed to investigate the relationship between placental volume measurements, bilateral uterine artery Doppler pulsatility indices, and beta HCG and PAPP-A values used in first-trimester aneuploidy screening, with the occurrence of preeclampsia and fetal growth restriction in pregnant women evaluated at 11 - 13+6 weeks of gestation. Materials and Methods: A total of 255 pregnant women who underwent first-trimester aneuploidy screening in our clinic between October 2021 and December 2022 were included in the study. Placental volume was measured in 2D at 11-13+6 weeks of gestation in the High-Risk Pregnancy Clinic of Çanakkale Onsekiz Mart University Health Application and Research Center, and uterine artery Doppler measurements were performed using abdominal ultrasonography. After completion of the pregnancy processes, patient records were reviewed. Four patients with missing data were excluded from the study. The data of 251 patients were analyzed using IBM SPSS Statistics 26.0. Results: Preeclampsia developed in 8 of the 251 included pregnant women, while fetal growth restriction (FGG) occurred in 29. The mean placental volume was calculated as 78.05 cm³ in the preeclampsia group and 86.10 cm³ in the non-preeclampsia group. In the FGG group, the mean placental volume was calculated as 78.98 cm³, compared to 86.74 cm³ in the non-FGG group. There was no statistically significant difference in placental volume between the groups in terms of its association with preeclampsia and FGG (P 0.478; P 0.342). Similarly, no statistically significant difference was observed between the groups in terms of uterine artery pulsatility index and biochemical markers. Conclusion: Although a trend of decreased placental volume was observed in groups with preeclampsia and FGG, no statistically significant difference was found when compared to the groups without these conditions. There was also no statistically significant difference in uterine artery pulsatility indices, beta HCG, and PAPP-A values between the groups with and without preeclampsia and FGG. Further studies in larger cohorts are needed to predict preeclampsia and FGG in the first-trimester screening, which could provide benefits for maternal and fetal morbidity-mortality in the future. Keywords: preeclampsia, fetal growth restriction, placental volume
Objective: In our study, we aimed to investigate the relationship between placental volume measurements, bilateral uterine artery Doppler pulsatility indices, and beta HCG and PAPP-A values used in first-trimester aneuploidy screening, with the occurrence of preeclampsia and fetal growth restriction in pregnant women evaluated at 11 - 13+6 weeks of gestation. Materials and Methods: A total of 255 pregnant women who underwent first-trimester aneuploidy screening in our clinic between October 2021 and December 2022 were included in the study. Placental volume was measured in 2D at 11-13+6 weeks of gestation in the High-Risk Pregnancy Clinic of Çanakkale Onsekiz Mart University Health Application and Research Center, and uterine artery Doppler measurements were performed using abdominal ultrasonography. After completion of the pregnancy processes, patient records were reviewed. Four patients with missing data were excluded from the study. The data of 251 patients were analyzed using IBM SPSS Statistics 26.0. Results: Preeclampsia developed in 8 of the 251 included pregnant women, while fetal growth restriction (FGG) occurred in 29. The mean placental volume was calculated as 78.05 cm³ in the preeclampsia group and 86.10 cm³ in the non-preeclampsia group. In the FGG group, the mean placental volume was calculated as 78.98 cm³, compared to 86.74 cm³ in the non-FGG group. There was no statistically significant difference in placental volume between the groups in terms of its association with preeclampsia and FGG (P 0.478; P 0.342). Similarly, no statistically significant difference was observed between the groups in terms of uterine artery pulsatility index and biochemical markers. Conclusion: Although a trend of decreased placental volume was observed in groups with preeclampsia and FGG, no statistically significant difference was found when compared to the groups without these conditions. There was also no statistically significant difference in uterine artery pulsatility indices, beta HCG, and PAPP-A values between the groups with and without preeclampsia and FGG. Further studies in larger cohorts are needed to predict preeclampsia and FGG in the first-trimester screening, which could provide benefits for maternal and fetal morbidity-mortality in the future. Keywords: preeclampsia, fetal growth restriction, placental volume
Açıklama
Tıp Fakültesi, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
