DOĞUMUN İKİNCİ EVRESİNİN SÜRESİ, UZAMASI VE YÖNETİMİ

Year 2019, Volume: 1 Issue: 2, 102 - 119, 31.12.2019

Ayşenur Turan , Tülay Yılmaz

Abstract

Doğum
eylemi dört evreden oluşan bir süreçtir. Doğumun ikinci evresi; ağrıların
sıklık ve süresinde artma ile karakterize, servikal dilatasyonun tamamlanması
ve kontraksiyonların olması ile başlayıp bebeğin doğumuna kadar olan süreç
olarak tanımlanmaktadır. Doğumun yönetimi ile ilgili rehberlere göre bu evrenin
süresi nulliparlarda 2 saat, multiparlarda 1 saat olarak belirtilmektedir.
Epidural uygulanan vakalarda bu sürelere birer saat daha eklenmesi uygun
görülmektedir. Bu sürelerin belirtilen sınırları aşması durumunda ise gebeye
ilerlemeyen eylem ya da doğumun ikinci evresinin uzaması gibi tanılar
konulmakta ve doğuma müdahale edilmesi gerektiği önerilmektedir. Ancak son
dönemlerde yapılan çalışmalarda, doğumun ikinci evresi ile ilgili belirtilen bu
süre sınırlamasının sezaryen ve müdahaleli doğumlarda artışa neden olduğu
belirlenmiştir. Ayrıca ikinci evrenin belirtilen sürelerden daha fazla uzaması
durumunda yapılan müdahalelerin anne ve bebekleri için daha iyi sonuçlara yol
açmadığı da öne sürülmüştür. Bunun sonucunda son yıllarda uzun süredir üzerinde
çalışılan uzamış ikinci evre tanımları revize edilmeye başlanmıştır. Anne ve
bebeğin sağlığının iyi olması durumunda bu sürelerin uzayabileceği kanısına
varılmış ve bu yönde çalışmalar artmıştır. Bu derlemenin amacı, doğum eyleminin
ikinci evresi, süresi, uzaması ve yönetiminin güncel literatür ışığında
incelenmesidir.

Keywords

İkinci Evre, Gebelik, Doğum

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