Abstract
Amaç: Postpartum kanama anne ölümlerinin en önemli nedenlerinden biridir. Burada erken postpartum dönemde uterin arter doppler indekslerini gözlemleyerek hemoglobin (Hb) düşüşünü tahmin etmeye çalıştık.
Gereçler ve yöntem: Çalışma prospektif bir kohort çalışması olarak tasarlanmıştır. 09/01/2018-09/01/2019 tarihleri arasında Gazi Üniversitesi Hastanesi'ne normal vajinal doğum için başvuran gebeler dahil edilmiş olup, herhangi bir risk faktörüne yer verilmemiştir.
Bulgular: Aşağıdaki parametrelere sahip toplam 85 hasta dahil edildi: ortalama doğum yaşı, 28.4 ± 4.6 yıl; doğumda ortalama gebelik yaşı, 38.83 ± 1.21 hafta. Hb, hematokrit (Htc), WBC ve PLT'deki diğer değişiklikler ve ortalama uterin arter sistol/diyastol (S/D), direnç indeksi (RI) ve PI değerleri arasında anlamlı bir korelasyon gözlenmedi. Ayrıca uterus hacmi, ortalama uterin arter S/D, PI ve RI arasında istatistiksel olarak anlamlı bir ilişki gözlenmedi. Benzer şekilde uterus hacmi, Hb, Htc, WBC ve PLT farklılıkları arasında da anlamlı bir ilişki gözlenmedi. Primigravid ve multigravida ayrımında ortalama uterin arter PI medyan değerleri gruplara göre farklılık göstermedi.
Sonuç: Uterin arterdeki olası Hb düşüşü ile direnç arasında bir ilişki gözlenmedi. Aynı zamanda etkileyebilecek diğer faktörler (uterus boyutları, gravida, parite, membran rüptürü olup olmadığı, doğum süreleri, doğum sırasındaki yırtıklar, epizyotomi ve doğum ağırlığı) değerlendirildi ve bu faktörler arasında korelasyon saptanmadı.
Keywords
Supporting Institution
YOK
References
- 1. Lu MC, Fridman M, Korst LM, Gregory KD, Reyes C, Hobel CJ, et al. Variations in the incidence of postpartum hemorrhage across hospitals in California. Matern Child Health J. 2005;9(3):297-306.
- 2. Sheldon WR, Blum J, Vogel JP, Souza JP, Gulmezoglu AM, Winikoff B, et al. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121(Suppl 1):5-13.
- 3. Guedes-Martins L, Gaio AR, Saraiva J, Cunha A, Macedo F, Almeida H. Uterine artery impedance during the first eight postpartum weeks. Sci Rep. 2015;5:8786.
- 4. Maged AM, Shoab AY, Dieb AS. Antepartum and postpartum uterine artery impedance in women with pre-eclampsia: a case control study. J Obstet Gynaecol. 2019;39(5):633-8.
- 5. Diniz CP, Araujo Junior E, Lima MM, Guazelli CA, Moron AF. Ultrasound and Doppler assessment of uterus during puerperium after normal delivery. J Matern Fetal Neonatal Med. 2014;27(18):1905-11.
- 6. Anna Kajdy DS, Artur Pokropek. Could uterine artery pulsatility indices predict risk of postpartum hemorrhage? IFPA2019; Buenos Aires, Argentina: Placenta; 2019.
- 7. Arbib N, Aviram A, Gabbay Ben-Ziv R, Sneh O, Yogev Y, Hadar E. The effect of labor and delivery on white blood cell count. J Matern Fetal Neonatal Med. 2016;29(18):2904-8.
Abstract
Aim: Postpartum bleeding is one of the most important causes of maternal mortality. Herein, we attempted to predict hemoglobin (Hb) decrease by observing uterine artery doppler indices during the early postpartum period.
Materials and Method: The study was designed as a prospective cohort study. Pregnant women who visited Gazi University Hospital for normal vaginal delivery between 09/01/2018–09/01/2019 were included, and no risk factors were included.
Results: A total of 85 patients were included with the following parameters: average age at birth, 28.4 ± 4.6 years; average gestational age at birth, 38.83 ± 1.21 weeks. No significant correlation was observed among Hb, hematocrit (Htc), WBC, and other changes in PLT and mean uterine artery systole/diastole (S/D), resistance index (RI), and PI values. Furthermore, no statistically significant relationship was observed among uterus volume, mean uterine artery S/D, PI, and RI. Similarly, no significant relationship was observed among uterus volume, Hb, Htc, WBC, and PLT differences. Upon dividing primigravid and multigravida, the mean uterine artery PI median values did not differ according to the groups.
Conclusion: No correlation was observed between possible Hb decrease and resistance in the uterine artery. At the same time, other factors that may affect were evaluated (uterus dimensions, gravida, parity, whether there was membrane rupture, delivery times, lacerations during delivery, episiotomy, and birth weight) and no correlation was noted among these factors.
References
- 1. Lu MC, Fridman M, Korst LM, Gregory KD, Reyes C, Hobel CJ, et al. Variations in the incidence of postpartum hemorrhage across hospitals in California. Matern Child Health J. 2005;9(3):297-306.
- 2. Sheldon WR, Blum J, Vogel JP, Souza JP, Gulmezoglu AM, Winikoff B, et al. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121(Suppl 1):5-13.
- 3. Guedes-Martins L, Gaio AR, Saraiva J, Cunha A, Macedo F, Almeida H. Uterine artery impedance during the first eight postpartum weeks. Sci Rep. 2015;5:8786.
- 4. Maged AM, Shoab AY, Dieb AS. Antepartum and postpartum uterine artery impedance in women with pre-eclampsia: a case control study. J Obstet Gynaecol. 2019;39(5):633-8.
- 5. Diniz CP, Araujo Junior E, Lima MM, Guazelli CA, Moron AF. Ultrasound and Doppler assessment of uterus during puerperium after normal delivery. J Matern Fetal Neonatal Med. 2014;27(18):1905-11.
- 6. Anna Kajdy DS, Artur Pokropek. Could uterine artery pulsatility indices predict risk of postpartum hemorrhage? IFPA2019; Buenos Aires, Argentina: Placenta; 2019.
- 7. Arbib N, Aviram A, Gabbay Ben-Ziv R, Sneh O, Yogev Y, Hadar E. The effect of labor and delivery on white blood cell count. J Matern Fetal Neonatal Med. 2016;29(18):2904-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 25, 2022 |
| Submission Date | September 23, 2021 |
| Acceptance Date | January 29, 2022 |
| Published in Issue | Year 2022 Volume: 19 Issue: 1 |
