Examination of Placental Dysfunction and Neonatal Outcomes in Hospitalized Patients who have Hyperemesis Gravidarum Diagnosis

Yıl 2023, Cilt: 13 Sayı: 4, 615 - 619, 31.07.2023

Jule Eriç Horasanlı , Nurullah Şengül

https://doi.org/10.16899/jcm.1256045

Öz

Background: Evidence on the effect of hyperemesis gravidarum (HG) on pregnancy outcomes is still unclear. In this study, placenta-related dysfunctions and neonatal outcomes in patients who were hospitalized with HG were retrospectively analyzed.
Methods: This study was conducted retrospectively among women who had singleton deliveries in our hospital between January 2015 and January 2020. As the case group, women with singleton pregnancies who were hospitalized due to HG and delivered were included. The control group consisted of women with singleton pregnancies who delivered without hospitalization due to HG. Through the hospitalization files of the patients who were hospitalized due to HG and not hospitalized due to HG, neonatal outcomes such as placental dysfunction, including gestational diabetes, gestational hypertension, preeclampsia, or stillbirth, and low birth weight, small for gestational age (SGA), preterm birth (PTB), the necessity for neonatal intensive care, 5-min Apgar scores, were examined.
Findings: The mean gestational age was determined as 37.7 ± 1.5 weeks in the HG group and 37.8 ± 1.4 weeks in the control group. The mean week of gestation upon hospitalization for HG was 10.6 ± 3.6 weeks. There was no significant difference between the groups regarding preeclampsia, PTB, postpartum hemorrhage, birth weight, GDM, or neonatal intensive care unit requirement. It was found that SGA babies with abnormal birth weights were seen more frequently in the deliveries of patients hospitalized for HG (P = 0.022). The 5-min Apgar scores were higher in the deliveries of patients hospitalized for HG than in the control group (P = 0.004).
Conclusion: It was concluded that hospitalizations due to HG do not pose a risk of placental dysfunction. Of the neonatal outcomes, SGA was more common in the infants of mothers with HG. Contrary to the expectations herein, the 5-min Apgar scores were higher in hospitalized patients for HG.

Anahtar Kelimeler

: Hyperemesis gravidarum, Placental dysfunction, Neonatal outcomes

Destekleyen Kurum

NO

Hastanede Yatan Hiperemezis Gravidarum Tanılı Hastalarda Plasental Disfonksiyon ve Neonatal Sonuçların İncelenmesi

Öz

Özet
Amaç: Hiperemezis gravidarumun (HG) gebelik sonuçları üzerindeki etkisine ilişkin kanıtlar hala belirsizdir. Bu çalışmada HG ile hastaneye yatırılan hastalarda plasenta ile ilişkili disfonksiyonlar ve neonatal sonuçlar retrospektif olarak incelenmiştir.
Yöntemler: Bu çalışma Ocak 2015-Ocak 2020 tarihleri arasında hastanemizde tekil doğum yapan kadınlar arasında retrospektif olarak yapılmıştır. Olgu grubu olarak HG nedeniyle hastaneye yatırılıp doğum yapmış tekil gebeliği olan kadınlar alınmıştır. Kontrol grubu, HG nedeniyle hastaneye yatmadan doğum yapan tekil gebe kadınlardan oluşturuldu. HG nedeniyle hastaneye yatırılan ve HG nedeniyle hastaneye yatırılmayan hastaların yatış dosyaları aracılığıyla, gestasyonel diyabet, gestasyonel hipertansiyon, preeklampsi veya ölü doğum dahil olmak üzere plasenta disfonksiyonu ve gebelik yaşına göre küçük düşük doğum ağırlığı (SGA) gibi yenidoğan sonuçları ), erken doğum (PTB), yenidoğan yoğun bakım gerekliliği, 5 dk Apgar skorları incelendi.
Bulgular: Ortalama gebelik yaşı HG grubunda 37,7 ± 1,5 hafta, kontrol grubunda 37,8 ± 1,4 hafta olarak belirlendi. HG nedeniyle hastaneye yatışın ardından ortalama gebelik haftası 10.6 ± 3.6 haftaydı. Gruplar arasında preeklampsi, PTB, doğum sonu kanama, doğum ağırlığı, GDM, yenidoğan yoğun bakım gereksinimi açısından anlamlı fark yoktu. HG nedeniyle hastaneye yatırılan hastaların doğumlarında anormal doğum ağırlığına sahip SGA bebeklerin daha sık görüldüğü saptandı (P=0,022). HG nedeniyle hastaneye yatırılan hastaların doğumlarında 5 dk Apgar skorları kontrol grubuna göre daha yüksekti (P=0.004).
Sonuç: HG nedeniyle hastaneye yatışların plasental disfonksiyon riski oluşturmadığı sonucuna varıldı. Yenidoğan sonuçlarından SGA, HG'li annelerin bebeklerinde daha yaygındı. Buradaki beklentinin aksine HG nedeniyle hastanede yatan hastalarda 5 dk Apgar skoru daha yüksekti.

Anahtar Kelimeler

Hiperemezis gravidarum, Plasenta disfonksiyonu, Neonatal sonuçlar

Kaynakça

• 1. Kasap E. Hiperemezis Gravidarumlu Hastalarda Anksiyete ve Depresyon Test Skorları. Selcuk University Medical Journal. 2018;34(4).
• 2. Evcil, H. Gebelikte beslenmenin fetal büyüme üzerine etkileri. Selcuk University Medical Journal.2007; 24(1), 49-59.
• 3. Niebyl JR. Nausea and vomiting in pregnancy. New England J Med. 2010;363(16):1544-50.
• 4. Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews. 2015(9).
• 5. Miller F. Nausea and vomiting in pregnancy: the problem of perception—is it really a disease? Am. J. Obstet. Gynecol. 2002;186(5):S182-S3.
• 6. Koudijs HM, Savitri AI, Browne JL, Amelia D, Baharuddin M, Grobbee DE, et al. Hyperemesis gravidarum and placental dysfunction disorders. BMC Pregnancy Chıldb. 2016;16(1):1-9.
• 7. Jordan V, MacDonald J, Crichton S, Stone P, Ford H. The incidence of hyperemesis gravidarum is increased among Pacific Islanders living in Wellington. New Zeal Med. J. 1995;108(1006):342-4.
• 8. Bacak SJ, Callaghan WM, Dietz PM, Crouse C. Pregnancy-associated hospitalizations in the United States, 1999-2000. Am. J. Obstet .Gynecol. 2005;192(2):592-7.
• 9. Trogstad LI, Stoltenberg C, Magnus P, Skjærven R, Irgens LM. Recurrence risk in hyperemesis gravidarum. BJOG: An International J. Obstet. Gynaecol. 2005;112(12):1641-5.
• 10. Berkowıtz R, Ozturk M, Goldsteın D, Bernsteın M, Hıll L, Wands Jr. Human chorionic gonadotropin and free subunits' serum levels in patients with partial and complete hydatidiform moles. Obstet & Gynaecol. 1989;74(2):212-6.
• 11. Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Bıol. Reprod. 2003;69(1):1-7.
• 12. Chen JZ-J, Sheehan PM, Brennecke SP, Keogh RJ. Vessel remodelling, pregnancy hormones and extravillous trophoblast function. Mol. Cellu. Endocrınol. 2012;349(2):138-44.
• 13. Bailit JL. Hyperemesis gravidarium: epidemiologic findings from a large cohort. Am. J. Obstet. Gynecol.2005;193(3):811-4.
• 14. Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta‐analysis. BJOG: An International J. Obstet. Gynaecol. 2011;118(11):1302-13.
• 15. Tranquilli A, Dekker G, Magee L, Roberts J, Sibai B, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy. Hypertens.2014;4(2):97-104.
• 16. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72(1):24-43.
• 17. Tuffnell D, Shennan A, Waugh J, Walker J. The management of severe pre-eclampsia/eclampsia. London (UK): RCOG Royal Coll. Obstet. Gynaecol. 2006;11.
• 18. Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet & Gynaecol. 1996;87(2):163-8.
• 19. Lees C, Stampalija T, Baschat A, da Silva Costa F, Ferrazzi E, Figueras F, et al. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2020;56(2):298-312.
• 20. Martins JG, Biggio JR, Abuhamad A. Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction: (Replaces Clinical Guideline Number 3, April 2012). Am J Obstet. Gynecol. 2020;223(4):B2-b17.
• 21. Fetus Co, Newborn A, Practice CoO, Pediatrics AAo. ACOG Committee Opinion. Number 333, May 2006 (replaces No. 174, July 1996): The Apgar score. Obstet. Gynaecol. 2006;107(5):1209-12.
• 22. Joshi N, Kissin D, Anderson JE, Session D, Macaluso M, Jamieson DJ. Trends and correlates of good perinatal outcomes in assisted reproductive technology. Obstet. Gynaecol. 2012;120(4):843.
• 23. Belfort MA, Lockwood C, Barss V. Overview of postpartum hemorrhage. UpToDate, Waltham, MA, USA. 2016.
• 24. Koot M, Boelig R, van ‘t Hooft J, Limpens J, Roseboom T, Painter R, et al. Variation in hyperemesis gravidarum definition and outcome reporting in randomised clinical trials: a systematic review. BJOG: An International J. Obstet. Gynaecol. 2018;125(12):1514-21.
• 25. Bolin M, Åkerud H, Cnattingius S, Stephansson O, Wikström A-K. Hyperemesis gravidarum and risks of placental dysfunction disorders: a population‐based cohort study. BJOG: An International J. Obstet. Gynaecol. 2013;120(5):541-7.
• 26. Zhang J, Cai W-w. Severe vomiting during pregnancy: antenatal correlates and fetal outcomes. Epidemiology. 1991:454-7.
• 27. Roseboom TJ, Ravelli AC, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis gravidarum. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2011;156(1):56-9.
• 28. Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Hadi PA. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran. J. Reprod. Med. 2014;12(1):47.
• 29. McCarthy FP, Khashan AS, North RA, Moss-Morris R, Baker PN, Dekker G, et al. A prospective cohort study investigating associations between hyperemesis gravidarum and cognitive, behavioural and emotional well-being in pregnancy. PloS one. 2011;6(11):e27678.
• 30. Kuru O, Sen S, Akbayır O, Goksedef BPC, Özsürmeli M, Attar E, et al. Outcomes of pregnancies complicated by hyperemesis gravidarum. Arch. Gynecol. Obstet. 2012;285(6):1517-21.
• 31. Vandraas K, Vikanes Å, Vangen S, Magnus P, Støer N, Grjibovski A. Hyperemesis gravidarum and birth outcomes—a population‐based cohort study of 2.2 million births in the Norwegian Birth Registry BJOG: An International J. Obstet. Gynaecol. 2013;120(13):1654-60.
• 32. Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet & Gynaecol. 2006;107(2):285-92.
• 33. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. New England J.Med. 2001;344(7):467-71.
• 34. Levine MG, Esser D. Total parenteral nutrition for the treatment of severe hyperemesis gravidarum: maternal nutritional effects and fetal outcome. Obstet. Gynaecol. 1988;72(1):102-7.
• 35. Ismail SK, Kenny L. Review on hyperemesis gravidarum. Best practice & research Clın. Gastroenterol. H. 2007;21(5):755-69.
• 36. Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod. 2003;69(1):1-7.
• 37. Koudijs HM, Savitri AI, Browne JL, Amelia D, Baharuddin M, Grobbee DE, et al. Hyperemesis gravidarum and placental dysfunction disorders. BMC Pregnancy Chıldb. 2016;16(1):374.
• 38. Yılmaz, E. BabIes WIth Low BIrth VveIght (sga) And TheIr Problems. Selcuk Medical Journal. 2000; 16(3), 183-187.
• 39. Dodds L, Fell DB, Joseph KS, Allen VM, Butler B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol. 2006;107(2 Pt 1):285-92.