Makrozomik Gebeliklerin Do�um �ekilleri ve Sonu�lar�

G�l, Mehmet; �akar, Erbil; Demirci, Oya; Pekin, Oya; S�zen, Hamdullah; Vatansever, Do�an; Ertekin, Arif Aktu�

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Makrozomik Gebeliklerin Do�um �ekilleri ve Sonu�lar� [Zeynep Kamil Med J]

Zeynep Kamil Med J. 2012; 43(2): 46-52

Makrozomik Gebeliklerin Do�um �ekilleri ve Sonu�lar�

Mehmet G�l¹, Erbil �akar², Oya Demirci², Oya Pekin², Hamdullah S�zen³, Do�an Vatansever², Arif Aktu� Ertekin²
¹Gynecology and Obstetrics Clinic, �arkikaraa�a� State Hospital, Isparta
²Gynecology and Obstetrics Clinic, Zeynep Kamil Obstetrics and Pediatrics Training and Research Hospital, Istanbul
³Department of Gynecology and Obstetrics, Istanbul Medical Faculty, Istanbul

INTRODUCTION: To evaluate the mode of deliveries and consequences of macrosomic pregnancies.
METHODS: The birth records between 1 st of January 2006 and 31 st of december 2008 in Obstetric Clinic of Zeynep Kamil Women�s Health and Children Diseases Education and Research Hospital, were rewieved retrospectively. Study group was composed of with bith weight 4000 g and above, and the control group was composed of with birth weight between 2500-3999 g randomly selected pregnancies at the same time period.
RESULTS: According t he birth records between 1 st of January 20 06 and 31 st of december 2008 in Obstetric Clinic of Zeynep Kamil Women�s Health and Children Diseases Education and Research Hospital, the insidance of macrosomia (≥ 4kg) was found as 5,15%. Ultrasound to predict the weight over 4000 grams, compared to normal birth weight infants were less successful. cpd, was the primary risk factor and indication for primary cesarean section. The duration of labour was longer and caeserean section rate was higher viewed in the cases with oxytocin infused and in macrosomic group. Shoulder dystocia was more prevalent in macrosomic infants and cases with diabetes. Uterine atony was only prevalent in macrosomic pregnancies. Fetal trauma, in the cases with shoulder dystocia and who delivered vaginally were more prevalent. The rate of perinatal mortality in the study group was 0.51%, and none in the control group
DISCUSSION AND CONCLUSION: Estimated fetal weight with ultrasound in macrosomic group was less successful and cesarean section rate was high, and also
in cases delivered vaginally shoulder dystocia and fetal trauma was more frequently observed in macrosomic group.

Keywords: macrosomia, estimated fetal weight, shoulder dystocia, fetal trauma

Makrozomik Gebeliklerin Do�um �ekilleri ve Sonu�lar�

Mehmet G�l¹, Erbil �akar², Oya Demirci², Oya Pekin², Hamdullah S�zen³, Do�an Vatansever², Arif Aktu� Ertekin²
¹Kad�n Hastal�klar� ve Do�um Klini�i, �arkikaraa�a� Devlet Hastanesi, Isparta
²Kad�n Hastal�klar� ve Do�um Klini�i, Zeynep Kamil Kad�n ve �ocuk Hastal�klar� E�itim ve Ara�t�rma Hastanesi, �stanbul
³Kad�n Hastal�klar� ve Do�um AD, �stanbul T�p Fak�ltesi, �stanbul

G�R�� ve AMA�: Makrozomik bebeklerin do�um �ekli ve sonu�lar�n�n incelenmesi.
Y�NTEM ve GERE�LER: Zeynep Kamil Kad�n ve �ocuk Hastal�klar� E�itim ve Ara�t�rma Hastanesi Kad�n Do�um Klini�i�ndeki 01/01/2006 ve 31/12/2008 tarihleri aras�ndaki do�um kay�tlar� retrospektif olarak incelendi. �al��ma grubu, do�um a��rl�� 4000 gr ve �zeri olan gebelikler, kontrol grubu
ise do�um a��rl�� 2500-3999 gr aras�nda olan, ayn� d�nemde do�um yapan gebelikler aras�ndan randomize olarak se�ilmi�tir.
BULGULAR: Zeynep Kamil Kad�n ve �ocuk Hastal�klar� E�itim ve Ara�t�rma Hastanesi Kad�n Do�um Klini�i�ndeki 01/01/2006 ve 31/12/2008 tarihleri aras�ndaki do�um kay�tlar� retrospektif olarak incelendi�inde makrozomik bebek (≥4kg) insidans� % 5,15 olarak bulunmu�tur.. Ultrasonografi ile iri bebeklerin a��rl��n� tahmin etmek, normal do�um a��rl�kl� bebeklere g�re daha ba�ar�s�z bulundu. Primer sezeryan i�in iri bebek/ cpd ba�l�ca risk fakt�r� ve endikasyonu olarak belirlendi. �ri bebek grubunda ve oksitosin uygulananlarda
travay s�resi ve sezaryen oran� daha y�ksek tespit edildi. Uterin atoni iri bebeklerde, omuz distosisi ise yine iri bebeklerde ve diyabeti
olanlarda s�k izlendi. Fetal travma, omuz distosisi olanlarda ve vajinal do�um yapanlarda daha s�k g�zlendi. Perinatal mortalite iri bebek grubunda % 0,51 oran�nda izlenirken kontrol grubunda izlenmedi.
TARTI�MA ve SONU�: Ultrasonografi ile fetal a��rl�klar� daha ba�ar�s�z �ng�r�len makrozomik bebeklerde sezaryen daha y�ksek oranda tespit edilmi�tir ve bu grupta vajinal do�um yapanlarda omuz distosisi ve fetal travma daha s�k izlenmektedir.

Anahtar Kelimeler: makrozomi, tahmini fetal a��rl�k, omuz distosisi, fetal travma

Corresponding Author: Erbil �akar, T�rkiye
Manuscript Language: Turkish

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