Plasenta invazyon anomalisi olan gebelerde fibrinojenin kandaki seviyesinin kanamayı öngörmedeki rolü
Yükleniyor...
Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada; pıhtılaşma faktörlerinden fibrinojenin (faktör1), plasenta previa tanısı almış sezaryen yapılan gebelerde, preop değerinin perop kanama nedeni ile verilen eritrosit süspansiyonu (es) sayısını öngörmedeki etkisini incelemeyi amaçladık. Yöntem:Etik kurul onayı alındıktan sonra, plasenta previası olan ve olmayan 21-40 yaş aralığında, ek hastalığı olmayan 33-40 hf gebeliği bulunan 76 hasta çalışmaya dahil edildi. Operasyon öncesi ve sonrasında hastalardan hemoglobin (Hgb), hematokrit (Hct), trombosit sayısı (Plt), INR, fibrinojen değerleri çalışıldı. Her iki grubun operasyon esnasında kanama miktarları ve replasman yapılan es sayısı kaydedildi. Bulgular:Plasenta previası olan hastalarda preop fibrinojen düzeyi kontrol grubuna göre daha düşük izlendi. P.previalı hasta grubunda perop kanama miktarı daha fazla izlendi ve p.previalı hastalarda preop fibrinojen düzeyi düşük olanlara daha fazla eritrosit süspansiyonu replasmanı yapıldığı görüldü.Preop fibrinojen değeri; ort 469,70 ±64,00 olan gebelere eritrosit süspansiyonu replasmanı yapılmazken, ort 343,50 ±39,59 olan gebelere 1 ünite es, ort 264,70 ±77,39 olan gebelere 2ü es replasmanı yapılmıştır (p<0,001). Ancak preop ve postop Hb, Hct ve Trombosit düşüşü açısından kontrol grubuyla karşılaştırıldığında plasenta previalı olan hastalara perop es replasmanı yapıldığı için anlamlı birfark izlenmedi. Sonuç:Plasenta previalı hastalarda preop fibrinojen seviyesiyle kanama miktarı ve eritrosit süspansiyonu replasmanı açısından anlamlı bir ilişki izlenmiştir. Preop fibrinojen seviyesi düşük olan hastalara daha fazla Es replasmanı yapılmıştır. Bu gebe grubunda preop fibrinojen seviyesine rutin bakmak , kanamayı öngörmede etkili olabilir.
Aim:In this study; we aimed to investigate the effect of the preop value in predicting the number of erythrocyte suspension (es) given due to perrop hemorrhage in cesarean section pregnant women diagnosed with placenta previa. Materials and Methods:After the approval of the ethics committee, 76 patients between the ages of 21-40 with and without placental previa and 33-40 weeks of gestation without any additional disease were included in the study.Hemoglobin (Hgb), hematocrit (Hct), thrombocyte count (Plt), INR and fibrinogen values were studied before and after the operation.The amount of bleeding during the operation and the amount of replacements in both groups were recorded. Results: In patients with placenta previa, preoperative fibrinogen level was lower than the control group. The amount of perop bleeding was higher in the p.previa patient group, and it was observed that more erythrocyte suspension replacement was performed in patients with low preoperative fibrinogen levels in patients with p.previa. While erythrocyte suspension replacement is not applied to pregnant women with average preop fibrinogen value of 469.70 ± 64.00 , 1 unit of erythrocyte suspension was given to pregnant women with average preop fibrinogen value of 343.50 ± 39.59, and 2 of erythrocyte suspension to pregnant women with average preop fibrinogen value of 264.70 ± 77.39 (p<0,001). However, in terms of preop and postop hb, hct and platelet reduction, no significant difference was observed compared to the control group as patients with placenta previa were replaced by perop erythrocyte suspension. Conclusion:In patients with placenta previa, a significant relationship was observed with preoperative fibrinogen level in terms of bleeding amount and erythrocyte suspension replacement.Patients with low preop fibrinogen levels received more Es replacementRoutine looking of preoperative fibrinogen level in this pregnant group may be effective in predicting bleeding.
Aim:In this study; we aimed to investigate the effect of the preop value in predicting the number of erythrocyte suspension (es) given due to perrop hemorrhage in cesarean section pregnant women diagnosed with placenta previa. Materials and Methods:After the approval of the ethics committee, 76 patients between the ages of 21-40 with and without placental previa and 33-40 weeks of gestation without any additional disease were included in the study.Hemoglobin (Hgb), hematocrit (Hct), thrombocyte count (Plt), INR and fibrinogen values were studied before and after the operation.The amount of bleeding during the operation and the amount of replacements in both groups were recorded. Results: In patients with placenta previa, preoperative fibrinogen level was lower than the control group. The amount of perop bleeding was higher in the p.previa patient group, and it was observed that more erythrocyte suspension replacement was performed in patients with low preoperative fibrinogen levels in patients with p.previa. While erythrocyte suspension replacement is not applied to pregnant women with average preop fibrinogen value of 469.70 ± 64.00 , 1 unit of erythrocyte suspension was given to pregnant women with average preop fibrinogen value of 343.50 ± 39.59, and 2 of erythrocyte suspension to pregnant women with average preop fibrinogen value of 264.70 ± 77.39 (p<0,001). However, in terms of preop and postop hb, hct and platelet reduction, no significant difference was observed compared to the control group as patients with placenta previa were replaced by perop erythrocyte suspension. Conclusion:In patients with placenta previa, a significant relationship was observed with preoperative fibrinogen level in terms of bleeding amount and erythrocyte suspension replacement.Patients with low preop fibrinogen levels received more Es replacementRoutine looking of preoperative fibrinogen level in this pregnant group may be effective in predicting bleeding.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, Fibrinojen, plasenta previa, kanama, kan transfüzyonu, Fibrinogen, placenta previa, bleeding, blood transfusion
