Sezaryen sırasında tüp ligasyonu ve bilateral salpenjektominin over fonksiyonları üzerine etkisinin karşılaştırılması
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Tarih
2020
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, sezaryen sırasında tüp ligasyonu ve bilateral salpenjektominin over fonksiyonları ve rezervi üzerine etkisini ultrasonografik ve biyokimyasal olarak değerlendirmeyi amaçladık. Yöntem: Bu çalışmaya, sezaryen uygulanan 90 hasta prospektif olarak dahil edildi. Hastalar; bilateral tüp ligasyonu (pomeroy yöntemi), bilateral salpenjektomi ve kontrol grubu olmak üzere üç eşit gruba ayrıldı. Hastaların dermografik özellikleri, gebelik haftaları kaydedildi. Cerrahi işlemden önce ve 10-12 hafta sonra ultrasonografik muayene ile over volümleri ve antral folikül sayıları (AFS) kaydedildi, venöz kan numuneleri alınarak anti müllerian hormon (AMH) ve inhibin B düzeyleri bakıldı. Bulgular: Grup 1'in yaş ortalaması 31±4.202, Grup 2'nin 35.47±3.481, Grup 3'ün 26.3±3.861 olup gruplar arası farklar istatistiksel olarak anlamlıydı. Tüm parametreler, preoperatif ve postoperatif dönemlerdeki değişimlerine göre değerlendirildi. AMH ortalama değerlerinde Grup 1'de 0.138±0.119 artma, Grup 2'de 0.230±0.094 artma, Grup 3'te 0.025±1.9830 azalma izlenmiş olup gruplar arası farklar istatiksel olarak anlamlıydı. İnhibin B ortalama değerlerinde Grup 1'de 2.241±4.538 azalma, Grup 2'de 0.545±3.981 azalma, Grup 3'te 5.907±6.00 azalma izlenmiş olup gruplar arası farklar istatiksel olarak anlamlıydı. Over volümü ortalama değerlerinde Grup 1'de 0.032±0.292 azalma, Grup 2'de 0.310±0.417 azalma, Grup 3'te 0.327±0.488 azalma izlenmiş olup gruplar arası farklar istatiksel olarak anlamlıydı. Sonuç: Çalışmamız sonucunda araştırdığımız parametrelerdeki değişimlerin, gebelik ve laktasyon dönemindeki hormonal durum nedeniyle mi yoksa tubal sterilizasyondan mı kaynaklandığı net değildir. Yine de sezaryen sırasında tubal sterilizasyon, pratik ve güvenli bir yöntem olarak kabul edilebilir.
Objective: In this study, we aimed to evaluate the effects of tube ligation and bilateral salpingectomy performed during cesarean section, on ovarian functions and reserves ultrasonographically and biochemically. Materials and methods: 90 patients who underwent caesarean section were included prospectively in this study. Patients were divided into three equal groups: bilateral tube ligation (pomeroy method), bilateral salpingectomy and control group. The patients dermographic characteristics, pregnancy weeks were recorded. Before and 10-12 weeks after the surgical procedure, with ultrasound examination ovarian volumes and antral follicle numbers (AFS) were recorded, venous blood samples were taken and anti müllerian hormone (AMH) and inhibin B levels were examined. Results: The mean age of Group 1 was 31±4.202, Group 2 was 35.47±3.481, Group 3 was 26.3±3.861 and the differences between groups were statistically significant. All parameters were evaluated according to their changes in preoperative and postoperative periods. The mean values of AMH increased 0.138±0.119 in Group 1, 0.230±0.094 increased in Group 2, 0.025±1.9830 decreased in Group 3 and the differences between the groups were statistically significant. The mean values of inhibin B decreased 2.241±4.538 in Group 1, 0.545±3.981 in Group 2, 5.907±6.00 in Group 3 and the differences between the groups were statistically significant. The mean ovarian volume values of decreased 0.032±0.292 in Group 1, 0.310±0.417 in Group 2, 0.327±0.488 in Group 3 and differences between groups were statistically significant. Conclusion: As a result of our study it was not clear whether the changes in the parameters we investigated, were caused by hormonal conditions during pregnancy and lactation period or by tubal sterilization. Nevertheless, tubal sterilization during caesarean section can be considered a practical, safely method.
Objective: In this study, we aimed to evaluate the effects of tube ligation and bilateral salpingectomy performed during cesarean section, on ovarian functions and reserves ultrasonographically and biochemically. Materials and methods: 90 patients who underwent caesarean section were included prospectively in this study. Patients were divided into three equal groups: bilateral tube ligation (pomeroy method), bilateral salpingectomy and control group. The patients dermographic characteristics, pregnancy weeks were recorded. Before and 10-12 weeks after the surgical procedure, with ultrasound examination ovarian volumes and antral follicle numbers (AFS) were recorded, venous blood samples were taken and anti müllerian hormone (AMH) and inhibin B levels were examined. Results: The mean age of Group 1 was 31±4.202, Group 2 was 35.47±3.481, Group 3 was 26.3±3.861 and the differences between groups were statistically significant. All parameters were evaluated according to their changes in preoperative and postoperative periods. The mean values of AMH increased 0.138±0.119 in Group 1, 0.230±0.094 increased in Group 2, 0.025±1.9830 decreased in Group 3 and the differences between the groups were statistically significant. The mean values of inhibin B decreased 2.241±4.538 in Group 1, 0.545±3.981 in Group 2, 5.907±6.00 in Group 3 and the differences between the groups were statistically significant. The mean ovarian volume values of decreased 0.032±0.292 in Group 1, 0.310±0.417 in Group 2, 0.327±0.488 in Group 3 and differences between groups were statistically significant. Conclusion: As a result of our study it was not clear whether the changes in the parameters we investigated, were caused by hormonal conditions during pregnancy and lactation period or by tubal sterilization. Nevertheless, tubal sterilization during caesarean section can be considered a practical, safely method.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, Sezaryen, tüp ligasyonu, salpenjektomi, antimüllerian hormon, inhibin b., Caesarean, tubal ligation, salpinjectomy, antimüllerian hormone, inhibin B.
