Plasenta previalı hastalarda servikal uzunluk ölçümü ile histerektomi ihtiyacını öngörmedeki rolü
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Tarih
2022
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Plasenta previa totalis olgularında servikal uzunluk ölçümünün histerektomi ihtiyacını öngörmedeki rolünü belirlemektir. Gereç ve Yöntem: Kliniğimize ocak-aralık 2021 arasında başvuran üçüncü trimesterda olup transvajinal ultrasonografi ile plasenta previa totalis tanısı alan gebelerin servikal uzunluk ölçümleri yapıldı. Hastaların değerlendirilmesinde 'VOLUSON 730' ultrasonografi cihazı kullanıldı. PP totalis tanılı ve acil peripartum histerektomi uygulanan gebelerin servikal uzunluk ölçümleri prospektif olarak değerlendirildi. Bulgular: Kliniğimizde 2021 yılında plasenta previa totalis tanısı alıp sezaryen uygulanan hasta sayısı 66'dır. Toplam doğum sayısına ve toplam sezaryen doğum sayısına göre PP totalis oranları sırasıyla %3.9 ve %4.5'tir. Çalışmaya katılan bireylerin ortalama gebelik haftası 35.55±1.71 olduğu belirlendi. Çalışmamızda yapılan ROC analizine göre servikal uzunluk değerlendirme sonucu için AUC=0.999 istatistiksel olarak anlamlı bulundu (p<0.001). Acil peripartum histerektominin (APH) var olma durumu ve var olmama durumu referans alınarak, servikal uzunluk değişkenine ait kesim noktası (cut-off point) 26.5 mm olarak tespit edildi. Sonuç: Çalışmamızda plasenta previa totalis tanılı hastaların servikal uzunluklarına göre acil peripartum histerektomi ihtiyacını öngördüğümüzde hasta ve yakınlarına ayrıntılı bilgi verilerek; gerekli kan ürünleri, ameliyathane ekibi ve cerrahi ekipman hazırlandı. Çalışmamızda servikal uzunluk ortalaması 29.29±5.63 olarak tespit edilmiştir. Çalışmamızda APH ihtiyacı olan hastalara bakıldığında servikal uzunluk cut-off point değeri 26.5 mm olarak tespit edilmiştir. Servikal uzunluk ≤26.50 mm için sensitivite %99.9, spesifite %96.2 olarak elde edilmiştir.
Aim: To determine the role of cervical length measurement in predicting the need for hysterectomy in cases of placenta previa (PP) totalis. Methods: Cervical length measurements of pregnant women in third trimester who were diagnosed with PP totalis in our clinic in 2021 were performed by transvaginal ultrasonography. 'VOLUSON 730' ultrasonography device was used for this. Cervical length measurements of patients with PP totalis and emergency peripartum hysterectomy (EPH) were evaluated prospectively. Results: The number of patients diagnosed with PP totalis in our clinic in 2021 is 66. The rate of PP totalis among to the total number of deliveries and total cesarean section is 3.9% and 4.5%, respectively. The mean gestational week of the patients in the study was 35.55±1.71. According to the ROC analysis performed in our study, AUC=0.999 was found to be statistically significant for the cervical length evaluation result (p<0.001). According to the accompanying EPH, the cut-off point of the cervical length was found to be 26.5 mm. Conclusion: In our study, when we predict the need for EPH according to the cervical lengths of patients with PP totalis, detailed information was given to the patients and their relatives; necessary blood products, operating room team and surgical equipment were prepared. In our study, the mean cervical length was found to be 29.29±5.63. Considering the patients who needed EPH, the cervical length cut-off point value was found to be 26.5 mm. For cervical length ≤26.50 mm, the sensitivity was 99.9% and the specificity was 96.2%.
Aim: To determine the role of cervical length measurement in predicting the need for hysterectomy in cases of placenta previa (PP) totalis. Methods: Cervical length measurements of pregnant women in third trimester who were diagnosed with PP totalis in our clinic in 2021 were performed by transvaginal ultrasonography. 'VOLUSON 730' ultrasonography device was used for this. Cervical length measurements of patients with PP totalis and emergency peripartum hysterectomy (EPH) were evaluated prospectively. Results: The number of patients diagnosed with PP totalis in our clinic in 2021 is 66. The rate of PP totalis among to the total number of deliveries and total cesarean section is 3.9% and 4.5%, respectively. The mean gestational week of the patients in the study was 35.55±1.71. According to the ROC analysis performed in our study, AUC=0.999 was found to be statistically significant for the cervical length evaluation result (p<0.001). According to the accompanying EPH, the cut-off point of the cervical length was found to be 26.5 mm. Conclusion: In our study, when we predict the need for EPH according to the cervical lengths of patients with PP totalis, detailed information was given to the patients and their relatives; necessary blood products, operating room team and surgical equipment were prepared. In our study, the mean cervical length was found to be 29.29±5.63. Considering the patients who needed EPH, the cervical length cut-off point value was found to be 26.5 mm. For cervical length ≤26.50 mm, the sensitivity was 99.9% and the specificity was 96.2%.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, Plasenta previa totalis, servikal uzunluk ölçümü, peripartum histerektomi, Placenta previa totalis, cervical length measurement, peripartum hysterectomy
