Abstract | Cilj istraživanja: Odrediti učestalost preeklampsije u višeplodnim trudnoćama zanesenim
sponatno i nakon medicinski potpomognute oplodnje, te ispitati medijan životne dobi rodilja,
BMI na početku i na kraju trudnoće, broj prethodnih porođaja i učestalost dovršetka poroda
carskim rezom.
Ustroj istraživanja: U retrospektivno istraživanje je uključeno 9388 rodilja koje su rodile u
razdoblju od 1. siječnja 2011. godine do 31. prosinca 2012. godine. Među promatranim
rodiljama izdvojili smo 182 s višeplodnom trudnoćom.
Mjesto istraživanja: Klinika za ženske bolesti i porode, KBC Split
Sudionici: U istraživanje su uključene 182 rodilje s višeplodnom trudnoćom od kojih je 117
rodilja zanijelo spontano, a 65 rodilja uz MPO.
Glavne mjere ishoda: Dob rodilja, način dovršetka poroda, paritet i način zanošenja.
Rezultati: Medijan životne dobi žena s trudnoćom zanesenom spontano je za 1 godinu manji
nego u žena s trudnoćom zanesenom nakon medicinski potpomognute oplodnje, prikazana je
statistički značajna razlika. Kod žena koje su spontano zanijele, broj prethodnih porođaja je
za 3,4 puta veći o odnosu na žene koje su zanijele nakon MPO (statistički značajno).
Razdioba broja poroda prema tjednima poroda nije se statistički značajno razlikovala u
odnosu na način začeća (spontano, MPO). Skupine žena nisu se statistički značajno
razlikovale prema načinu poroda u odnosu na način začeća. Nema značajne razlike u
učestalosti preeklampsije, ali je za 2,7 puta češća u skupini žena koje su zanijele nakon MPO
od onih koje su zanijele spontano, na razini značajnosti od 92%. U skupini žena koje su
spontano zanijele, dokazali smo statistički značajnu razliku, BMI na kraju trudnoće je za 7,7
kg/m2 veći nego u skupini žena koje su zanijele nakon MPO. Nema značajne razlike u
gestacijskom tjednu s obzirom na način zanošenja (spontano/MPO). U istraživanim
skupinama nema značajne razlike u trofičnosti, Apgar-zbroju i masi djece u odnosu na način
začeća (spontano/MPO).
Zaključci:
1. Medijan životne dobi žena s trudnoćama zanesenim spontano je manji od žena koje su
zanijele nakon MPO.
2. Žene koje su spontano zanijele imaju veći broj prethodnih poroda u odnosu na žene koje su
zanijele nakon MPO.
3. Razdioba broja poroda prema tjednima poroda nije se statistički značajno razlikovala u
odnosu na način začeća.
4. Skupine žena nisu se statistički značajno razlikovale prema načinu poroda u odnosu na
način začeća.
5. Nema značajne razlike u učestalosti preeklampsije, ali je za 2,7 puta češća u skupini žena s
trudnoćom zanesenom nakon MPO nego u žena s trudnoćom zanesenom spontano, na razini
značajnosti od 92%.
6. U skupini žena koje su spontano zanijele, dokazali smo statistički značajnu razliku u BMI
na kraju trudnoće, veći je od skupine žena koje su zanijele nakon MPO.
7. Nema statistički značajne razlike u gestacijskom tjednu u odnosu na način zanošenja
(spontano/MPO).
8. Nema značajne razlike u trofičnosti, Apgar-zbroju i masi djece u promatranim skupinama
trudnoća zanesenim spontano i nakon MPO. |
Abstract (english) | Objective: To determine the incidence of preeclampsia in multiple pregnancies concieved
spontaneously and after medically assisted fertilization, and to examine the median maternal
age, BMI at the beginning and at the end of pregnancy, number of previous births and
frequency of delivery by caesarean section.
Study design: The retrospective study included 9388 parturient women who gave birth
during the period of 1st january 2011 to 31st december 2012. Among the women that were
observed we sorted out 182 of those with multiple pregnancies.
Place of research: Department of Obstetrics and Gynecology , University Hospital Split.
Participants: The study included 182 parturient women with multiple pregnancies, of wich
117 women concieved spontaneusly, and 65 women concieved with the help of medically
assisted fertilization.
Main outcome measures: Age of parturient women, ways in witch the parturitions ended,
parity and the means of conception.
Results: The median age of women with pregnancy concieved spontaneously is by one year
less than in women with pregnancy concieved after medically assisted fertilization, a
statistically relevant difference was shown. In women with pregnancies wich were concieved
spontaneously, the number of previous births is 3.4 timeshigher than in women multiple
pregnancies concieved after medically assisted fertilization (statistically relevant). The
distribution of births according to the week of birth was not statistically relevant in relation to
the way of conception (spontaneoous or medically assisted). Groups of pregnant women were
not significantly different according to the mode of delivery in relation to the manner of
conception. There is no relevant difference in incidence of preeclampsia, but it is 2.7 times
more common among women who concieved after medically assisted fertilization than in the
group of women who concieved spontaneously at the level of significance of 92%. In the
group of women with pregnancy wich concieved spontaneously we proved a statistically
relevant difference in body mass index at the end of pregnancy of 7.7kg/m2 higher than in the
group of women with pregnancy concieved after medically assisted fertilization. There is no
significant difference in gestational week in relation to the means of conception
(spontaneous/medically assisted fertilization). In the studied groups of pregnancies there are
no significant differences in trophicity, Apgar-sum, or weight of the children in relation to the
method of conception (spontaneous/medically assisted fertilization).
Conclusions:
1.The median age of women who concieved spontaneously is less than in women who
concieved after medically assisted fertilization.
2. Women who concieved spontaneously had a higher number of previous births compared to
women who conceived after medically assisted fertilization.
3. The distribution of births according to weeks of birth was not significantly different
compared to the method of conception.
4. Groups of pregnant women were not significantly different according to the mode of
delivery in relation to the manner of conception.
5. There is no significant difference in the incidence of pre-eclampsia, but it is 2.7 times more
common among women with pregnancy concieved after medically assisted fertilization than
in women with pregnancy concieved spontaneously, at a significance level of 92%.
6. In the group of women with pregnancies that were spontaneously conceived we showed a
statistically significant difference in BMI at the end of pregnancy, which is larger than in the
group of women with pregnancy concieved after medically assisted fertilization.
7. There is no statistically significant differences in gestational week compared to the method
of conception (spontaneous / MPO).
8. There is no significant differences in trophic status, Apgar-sum and weight of children in
the study groups of pregnancies concieved spontaneously of after medically assisted
fertilization. |