| Abstract | Cilj istraživanja: Istražiti učestalost dovršetka jednoplodovih nedonošenih trudnoća carskim rezom.
Ispitanici i metode: Istraživano razdoblje obuhvaća period od 01.01.2015.-31.12.2018. Podaci su prikupljeni su popisnom metodom iz pisanih rađaoničkih protokola Klinike za ženske bolesti i porođaje KBC-a Split.
Rezultati:
U promatranom razdoblju je bilo 1124 prijevremena porođaja, a od toga 922 jednoplodovih trudnoća. U istraživanom razdoblju nije bilo razlike u učestalosti prijevremenog porođaja između istraživanih godina (χ2=12,44; P=0,053).U promatranom razdoblju nismo našli razlike u učestalosti raznih stupnjeva nednonošenosti (χ2=4,03; P=0,903 ) kao ni u načinu dovršetka trudnoće; ekstremna nedonošenost (χ2=0,65: P=0,885), teška nedonešenost (χ2=1,07; P=0,783), umjerena nedonošenost (χ2=6,05; P=0,109), i blaga nedonošenost (χ2=0,49; P=0,919). Uočili smo razliku u načinu dovršetka trudnoće s obzirom na porođajnu masu djece (χ2=70,85; P<0,001). Nismo vidjeli razliku u dobi majki koje su rađale vaginalno i carskim rezom (t=-1,14:p=0,13), kao ni u razliku u porođajnoj masi (t=-1,125; P=0,08 ) i duljini djece (t=0,6; p=0,548). Pronašli smo razliku u paritetu majki (χ2 test=44,91; P<0,001) te vodećoj česti u porođaju (χ2=60,55; P<0,050). Dokazali smo razliku u kategorijama pH vrijednosti krvi iz pupčane arterije novorođenčadi djece rođene vaginalno i carskim rezom (χ2=19,17; p<0,050) te u APGAR zbroju djece između istraživanih skupina (χ2=104,22; P<0,001). U žena koje su tijekom trudnoće razvile kliničke simptome preeklampsije (χ2= 6,02; P=0,014) i HELLP sindroma (χ2=6,42; P=0,011) pronašli smo statistički značajnu razliku u načinu završetka trudnoće. U žena koje su tijekom trudnoće razvile kliničke simptome GDM (χ2=0,11; P=0,745), IDDM (χ2=0,08; P=0,782), te kolestaze (χ2=0,03; P=0,862) nismo pronašli statistički značajnu razliku u načinu porođaja.
Zaključci: Naše istraživanje pokazalo je da u promatranom razdoblju nema razlike u učestalosti svih prijevremenih porođaja. Učestalost jednoplodnih nedonošenih trudnoća je u promatranom razdoblju stalna, kao i njihova razdioba po stupnju nedonošenosti. Nismo pronašli razlike u učestalosti dovršetka trudnoće carskim rezom s obzirom na stupanj nedonošenosti, ali smo pronašli razliku u odnosu na porođajnu masu djece. Način porođaja ima utjecaja na vrijednost zbroja po Apgarovoj te pH vrijednost iz pupčane arterije |
| Abstract (english) | Aim: The aim of the study was to investigate does delivery mode has impact on perinatal outcome in singleton preterm birth.
Material and methods: This retrospective study included singleton preterm deliveries in the period from January 1, 2015 to December 31, 2018. Data were collected from the official delivery book of University Hospital of Split.
Results: In investigate period there was 1124 preterm births, and 922 singletons. There was no statistically significant difference in the preterm delivery rate (χ2=12.44; P=0.053). Also there were no differnce in degree of prematurity (χ2=4.03; P=0.903), and in cesarean delivery rate in differentnt degrees of prematurity; extreme (χ2=0.65: P=0.885), very (χ2=1.07; P=0.783), moderate (χ2=6.05; P=0.109), and mild (χ2=0.49; P=0.919). We found difference in birth weight (χ2=70.85; P<0.001) between investigated groups. There was a statistically significant differenca in maternal age (t=-1,14:P=0.13), birth weight (t=-1.125; P=0.08) and legth of newborns (t=0.6; P=0.548). We find difference in parity and (χ2 test=44,91; P<0.001) and presentation (χ2=60.55; P<0.050) between investigated groups. There was a statistically significant difference in the APGAR score (χ2=104.22; P<0.001) and umbilical artery pH (χ2=19.17; P<0.050) between study groups. In women with preeclampsia (χ2= 6.02; P=0.014) and HELLP (χ2=6.42; P=0.011) we find difference in delivery mode between study groups.
Conclusion: Our research has shown that there is no difference in the incidence of all premature deliveries in the observed period. The frequency of uncommon premature pregnancies is constant in the observed period, as well as their distribution by degree of non-obesity. We did not find any differences in the incidence of pregnancy completion with Caesarean section due to the degree of inadequacy, but we found a difference in relation to the birth weight of children. The method of delivery has an effect on the value of the sum of Apgarus and the pH of the umbilical artery. |
