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Gebelik Terminasyonu Olgularının Retrospektif Analizi: 177 Olgunun Değerlendirilmesi

Year 2022, Volume: 12 Issue: 1, 116 - 121, 18.03.2022
https://doi.org/10.31832/smj.1061707

Abstract

Özet:
Amaç: Kliniğimizde yapılmış olan 10 hafta ve üzeri gebelik terminasyonlarının endikasyonlarını ve obstetrik özelliklerini araştırmak.
Yöntem ve Gereçler: 01/01/2016- 15/06/2021 tarihleri arasında kiniğimizde herhangi bir nedenle 10 hafta ve üzeri gebelik terminasyonu yapılan 177 olgu değerlendirildi.
Bulgular: Çalışmaya dahil edilen olguların 153’ünü (%86,4) erken gebelik terminasyonu, 24’ünü (%13,6) geç gebelik terminasyonu oluşturdu. Gebelik terminasyonlarının en sık nedenini % 32,2 sıklıkla Merkezi sinir sistemi (MSS) anomalileri oluşturdu. Anhidramnios sıklığı % 24,3’dü ve ikinci sen sık gebelik terminasyonu nedeniydi. Gebelik terminasyonu nedeni olarak, kromozomal anomalilerden en sık Trizomi 21 saptanırken (%12) ,yapısal malformasyonlar içerisinde en az kardiak anomaliler (%0,6) saptandı. Terminasyon süresi açısından erken ve geç terminasyon grubu ve terminasyon yöntemleri kendi aralarında karşılaştırıldıklarında ise istatistiksel olarak anlamlı bir fark saptanmadı.
Sonuç: Kliniğimizde gebelik terminasyonu uygulanan olgularda yapısal malformasyonlardan en sık olarak MSS anomalileri, kromozomal anomalilerden ise en sık olarak Trizomi 21 görüldü.
Anahtar kelimeler: Gebelik terminasyonu; yapısal malformasyon; kromozomal anomali; prenatal tanı;ultrason

References

  • 1- Templeton A, Grimes DA. Clinical practice. A request for abortion. N Engl J Med. 2011;365:2198–2204.
  • 2- Klemetti R, Gissler M, Niinimäki M, Hemminki E. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Hum Reprod. 2012 Nov;27(11):3315-20. doi: 10.1093/humrep/des294. Epub 2012 Aug 29. PMID: 22933527.
  • 3- Gold RB, Sonfield A. Publicly funded contraceptive care: a proven investment. Contraception. 2011;84:437–439.
  • 4- Aslan H, Yildirim G, Ongut C, Ceylan Y. Termination of pregnancy for fetal anomaly. Int J Gynaecol Obstet 2007;99: 221–4.
  • 5- Boyd PA, Devigan C, Khoshnood B, Loane M, Garne E, Dolk H; EUROCAT Working Group. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down's syndrome. BJOG. 2008 May;115(6):689-96. doi: 10.1111/j.1471-0528.2008.01700.x. PMID: 18410651; PMCID: PMC2344123.
  • 6- Rydberg C, Tunón K. Detection of fetal abnormalities by second-trimester ultrasound screening in a non-selected population. Acta Obstet Gynecol Scand 2017;96:176–82.
  • 7- Saltvedt S, Almström H, Kublickas M, Valentin L, Grunewald C. Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation – a randomised controlled trial in 39,572 pregnancies. BJOG 2006;113:664–74.
  • 8- 2827 sayılı nüfus planlaması hakkındaki kanun. Resmi Gazete 1983(24 Mayıs);(18059):3–6.
  • 9- ACOG. 2013. ACOG Practice Bulletin No. 135: Second-trimester abortion. Obstetrics and Gynecology 121:1394–1406.
  • 10- RCOG. 2015. Best practice in comprehensive abortion care. Best Practice Paper No 2.
  • 11- Morris JL, Winikoff B, Dabash R, Weeks A, Faundes A, GemzellDanielsson K, et al. FIGO’s updated recommendations for misoprostol used alone in gynecology and obstetrics. Int J Gynaecol Obstet. 2017 Sep;138(3): 363-366. https://doi.org/10.1002/ijgo.12181.
  • 12- Barel O, Vaknin Z, Smorgick N, Reish O, Mendlovic S, Herman A, et al. Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center. Prenat Diagn. 2009 Mar;29(3):223-8. doi: 10.1002/pd.2188. PMID: 19177335.
  • 13- Hern WM. Fetal diagnostic indications for second and third trimester outpatient pregnancy termination. Prenat Diagn. 2014 May;34(5):438-44. doi: 10.1002/pd.4324. Epub 2014 Feb 27. PMID: 24424620; PMCID: PMC423881.
  • 14- Vaknin Z, Lahat Y, Barel O, Ben-Ami I, Reish O, Herman A, et al. Termination of pregnancy due to fetal abnormalities performed after 23 weeks' gestation: analysis of indications in 144 cases from a single medical center. Fetal Diagn Ther. 2009;25(2):291-6. doi: 10.1159/000229501. Epub 2009 Jul 24. PMID: 19628945.
  • 15- Ozyuncu O, Orgul G, Tanacan A, Aktoz F, Guleray N, Fadiloglu E, et al. Retrospective analysis of indications for termination of pregnancy. J Obstet Gynaecol. 2019 Apr;39(3):355-358. doi: 10.1080/01443615.2018.1506427. Epub 2018 Nov 14. PMID: 30428730.
  • 16- Baumann S, Darquy S, Miry C, Duchange N, Moutel G. Termination of pregnancy for foetal indication in the French context analysis of decision-making in a Multidisciplinary Centre For Prenatal Diagnosis. J Gynecol Obstet Hum Reprod. 2021 Oct;50(8):102067. doi: 10.1016/j.jogoh.2021.102067. Epub 2021 Jan 21. PMID: 33484935.
  • 17- Borgatta L, Kapp N: Society of family planning. Clinical guidelines. Labor induction abortion in the second trimester. Contraception 84, 4–18 (2011).
  • 18- Lee VC, Ng EH, Ho PC. Issues in second trimester induced abortion (medical/surgical methods). Best Pract Res Clin Obstet Gynaecol. 2010 Aug;24(4):517-27. doi: 10.1016/j.bpobgyn.2010.02.008. Epub 2010 Mar 29. PMID: 20347397.
  • 19- Rezk MA, Sanad Z, Dawood R, Emarh M, Masood A. Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. J Matern Fetal Neonatal Med. 2015 Jan;28(1):93-6. doi:10.3109/14767058.2014.905909. Epub 2014 Apr 9. PMID: 24635496.
  • 20- Ercan Ö, Köstü B, Özer A, Serin S, Bakacak M. Misoprostol versus misoprostol and foley catheter combination in 2nd trimester pregnancy terminations. J Matern Fetal Neonatal Med. 2016 Sep;29(17):2810-2. doi: 10.3109/14767058.2015.1105950. Epub 2015 Nov 23. PMID: 26452400.
  • 21- Goyal V. Uterine rupture in second-trimester misoprostol-induced abortion after cesarean delivery: a systematic review. Obstet Gynecol. 2009 May;113(5):1117-1123. doi: 10.1097/AOG.0b013e31819dbfe2. PMID: 19384128.
Year 2022, Volume: 12 Issue: 1, 116 - 121, 18.03.2022
https://doi.org/10.31832/smj.1061707

Abstract

References

  • 1- Templeton A, Grimes DA. Clinical practice. A request for abortion. N Engl J Med. 2011;365:2198–2204.
  • 2- Klemetti R, Gissler M, Niinimäki M, Hemminki E. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Hum Reprod. 2012 Nov;27(11):3315-20. doi: 10.1093/humrep/des294. Epub 2012 Aug 29. PMID: 22933527.
  • 3- Gold RB, Sonfield A. Publicly funded contraceptive care: a proven investment. Contraception. 2011;84:437–439.
  • 4- Aslan H, Yildirim G, Ongut C, Ceylan Y. Termination of pregnancy for fetal anomaly. Int J Gynaecol Obstet 2007;99: 221–4.
  • 5- Boyd PA, Devigan C, Khoshnood B, Loane M, Garne E, Dolk H; EUROCAT Working Group. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down's syndrome. BJOG. 2008 May;115(6):689-96. doi: 10.1111/j.1471-0528.2008.01700.x. PMID: 18410651; PMCID: PMC2344123.
  • 6- Rydberg C, Tunón K. Detection of fetal abnormalities by second-trimester ultrasound screening in a non-selected population. Acta Obstet Gynecol Scand 2017;96:176–82.
  • 7- Saltvedt S, Almström H, Kublickas M, Valentin L, Grunewald C. Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation – a randomised controlled trial in 39,572 pregnancies. BJOG 2006;113:664–74.
  • 8- 2827 sayılı nüfus planlaması hakkındaki kanun. Resmi Gazete 1983(24 Mayıs);(18059):3–6.
  • 9- ACOG. 2013. ACOG Practice Bulletin No. 135: Second-trimester abortion. Obstetrics and Gynecology 121:1394–1406.
  • 10- RCOG. 2015. Best practice in comprehensive abortion care. Best Practice Paper No 2.
  • 11- Morris JL, Winikoff B, Dabash R, Weeks A, Faundes A, GemzellDanielsson K, et al. FIGO’s updated recommendations for misoprostol used alone in gynecology and obstetrics. Int J Gynaecol Obstet. 2017 Sep;138(3): 363-366. https://doi.org/10.1002/ijgo.12181.
  • 12- Barel O, Vaknin Z, Smorgick N, Reish O, Mendlovic S, Herman A, et al. Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center. Prenat Diagn. 2009 Mar;29(3):223-8. doi: 10.1002/pd.2188. PMID: 19177335.
  • 13- Hern WM. Fetal diagnostic indications for second and third trimester outpatient pregnancy termination. Prenat Diagn. 2014 May;34(5):438-44. doi: 10.1002/pd.4324. Epub 2014 Feb 27. PMID: 24424620; PMCID: PMC423881.
  • 14- Vaknin Z, Lahat Y, Barel O, Ben-Ami I, Reish O, Herman A, et al. Termination of pregnancy due to fetal abnormalities performed after 23 weeks' gestation: analysis of indications in 144 cases from a single medical center. Fetal Diagn Ther. 2009;25(2):291-6. doi: 10.1159/000229501. Epub 2009 Jul 24. PMID: 19628945.
  • 15- Ozyuncu O, Orgul G, Tanacan A, Aktoz F, Guleray N, Fadiloglu E, et al. Retrospective analysis of indications for termination of pregnancy. J Obstet Gynaecol. 2019 Apr;39(3):355-358. doi: 10.1080/01443615.2018.1506427. Epub 2018 Nov 14. PMID: 30428730.
  • 16- Baumann S, Darquy S, Miry C, Duchange N, Moutel G. Termination of pregnancy for foetal indication in the French context analysis of decision-making in a Multidisciplinary Centre For Prenatal Diagnosis. J Gynecol Obstet Hum Reprod. 2021 Oct;50(8):102067. doi: 10.1016/j.jogoh.2021.102067. Epub 2021 Jan 21. PMID: 33484935.
  • 17- Borgatta L, Kapp N: Society of family planning. Clinical guidelines. Labor induction abortion in the second trimester. Contraception 84, 4–18 (2011).
  • 18- Lee VC, Ng EH, Ho PC. Issues in second trimester induced abortion (medical/surgical methods). Best Pract Res Clin Obstet Gynaecol. 2010 Aug;24(4):517-27. doi: 10.1016/j.bpobgyn.2010.02.008. Epub 2010 Mar 29. PMID: 20347397.
  • 19- Rezk MA, Sanad Z, Dawood R, Emarh M, Masood A. Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. J Matern Fetal Neonatal Med. 2015 Jan;28(1):93-6. doi:10.3109/14767058.2014.905909. Epub 2014 Apr 9. PMID: 24635496.
  • 20- Ercan Ö, Köstü B, Özer A, Serin S, Bakacak M. Misoprostol versus misoprostol and foley catheter combination in 2nd trimester pregnancy terminations. J Matern Fetal Neonatal Med. 2016 Sep;29(17):2810-2. doi: 10.3109/14767058.2015.1105950. Epub 2015 Nov 23. PMID: 26452400.
  • 21- Goyal V. Uterine rupture in second-trimester misoprostol-induced abortion after cesarean delivery: a systematic review. Obstet Gynecol. 2009 May;113(5):1117-1123. doi: 10.1097/AOG.0b013e31819dbfe2. PMID: 19384128.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Koray Gök 0000-0002-7420-1484

Asude Özgül 0000-0003-1710-5282

Erdal Yılmaz 0000-0002-6717-9047

Osman Köse 0000-0001-5656-6853

Mehmet Sühha Bostancı 0000-0002-4776-6244

Selçuk Özden 0000-0002-3346-7227

Publication Date March 18, 2022
Submission Date January 22, 2022
Published in Issue Year 2022 Volume: 12 Issue: 1

Cite

AMA Gök K, Özgül A, Yılmaz E, Köse O, Bostancı MS, Özden S. Gebelik Terminasyonu Olgularının Retrospektif Analizi: 177 Olgunun Değerlendirilmesi. Sakarya Tıp Dergisi. March 2022;12(1):116-121. doi:10.31832/smj.1061707

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