Çok düşük doğum ağırlıklı prematürelerde antenatal steroid uygulama zamanının postnatal dönemde kan basıncı üzerine etkileri
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Tarih
2012
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çok düşük doğum ağırlıklı prematürelerde antenatal steroid uygulama zamanının postnatal dönemde kan basıncı üzerine etkilerini araştırmak amacıyla, 1500 gr. altında doğmuş 120 prematüre bebek geriye dönük olarak incelendi. Tüm olgular; antenatal steroid uygulanmayan (Grup-I), antenatal steroid uygulamasından doğuma kadar 48 saatten az zaman geçenler (Grup-II) ve 48 saat-7 gün arasında olanlar (Grup-III) olarak 3 gruba ayrıldı. Çalışmaya alınan yenidoğanların postnatal ilk 72 saatte 2 saatlik aralıklarla ossilometrik yöntemle ölçülmüş sistolik, diyastolik, ortalama kan basınçları değerleri ve kalp tepe atımı sayısı not edildi. Kan basıncı değerlerinin 6 saatlik aralarla ortalamaları alındı. Kan basıncını etkileyen antenatal, perinatal ve postnatal faktörler açısından gruplar arasında anlamlı bir fark saptanmadı. Sadece, respiratuar distress sendromu'nun Grup-III'te daha az görüldüğü saptandı (p=0.016). Her üç grupta postnatal 72 saatte 2 saatlik aralarla ölçülen sistolik, diyastolik ve ortalama kan basınçları karşılaştırıldığında 42. ve 48. saatlerdeki sistolik kan basınçları (p= 0,046, p= 0,006), 6.-12. saatlerdeki diastolik kan basınçları (p=0,005, p=0,022) ve 48. saatteki ortalama kan basıncı (p=0.013) Grup-II'de diğer gruplara göre yüksek bulundu. Ölçülen 72 saatlik sistolik, diastolik ve ortalama kan basınçlarının ortalaması karşılaştırıldığında sistolik ve ortalama kan basınçları ortalamalarında gruplar arasında anlamlı fark saptanmadı. Diastolik kan basınçlarının ortalaması karşılaştırıldığında ise Grup-III'te diğer gruplara göre istatistiksel olarak anlamlı düşük saptandı (p=0,034). Her üç grupta postnatal 72 saatte bakılan kalp tepe atımlarının ortalamaları kıyaslandığında, Grup-I'de diğer gruplara göre istatistiksel olarak anlamlı düşük saptandı (p=0,035). Sonuç olarak çalışmamızda; sistolik, diastolik ve ortalama kan basıncı değerleri antenatal betametazon uygulamasından doğuma kadar 48 saatten az zaman geçen yenidoğanlarda diğer gruplara göre yüksek saptandığı için bu bebeklere de postnatal ilk 48 saatte hipertansiyon yönünden takip ve ihtiyaç durumunda tedavi gerekliliği ortaya konmuştur. Anahtar kelimeler: Prematüre, çok düşük doğum ağırlığı, antenatal steroid, kan basıncı, postnatal
Abstract
With an aim to investigate the effect of the administration time of antenatal steroids on blood pressure in very low birth weight premature infants during the postnatal period, 120 premature infants weighing less than 1500 gr evaluated retrospectively. The study groups were classified as Group I (n = 40, without antenatal steroid), Group II (n = 40, antenatal steroid administration less than 48 hours before birth) and Group III (n = 40, antenatal steroid administration between 48 hours ? 7 days before birth). Systolic, diastolic and mean blood pressure measurements recorded by using occilometric methods during the first 72 hours after birth (with 2-hour intervals) and heart rates were noted. There was no statistically significant difference among the study groups in terms of antenatal, perinatal and neonatal factors which can effect blood pressure except for respiratory distress syndrome which was less frequently see in Group III (p = 0.016). When the three groups were compared in terms of systolic, diastolic and mean blood pressure measured once every two hours during the first 72 hrs after birth there was found that systolic blood pressure was statistically higher on the 42nd and 48th hour (p = 0,046, p = 0,006), diastolic blood pressure was statistically higher during the 6th - 12th hours (p=0.005, p=0.022) and mean blood pressure taken on the 48th hour (p=0.013) was higher among those in group II. When the groups were compared in terms of mean systolic blood pressure, no significant difference was observed. When the groups were compared with regard to mean diastolic blood pressure measured during the first 72 hours, the mean diastolic pressure was found to be statistically lower among those in Group III (p=0.034). However the difference among the 3 groups with respect to mean blood pressure measured on the 72nd hour was statistically insignificant. When the 3 groups were compared in terms of mean peak heart rate measured once after every two hours during the first 72 hours after birth it was found that this rate was significantly lower among those in group I compared to those in groups II and III (p=0.035). Finally in our study, therefore systolic, diastolic and mean blood pressure values are found higher in neonatals, less than 48 hours passed between antenatal steroid application and birth, in these babies at first 48 hours follow for hypertension and therapy is formed in case of necessity requirement. Key words: Premature, very low birth weight, antenatal steroid, blood pressure, postnatal
Abstract
With an aim to investigate the effect of the administration time of antenatal steroids on blood pressure in very low birth weight premature infants during the postnatal period, 120 premature infants weighing less than 1500 gr evaluated retrospectively. The study groups were classified as Group I (n = 40, without antenatal steroid), Group II (n = 40, antenatal steroid administration less than 48 hours before birth) and Group III (n = 40, antenatal steroid administration between 48 hours ? 7 days before birth). Systolic, diastolic and mean blood pressure measurements recorded by using occilometric methods during the first 72 hours after birth (with 2-hour intervals) and heart rates were noted. There was no statistically significant difference among the study groups in terms of antenatal, perinatal and neonatal factors which can effect blood pressure except for respiratory distress syndrome which was less frequently see in Group III (p = 0.016). When the three groups were compared in terms of systolic, diastolic and mean blood pressure measured once every two hours during the first 72 hrs after birth there was found that systolic blood pressure was statistically higher on the 42nd and 48th hour (p = 0,046, p = 0,006), diastolic blood pressure was statistically higher during the 6th - 12th hours (p=0.005, p=0.022) and mean blood pressure taken on the 48th hour (p=0.013) was higher among those in group II. When the groups were compared in terms of mean systolic blood pressure, no significant difference was observed. When the groups were compared with regard to mean diastolic blood pressure measured during the first 72 hours, the mean diastolic pressure was found to be statistically lower among those in Group III (p=0.034). However the difference among the 3 groups with respect to mean blood pressure measured on the 72nd hour was statistically insignificant. When the 3 groups were compared in terms of mean peak heart rate measured once after every two hours during the first 72 hours after birth it was found that this rate was significantly lower among those in group I compared to those in groups II and III (p=0.035). Finally in our study, therefore systolic, diastolic and mean blood pressure values are found higher in neonatals, less than 48 hours passed between antenatal steroid application and birth, in these babies at first 48 hours follow for hypertension and therapy is formed in case of necessity requirement. Key words: Premature, very low birth weight, antenatal steroid, blood pressure, postnatal
Açıklama
Anahtar Kelimeler
Prematüre, Çok Düşük Doğum Ağırlığı, Antenatal Steroid, Kan Basıncı, Postnatal
