master's thesis
Analiza ishoda i tijeka trudnoća s HELLP sindromom u KBC-u Rijeka od 2005. do 2014. godine

Dolores Marinić (2016)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za ginekologiju i opstetriciju
Metadata
TitleAnaliza ishoda i tijeka trudnoća s HELLP sindromom u KBC-u Rijeka od 2005. do 2014. godine
AuthorDolores Marinić
Mentor(s)Aleks Finderle (thesis advisor)
Abstract
Uvod: HELLP sindrom je težak oblik preeklampsije kojeg klinički karakteriziraju hemoliza, povišeni jetreni enzimi i niski trombociti. Pojavljuje se u 0.2–0.8% svih trudnoća te vrlo često prati preeklampsiju. HELLP sindrom se prema važećoj Mississippi klasifikaciji dijeli na 3 stupnja ovisno o težini kliničke slike. Također, HELLP sindrom nosi visok rizik nepovoljnog perinatalnog ishoda. Ovaj znanstveni rad opisuje incidenciju, dijagnostiku, čimbenike rizika i komorbiditete majke, način dovršenja poroda, gestacijsku dob te Apgar indeks fetusa u trudnoća s HELLP sindromom. Svrha rada: Svrha ovog rada bila je utvrditi tijek i ishod trudnoća s HELLP sindromom u trudnica zaprimljenih na Kliniku za ginekologiju i porodništvo, KBC-a Rijeka, u razdoblju od 1. siječnja 2005. do 31. prosinca 2014. godine. Ispitanici i metode: Analizirano je 25 trudnica s HELLP sindromom, na temelju podataka prikupljenih iz Baze podataka Klinike za ginekologiju i porodništvo, KBC Rijeka. Za analizu podataka korišten je Microsoft Excel program. Rezultati: HELLP sindrom manifestirao se kod 25 trudnica u razdoblju od 1. siječnja 2005. do 31. prosinca 2014. godine s najvećim brojem slučajeva i najvećom incidencijom 2010. godine. HELLP sindrom bio je najviše zastupljen u nulipara s jednoplodnim trudnoćama, kod trudnica dobi u rasponu 31-35 godina koje su začele prirodnim putem. Trudnice su prije trudnoće većinom imale idealan BMI te nisu imale zabilježenih hipertenzivnih poremećaja. Najčešće navedeni simptomi pri hospitalizaciji bili su povišen tlak, bol u području epigastrija i/ili desnog gornjeg kvadranta abdomena i glavobolja. Najčešći komorbiditeti trudnoća bili su preeklampsija, IUGR te kronična placentarna insuficijencija. Trudnoće su se najčešće dovršile carskim rezom. Gestacijska dob novorođenčeta u 80% slučajeva bila je <37 tjedana, a istraživani Apgar indeks u 1. minuti u 37% novorođenčadi bio je <7 dok je u 5. minuti ostao <7 kod 22% novorođenčadi. U 76% slučajeva trudnice su se prezentirale blažim poremećajima laboratorijskih nalaza i lakšom kliničkom slikom. Nije zapažena statistički značajna razlika pri ispitivanju povezanosti stadija HELLP sindroma i navedenih parametara : dob trudnice, BMI prije trudnoće te gestacijska dob djeteta. Zaključak: Ova retrospektivna analiza pokazala je da HELLP sindrom komplicira trudnoću, porod i puerperij, no njegova pravovremena dijagnoza i rano dovršenje trudnoće dovode do dobrog perinatalnog ishoda u djece majki s HELLP sindromom. Unatoč brojnoj literaturi koja govori o HELLP sindromu potrebno je učiniti daljnja istaživanja na ovu temu.
KeywordsHELLP syndrome pregnant women hypertension preeclampsia Caesarean section gestational age Apgar score
Committee MembersAlemka Brnčić-Fischer (committee chairperson)
Sandra Milić (committee member)
Tea Štimac (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za ginekologiju i opstetriciju
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
Introduction: HELLP syndrome is characterized by hemolysis, elevated liver enzymes and low platelet count. It’s a serious complication in pregnancy which occurs in 0.2 to 0.8% of all pregnancies and often follows severe preeclampsia. According to the current Mississippi classification HELLP syndrome is divided into three stages depending on the severity of the clinical presentation. Also, it carries a high risk of adverse perinatal outcomes. This article describes incidence, diagnosis, maternal risk factors and comorbidities, mode of delivery, gestational age and Apgar score of the fetus. Purpose: The purpose of this study was to determine the course and outcome of pregnancies with HELLP syndrome in women received at the Department of Obstetrics and Gynecology, Clinical Hospital Center Rijeka, during the period from 1 January 2005 to 31 December 2014. Patients and methods: We analyzed a group of 25 pregnant women, based on data collected from the Register of Clinical Hospital Center Rijeka. Microsoft Excel was used for analysis. Results: HELLP syndrome manifested itself in 25 pregnant women in the period from 1 January 2005 to 31 December 2014, with the largest number of cases and the highest incidence in year 2010. HELLP syndrome represented the most in nulliparous single pregnancies, in pregnant women aged from 31 to 35 years and natural pregnancies. Most pregnant women had an ideal BMI before pregnancy and had no recorded hypertensive disorder. The most frequently mentioned symptoms in hospitalization were high blood pressure, epigastric pain or pain in the right upper abdominal quadrant and headache. The most common comorbidities were preeclampsia, IUGR and chronic placental insufficiency. HELLP syndrome pregnancies were usually completed by caesarean section. The gestational age of newborns was <37 weeks in 80% and the investigated Apgar score in the first minute was <7 in 37% of infants while in the 5th minute it remained <7 in 22% of infants. In 76% of pregnant women HELLP syndrome presented itself with mild laboratory abnormalities. There was no statistically significant difference in examining the relationship between the stages of HELLP syndrome and the parameters above : maternal age, BMI before pregnancy and gestational age of the child. Conclusion: In this retrospective analysis, it has been proven that HELLP syndrome complicates pregnancy, childbirth and the puerperium, but his diagnosis and early termination of pregnancy lead to good perinatal outcomes in children of mothers with HELLP syndrome. Despite numerous literature that talks about HELLP syndrome there is a need to do further research on this topic.
Parallel keywords (Croatian)HELLP sindrom trudnice hipertenzija preeklampsija carski rez gestacijska dob Apgar indeks 27
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:064579
CommitterBosa Licul