Amaç: Bu çalışmada, daha önce sezaryen ile doğum yapmış gebelerde sezaryen doğumun optimal fetal ve maternal zamanlamasını belirlemeyi amaçladık.
Materyal/Yöntem: Bir yıllık çalışma süresinde tekil gebeliği olan ve gebelik yaşı 37-40 hafta arasında olan toplam 150 gebe çalışmaya dahil edildi. Gebe ve yenidoğan verileri prospektif olarak incelendi. Gebeler gebelik yaşlarına göre 37 hafta, 38 hafta ve 39 hafta olmak üzere üç gruba ayrıldı. Gebelerin gravida, parite, yaş bilgileri, ek hastalıkları ve sezaryen doğum sayıları kaydedildi. Doğum sırasında yaşanan fetal ve doğum komplikasyonları kaydedildi.
Bulgular: 1. dakika ve 5. dakika Apgar skorları 37. haftada diğer haftalara göre anlamlı derecede düşüktü (p <0,001). Yoğun bakım ihtiyacı 37+0 ile 37+6 haftalar arasında % 45,5-68,2, 38+0 ile 38+6 haftalar arasında %22,7-40,9 ve 39 hafta sonra %0-4,5 arasında değişmektedir. Grupların değerlendirilmesi, medyan yaş değerinin 38 haftalık grupta 37 ve 39 haftalık gruplara göre anlamlı olarak daha yüksek olduğunu ortaya koydu (p <0.001).
Sonuç: Sezaryen öyküsü olan gebelerde doğum süresi için en uygun gebelik haftasının 39 hafta ve sonrası olduğu belirlendi.
1. Fleischman AR, Oinuma M, Clark SL. Rethinking the definition of "term pregnancy". Obstet Gynecol. 2010;116:136-139. doi: 10.1097/AOG.0b013e3181e24f28.
2. Jukic AM, Baird DD, Weinberg CR, McConnaughey DR, Wilcox AJ. Length of human pregnancy and contributors to its natural variation. Hum Reprod. 2013;28:2848-55. doi: 10.1093/humrep/det297.
3. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371:75-84. doi: 10.1016/S0140-6736(08)60074-4.
4. Bastek JA, Sammel MD, Paré E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008;199:367.e1-8. doi: 10.1016/j.ajog.2008.08.002
5.American College of Obstetricians and Gynecologists. ACOG committee opinion no. 561: Nonmedically indicated early-term deliveries. Obstet Gynecol. 2013;121:911-5. doi: 10.1097/01.AOG.0000428649.57622.a7
6. Engle WA. Morbidity and mortality in late preterm and early term newborns: a continuum. Clin Perinatol. 2011;38: 493-516. doi: 10.1016/j.clp.2011.06.009.
7. Crump C, Sundquist K, Winkleby MA, Sundquist J. Earlyterm birth (37-38 weeks) and mortality in young adulthood. Epidemiology. 2013;24:270-6. doi: 10.1097/EDE.0b013e318280da0f
8. Quigley MA, Poulsen G, Boyle E, Wolke D, Field D, Alfirevic Z, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2012;97: F167-73. doi: 10.1136/archdischild-2011-300888
9. Robinson M, Whitehouse AJ, Zubrick SR, Pennell CE, Jacoby P, McLean NJ, et al. Delivery at 37 weeks’ gestation is associated with a higher risk for child behavioural problems. Aust N Z J Obstet Gynaecol. 2013;53:143-51. doi: 10.1111/ajo.12012. Epub 2012 Nov 22.
10. Hart L, Refuerzo J, Sibai B, Blackwell S. Should the “39 week rule” apply to women with multiple prior cesarean deliveries? Am J Obstet Gynecol. 2014;210:S27.
11. Spong CY, Mercer BM, D’alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011;118:323-33. doi: 10.1097/AOG.0b013e3182255999
12. Catalano PM, Sacks DA. Timing of indicated late preterm and early-term birth in chronic medical complications: diabetes. Semin Perinatol. 2011;35:297-301. doi: 10.1053/j.semperi.2011.05.003. doi: 10.1053/j.semperi.2011.05.003
13. Silver RM. Previous stillbirth, late preterm, and early-term birth. Semin Perinatol. 2011;35:302-8. doi: 10.1053/j.semperi.2011.05.006
15. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2013;121:908-10. doi: 10.1097/01.AOG.0000428648.75548.00
16. Medically indicated late-preterm and early-term deliveries. ACOG Committee Opinion No. 764. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2019;133:e151–55.
1. Fleischman AR, Oinuma M, Clark SL. Rethinking the definition of "term pregnancy". Obstet Gynecol. 2010;116:136-139. doi: 10.1097/AOG.0b013e3181e24f28.
2. Jukic AM, Baird DD, Weinberg CR, McConnaughey DR, Wilcox AJ. Length of human pregnancy and contributors to its natural variation. Hum Reprod. 2013;28:2848-55. doi: 10.1093/humrep/det297.
3. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371:75-84. doi: 10.1016/S0140-6736(08)60074-4.
4. Bastek JA, Sammel MD, Paré E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008;199:367.e1-8. doi: 10.1016/j.ajog.2008.08.002
5.American College of Obstetricians and Gynecologists. ACOG committee opinion no. 561: Nonmedically indicated early-term deliveries. Obstet Gynecol. 2013;121:911-5. doi: 10.1097/01.AOG.0000428649.57622.a7
6. Engle WA. Morbidity and mortality in late preterm and early term newborns: a continuum. Clin Perinatol. 2011;38: 493-516. doi: 10.1016/j.clp.2011.06.009.
7. Crump C, Sundquist K, Winkleby MA, Sundquist J. Earlyterm birth (37-38 weeks) and mortality in young adulthood. Epidemiology. 2013;24:270-6. doi: 10.1097/EDE.0b013e318280da0f
8. Quigley MA, Poulsen G, Boyle E, Wolke D, Field D, Alfirevic Z, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study. Arch Dis Child Fetal Neonatal Ed. 2012;97: F167-73. doi: 10.1136/archdischild-2011-300888
9. Robinson M, Whitehouse AJ, Zubrick SR, Pennell CE, Jacoby P, McLean NJ, et al. Delivery at 37 weeks’ gestation is associated with a higher risk for child behavioural problems. Aust N Z J Obstet Gynaecol. 2013;53:143-51. doi: 10.1111/ajo.12012. Epub 2012 Nov 22.
10. Hart L, Refuerzo J, Sibai B, Blackwell S. Should the “39 week rule” apply to women with multiple prior cesarean deliveries? Am J Obstet Gynecol. 2014;210:S27.
11. Spong CY, Mercer BM, D’alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011;118:323-33. doi: 10.1097/AOG.0b013e3182255999
12. Catalano PM, Sacks DA. Timing of indicated late preterm and early-term birth in chronic medical complications: diabetes. Semin Perinatol. 2011;35:297-301. doi: 10.1053/j.semperi.2011.05.003. doi: 10.1053/j.semperi.2011.05.003
13. Silver RM. Previous stillbirth, late preterm, and early-term birth. Semin Perinatol. 2011;35:302-8. doi: 10.1053/j.semperi.2011.05.006
15. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2013;121:908-10. doi: 10.1097/01.AOG.0000428648.75548.00
16. Medically indicated late-preterm and early-term deliveries. ACOG Committee Opinion No. 764. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2019;133:e151–55.
Öz İŞ, Kutlay Ö (October 1, 2023) Optimal Timing of Cesarean Delivery in Pregnant Women with Previous Cesarean Delivery. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 14 4 542–548.