RESUMEN
OBJECTIVES: The incidence of PAS is increasing day by day as a life-threatening condition. The purpose of the present study was to determine the factors affecting PAS formation in primiparous pregnant women and to define possible risk factors for the mother and the baby. MATERIAL AND METHODS: Bursa Yüksek Ihtisas Training and Research Hospital, department of obstetrics and gynecology, Bursa, Turkey, between June 2016 and December 2020. A total of 58,895 patients were included in the study. After the exclusion criteria, the study was continued with 27 primiparous PAS and 54 non-primiparous PAS patients. The primary purpose is to evaluate PAS risk factors. The secondary aim is to examine maternal and neonatal characteristics. RESULTS: When the parameters that are significant in terms of PAS risk factors were analyzed by Logistic Regression Analysis, it was found that the increase in age also increased the development of PAS 1.552 times (95% CI: 1.236-1.948) and a history of abortion was 7.928. times (95% CI: 1.408-44.654) and 11,007 times (95% CI: 2.059-58.832) with history of myomectomy; postoperative HB values (p < 0.001), an estimated amount of bleeding (p < 0.001), need for transfusion (p = 0.002), and use of drains ( < 0.001) were statistically significant different between two groups. When the neonatal results between patients with and without PAS were examined, birth weight (p < 0.001) and gestational week ( < 0.001) were statistically significant. CONCLUSIONS: PAS does not occur only in multiparous patients who have a history of previous cesarean section. It may also occur in primiparous patients and is a life-threatening condition.
Asunto(s)
Placenta Accreta , Placenta Previa , Recién Nacido , Embarazo , Humanos , Femenino , Placenta Accreta/epidemiología , Placenta Accreta/cirugía , Mujeres Embarazadas , Cesárea/métodos , Obstetras , Sueños , Estudios Retrospectivos , Placenta Previa/epidemiología , PlacentaRESUMEN
OBJECTIVE: Our aim in this study is to determine the relationship between TPOAb positivity and pregnancy outcomes in the subclinical hypothyroid patient group. MATERIALS AND METHODS: This study was started with 21,321 pregnant women, but after the exclusion criteria, 11,387 pregnant women were included int his study. Demographic characteristics of each patient group included in the study, such as age, bodymass index (BMI), and laboratory parameters such as complete blood count (hemogram), liver and kidney function tests, type of delivery, birth weight, neonatal intensive care admission, 1st and 5th minute APGAR scores, glucose tolerance test results, whether there was high blood pressure during pregnancy, whether there was premature rupture of membranes were recorded from the hospital information system and patient files. RESULTS: Pregnant women with subclinical hypothyroidism were divided into groups according to their TPOAb status. When maternal and neonatal outcomes were evaluated between groups; Among these four groups there was a statistically significant difference only in impaired glucose tolerance (IGT) antibody groups with and without subclinical hypothyroidism according to their positivity (p < 0.01). When the euthyroid TPOAb negative group was taken as reference, the risk of impaired and TPOAb positive groups (OR: 1.210; 95% CI: 0.936-1.563; P = 0.145), impaired in the group with subclinical hypothyroidism but TPOAb positivity glucose tolerance 1.358(OR: 1.358); 95% CI: 1.042-1.770; P = 0.023) fold increased by 3.556 (OR: 3.556) in the group with subclinical hypothyroidism and TPOAb positivity; (95% CI: 2.37-5.343; p < 0,001). CONCLUSION: In ourstudy, there was a significant difference only in terms of IGT between the Groups with and without subclinical hypothyroidism, depending on whether they were positive for TPOAb or not. Therefore, studies in volving larger patient groups are needed.