Utjecaj multiple skleroze na tijek i ishod trudnoće u KB Sv. Duh

master's thesis

• Title (english): The influence of multiple sclerosis on the course and outcome of pregnancy on KB Sv. Duh
• Author: Nikolina Musulin
• Mentor: Berivoj Mišković (mentor)
• Committee member: Vesna Elveđi Gašparović (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Berivoj Mišković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Multipla skleroza je autoimuna demijelinizacijska bolest središnjeg živčanog sustava koja se najčešće javlja u žena generativne dobi. S obzirom na to javlja se potreba odgovoriti na pitanje utjecaja same bolesti na tijek i ishod trudnoće. Ovo retrospektivno istraživanje provedeno je u KB ˝Sv. Duh˝ u razdoblju od 1. siječnja 2015. do 31. prosinca 2020. godine s ciljem utvrđivanja utjecaja multiple skleroze na tijek i ishod trudnoće. U navedenom razdoblju bilo je 24 trudnice s dijagnozom multiple skleroze te su uspoređene s 48 ispitanice kontrolne skupine izabranih sustavnim uzorkovanjem. U svrhu donošenja zaključka podaci su analizirani u sklopu tri kategorije: osobna anamneza trudnice, podaci o ishodu trudnoće te podaci o novorođenčetu. U sklopu prve kategorije nije pronađena statistički značajna razlika u dobi prve trudnoće niti u udjelu prvorotki i višerotki između istraživane i kontrolne skupine. U drugoj kategoriji uspoređene su slijedeće varijable: način zatrudnjivanja, trajanje trudnoće u tjednima, način dovršetka trudnoće, uporaba indukcije, epiduralne analgezije, oksitocinske infuzije te epiziotomije. Statistički značajna razlika pronađena je broju dovršetka poroda carskim rezom (p – vrijednost = 0.02). Navedeno govori u prilog većoj učestalosti dovršenja poroda carskim rezom u trudnica oboljelih od multiple skleroze. U preostalim varijablama iz druge kategorije nije pronađena statistički značajna razlika. U posljednjoj trećoj kategoriji uspoređene su sljedeće varijable: dijagnoza fetalnog zastoja rasta (˝FZR-a˝), tjelesna težina i duljina novorođenčeta, Apgar indeks u 1. i 5. minuti i prirođene malformacije. U našem istraživanju nije pronađena statistički značajna razlika u porođajnoj duljini i težini kao ni prilikom usporedbe učestalosti dijagnoze FZR-a i prirođenih malformacija. U istraživanoj skupini udio trudnoća s dijagnozom FZR-a iznosi 7% , a u kontrolnoj skupini 2.5%. Zaključno s našim rezultatima i rezultatima uspoređenih studija utjecaj multiple skleroze na tijek i ishod trudnoće je minimalan te ne postoji razlog za odgađanje ili izbjegavanje trudnoće.

Abstract (english)

Multiple sclerosis is an autoimmune demyelinating disease of the central nervous system that most commonly occurs in women of childbearing age. Given this, there is a need to answer the question of the impact of the disease itself on the course and outcome of pregnancy. This retrospective research was conducted in KB ˝Sv. Duh˝ in the period from 1 January 2015 to 31 December 2020 with the aim of determining the impact of multiple sclerosis on the course and outcome of pregnancy. In this period, there were 24 pregnant women diagnosed with multiple sclerosis and were compared with 48 subjects in the control group selected by systematic sampling. In order to draw a conclusion, the data were analyzed in three categories: personal history of the pregnant woman, data on the outcome of pregnancy and data on the newborn. Within the first category, no statistically significant difference was found in the age of the first pregnancy or in the share of primipara and multipara between the study and control groups. The second category compared the following variables: type of conception, duration of pregnancy in weeks, method of termination of pregnancy, use of induction, epidural analgesia, oxytocin infusion and episiotomy. A statistically significant difference was found in the number of cesarean delivery completions (p - value = 0.02). This speaks in favor of a higher frequency of cesarean delivery in pregnant women with multiple sclerosis. No statistically significant difference was found in the remaining variables from the second category. In the last third category, the following variables were compared: diagnosis of fetal growth restriction (˝FGR˝), body weight and length of the newborn, Apgar index at 1 and 5 minute, and congenital malformations. No statistically significant difference in newborn length and weight was found in our study, nor when comparing the frequency of diagnosis of FGR and congenital malformations. In the study group, the share of pregnancies diagnosed with FGR was 7%, and in the control group 2.5%. In conclusion with our results and the results of comparative studies, the impact of multiple sclerosis on the course and outcome of pregnancy is minimal and there is no reason to delay or avoid pregnancy.

• Keywords: multipla skleroza; carski rez; fetalni zastoj rasta
• Keywords (english): multiple sclerosis; Cesarean section; fetal growth restriction
• Language: croatian
• URN:NBN: urn:nbn:hr:105:462379
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-17 11:58:45