Vaginalni porod zatkom kod blizanačkih trudnoća u KB "Sveti Duh" u razdoblju od 2005.-2018.

master's thesis

• Title (english): Vaginal breech delivery in twin pregnancies at the Clinical Hospital Sveti Duh in the period 2005-2018
• Author: Analena Gregorić
• Mentor: Ivanka Bekavac Vlatković (mentor)
• Committee member: Tatjana Pavelić Turudić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Ivanka Bekavac Vlatković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Blizanačke trudnoće razlikuju se od jednoplodnih po prosječnom trajanju trudnoće i češćim komplikacija tijekom trudnoće i samog porođaja. Vaginalni porođaj blizanaca od kojih je barem jedan u stavu zatkom nije učestala pojava, ali je svakako prisutan u opstetričkoj praksi. Ovo retrospektivno istraživanje provedeno je na Klinici za ginekologiju i porodništvo Kliničke bolnice „Sveti Duh“ u razdoblju od 1. siječnja 2005. do 31. prosinca 2018. godine. U istraživanje su bile uključene rodilje koje su rodile blizance vaginalnim putem, a jedan ili oba blizanca bila su bila u stavu zatkom. Takvih je porođaja u promatranom razdoblju bilo 45. Porođaja u kojima su blizanci bili u stavu prvi glava, drugi zadak bilo je 40; 2 porođaja su bila gdje je prvi blizanac bio u stavu zadak, drugi u stavu glava te 3 porođaja gdje su oba blizanca bila u stavu zadak. Analizirani su bili maternalni demografski podatci te perinatalni ishod kod novorođenčadi u ovisnosti o metodi asistencije tijekom porođaja. Od maternalnih podataka analizirano je sljedeće: godine majke, paritet, način započinjanja porođaja te učestalost epiziotomije , a kod perinatalnog ishoda novorođenčeta promatrani su: dužina i težina jednog i drugog blizanca, gestacijska dob te Apgar score u 1. i 5. minuti nakon porođaja. Rezultati su pokazali kako bolji perinatalnih ishod imaju novorođenčad porođena metodom po Thiessenu (minimalna asistencija tijekom porođaja zatkom) te Vermelinu (spontani vaginalni porođaj zatkom bez asistencije). Više od 65% blizanačkih trudnoća bilo je dovršeno u terminu te su 6 od ukupno 90 novorođenčadi (6,67%) bili premješteni u neonatalnu jedinicu intenzivnog liječenja (NICU). Ovakvi rezultati pokazuju da tehnika asistencije tijekom porođaja u stavu zatkom ima utjecaj na perinatalni ishod te da bolji perinatalni ishod ima novorođenčad porođena metodom asistencije s najmanje manipulacije.

Abstract (english)

Twin pregnancies differ from singleton pregnancies by the average duration of the pregnancy and the prevalence of complications during pregnancies and during a labor. Vaginal delivery of twins, and one of them is in breech presentation, is not common occurrence but it is certainly present in opstetric practice. This retrospective study was conducted at the Clinical hospital „Sveti Duh“ from January 1, 2005 to December 31, 2018. The study involved women who delivered twins by vaginally, and one of twins or both were in breech presentation. There were 45 vaginal deliveries of twins in beech presentation during observed period. There were 40 deliveries where first twin was in head presentation and second twin in breech presentation, furthermore 2 deliveries where first twin was in breech and second in head presentation and 3 deliveries where both twins were in breech presentation. Maternal demographic parametars and perinatal outcome of newborns depending on the mode of delivery used were observed. Maternal parametars that were observed include: maternal age, parity, the course od labor (spontaneous, induced) and the incidence of the episiotomy. In perinatal outcome of newborns, birth weight and lenght of newborns, gestational age and an Apgar score at 1 and 5 minutes after delivery of both twins were observed. The results showed that twins delivered by mode of Thiessen (minimally assisted breech delivery) and Vermelin (spontaneous vaginal breech delivery without procedures) had a better perinatal outcome. More than 65% of observed twin pregnancies were terminated and 6 of a total of 90 newborns (6,67%) were tranferred to nenatal intensive care unit (NICU). This results indicate that the assisted delivery tehnique has an impact on perinatal outcome of newborns delivered by vaginally and that newborns delivered with less- traumatizing method of assistance have better perinatal outcome.

• Keywords: blizanačka trudnoća; stav zatkom; vaginalni porođaj
• Keywords (english): twin pregnancies; breech presentation; vaginal delivery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:548863
• 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: 2021-09-06 10:07:41