Fetal gelişim kısıtlılığı ile komplike gebeliklerde fetal adrenal bez boyutlarının incelenmesi

Abstract

Amaç: Fetal geliflim kısıtlalaması olgularında fetal adrenal bez boyutlarının ölçülmesi ve gebelik haftası ile uyumlu geliflim gösteren fetüsler ile karfl›laflt›r›lmas› amaçland›. Yöntem: Gebeli¤in 24–34 haftalar› aras›nda, fetal geliflme k›s›tl›- l›¤› tan›s› alan 44 olgu çal›flma grubu olarak ve benzer gebelik haftalar›nda gebelik haftas› ile uyumlu geliflim gösteren 44 olgu ise kontrol grubu olarak çal›flmaya dahil edildi. Olgular›n fetal adrenal bez boyutlar› fetal abdomenin transvers kesitinde incelendi. Bulgular: Çal›flma ve kontrol gruplar› aras›nda maternal yafl, gravida, parite, vücut kitle indeksi ve tan› an›ndaki gebelik haftas› aç›- s›ndan anlaml› fark saptanmad› (p>0.05). Fetal adrenal bez toplam uzunlu¤u, toplam geniflli¤i ve korteks geniflli¤i z-skorlar› çal›flma grubunda kontrol grubuna göre istatistiksel olarak anlaml› flekilde yüksek saptand› (p<0.001). Fetal adrenal bez medulla geniflli¤i zskoru ise çal›flma grubunda kontrol grubuna göre istatistiksel olarak anlaml› flekilde düflük saptand› (p<0.001). Fetal adrenal bez medulla uzunlu¤u z-skoru aç›s›ndan gruplar aras›nda anlaml› fark yoktu (p>0.05). Sonuç: Fetal geliflim k›s›tl›l›¤› tan›l› olgularda fetal adrenal bez boyutlar›nda gözlenen de¤iflikliklerin uteroplasental yetmezli¤e ba¤l› kronik hipoksinin bir sonucu oldu¤u ve uzun dönem olumsuz sa¤l›k sonuçlar› ile iliflkili kötü fetal programlaman›n da bir bilefleni oldu¤u düflünülebilir.Objective: We aimed to measure fetal adrenal gland sizes in the cases of intrauterine growth restriction and to compare them with the fetuses growing consistent with the week of gestation. Methods: Forty-four cases diagnosed with intrauterine growth restriction between 24 and 34 weeks of gestation were included in the study as the study group and 44 cases in the similar weeks of gestation and growing consistent with the week of gestation were included in the study as the control group. The fetal adrenal gland sizes of the cases were examined in the transverse sections of fetal abdomens. Results: No significant difference was found between the study and control groups in terms of maternal age, gravida, parity, body mass index and the week of gestation during diagnosis (p>0.05). The zscores of total length, total width and cortex width of the fetal adrenal glands were higher in the study group than the control group which was statistically significant (p<0.001). The z-scores of the medulla width of the fetal adrenal glands were lower in the study group than the control group which was statistically significant (p<0.001). There was no significant difference between the groups in terms of the z-scores of the medulla length of the fetal adrenal glands (p>0.05). Conclusion: It is possible to consider that the changes observed in the fetal adrenal gland sizes of the cases diagnosed with intrauterine growth restriction is a result of chronic hypoxia associated with uteroplacental failure and a component of poor fetal programming associated with the long-term poor health outcomes.