PRETERM EYLEM TEDAVİSİNDE NİFEDİPİN’İN ETKİNLİĞİ
PRETERM EYLEM TEDAVİSİNDE NİFEDİPİN’İN ETKİNLİĞİ
Yazar: Başer, Hakan; Özdemir, Özhan; Kılıç, Niyazi; Demircan, Fadime; Ekmez, Fırat; Yücel, Oğuz
Dergi: Bozok Tıp Dergisi, Vol. 4 No. 3, 2014
Anahtar kelimeler: Tokoliz; Nifedipin; Preterm eylem ; Tocolizis; Nifedipine; Preterm labor

ÖZETAmaç: Preterm eylem tedavisinde tokolitik olarak nifedipin kullanılan hastaların sonuçları incelenerek nifedipinin etkinliği ve doğumun geciktirilmesinde katkısı olabilecek faktörleri belirlemeyi amaçladık. Gereç ve Yöntemler: Çalısmaya Ocak 2007- Aralık 2011 tarihleri arasında Süleymaniye Doğum ve Ka- dın Hastalıkları Eğitim Hastanesi’nde preterm eylem tanısıyla hospitalize edilen ve nifedipin ile tokolitik tedavi alan, 24-37 haftalar arasındaki 112 gebe dahil edildi. Çalışmaya dahil edilen hastalar doğumun geciktirildiği gün sayısına göre 7 gün veya daha az geciktirilenler ve 7 günden daha fazla geciktirilenler olmak üzere iki gruba ayrılarak her iki grup demografik özellikler ile perinatal, neonatal ve maternal sonuçlar açısından karşılaştırıldı.Bulgular: Her iki grup arasında yaş, vücut kitle indeksi, gravida, parite, başvuru anındaki servikal kanal uzunluğu, Bishop skoru, tanı anındaki ortalama gebelik haftaları açısından istatistiksel olarak anlam- lı farklılık gözlenmedi (p<0.05). Hastaların %69,7’de doğum 7 günden daha fazla geciktirilmiş olup 34 haftadan önce doğum yapan hasta sayısı 32’dir ve bu hastaların 21(%65,6)’i 7 gün ve daha az doğumun geciktirilebildiği grupta izlendi (p=0,021). Doğum şekilleri açısından, kazanılan gün sayısı >7 gün olan grupta, sezaryen doğum oranı istatistiksel olarak anlamlı derecede daha düşük olarak bulundu (%61,8& %34,6, p=0,008). Neonatal komplikasyonlar açısında gruplar karşılaştırıldığında 7 gün ve daha az do- ğumun geciktirildiği grupta respiratuar distres sendromu ve yoğun bakım ihtiyacı istatistiksel olarak an- lamlı derecede daha yüksek olarak tespit edildi (sırasıyla p=0,017; p=0,036).Sonuç: Ciddi maternal ve fetal yan etkilerinin olmaması ve oral kullanıma uygun olması nedeniyle to- kolitik olarak nifedipinlerin kullanımı giderek artmıştır. Ancak nifedipinlerin etkinliğine yönelik yeterli plasebo kontrollü klinik çalışmalar ve ideal rejim bulunmamaktadır.Anahtar kelimeler: Tokoliz; Nifedipin; Preterm eylemABSTRACTObjective: Our aim is to determine the effectiveness of nifedipine as a tocolytic in woman with preterm labor and to determine the factors to prolong pregnancy.Material and Methods: 112 woman in 24-37 weeks’ gestation who were admitted to Suleymaniye Birth And Women Health Education And Research Hospital and hospitalized to take nifedipine as tocolytic from january 2007 to 2011 december were added to our study. Partisipants were diveded into two groups according to their delay in timing of birth: Less than seven days and lonfer than seven days. These groups were compared on the basis of their demographical feature,nenotal and maternal follow- up results.Results: There were no statistically difference in between two groups for age, body mass index, gravidity, parity, cervical lenght at time of admission, Bishop score and the mean gestational age (p< 0,05). In 69,7% of patients delivery was prolonged for longer than 7 days and 32 patients gave birth before 34 weeks. 21 of these 32 patients (65,6%) was in the first group in which delivery was prolonged for 7 days or less (p: 0,021). In the other group as compared for mode of delivery cesarean section was statistically low (61,8% vs 34,6% p: 0,008). Neonatal complications as respiratory distress syndrome need for intensive care unit was statistically high in less than 7 days prolonged for gestation group (p: 0,017, p: 0,036 respectively).Conclusion: Use of nifedipine is pervaded as a tocolytic since it has minimal adverse effects on fetal and maternal systems with its simple oral usage, but there is no satisfactory placebo clinical trials on ideal medication.Keywords: Tocolizis; Nifedipine; Preterm labor

Objective: Our aim is to determine the effectiveness of nifedipine as a tocolytic in woman with preterm labor and to determine the factors to prolong pregnancy.Material and Methods: 112 woman in 24-37 weeks’ gestation who were admitted to Suleymaniye Birth And Women Health Education And Research Hospital and hospitalized to take nifedipine as tocolytic from january 2007 to 2011 december were added to our study. Partisipants were diveded into two groups according to their delay in timing of birth: Less than seven days and lonfer than seven days. These groups were compared on the basis of their demographical feature,nenotal and maternal followup results.Results: There were no statistically difference in between two groups for age, body mass index, gravidity, parity, cervical lenght at time of admission, Bishop score and the mean gestational age (p< 0,05). In 69,7% of patients delivery was prolonged for longer than 7 days and 32 patients gave birth before 34 weeks. 21 of these 32 patients (65,6%) was in the first group in which delivery was prolonged for 7 days or less (p: 0,021). In the other group as compared for mode of delivery cesarean section was statistically low (61,8% vs 34,6% p: 0,008). Neonatal complications as respiratory distress syndrome need for intensive care unit was statistically high in less than 7 days prolonged for gestation group (p: 0,017, p: 0,036 respectively). Conclusion: Use of nifedipine is pervaded as a tocolytic since it has minimal adverse effects on fetal and maternal systems with its simple oral usage, but there is no satisfactory placebo clinical trials on ideal medication.