| Abstract | Ovo je retrospektivno istraživanje ishoda trudnoća nakon teške preeklampsije na Klinici za ginekologiju i porodništvo KB „Sveti Duh“ u razdoblju od 1. siječnja 2012. do 31. prosinca 2017. U tom razdoblju bilo je 17 550 porođaja, od čega 181 trudnica s preeklampsijom. Teških preeklampsija bilo je 56, a blagih 125. 240 trudnica sustavno je odabrano za kontrolnu skupinu. Učestalost preeklampsije bila je 1,0%, a učestalost teške preeklampsije 0,3%. Analizom rizičnih čimbenika nađeno je da su trudnice s teškom preeklampsijom u odnosu na kontrolnu skupinu statistički značajno starije, uz veći udio prvorotkinja (67,9% vs. 43,75%). U obje skupine podjednaka je raspodjela spolova djeteta i učestalost višeplodnih trudnoća (7,1% vs. 2,5%). U istraživanoj skupini više je prijevremenih porođaja (67,9% vs. 3,75%), uz kraće prosječno trajanje trudnoće (34,5 tj vs. 39,7 tj). Od teških komplikacija, u istraživanoj skupini nije bilo maternalne smrti, moždanog udara niti plućnog edema. Samo jedna trudnica imala je eklampsiju (0,6/10000) i jedna tranzitorno zatajenje bubrega koje je izliječeno dijalizom. U trudnica s teškom preeklampsijom višestruko je veći udio abrupcija placente (10,7% vs. 0,4%), od kojih je jedna trudnica imala apopleksiju uterusa, teški DIK i posljedičnu histerektomiju. U istraživanoj skupini značajno je veći udio carskih rezova (76,8% vs. 14,6%) i induciranih porođaja (33,9% vs. 16,7%). Isto tako, statistički je značajno viši perinatalni mortalitet (98,4‰ vs. 4,1‰), češći fetalni zastoj u rastu (41,1% vs. 3,8%), manja prosječna porođajna težina (1880 g vs. 3480 g) te veća učestalost Apgar indeksa manjih od 7 u 1. minuti (14,3% vs. 0,4%) i 5. minuti (10,7% vs. 0%). Usporedba skupina teških i blagih preeklampsija pokazala je statistički značajnu razliku u udjelu prijevremenih porođaja, učestalosti carskog reza i induciranog porođaja, perinatalnom mortalitetu, učestalosti fetalnog zastoja u rastu, porođajnoj težini i Apgar indeksima. Rezultati ukazuju na vrlo dobru prenatalnu skrb i pravovremeno završavanje trudnoće kod trudnica s teškom preeklampsijom. |
| Abstract (english) | This study was performed retrospectively at the Department of Obstetrics and Gynecology, University Hospital “Sveti Duh” for the period from January 1, 2012 to December 31, 2017. There were 17,550 births and 181 pregnant women with preeclampsia during that period. Between them, 56 women had severe preeclampsia and 125 had mild. 240 pregnant women were systematically sampled into the control group. The incidence of preeclampsia was 1,0% and the incidence of severe preeclampsia was 0,3%. Analysis of risk factors for preeclampsia revealed older age and higher rate of nulliparous women (67,9% vs. 43,75%) among pregnant women with severe preeclampsia compared to the control group. Both groups had similar fetal sex distribution and rate of multiple pregnancy (7,1% vs. 2,5%). Studied group had more preterm births (67,9% vs. 3,75%), along with shorter pregnancy duration (34,5 weeks vs. 39,7 weeks). Regarding severe complications, there was no maternal death, stroke nor pulmonary edema. Only one pregnant woman had eclampsia (0,6/10000) and one had transient renal insufficiency requiring hemodialysis. Pregnant women with severe preeclampsia had significantly higher risk of placental abruption (10,7% vs. 0,4%), of which one had uterine apoplexy, severe DIC and histerectomy. In the studied group, C-section and induced labour were performed more frequently (76,8% vs. 14,6% and 33,9% vs. 16,7%, respectively). Moreover, there was higher perinatal mortality rate (98,4‰ vs. 4,1‰), higher fetal growth restriction incidence (41,1% vs. 3,8%), lower average birth weight (1880 g vs. 3480 g) and more frequent Apgar score less than 7 at 1 minute (14,3% vs. 0,4%), as well as at 5 minutes (10,7% vs. 0%). There was a statistically significant difference in comparison between groups of severe and mild preeclampsia for proportion of preterm births, C-section and induction of labour, perinatal mortality, fetal growth restriction, birth weight, and Apgar score. The results of this study point to very good prenatal care and in time termination of pregnancies affected by severe preeclampsia. |
