Title Porođaj makrosomne novorođenčadi nakon prethodnog carskog reza u KBC-u Split
Title (english) Delivery of macrosomic newborns after a previous caesarean section at the University Hospital of Split
Author Matea Jakas
Mentor Damir Roje (mentor)
Committee member Marko Vulić (predsjednik povjerenstva)
Committee member Zoran Meštrović (član povjerenstva)
Committee member Zenon Pogorelić (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2023-07-14, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Ciljevi: Analiza uspješnosti ultrazvučne procjene fetalne makrosomije iz porođaja nakon
prethodnog carskog reza te usporedba perinatalnih čimbenika.
Materijali i metode: U Klinici za ženske bolesti i porode KBC-a Split provedeno je istraživanje u
kojem su uključene trudnice i novorođenčad iz porođaja nakon prethodnog carskog reza s
makrosomijom ploda u razdoblju od 1. siječnja 2020. do 31. prosinca 2022. godine. Podaci o
životnoj dobi trudnice, načinu porođaja, porođajnoj masi i duljini APGAR zbroj i pH vrijednost
pupkovine su dobiveni nakon uvida u Dnevne programe Klinike, Rađaonski protokol i Operacijski
protokol Klinike.
Rezultati: U Klinici za ženske bolesti i porode u trogodišnjem razdoblju zabilježen je statistički
značajan blagi porast porođaja nakon prethodnog carskog reza. Od 1417 porođaja nakon
prethodnog carskog u anamnezi u manje od 30% slučajeva trudnoća je dovršena vaginalnim putem.
175 (12,3%) novorođenčadi u pripremi i planiranju porođaja imalo je ultrazvukom procijenjenu
masu na više od 4000 g. Vaganjem nakon porođaja kod 111 (63,4%) potvrđena je ultrazvučna
procjena, dok je kod 64 (36,6%) novorođenčeta izmjerena porođajna masa bila manja. U
ispitivanom razdoblju najveći broj porođaja nakon prethodnog carskog reza je obavljen hitnim
carskim rezom. Vrijednost pH iz pupkovine manja od 7,2 zabilježena je u devet novorođenčadi.
Najviši APGAR zbroj u prvoj i petoj minuti imala je makrosomna novorođenčad rođena
elektivnim carskim rezom. Ponderalni indeks petero makrosomne novorođenčadi iz porođaja
nakon prethodnog carskog reza je manji od 2,45 g/cm3
. Najveći udio makrosomne novorođenčadi
visokog ponderalnog indeksa evidentiran je kod djece rođene elektivnim carskim rezom, a najmanji
nakon vaginalnog porođaja. Korištenjem ROC analize određena je statistički značajna kategorija
težine novorođenčeta od 4025 g pri kojoj osjetljivost ultrazvučne procjene fetalne makrosomije
iznosi 94,6%, uz specifičnost 89,3% što je vrlo visoka vrijednost za promatranu rezultate.
Zaključak: Zabilježen je porast broja porođaja nakon prethodnog carskog reza. Najveći broj
porođaja nakon prethodnog carskog reza je obavljen hitnim carskim rezom, a najmanji broj rađa se
vaginalnim porođajem. Vrijednost pH iz pupkovine manja od 7,2 najčešća je nakon hitnog carskog
reza. Najviši APGAR zbroj u prvoj i petoj minuti imala su makrosomna novorođenčad rođena
elektivnim carskim rezom. Najveći udio makrosomne novorođenčadi visokog ponderalnog indeksa
zabilježen je kod djece rođene elektivnim carskim rezom, a najmanji nakon vaginalnog porođaja.
Abstract (english) Objectives: Analysis of the success of the ultrasound assessment of fetal macrosomia from
childbirth after a previous caesarean section and comparison of perinatal factors.
Materials and methods: In the Department of Gynecology and Obstetrics, University Hospital of
Split, a study was conducted in which we included pregnant women and newborns from childbirth
after a previous caesarean section with fetal macrosomia, from January 1st, 2020. until December
31st, 2022. Clinical data were obtained from the medical documentation.
Results: In our Clinic there was a statistically significant slight increase in births after previous
cesarean section. Out of 1417 births after a previous caesarean section, in less than 30% of cases
the pregnancy was completed vaginally. 175 (12.3%) newborns in the preparation and planning of
delivery had an ultrasound estimated weight of more than 4000 g. Weighing after delivery in 111
(63.4%) confirmed the ultrasound assessment, while in 64 (36.6%) newborns, the measured birth
weight was lower. In the three-year period, the largest number of births after a previous caesarean
section was performed by emergency caesarean section. pH value of the umbilical arterial blood
less than 7.2 was recorded in nine newborns. Macrosomic newborns born by elective caesarean
section had the highest APGAR scores in the first and the fifth minute. The ponderal index of five
macrosomic newborns born after a previous caesarean section is less than 2.45 g/cm3. The highest
proportion of macrosomic newborns with a high ponderal index was recorded in children born by
elective caesarean section, and the lowest after vaginal delivery. Using ROC analysis, it was proven
that a statistically significant category of newborn weight of 4025 grams is where the sensitivity of
the ultrasound assessment of fetal macrosomia is 94.6%, with a specificity of 89.3%.
Conclusion: An increase in the number of births after a previous caesarean section was recorded.
The largest number of births after a previous caesarean section was performed by an emergency
caesarean section. The smallest number of macrosomic newborns are born through vaginal
delivery. pH value of the umbilical arterial blood less than 7.2 is most common after emergency
caesarean section. Macrosomic newborns born by elective caesarean section had the highest
APGAR scores in the first and the fifth minute. The highest proportion of macrosomic newborns
with a high ponderal index was recorded in children born by elective caesarean section, and the
lowest after vaginal delivery.
Keywords
makrosomija
porođaj
prethodni carski rez
Keywords (english)
fetal macrosomia
delivery
previous caesarean section
Language croatian
URN:NBN urn:nbn:hr:171:962226
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
Terms of use
Created on 2023-07-13 11:44:42