Title POROĐAJ KOD BLIZANACA Title (english) BIRTH OF TWINS Author Jelena Klarić Mentor Marko Mimica (mentor)Committee member Zdeslav Benzon (predsjednik povjerenstva) Committee member Indira Kosović (član povjerenstva) Committee member Marko Mimica (član povjerenstva)Granter University of Split Defense date and country 2014-09-26, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Istovremeni razvoj više od jednog ploda u maternici ţene nazivamo višeplodnom trudnoćom. Uĉestalost blizanaca ovisi o rasi, nasljednom faktoru, dobi i paritetu rodilje.
Ove trudnoće prati veći broj komplikacija tokom trudnoće i poroĊaja kako za plodove tako i za majku. Fetalni perinatalni mortalitet je nekoliko puta veći nego kod jednoplodne trudnoće. Dijagnoza višeplodne trudnoće temelji se na anamnezi, kliniĉkom i ultrazvuĉnom pregledu koji ujedno ima i najveću vrijednost.
Na koji naĉin će se blizanci poroditi najviše ovisi o njihovom poloţaju. Najĉešća kombinacija gdje su oba blizanca poloţeni glavom je najpovoljnija za vaginalni poroĊaj.
Sljedeća najĉešća kombinacija, gdje je prvi blizanac namješten glavom, a drugi zatkom takoĊer dozvoljava vaginalni poroĊaj. U sluĉaju kada je prvi blizanac poloţen zatkom većina autora smatra da je carski rez najbolji naĉin poroĊaja. Poloţaj blizanaca u bilo kojem trenutku trudnoće nije definitivan, jer ĉak i u blizanaĉkoj trudnoći do zadnjeg trenutka ima dovoljno mjesta da se djeca okrenu. Ovo se vrlo ĉesto dogaĊa sa drugim blizancem.
TakoĊer, nakon poroĊaja prvog blizanca, drugi ima puno mjesta te u samom poroĊaju lako moţe promijeniti poloţaj. Upravo zbog toga, nakon poroĊaja prvoga blizanca poloţaj drugoga treba provjeriti ultrazvukom.
Vaginalni poroĊaj, osim o namještaju blizanaca, ovisi i o zdravlju rodilje i djece pa se danas ipak preko 50% blizanaĉkih trudnoća dovršava carskim rezom. Kao indikacije za carski rez navode se abnormalne prezentacije blizanaca, prijevremeno prsnuće vodenjaka, prolaps pupkovine, abrupcija posteljice, krvarenje zbog atonije i nepravilnog ljuštenja posteljice.
Abstract (english) Simultaneous development of more than one fetus in the uterus is called multiple pregnancy. The frequency of twins depends on the race, inheritance, age and parity.
Compared to singleton pregnancy there are more complications during pregnancy and birth for both. Mortality of fetuses is several times higher than in the singleton pregnancies. Diagnosis of multiple pregnancy is based on the history, clinical and ultrasound examination.
The way of birth depends on presentation of both fetuses. When both fetuses are vertex it is most suitable for vaginal delivery.
Than, the next common combination is when the first twin is vertex, and the second twin is non-vertex. This presentation is also suitable for vaginal delivery.
In the case when the first twin is non-vertex, most autors consider that caesarean section is the best way of delivery.
Presentation of the twins during the pregnancy is not defined, because there are enough space for turn. This is common for second twin.
When the first twin is delivered, second twin can switch position. Because of it, after delivery of the first twin the position of second twin should be examinated by the ultrasound.
Vaginal delivery depends not just on the presentation of twins but also on the health of mother and fetuses, but still over 50% multiple pregnancies ends by the caesarean section.
Indications for the caesarean section are malpresentations of twins, premature rupture of membranes, umbilical cord prolapse, placental abruption, haemorrhage caused by the atony, abnormal abruption of the placenta.
Keywords
višeplodna trudnoća
blizanci
komplikacije tijekom trudnoće
porođaj blizanaca
Keywords (english)
multiple pregnancy
twins
complications during pregnancy
birth of twins
Language croatian URN:NBN urn:nbn:hr:176:233763 Study programme Title: Midwifery (university/undergraduate) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-03-08 11:51:37
