Hipoksik İskemik Ensefalopati Vakalarının Analizi, Sezaryen Doğum ve Hipoksik İskemik Ensefalopati Oranları Arasındaki İlişki

Objective: Hypoxic-ischemic encephalopathy (HIE) is the most important cause of neonatal encephalopathy. Worldwide, Incidence of HIE is approximately ‰ 2-9 of live births. Aur aim is to analyse the neonatal encephalopathy cases treated with hypothermia and to evaluate the correlation between cesarean and Hypoxic-ischemic encephalopathy rates. Methods: This cross sectional descriptive retrospective study was performed on HIE cases treated with hypothermia in the neonatal intensive care unit. We compared the caesarean section and HIE rates between May 2015-December 2016 and January 2017-August 2018 during which effective methods for decreasing caesarean section rates used. We also analysed the maternal and neonatal characteristics, delivery methods, caesarean indications of neonates treated with hypothermia because of HIE between January 2017-August 2018. Results: Despite 4,4 % decrease in primary caesarean section rates between May 2015-December 2016 and January 2017-August 2018 (23,6% versus 19,2%), HIE ( 3.01‰ versus 3,26‰) didn’t change significantly (p> 0,05). The number of HIE cases treated with hypothermia between January 2017-August 2018 were 102. Delivery methods of 52,9 % were vaginal birth and 47,1 % primary caesarean section birth. All caesarean section births were emergency caesarean and indications of all were fetal distress. 14,8 % of vaginal births were operative vaginal birth. Convulsion was seen in % 45,1 of cases and %17,6 of cases died before discharged. There were‘nt sitatistically significant differance between blood parameters of died and survived HIE cases (p>0.05). Conclution: HIE is complex, multifactorial and unexplained chain of events. We think that heading to emergency caesarean birth because of decreasing neonatal morbidity don’t have positive effect on neonatal morbidity and also lead to increase in the number of caesarean births.