fa PH شریان بند ناف و عوامل خطر مادری در زایمان های زودرس کودکان Children تحلیلی Research <p class="MsoNormal" dir="rtl" style="line-height: 16pt"><b><span style="font-size: 10pt font-family: '2 Mitra' color: blue">سابقه و هدف:</span></b><span style="font-size: 10pt font-family: '2 Mitra'"> تعیین</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">PH </span><span style="font-size: 10pt font-family: '2 Mitra'">&nbsp;خون شریان نافی در بسیاری از موارد زایمان های پرخطر میتواند بعنوان وسیله ای برای پیش بینی میزان آسیب وارده به جنین مورد استفاده قرار گیرد و احتمال بروز عوارض را با آن تعیین کرد . این مطالعه </span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">به منظور </span><span style="font-size: 10pt font-family: '2 Mitra'">بررسی ارتباط بین </span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">PH</span><span style="font-size: 10pt font-family: '2 Mitra'"> خون شریان نافی در نوزادان نارس و </span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">عوامل خطر مادری</span><span style="font-size: 10pt font-family: '2 Mitra'"> انجام شد</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">.</span><span style="font-size: 10pt font-family: '2 Mitra'"> <!--stripped--><!--stripped--></span></p> <p class="MsoNormal" dir="rtl" style="line-height: 16pt"><b><span style="font-size: 10pt font-family: '2 Mitra' color: blue">مواد و روشها:</span></b><span style="font-size: 10pt font-family: '2 Mitra'"> در این مطالعه مورد شاهدی 600 نوزاد نارس 37-27 هفته از نظر </span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">PH</span><span style="font-size: 10pt font-family: '2 Mitra'"> خون شریان نافی طی 5 دقیقه اول پس از تولد مورد بررسی قرار گرفتند. 181 نوزاد متولد شده مبتلا به اسیدوز با 7/1</span><span lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif">></span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">PH</span><span style="font-size: 10pt font-family: '2 Mitra'"> (گروه مورد) و 419 نوزاد فاقد اسیدوز (شاهد) از نظر وجود سابقه مادری دکولمان جفت، دیابت مادر، پارگی طولانی مدت پرده های جفتی، الیگوهیدرامنیوس، کوریوآمنیونیت، چندقلویی، پرویا، تاخیر</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span style="font-size: 10pt font-family: '2 Mitra'">رشد داخل رحمی، کاهش دیررس قلب جنین مورد مقایسه قرار گرفتند</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">.</span><span style="font-size: 10pt font-family: '2 Mitra'"><!--stripped--><!--stripped--></span></p> <p class="MsoNormal" dir="rtl" style="line-height: 16pt"><b><span style="font-size: 10pt font-family: '2 Mitra' color: blue">یافته&shy;ها:</span></b><b><span style="font-size: 10pt font-family: '2 Mitra' color: blue">&nbsp;</span></b><span style="font-size: 10pt font-family: '2 Mitra'">اسیدوز جنینی در</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">(30 نوزاد)</span><span style="font-size: 10pt font-family: '2 Mitra'">2/7</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">% </span><span style="font-size: 10pt font-family: '2 Mitra'">از موارد </span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">IUGR</span><span style="font-size: 10pt font-family: '2 Mitra'"> (1/3=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span style="font-size: 10pt font-family: '2 Mitra'">) و</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'"> در (15نوزاد)</span><span style="font-size: 10pt font-family: '2 Mitra'"> 3/8</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">% از </span><span style="font-size: 10pt font-family: '2 Mitra'">دکولمان جفت (25/2=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span style="font-size: 10pt font-family: '2 Mitra'">)</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span style="font-size: 10pt font-family: '2 Mitra'">،</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">(13</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">(</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">نوزاد)</span><span style="font-size: 10pt font-family: '2 Mitra'"> 2/7</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">%</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">&nbsp;</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">از </span><span style="font-size: 10pt font-family: '2 Mitra'">کوریوآمنیوتیت (54/4=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">) (27 نوزاد)</span><span dir="ltr" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span style="font-size: 10pt font-family: '2 Mitra'">9/14</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">% از</span><span dir="ltr" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span style="font-size: 10pt font-family: '2 Mitra'">چند قلویی (79/1=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span style="font-size: 10pt font-family: '2 Mitra'">)</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span style="font-size: 10pt font-family: '2 Mitra'">،</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">(10 نوزاد) </span><span style="font-size: 10pt font-family: '2 Mitra'">5/5</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">%</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">&nbsp;</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">از </span><span style="font-size: 10pt font-family: '2 Mitra'">آنمی مادری (64/2=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span style="font-size: 10pt font-family: '2 Mitra'">) و</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'"> (44</span><span dir="ltr" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">نوزاد) </span><span style="font-size: 10pt font-family: '2 Mitra'">6/28</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">%</span><span dir="ltr" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif"> </span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">از </span><span style="font-size: 10pt font-family: '2 Mitra'">تاخیر دیررس قلب جنین (57</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">%</span><span style="font-size: 10pt font-family: '2 Mitra'">=</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">OR</span><span style="font-size: 10pt font-family: '2 Mitra'">)</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'"> مشاهده شد</span><span style="font-size: 10pt font-family: '2 Mitra'">. (مقدار</span><span style="font-size: 10pt font-family: '2 Mitra'">&nbsp;</span><span dir="ltr" style="font-size: 10pt font-family: 'Times New Roman', serif">p</span><span style="font-size: 10pt font-family: '2 Mitra'"> به ترتیب= 001/0، 002/0، 03/0، 03/0، 04/0، 03/0) اما بین پارگی طولانی پرده های جنینی</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">،</span><span style="font-size: 10pt font-family: '2 Mitra'"> پرویا</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">،</span><span style="font-size: 10pt font-family: '2 Mitra'"> الیگوهیدرآمنیوس</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">،</span><span style="font-size: 10pt font-family: '2 Mitra'"> پره اکلامپسی</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">،</span><span style="font-size: 10pt font-family: '2 Mitra'"> بیماریهای کلیه-کبد-ریه و دیابت مادری با اسیدوز جنین ارتباط معنی داری یافت نشد</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">.</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">&nbsp;</span><b><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'"><!--stripped--><!--stripped--></span></b></p> <p class="MsoNormal" dir="rtl" style="line-height: 16pt direction: rtl"><b style="line-height: 2.2"><span lang="FA" style="font-size: 10pt font-family: '2 Mitra' color: blue">نتیجه</span></b><b style="line-height: 2.2"><span dir="ltr" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif color: blue"> </span></b><b style="line-height: 2.2"><span lang="FA" style="font-size: 10pt font-family: '2 Mitra' color: blue">گیری:</span></b><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">&nbsp;</span><span style="font-size: 10pt font-family: '2 Mitra'">در صورت وجود تاخیر رشد داخل رحمی، کریوآمنیونیت، دکولمان جفت، حاملگی چند قلوئی، آنمی مادر وکاهش تاخیری ضربان قلب جنین در زایمان نارسها احتمال وجود اسیدوز جنینی بیشتر است</span><span lang="FA" style="font-size: 10pt font-family: '2 Mitra'">.</span></p> <p class="MsoNormal" style="line-height: 16pt direction: ltr unicode-bidi: embed"><b><span style="font-size: 10pt font-family: 'Times New Roman', serif color: blue">BACKGROUND AND OBJECTIVE:</span></b><span style="font-size: 10pt font-family: 'Times New Roman', serif"> In many deliveries, determination of umbilical artery PH is considered a suitable tool for predicting the risk of damage to the fetus and determining the likelihood of associated complications.<span class="Heading7Char">&nbsp;</span><span class="alt-edited">This study was performed in order to investigate the relationship between maternal risk factors and umbilical artery PH in premature infants.</span></span><span style="font-size: 10pt font-family: 'Times New Roman', serif"><!--stripped--><!--stripped--></span></p> <p class="MsoNormal" style="line-height: 16pt direction: ltr unicode-bidi: embed"><b><span style="font-size: 10pt font-family: 'Times New Roman', serif color: blue">METHODS:</span></b><span style="font-size: 10pt font-family: 'Times New Roman', serif"> <span class="hps">In this case-control study, 600 premature neonates (gestational age of 27-37 weeks), were examined in terms of umbilical artery pH within the first 5 minutes after birth.</span> In total, <span class="hps">181 newborns suffering from acidosis with pH</span></span><span dir="rtl" lang="FA" style="font-size: 10pt font-family: 'Times New Roman', serif">></span><span class="hps"><span style="font-size: 10pt font-family: 'Times New Roman', serif"> 1.7 (case group) and 419 neonates without acidosis (control group) were compared in terms of maternal history of placental detachment,</span></span><span class="Heading7Char"><span style="font-size: 10pt font-family: 'Times New Roman', serif">&nbsp;</span></span><span class="hps"><span style="font-size: 10pt font-family: 'Times New Roman', serif">maternal diabetes,</span></span><span style="font-size: 10pt font-family: 'Times New Roman', serif"> <span class="hps">prolonged</span><span class="shorttext">&nbsp;</span><span class="hps">rupture</span><span class="shorttext">&nbsp;</span><span class="hps">of membranes,</span><span class="Heading7Char">&nbsp;</span><span class="hps">oligohydramnios,</span><span class="Heading7Char">&nbsp;</span><span class="hps">chorioamnionitis,</span><span class="Heading7Char">&nbsp;</span><span class="hps">multiple birth pregnancy,</span><span class="Heading7Char"> placental </span><span class="hps">previa, intrauterine growth</span><span class="shorttext">&nbsp;</span><span class="hps">retardation,</span><span class="Heading7Char"> and </span><span class="alt-edited">late deceleration of fetal heart rate.</span><!--stripped--><!--stripped--></span></p> <p class="MsoNormal" style="line-height: 16pt direction: ltr unicode-bidi: embed"><b><span style="font-size: 10pt font-family: 'Times New Roman', serif color: blue">FINDINGS:</span></b><span style="font-size: 10pt font-family: 'Times New Roman', serif">&nbsp;</span><span class="hps"><span style="font-size: 10pt font-family: 'Times New Roman', serif">Fetal acidosis</span></span><span style="font-size: 10pt font-family: 'Times New Roman', serif"> <span class="hps">was reported in</span> <span class="hps">7.2</span>% of <span class="hps">cases with intrauterine growth restriction &nbsp;(N=</span>30 ) (<span class="hps">OR=3.1)</span>, <span class="hps">8.3</span>% <span class="hps">of</span> neonates with <span class="hps">placental detachment</span> <span class="hps">(N=</span>15) <span class="hps">(OR= 2.25), 7.2</span>% of cases<span class="hps"> with chorioamnionitis (N=13) (OR=4.54) 14.9</span>% <span class="hps">of</span> <span class="hps">multiple births (N=27</span>) <span class="hps">(OR=1.79), 5.5</span>% <span class="hps">of</span> cases with <span class="hps">maternal</span> <span class="hps">anemia (N=10</span>) <span class="hps">(OR= 2.64),</span> <span class="hps">and</span> <span class="hps">28.6</span>% <span class="hps">of</span> newborns with <span class="hps">late deceleration of fetal heart rate (N=</span>44<span class="hps">)</span> <span class="hps">(OR= 57%)</span> <span class="hps">(</span>P<span class="hps">=</span> <span class="hps">0.001</span>, <span class="hps">0.002</span>, <span class="hps">0.03</span>, <span class="hps">0.03</span>, <span class="hps">0.04</span>, and <span class="hps">0.03, respectively</span>).<span class="Heading7Char">&nbsp;</span><span class="hps">However,</span> <span class="hps">fetal</span> <span class="hps">acidosis was </span>not <span class="hps">significantly associated with prolonged</span> <span class="hps">rupture</span> <span class="hps">of membranes</span>, placental <span class="hps">previa</span>, <span class="hps">oligohydramnios</span>, <span class="hps">preeclampsia</span>, <span class="hps">maternal</span> <span class="hps">diabetes,</span> or diseases of the lung, liver,<span class="atn"> and kidney.</span><!--stripped--><!--stripped--></span></p> <p><b><span style="font-size: 10pt font-family: 'Times New Roman', serif color: blue">CONCLUSION:</span></b><span style="font-size: 10pt font-family: 'Times New Roman', serif"> <span class="hps">Intrauterine growth</span> <span class="hps">retardation</span>, <span class="hps">chorioamnionitis</span>, placental detachment, <span class="hps">multiple birth pregnancy</span>, <span class="hps">maternal</span> <span class="hps">anemia,</span> and <span class="hps">late deceleration of fetal heart rate increased the risk of</span> <span class="hps">fetal</span> <span class="hps">acidosis in</span> <span class="hps">premature births</span>.</span></p> اسیدوز جنین, PH شریان بندناف, عوارض مامایی, زایمان نارس Fetal Acidosis, Umbilical Artery PH, Obstetric Complications, Premature Birth 18 22 http://jbums.org/browse.php?a_code=A-10-767-1&slc_lang=fa&sid=1 Z Akbarian زهرا اکبریان راد 100319475328460013851 100319475328460013851 No Hospital ayatollah rohani مرکز آیت الله روحانی M Haghshenas محسن حق شناس 100319475328460013852 100319475328460013852 No K Hajian کریم الله حاجیان 100319475328460013853 100319475328460013853 No N Asnafi نساء اصنافی asnafi2001@yahoo.com 100319475328460013854 100319475328460013854 Yes hospital ayatoollah rohani مرکز آموزشی درمانی آیت الله روحانی V Hajaliakbar ونوس حاج علی اکبر 100319475328460013855 100319475328460013855 No