PERINATALNI ISHOD VIŠEPLODNIH TRUDNOĆA U RODILIŠTIMA KNIN I LIVNO 1990.–2002. GODINE

ŽARKO MIŠIĆ, IVICA MAMIĆ, STIPE KREZO, ANDREA PLAVEC, BORIS BAŠIĆ, DENI KARELOVIĆ

Cilj rada. Ispitati perinatalni ishod blizanačkih trudnoća u rodilištima Livno i Knin. Metode. Retrospektivno je ispitan perinatalni ishod blizanačkih trudnoća u rodilištima Knin i Livno u razdoblju od 1990. do 2002. godine. Ispitana je učestalost rađanja blizanaca, kalendarski mjeseci kada se najčešće rađaju blizanci, njihova obilježja u odnosu na dob i paritet trudnice, dob trudnoće, usporedba perinatalnog ishoda rađanja blizanačke s jednoplodnom trudnoćom, raspodjela blizanaca po spolu i kombinacije smještaja i prezentacije blizanaca u vrijeme poroda. Rezultati. U trinaestogodišnjem razdoblju rođeno je 10856-ero djece, od čega 127-ero (1,2%) poroda iz blizanačke trudnoće. Između promatranih rodilišta u ratnom i poslijeratnome razdoblju ne postoji statistički značajna razlika učestalosti rađanja blizanaca (p=0,89). Najviše blizanaca rođeno je u mjesecu svibnju (14,8%). Prosječna dob žena koje su rađale blizance je 28,9±9,7 godina. Blizance su češće rađale mnogorotkinje (59,8%), odnosno žene s 5 i više poroda. U terminu su rođena 94 blizanca (74%), a njih 33 (26%) rođeno je prijevremeno. Perinatalno je umrlo 74-ero djece (7‰) iz jednoplodne trudnoće, a iz blizanačke trudnoće umrlo je 11-ero novorođenčadi (43‰). Carskim rezom triput je češće dovršena blizanačka trudnoća (27%) nego jednoplodna (8%). Hipertenzija u blizanačkim trudnoćama (7%) gotovo je dvostruko češća nego u jednoplodnim trudnoćama (4%). Rođeno je 132-je (51,6%) muške i 122-je (48,4%) ženske djece. Omjer parova blizanaca prema spolu je: 58 (46%) parova muško-žensko, 37 (29%) parova muško-muško i 32 (25%) para žensko-žensko. Prema prezentaciji blizanaca u vrijeme poroda bilo je 49% glava-glava, 29% glava-zadak, 12% glava-poprečno, 5% zadak-zadak i 5% ostale inačice prezentacije. Zaključak. Naši rezultati podudaraju se s podacima iz literature, bez obzira na ratno i poslijeratno razdoblje, što pripisujemo kvalitetnoj antenatalnoj skrbi i pravodobnom premještaju ugroženih blizanačkih trudnoća u središta više razine zdravstvene zaštite.

Summary. The aim of this study was to examine perinatal outcome of twin pregnancies in maternity wards in Livno and Knin. The perinatal outcome in these two maternity wards was examined retrospectively during the period 1990–2002. The incidence of twin births, the month with the highest incidence of twin births, the age and parity of the women with twins and their gestational age were examined. Also, we compared the perinatal outcome of twins with singletons, distribution according to sex, lie and presentation at birth. During 13 years 10 856 newborns were delivered, and 127 (1.2%) of them were twins. The incidence of twins in maternity wards in Knin and Livno during the war and after the war was not significantly different (p=0.89). The month with the highest incidence of twin births was May (14.8%). The avarage age of women with twins was 28.9±9.7. Twins were born mostly by multiparas (2–4 deliveries). 94 (74%) twins were born on term and 33 (26%) twins before term. 74 newborns (7‰) from singletons and 11 (43‰) from twins died during perinatal period. Twins were delivered by cesarean section (27%) three times more often than singletons (8%). Hypertension in twin pregnancies (7%) was twice as frequent as in singletons (4%). 132 (51.6%) male and 122 (48.4%) female newborns were born. The distribution according to sex was: 58 pairs »male-female«, 37 »male-male« and 32 pairs »female-female«. The distribution according to presentation at birth was: 49% »cephalic-cephalic«, 29% »cephalic-breech«, 12% »cephalic-transverse«, 5% »breech-breech« and all other combinations got 5%. In conclusion, our results during the war and after the war were not different from other centers and studies thanks to good antenatal care and selection of twin pregnancies for transportation on time to the center with higher level of health care.