Uticaj horioniciteta na ishod zdrave blizanačke trudnoće
Sažetak
Uvod/Cilj. Još uvek se raspravlja u kom smislu i do kog stepena horionicitet može uticati na ishod blizanačke trudnoće bez gestacijskih komplikacija specifičnih za monohorionicitet. Studija je imala za cilj da se proceni efekat horioniciteta na ishod zdrave blizanačke trudnoće. Metode. Studijom su bile obuhvaćene sve trudnice sa nekomplikovanom blizanačkom trudnoćom nakon prvog trimestra koje su kontrolisane i porođene na Klinici za ginekologiju i akušerstvo Kliničkog centra Srbije u Beogradu tokom tri godine (2010–2013). Utvrđeni su podaci o starosti majke, komorbiditetima, paritetu, prisutnosti i tipu gestacijskih komplikacija, horionicitetu, načinu i vremenu završetka trudnoće, težini na rođenju i Apgar skoru blizanaca. Dobijeni podaci su upoređeni i statistički analizirani. Rezultati. Studijom je bila obuhvaćena 361 žena prosečne starosti od 33 godine. Bez obzira na horionicitet, blizanci su uglavnom bili rođeni tokom 36. gestacijske nedelje i dobili Apgar skor ≥ 8. Samo tri monohorionska blizanca su bila mrtvorođena, dva pre termina (29. i 32. nedelja gestacije) i jedan u terminu (35. nedelja gestacije). Nasuprot tome, nisu registrovane intrauterusne smrti plodova. Monohorionicitet je negativno korelisao sa živorođenošću blizanaca (OR = 0,023; CI = [0,001–0,609], p = 0,024) i nije bio povezan sa stanjem blizanaca na rođenju, tj. Apgar skorom (p = 0,345), vremenom završetka trudnoće (p = 0.578) ili bilo kojom drugom karakteristikom blizanaca Međutim, prevremena ruptura vodenjaka i ranije gestacijske nedelje završetka trudnoće su važni “konfaunding” faktori koji su uticali na odnos između horioniciteta i ishoda trudnoće. Zaključak. Monohorionicitet povećava rizik od loših ishoda trudnoće čak i kod nekomplikovane, zdrave blizanačke trudnoće, ali nema uticaj na stanje blizanaca koji prežive do termina. Uz primenu odgovarajućeg nadzora i terapije, oba zdrava blizanca mogu biti porođena u terminu bez obzira na horionicitet.
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