علل دیس پنه ناگهانی زنان باردار در بیمارستان های دانشگاه علوم پزشکی ارومیه در سال ۱۳۹۷ تا ۱۳۹۸

نویسندگان
معصومه ربیعی پور 1
امین بشارت 2
شبنم وظیفه خواه 3
1 فوق تخصص ریه، استادیار بیماری های داخلی، گروه بیماری های داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه،ایران
2 دانشجوی ی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه،ایران
3 فوق تخصص پریناتالوژی، استادیار مرکز تحقیقات چاقی مادر و کودک، دانشگاه علوم پزشکی ارومیه، ارومیه،ایران
10.22034/pjms.2022.700474
چکیده
مقدمه: هدف از مطالعه حاضر، تعیین علل دیس پنه ناگهانی در زنان باردار مراجعه کننده به بیمارستان های دانشگاه علوم پزشکی ارومیه در سال های 1397 تا 1398 و بررسی ارتباط آن با تغییرات دی دایمر در این بیماران بود.  
روش کار: در این مطالعه ی توصیفی، ۵۰ نفر از زنان باردار با شکایت دیس پنه ناگهانی که طی سال های 1397 تا 1398 به بخش داخلی بیمارستان امام خمینی و بخش کوثر بیمارستان مطهری ارومیه مراجعه کرده بودند، وارد مطالعه شدند. داده های مربوط به تغییرات
دی دایمر  و سایر یافته های پاراکلینیکی به کمک نرم افزار SPSS تحلیل شدند. 
یافته ها: بیست نفر از افراد مورد مطالعه (40 درصد) دی دایمر مثبت داشتند که ۱۶ نفر آن ها دارای علل پاتولوژیک شناخته شده بودند.  هیچ یک از افراد با دی دایمر منفی بیماری پاتولوژیک قابل نشخیصی نداشتند. آزمون مربع کای یک ارتباط مثبت و معنادار بین افزایش مقدار دی دایمر و حوادث پاتولوژیک دوران حاملگی نشان داد (p<0.0001).
نتیجه گیری: نتایج بدست آمده در روند درمان بیماران در این مطالعه حاکی از آن بود که افزایش دی دایمر در طول حاملگی به علت حوادث ترومبوآمبولیک یا دیگر تغییرات و اختلالات پاتولوژیک است.
کلیدواژه‌ها
دیس پنه
ترومبوآمبولی
حاملگی
دی دایمر

عنوان مقاله English

Assessment of the causes of sudden dyspnea in pregnant women in hospitals of Urmia University of Medical Sciences in 2018-2019

نویسندگان English

Masoumeh Rabiepour 1
Amin Besharat 2
Shabnam Vazifekhah 3
1 Fellowship in Lung Disease, Assistant Professor of Internal Medicine, Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia. Iran
2 Medical students, School of Medicine, Urmia University of Medical Sciences, Urmia. Iran
3 Fellowship in perinatology, Assistant Professor of Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia. Iran
چکیده English

Background: This study aimed to determine the causes of sudden dyspnea in pregnant women referred to the hospitals of Urmia University of Medical Sciences in 2018-2019 and to investigate the relationship between these causes and dimer changes in these patients.

Method: In this descriptive-analytical study, 50 pregnant women with sudden dyspnea complaints were referred to the internal ward of Imam Khomeini Hospital in the Urmia and Kosar ward of Motahhari Hospital in Urmia 2018-2019 were included in the study. Information about D-dimer changes and other paraclinical findings were entered into unique forms, and the results were analyzed after entering SPSS software.

Results: In this study, between 50 pregnant women, 20 women had positive D-dimer, of which 16 had positive D-dimer with a known pathological cause, and only 4 had high D-dimer without any clinical or paraclinical findings. Of the thirty patients with negative D- dimer, none had a detectable pathological disease. Chi-Square test (showed a positive and significant relationship between D-dimer and pathological events during pregnancy) p <0.0001 (


Conclusion: The results obtained in patients' treatment process in this study indicate that the increase in D-dimer during pregnancy is due to thromboembolic events or other pathological changes and disorders.
 

کلیدواژه‌ها English

Dyspnea
Thromboembolism
Pregnancy
D-Dimer
1) Goland S, Perelman S, Asalih N, Shimoni S, Walfish O, Hallak M, Hagay Z, George J, Shotan A, Blondheim DS. Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?. Clinical cardiology. 2015 Oct;38(10):598-603. 2) Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. New England Journal of Medicine. 2008 Nov 6;359(19):2025-33. 3) Réger B, Péterfalvi Á, Litter I, Pótó L, Mózes R, Tóth O, Kovács GL, Losonczy H. Challenges in the evaluation of D-dimer and fibrinogen levels in pregnant women. Thrombosis research. 2013 Apr 1;131(4):e183-7. 4) Haki BK, Moaddab SR, Rafii MR, Eftekhari M, Lebadi S, Ghorbaniyan N, Amini K. The Effect of Sodium Selenite on the Acute Phase Protein Response and Plasma Variables in Patients Admitted in ICU. Jentashapir Journal of Health Research. 2017 Dec;9(2). 5) Brown HL, Hiett AK. Deep vein thrombosis and pulmonary embolism in pregnancy: diagnosis, complications, and management. Clinical obstetrics and gynecology. 2010 Jun 1;53(2):345-59. 6) Lee SY, Chien DK, Huang CH, Shih SC, Lee WC, Chang WH. Dyspnea in pregnancy. Taiwanese Journal of Obstetrics and Gynecology. 2017 Aug 1;56(4):432-6. 7) Pereira A, Krieger BP. Pulmonary complications of pregnancy. Clinics in chest medicine. 2004 Jun 1;25(2):299-310. 8) Tripodi A. D-dimer testing in laboratory practice. Clinical chemistry. 2011 Sep 1;57(9):1256-62 9) Kovac M, Mikovic Z, Rakicevic L, Srzentic S, Mandic V, Djordjevic V, Radojkovic D, Elezovic I. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2010 Jan 1;148(1):27-30. 10) Kline JA, Williams GW, Hernandez-Nino J. D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed. Clinical chemistry. 2005 May 1;51(5):825-9. 11) Hedengran KK, Andersen MR, Stender S, Szecsi PB. Large D-dimer fluctuation in normal pregnancy: a longitudinal cohort study of 4,117 samples from 714 healthy Danish women. Obstetrics and gynecology international. 2016 Jan 1;2016. 12) Jeremiah ZA, Adias TC, Opiah M, George SP, Mgbere O, Essien EJ. Elevation in D-dimer concentrations is positively correlated with gestation in normal uncomplicated pregnancy. International journal of women's health. 2012;4:437. 13) Hedengran KK, Andersen MR, Stender S, Szecsi PB. Large D-dimer fluctuation in normal pregnancy: a longitudinal cohort study of 4,117 samples from 714 healthy Danish women. Obstetrics and gynecology international. 2016 Jan 1;2016. 14) Kline JA, Williams GW, Hernandez-Nino J. D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed. Clinical chemistry. 2005 May 1;51(5):825-9. 15) Ercan Ş, Özkan S, Yücel N, Orçun A. Establishing reference intervals for D-dimer to trimesters. The Journal of Maternal-Fetal & Neonatal Medicine. 2015 May 24;28(8):983-7. 16) Khalafallah AA, Morse M, Al-Barzan AM, Adams M, Dennis A, Bates G, Robertson I, Seaton D, Brain T. D-Dimer levels at different stages of pregnancy in Australian women: a single centre study using two different immunoturbidimetric assays. Thrombosis research. 2012 Sep 1;130(3):e171-7 17) Parilla BV, Fournogerakis R, Archer A, Sulo S, Laurent L, Lee P, Chhotani B, Hesse K, Kulstad E. Diagnosing pulmonary embolism in pregnancy: are biomarkers and clinical predictive models useful?. AJP reports. 2016 Apr;6(2):e160. 18) Goland S, Perelman S, Asalih N, Shimoni S, Walfish O, Hallak M, Hagay Z, George J, Shotan A, Blondheim DS. Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?. Clinical cardiology. 2015 Oct;38(10):598-603. 19) Eftekhari J, Kazemi Haki B, Tizro P, Alizadeh V. A comparison to facilitate insertion of the laryngeal mask: term of recovery and postoperative nausea and vomiting after anesthesia with propofol-atracurium and thiopental-atracurium. Acta Med Iran. 2015;53(2): pp.117-21. 20) Sane S, Aghdashi MM, Kazemi Haki B, Gholamveisi B, Rajabzadeh M, Golabi P. The effect of pregabalin on the prevention of succinylcholine-induced fasciculation and myalgia. J Perianesth Nurs. 2020;35(3): pp.255-9.