Yıl: 2014 Cilt: 45 Sayı: 1 Sayfa Aralığı: 14 - 21 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi

Öz:
Obezite tüm dünyada gün geçtikçe artan önemli bir toplum sağlık sorunu haline gelmiştir. Anestezi pratiğimizde bu hasta grubu ile karşılaşma sıklığımız artmaktadır. Obezitenin beraberinde kendine ait bazı problemleri getirdiği düşünülürse, bu problemlerin obez bir gebede daha sık ve ciddi olacağı aşikardır. Obezite, gebelikte maternal ve fetal komplikasyonları artırmaktadır. Sezeryan, diabet, hipertansiyon ve preeklampsi, postpartum enfeksiyon, tromboembolizm riski bu problemlerden sadece birkaçını oluşturmaktadır. Obezite ve gebelikle birlikte ortaya çıkan fizyolojik değişikler ve bunların morbidite ile ilişkilerinin bilinmesi obez bir gebeye anestezik yaklaşımımızın planlanmasında yardımcı olacaktır
Anahtar Kelime:

Konular: Cerrahi

Obstetric anestesia in pregnants with obesity and morbid obesity

Öz:
Obesity is a major public health problem all over the world increasing day by day. The prevalence of encounter with this patient group is increasing in our anesthesia practice. When we think that obesity brings some of problems with it, it is obvious that these problems may be more frequent and severe health problems in an obese pregnant woman. Obesity increases maternal and fetal complications in pregnancy. Cesarean section, diabetes, hypertension and pre-eclampsia, postpartum infection, the risk of tthromboembolism are just a few of these problems. Knowing the physiologic changes in obesity and pregnancy and also their relaitons with the morbidity will all help in planning of the anesthetic approach.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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APA ATALAY Y, ŞAHİN S, EROĞLU M (2014). Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. , 14 - 21.
Chicago ATALAY YUNUS OKTAY,ŞAHİN Sadık,EROĞLU MUSTAFA Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. (2014): 14 - 21.
MLA ATALAY YUNUS OKTAY,ŞAHİN Sadık,EROĞLU MUSTAFA Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. , 2014, ss.14 - 21.
AMA ATALAY Y,ŞAHİN S,EROĞLU M Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. . 2014; 14 - 21.
Vancouver ATALAY Y,ŞAHİN S,EROĞLU M Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. . 2014; 14 - 21.
IEEE ATALAY Y,ŞAHİN S,EROĞLU M "Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi." , ss.14 - 21, 2014.
ISNAD ATALAY, YUNUS OKTAY vd. "Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi". (2014), 14-21.
APA ATALAY Y, ŞAHİN S, EROĞLU M (2014). Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. Zeynep Kamil Tıp Bülteni, 45(1), 14 - 21.
Chicago ATALAY YUNUS OKTAY,ŞAHİN Sadık,EROĞLU MUSTAFA Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. Zeynep Kamil Tıp Bülteni 45, no.1 (2014): 14 - 21.
MLA ATALAY YUNUS OKTAY,ŞAHİN Sadık,EROĞLU MUSTAFA Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. Zeynep Kamil Tıp Bülteni, vol.45, no.1, 2014, ss.14 - 21.
AMA ATALAY Y,ŞAHİN S,EROĞLU M Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. Zeynep Kamil Tıp Bülteni. 2014; 45(1): 14 - 21.
Vancouver ATALAY Y,ŞAHİN S,EROĞLU M Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi. Zeynep Kamil Tıp Bülteni. 2014; 45(1): 14 - 21.
IEEE ATALAY Y,ŞAHİN S,EROĞLU M "Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi." Zeynep Kamil Tıp Bülteni, 45, ss.14 - 21, 2014.
ISNAD ATALAY, YUNUS OKTAY vd. "Obez ve Morbı̇d Obez Gebelerde Obstetrı̇k Anestezi". Zeynep Kamil Tıp Bülteni 45/1 (2014), 14-21.