Eficacia y seguridad de la inducción del trabajo de parto con misoprostol en pacientes con embarazo a término con indicación de inducción y cérvix desfavorable, en el Hospital Matilde Hidalgo de Procel en el período de septiembre del 2012 a febrero del 2013
Fecha
2013-09-20
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Obstetricia
Resumen
Se realizó un estudio de tipo descriptivo, retrospectivo, transversal, de diseño no experimental en
124 fichas clínicas de pacientes con embarazo a término con indicación de inducción y cérvix desfavorable
atendidas en el Hospital Materno-Infantil Matilde Hidalgo de Procel en el periodo de Septiembre del 2012 a
Febrero del 2013, a las que se les administro 25mcg de misoprostol por vía sublingual cada 4-6 horas hasta un
total de 4 dosis, con la finalidad de buscar y proponer la eficacia y seguridad del uso de misoprostol como
inductor del trabajo de parto.
De los resultados obtenidos encontramos que 60 pacientes (48,39%) tuvieron entre 39-40 semanas de
gestación, 73 (58,87%) fueron nulíparas y 51 (41,13%) multíparas, 69 pacientes (55,65%) ingresaron con un
bishop de 0-2, la indicación más frecuente de interrupción del embarazo fue rotura prematura de membranas 35
pacientes (28,23%), se encontró que las pacientes que alcanzaron un cérvix favorable (bishop >6) fueron 97, de
las cuales en un tiempo de 1-6 horas 42 (33,87%), en 64 pacientes (51,61%) solo se administró una dosis de
misoprostol y 8 (6,45%) requirieron la cuarta dosis, además se evaluó la seguridad de dicho medicamento, la
mayoría de recién nacidos de las madres que recibieron misoprostol nacieron con puntaje de apgar al minuto y
5 minutos superior a 7 puntos y aunque se observó compromiso del bienestar fetal, este no repercutió en la
condición del recién nacido. Se obtuvieron 81 partos vaginales (65,32%) de los cuales 55 (67,90%) ocurrieron
antes de las 12 horas. La tasa de cesárea fue de 43 pacientes (34,68%), siendo la causa principal inducción
fallida 9 pacientes (20,93%) y sufrimiento fetal 9 pacientes (20,93%). Hubo 1 caso de hiperdinamia (0,81%) y
3 de hemorragia postparto (2,42%). Se concluye que el misoprostol es eficaz y seguro para la inducción del
trabajo de parto en embarazos a término con indicación de inducción y cérvix desfavorable.
A study descriptive, retrospective , cross-sectional non-experimental design in 124 medical records of patients with term pregnancies indicating induction and unfavorable cervix served in the Maternal and Child Hospital Matilde Hidalgo de Procel in the period September 2012 to February 2013 , which were administered 25mcg sublingual misoprostol every 4-6 hours to a 4 doses , in order to seek and propose the efficacy and safety of misoprostol as inducing labor. From the results we found that 60 patients ( 48.39 %) had between 39-40 weeks gestation , 73 ( 58.87 %) were nulliparous and 51 ( 41.13 % ) multiparous , 69 patients ( 55.65 %) were admitted with bishop of 0-2, the most frequent indication for termination of pregnancy was premature rupture of membranes 35 patients ( 28.23 %) , found that patients reaching favorably cervix ( Bishop> 6) were 97 of which in a time of 1-6 hours 42 ( 33.87% ) in 64 patients ( 51.61 %) were administered a single dose of misoprostol and 8 (6.45 %) required the fourth dose also evaluated the safety of that drug Most newborns of mothers who received misoprostol were born with Apgar score at one minute and 5 minutes than 7 points and although there was compromise of fetal wellbeing , this did not affect the condition of the newborn . Vaginal deliveries were obtained 81 ( 65.32 % ) of which 55 ( 67.90% ) occurred before 12 hours. The caesarean section rate was 43 patients (34.68 % ) , remains the leading cause induction failed 9 patients ( 20.93% ) and fetal distress 9 patients ( 20.93% ) . There was one case of hyperdynamic ( 0.81 %) and 3 of postpartum haemorrhage ( 2.42 % ) . We conclude that misoprostol is effective and safe for induction of labor at term indicating induction and unfavorable cervix
A study descriptive, retrospective , cross-sectional non-experimental design in 124 medical records of patients with term pregnancies indicating induction and unfavorable cervix served in the Maternal and Child Hospital Matilde Hidalgo de Procel in the period September 2012 to February 2013 , which were administered 25mcg sublingual misoprostol every 4-6 hours to a 4 doses , in order to seek and propose the efficacy and safety of misoprostol as inducing labor. From the results we found that 60 patients ( 48.39 %) had between 39-40 weeks gestation , 73 ( 58.87 %) were nulliparous and 51 ( 41.13 % ) multiparous , 69 patients ( 55.65 %) were admitted with bishop of 0-2, the most frequent indication for termination of pregnancy was premature rupture of membranes 35 patients ( 28.23 %) , found that patients reaching favorably cervix ( Bishop> 6) were 97 of which in a time of 1-6 hours 42 ( 33.87% ) in 64 patients ( 51.61 %) were administered a single dose of misoprostol and 8 (6.45 %) required the fourth dose also evaluated the safety of that drug Most newborns of mothers who received misoprostol were born with Apgar score at one minute and 5 minutes than 7 points and although there was compromise of fetal wellbeing , this did not affect the condition of the newborn . Vaginal deliveries were obtained 81 ( 65.32 % ) of which 55 ( 67.90% ) occurred before 12 hours. The caesarean section rate was 43 patients (34.68 % ) , remains the leading cause induction failed 9 patients ( 20.93% ) and fetal distress 9 patients ( 20.93% ) . There was one case of hyperdynamic ( 0.81 %) and 3 of postpartum haemorrhage ( 2.42 % ) . We conclude that misoprostol is effective and safe for induction of labor at term indicating induction and unfavorable cervix
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Embarazo, Misoprostol, Hospital Materno Infantil Dra. Matilde Hidalgo de Procel, Trabajo de parto, Cantón Guayaquil, Ecuador