Factores de riesgo y complicaciones del embarazo ectópico roto en pacientes de 25 a 35 años estudio realizado en el Hospital León Becerra Camacho
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
El embarazo ectópico ocurre cuando la implantación del blastocito se realiza en cualquier sitio fuera del endometrio de la cavidad uterina, su prevalencia representando una de las causas más frecuentes de sangrado durante el primer trimestre de embarazo va del 6 al 16 %, y se estima que siga en aumento debido a la dificultad que genera su diagnóstico oportuno (Shaw JL, 2010).
Tanto para la consulta externa como en el área de emergencia el diagnóstico y tratamiento de embarazo ectópico es uno de los problemas que se ve con mucha frecuencia debido a que la similitud con otras entidades patológicas por sus manifestaciones clínicas, confundiendo muchas veces al médico, además es de importancia especificar que no existe hasta el momento un método diagnostico lo suficientemente sensible y especifico que garantice el diagnóstico definitivo del embarazo ectópico en nuestro medio.
Mediante diferentes estudios clínicos se ha podido identificar diferentes factores de riesgos que se asocian directamente con el desarrollo de embarazo ectópico en una mujer durante su vida reproductiva, entre ellos siendo un riesgo elevado tenemos al embarazo ectópico previo, patologías tubulares ya sea por disrupción de la anatomía frente a agentes agresores como infecciones, cirugías, tumores y anomalías congénitas. A esto se le agrega factores de riesgo no tan elevados como dispositivos intrauterinos, infertilidad, múltiples parejas sexuales, fumadoras, duchas vaginales y la edad (Villegas, 2014) (Stulberg DB, 2014).
Los lugares de nidación con mayor frecuencia se da en las trompas de Falopio, siendo así la zona ampular la región más frecuente representada por un 70%, seguido por la zona ístmica y fimbrias con un 12 y 11 % respectivamente (Taran FA, 2015).
Dentro de las manifestaciones clínicas del embarazo ectópico más frecuente son sangrado vaginal y dolor abdominal, pero debemos tener en cuenta que puede presentarse de manera asintomática. Es posible sospecharlo en las mujeres que presenten lo ya mencionado más manifestaciones típicas de un embarazo normal que aparecen posterior a la 6- 8 semanas del último periodo de menstruación (Parashi S, 2014).
El propósito de este estudio es determinaran los factores de riesgo más frecuentes que presentan nuestra población asociados al desarrollo de embarazo ectópico rotos en mujeres en EL HOSPITAL LEON BECERRA CAMACHO DE MILAGRO el periodo DE MAYO2016- A FEBRERO DE 2017
Ectopic pregnancy occurs when the implantation of the blastocyst is performed anywhere outside the endometrium of the uterine cavity, its prevalence representing one of the most frequent causes of bleeding during the first trimester of pregnancy ranges from 6 to 16%, and it is estimated that continue to increase due to the difficulty generated by its timely diagnosis (Shaw JL, 2010). Both for the outpatient and in the emergency area, the diagnosis and treatment of ectopic pregnancy is one of the problems that is seen very frequently due to the similarity with other pathological entities due to their clinical manifestations, often confusing the doctor. It is important to specify that there is no sufficiently sensitive and specific diagnostic method to guarantee the definitive diagnosis of ectopic pregnancy in our environment. Through different clinical studies it has been possible to identify different risk factors that are directly associated with the development of ectopic pregnancy in a woman during her reproductive life, among them being a high risk we have previous ectopic pregnancy, tubular pathologies either by disruption of the anatomy against aggressive agents such as infections, surgeries, tumors and congenital anomalies. To this is added risk factors not as high as intrauterine devices, infertility, multiple sexual partners, smokers, douching and age (Villegas, 2014) (Stulberg DB, 2014). The nesting sites are most frequently found in the fallopian tubes, with the ampullary area being the most frequent region represented by 70%, followed by the isthmic zone and fimbrias with 12 and 11% respectively (Taran FA, 2015) . Among the clinical manifestations of ectopic pregnancy most frequent are vaginal bleeding and abdominal pain, but we must bear in mind that it can occur asymptomatically. It is possible to suspect it in women who present the aforementioned more typical manifestations of a normal pregnancy than appear after 6-8 weeks of the last period of menstruation (Parashi S, 2014). The purpose of this study is to determine the most frequent risk factors that present our population associated with the development of ectopic pregnancy broken in women in the LEON BECERRA CAMACHO DE MILAGRO HOSPITAL the period MAY2016- FEBRUARY 2017
Ectopic pregnancy occurs when the implantation of the blastocyst is performed anywhere outside the endometrium of the uterine cavity, its prevalence representing one of the most frequent causes of bleeding during the first trimester of pregnancy ranges from 6 to 16%, and it is estimated that continue to increase due to the difficulty generated by its timely diagnosis (Shaw JL, 2010). Both for the outpatient and in the emergency area, the diagnosis and treatment of ectopic pregnancy is one of the problems that is seen very frequently due to the similarity with other pathological entities due to their clinical manifestations, often confusing the doctor. It is important to specify that there is no sufficiently sensitive and specific diagnostic method to guarantee the definitive diagnosis of ectopic pregnancy in our environment. Through different clinical studies it has been possible to identify different risk factors that are directly associated with the development of ectopic pregnancy in a woman during her reproductive life, among them being a high risk we have previous ectopic pregnancy, tubular pathologies either by disruption of the anatomy against aggressive agents such as infections, surgeries, tumors and congenital anomalies. To this is added risk factors not as high as intrauterine devices, infertility, multiple sexual partners, smokers, douching and age (Villegas, 2014) (Stulberg DB, 2014). The nesting sites are most frequently found in the fallopian tubes, with the ampullary area being the most frequent region represented by 70%, followed by the isthmic zone and fimbrias with 12 and 11% respectively (Taran FA, 2015) . Among the clinical manifestations of ectopic pregnancy most frequent are vaginal bleeding and abdominal pain, but we must bear in mind that it can occur asymptomatically. It is possible to suspect it in women who present the aforementioned more typical manifestations of a normal pregnancy than appear after 6-8 weeks of the last period of menstruation (Parashi S, 2014). The purpose of this study is to determine the most frequent risk factors that present our population associated with the development of ectopic pregnancy broken in women in the LEON BECERRA CAMACHO DE MILAGRO HOSPITAL the period MAY2016- FEBRUARY 2017
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Embarazo ectópico, Complicaciones del embarazo, Hospital General Dr. León Becerra Camacho, Cantón Milagro, Ecuador