Factores asociados y complicaciones en puerperio entre el 2015 - 2016 del Hospital León Becerra Camacho de la ciudad de Milagro
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Puede considerarse fenómenos patológicos del puerperio INFECCIONES que se pueden manifestar localmente o en las mamas. Otro carácter patológico posible son las HEMORRAGIAS POSPARTO, que pueden poner en riesgo la vida de la paciente. Para no tener una excesiva pérdida de sangre, en esta fase es fundamental que el útero esté bien contraído; de este modo los vasos presentes en la zona de inserción placentaria se "comprimen" y se evita, de esta manera, el derrame de sangre. Otros problemas ligados al puerperio son la flebitis, la septicemia, la infección vulvo-vaginal, etcétera, todas parte de la infección puerperal. El estreptococo β-hemolítico es el agente más importante, junto con los anaerobios y sobre todo las bacterias gran negativas. La isquemia, la herida placentaria y del canal blando incluyendo la episiotomía y posibles desgarros perineales, la corioamnionitis, ruptura prematura de membranas, partos prolongados y exámenes vaginales repetidos se han descrito como posibles factores predisponentes de la infección puerperal.
Consecuentes al parto, se pueden dar embolias gaseosas o embolias de trombos, que causan asistolia aguda o edema pulmonar.
Además, la disminución de hormonas sexuales y el aumento de la prolactina producen un efecto negativo en el estado emocional de la mujer (depresión postparto) y disminuye su deseo sexual.
Después de las primeras dos horas del parto vuelven los mecanismos normales de coagulación que determinan la formación de fibrina en la zona de inserción placentaria, y por este motivo las hemorragias son más raras.
Ciertas patologías afectan al útero, que van ligadas a una atonía muscular o a la inversión completa y topográfica del útero, y pueden ir acompañadas de derrames totales o parciales de líquido; también son posibles las laceraciones del órgano.
It can be considered pathological phenomena of the puerperium INFECTIONS that can be manifested locally or in the breasts. Another possible pathological character is POSTPARTUM HEMORRHAGE, which can put the patient's life at risk. To avoid excessive blood loss, it is essential at this stage that the uterus be well contracted; in this way the vessels present in the area of placental insertion are "compressed" and in this way, the blood flow is avoided. Other problems linked to the puerperium are phlebitis, septicemia, vulvovaginal infection, etc., all part of the puerperal infection. The β-hemolytic streptococcus is the most important agent, along with the anaerobes and especially the large negative bacteria. Ischemia, placental and soft-tissue injury including episiotomy and possible perineal tears, chorioamnionitis, premature rupture of membranes, prolonged labor and repeated vaginal examinations have been described as possible predisposing factors for puerperal infection. Consistent with the birth, gaseous embolisms or thrombus emboli can occur, causing acute asystole or pulmonary edema. In addition, the decrease in sex hormones and the increase in prolactin produce a negative effect on a woman's emotional state (postpartum depression) and decrease her sexual desire. After the first two hours of labor, the normal coagulation mechanisms that determine the formation of fibrin in the area of placental insertion return, and for this reason hemorrhages are more rare. Certain pathologies affect the uterus, which are linked to a muscular atony or to the complete and topographic inversion of the uterus, and may be accompanied by total or partial fluid spills; lacerations of the organ are also possible.
It can be considered pathological phenomena of the puerperium INFECTIONS that can be manifested locally or in the breasts. Another possible pathological character is POSTPARTUM HEMORRHAGE, which can put the patient's life at risk. To avoid excessive blood loss, it is essential at this stage that the uterus be well contracted; in this way the vessels present in the area of placental insertion are "compressed" and in this way, the blood flow is avoided. Other problems linked to the puerperium are phlebitis, septicemia, vulvovaginal infection, etc., all part of the puerperal infection. The β-hemolytic streptococcus is the most important agent, along with the anaerobes and especially the large negative bacteria. Ischemia, placental and soft-tissue injury including episiotomy and possible perineal tears, chorioamnionitis, premature rupture of membranes, prolonged labor and repeated vaginal examinations have been described as possible predisposing factors for puerperal infection. Consistent with the birth, gaseous embolisms or thrombus emboli can occur, causing acute asystole or pulmonary edema. In addition, the decrease in sex hormones and the increase in prolactin produce a negative effect on a woman's emotional state (postpartum depression) and decrease her sexual desire. After the first two hours of labor, the normal coagulation mechanisms that determine the formation of fibrin in the area of placental insertion return, and for this reason hemorrhages are more rare. Certain pathologies affect the uterus, which are linked to a muscular atony or to the complete and topographic inversion of the uterus, and may be accompanied by total or partial fluid spills; lacerations of the organ are also possible.
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Período posparto, Complicaciones, Factores de riesgo, Hospital General Dr. León Becerra Camacho, Cantón Milagro, Ecuador, Factores asociados