Sutura hemostática cuadrada para el manejo de la atonía uterina refractaria intraoperatoria trabajo preliminar 2013-2014
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La atonía es la causa más común de hemorragia postparto. En el 2013 la OPS reportó 9300 muertes maternas en América Latina y el Caribe por causas relacionadas con el embarazo, el 27% debido a hemorragia postparto. En la Maternidad Enrique C. Sotomayor la hemorragia postparto por atonía uterina transquirúrgica representa el 1.09% en el 2013 de un total de 25.463 partos; por lo cual es importante tener varias opciones de manejo y tratamiento de esta patología. OBJETIVOS: Evaluar la utilidad intraoperatoria de la técnica sutura hemostática cuadrada para el tratamiento de la atonía uterina refractaria al tratamiento médico convencional. MATERIALES Y MÉTODOS: Se realiza un estudio de tipo descriptivo, correlacional con diseño no experimental, longitudinal y prospectivo. Constituido por 105 pacientes que presentaron atonía uterina refractaria intraoperatoria en el Hospital Gineco-Obstétrico Enrique C. Sotomayor durante el período de Enero a diciembre del año 2013 que reúnan los criterios de inclusión. RESULTADOS: El empleo de la técnica de sutura cuadrada resultó satisfactorio en el 100% (n=105) de los casos, cabe recalcar que se considera exitoso debido a que logró controlar la atonía uterina, dejó de sangrar en todos los casos y no se recurrió a la histerectomía. CONCLUSIÓN: La técnica de sutura cuadrada resultó eficaz, segura y fácilmente reproducible con resultado exitoso en todas las pacientes en que fue aplicada.
The atony is the most common reason of postpartum hemorrhage. In the year 2013, the PHO reported 9300 maternal deaths worldwide being 27 % due to PPH. In Enrique C. Sotomayor Maternity, postpartum hemorrhage by transsurgycal uterine atony represents 1.09 % in 2013 of a total of 25,463 births; by which it is important to have various options o management and treatment for this pathology. OBJECTIVES: To evaluate the usefulness of intraoperative hemostasis square suture technique for the treatment of uterine atony refractory to conventional medical treatment. METHODS: A descriptive study, with no experimental correlational, longitudinal and prospective design is performed. Consisting of 105 patients who had refractory intraoperative uterine atony in Obstetric-Gynecologic Hospital Enrique C. Sotomayor during the period January to December 2013 meeting the inclusion criteria. RESULTS: The use of square suture technique was successful in 100% (n = 105) of cases, it should be emphasized that is considered successful because they managed to control the uterine atony, it stopped bleeding in all the cases and the hysterectomy was not used. CONCLUSION: Square suture technique was effective, safe and easily reproducible with successful outcome in all patients in whom it was applied.
The atony is the most common reason of postpartum hemorrhage. In the year 2013, the PHO reported 9300 maternal deaths worldwide being 27 % due to PPH. In Enrique C. Sotomayor Maternity, postpartum hemorrhage by transsurgycal uterine atony represents 1.09 % in 2013 of a total of 25,463 births; by which it is important to have various options o management and treatment for this pathology. OBJECTIVES: To evaluate the usefulness of intraoperative hemostasis square suture technique for the treatment of uterine atony refractory to conventional medical treatment. METHODS: A descriptive study, with no experimental correlational, longitudinal and prospective design is performed. Consisting of 105 patients who had refractory intraoperative uterine atony in Obstetric-Gynecologic Hospital Enrique C. Sotomayor during the period January to December 2013 meeting the inclusion criteria. RESULTS: The use of square suture technique was successful in 100% (n = 105) of cases, it should be emphasized that is considered successful because they managed to control the uterine atony, it stopped bleeding in all the cases and the hysterectomy was not used. CONCLUSION: Square suture technique was effective, safe and easily reproducible with successful outcome in all patients in whom it was applied.
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Atonía uterina, Sutura hemostática, Hemorragia posparto, Epidemiología descriptiva, Estudios prospectivos, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador