Resultante materna y neonatal de las pacientes obstétricas con trombocitopenia según su etiología en el Hospital Gineco-Obstétrico Enrique C. Sotomayor 2015
No hay miniatura disponible
Fecha
2016
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La trombocitopenia es un trastorno hematológico frecuentemente encontrado en el embarazo y se define como el conteo plaquetario menor a 150 x 109/L. Entre las causas
más comunes están trombocitopenia gestacional, preeclampsia y síndrome HELLP,
procesos inmunes y trombocitopenias constitucionales. Los efectos más importantes de
la trombocitopenia sobre el embarazo están vinculados al parto. En la gestante existe la
posibilidad de sangrado durante procedimientos como la episiotomía o la propia
operación cesárea. Los efectos sobre el neonato están referidos a la posibilidad que
nazca con trombocitopenia que pueda generar sangrado intracraneal y además se asocia
con mayor tasa de partos pretérmino. Se realizó un estudio de tipo descriptivo y
observacional, y de diseño no experimental, longitudinal y retrospectivo que incluyó a
todas las pacientes embarazadas del Hospital Enrique C. Sotomayor atendidas por la
especialidad de Hematología durante el año 2015 con valores plaquetarios menores a 150 x 109/L durante esa gestación. Entre las pacientes, se determinó la causa de la
trombocitopenia, se hizo la clasificación por etiología y se analizó la resultante materna
y neonatal. Entre los resultados, se observó que las pacientes en edades entre 20 y 39
años son las más afectadas con trombocitopenia. Las causas más frecuentes fueron la
trombocitopenia gestacional, preeclampsia severa y síndrome HELLP. Entre las
complicaciones maternas más frecuentes se encontró anemia severa en un 10% y
desprendimiento placentario en un 6%. La cesárea se realizó en el 87% de los casos
obteniendo neonatos a término en un 45% mientras que el otro 55% fueron prematuros,
de pacientes con preeclampsia severa y síndrome HELLP más frecuentemente. Por tal
razón se concluyó que causas como trombocitopenia gestacional no tuvieron un mayor
efecto sobre la resultante materna y neonatal, mientras que la preeclampsia severa y
síndrome HELLP tuvieron un efecto negativo ya que presentaron mayores
complicaciones maternas y el mayor porcentaje de recién nacidos prematuros
Thrombocytopenia is a hematologic abnormality frequently found in pregnancy and it is defined as a platelet count less than 150 x 109/L. Its causes are gestational thrombocytopenia, hypertensive disorders, autoimmune diseases and constitutional thrombocytopenia. The most important effects in pregnancy are related to the delivery. The pregnant woman has the risk of bleeding specially in cases of procedures like episiotomy or a cesarean section. On the other hand, the newborn can be born with thrombocytopenia which can cause intracranial bleeding, and it is also associated with a high rate of prematurity. This was a descriptive and observational study, with no experimental, longitudinal and retrospective design. It included all the pregnant patients treated by Hematology Service of “Hospital Enrique C. Sotomayor” during 2015 with a platelet count less than 150 x 109/L during the pregnancy. It was possible to determine the cause of thrombocytopenia, make a classification according to the cause and make the analysis of the effects in the mother and the newborn. Among the results, patients between 20 and 39 years old are the most commonly affected with thrombocytopenia. The most frequent causes are gestational thrombocytopenia, severe preeclampsia and HELLP syndrome. Complications in pregnant women were severe anemia in 10% and abruption placentae in 6% of cases. A cesarean section was performed in 87% of patients, getting birth term newborns in 45% while the other 55% were preterm newborns, mostly from mothers with preeclampsia and HELLP syndrome. It was possible to conclude that gestational thrombocytopenia didn’t have a negative effect in mothers and offspring, but other causes like preeclampsia and HELLP had a negative effect because pregnant women presented more complications and most newborns were preterm.
Thrombocytopenia is a hematologic abnormality frequently found in pregnancy and it is defined as a platelet count less than 150 x 109/L. Its causes are gestational thrombocytopenia, hypertensive disorders, autoimmune diseases and constitutional thrombocytopenia. The most important effects in pregnancy are related to the delivery. The pregnant woman has the risk of bleeding specially in cases of procedures like episiotomy or a cesarean section. On the other hand, the newborn can be born with thrombocytopenia which can cause intracranial bleeding, and it is also associated with a high rate of prematurity. This was a descriptive and observational study, with no experimental, longitudinal and retrospective design. It included all the pregnant patients treated by Hematology Service of “Hospital Enrique C. Sotomayor” during 2015 with a platelet count less than 150 x 109/L during the pregnancy. It was possible to determine the cause of thrombocytopenia, make a classification according to the cause and make the analysis of the effects in the mother and the newborn. Among the results, patients between 20 and 39 years old are the most commonly affected with thrombocytopenia. The most frequent causes are gestational thrombocytopenia, severe preeclampsia and HELLP syndrome. Complications in pregnant women were severe anemia in 10% and abruption placentae in 6% of cases. A cesarean section was performed in 87% of patients, getting birth term newborns in 45% while the other 55% were preterm newborns, mostly from mothers with preeclampsia and HELLP syndrome. It was possible to conclude that gestational thrombocytopenia didn’t have a negative effect in mothers and offspring, but other causes like preeclampsia and HELLP had a negative effect because pregnant women presented more complications and most newborns were preterm.
Descripción
PDF
Palabras clave
Embarazo, Trombocitopenia, Epidemiología descriptiva, Estudios retrospectivos, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador, Resultante materno, Resultante neonatal