Resultante perinatal postcerclaje cervical terapéutico y de emergencia Hospital Gineco-Obstétrico Enrique C. Sotomayor enero 2013 - diciembre 2015
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La incompetencia cervical es un cuadro clínico que presentan las gestantes con la incapacidad de retener un peso intrauterino en el cuello uterino, provocando el parto prematuro o los abortos involuntarios al segundo trimestre, su diagnóstico puede ser ambiguo y variado ya que presenta muchos factores que lo pueden evidenciar. Durante muchos años se han desarrollado distintos métodos para tratarlo una de las más estudiada es el cerclaje cervical. Esta operación quirúrgica presenta tres tipos de niveles o indicaciones como lo son: el profiláctico, terapéutico y el de emergencia o terciario. Las técnicas quirúrgicas tienen los nombres de los pioneros en este método como lo son Shirodkar y McDonald ambos por vía vaginal, seguido de otras nuevas técnicas que han sido variantes de los dos anteriores. Los estudios clínicos randomizados no muestran especial ventaja de este tratamiento en cuanto a la disminución de partos prematuros, sin embargo si se puede evidenciar los beneficios en la disminución de la morbilidad neonatal, se presentaron 49 casos de cerclaje de emergencia y 48 casos de cerclaje terapéutico. El cerclaje de emergencia presentó resultados bajos para los neonatos. El estudio retrospectivo se basó en las historias clínicas de 97 pacientes, del Hospital Gineco-obstetrico Enrique Sotomayor de enero del 2013 a diciembre del 2015, bajo la aplicación del cerclaje terapéutico y de emergencia, con la técnica de McDonald; para el análisis de la relación con el resultado perinatal
The cervical incompetence is a clinical entity in which the pregnant has the inability to retain the weight’s intrauterine in their cérvix. This can be produce preterm birth or in voluntaries abortions in the second trimester, the diagnosis is usually ambiguous and varied because of their multi-factorial. During the dears, it has been developed many several methods to treated it, one of the more investigated is the cervical stitch. This surgery presents three types of level: profilactic, urgency and emergency. The surgeries’ techniques have the name of the pioneers in those methods, McDonald and Shirodkar both via vaginal, with posteriors techniques with the same bases. The randomized clinical studies don’t show a special advantage of this treatment in the influence to the diminution of preterm birth, however, exist benefits with the improves in the neonatal mobility, 49 cases of emergency cerclage and 48 of urgency cerclage were presented. Emergency cerclage presented low results for neonates. The retrospective investigation is based in the clinical history of ninety-seven patients, since February 2013 to December 2015 documented in the Hospital obstetric-gynecologists Enrique Sotomayor, with the McDonald’s Technique, for the analysis of the perinatal outcome
The cervical incompetence is a clinical entity in which the pregnant has the inability to retain the weight’s intrauterine in their cérvix. This can be produce preterm birth or in voluntaries abortions in the second trimester, the diagnosis is usually ambiguous and varied because of their multi-factorial. During the dears, it has been developed many several methods to treated it, one of the more investigated is the cervical stitch. This surgery presents three types of level: profilactic, urgency and emergency. The surgeries’ techniques have the name of the pioneers in those methods, McDonald and Shirodkar both via vaginal, with posteriors techniques with the same bases. The randomized clinical studies don’t show a special advantage of this treatment in the influence to the diminution of preterm birth, however, exist benefits with the improves in the neonatal mobility, 49 cases of emergency cerclage and 48 of urgency cerclage were presented. Emergency cerclage presented low results for neonates. The retrospective investigation is based in the clinical history of ninety-seven patients, since February 2013 to December 2015 documented in the Hospital obstetric-gynecologists Enrique Sotomayor, with the McDonald’s Technique, for the analysis of the perinatal outcome
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Cerclaje cervical, Terapéutica ginecológica, Emergencias, Resultante perinatal, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador