Procalcitonia materna como predictor subclinico de amnionitis resultante materno-neonatal
Fecha
2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La amnionitis subclínica es causa importante de morbimortalidad materna y neonatal y
es consecuencia de colonización bacteriana en un 90 % de casos. El presente estudio de
investigación tiene como propósito: Correlacionar los niveles de procalcitonina materna
como predictor subclínico de amnionitis y su resultante materno neonatal en gestantes
atendidas en el hospital de la mujer Alfredo G Paulson de la ciudad de Guayaquil. Por el tipo
de investigación se planteó un estudio: Analítico - Correlacional, retrospectivo, no
experimental, de corte transversal. Los datos obtenidos y prueba de hipótesis utilizada
arrojaron un p valor de (.002) para resultante materno y (.003) para resultante neonatal
aceptándose la hipótesis afirmativa que sostiene si existe correlación. El valor de
procalcitonina significativo fue de (2 ng/ml), en el análisis de regresión se observó que
procalcitonina actuó como predictor 48 h (± 6 h) previo al inicio de síntomas, entre las
complicaciones observadas destacaron: Amenaza de parto pretérmino (48.57 %), ruptura de
membranas pretérmino (34.29 %), endometritis (7.62 %), infección de herida quirúrgica
(6.67 %). Los principales resultados neonatales observados fueron: Prematurez (50.48 %),
Distrés respiratorio del recién nacido (35.24 %), sepsis neonatal temprana (4.76 %),
Enterocolitis necrotizante (1.90 %), Muerte neonatal (0.95 %). En el análisis de regresión se
observó que procalcitonina actúa como predictor de amnionitis 48 h previo al inicio de
síntomas, lo que le confiere validez estadística adecuada como prueba diagnóstica de
amnionitis subclínica. Finalmente se observó una sensibilidad del (80.87 %) y especificidad
del (92.31%) para el total de casos.
Subclinical amnionitis is an important cause of maternal and neonatal morbidity and mortality and is a consequence of bacterial colonization in 90% of cases. The purpose of this research study is to correlate the levels of maternal procalcitonin as a subclinical predictor of amnionitis and its neonatal maternal outcome in pregnant women treated at the Alfredo G Paulson woman's hospital in the city of Guayaquil. For the type of research a study was proposed: Analytical - Correlational, retrospective, non-experimental, cross-sectional. The data obtained and test of hypothesis used showed a p value of (.002) for the maternal result and (.003) for the neonatal outcome, accepting the affirmative hypothesis that holds if there is a correlation. The significant procalcitonin value was (2 ng / ml), in the regression analysis it was observed that procalcitonin acted as a predictor 48 h (± 6 h) prior to the onset of symptoms, among the observed complications highlighted: Threat of preterm delivery ( 48.57%), rupture of preterm membranes (34.29%), endometritis (7.62%), surgical wound infection (6.67%). The main neonatal results observed were: Prematurity (50.48%), Respiratory distress of the newborn (35.24%), early neonatal sepsis (4.76%), Necrotizing enterocolitis (1.90%), Neonatal death (0.95%). In the regression analysis, it was observed that procalcitonin acts as a predictor of amnionitis 48 h prior to the onset of symptoms, which gives it adequate statistical validity as a diagnostic test for subclinical amnionitis. Finally, a sensitivity of (80.87%) and specificity of (92.31%) was observed for the total cases.
Subclinical amnionitis is an important cause of maternal and neonatal morbidity and mortality and is a consequence of bacterial colonization in 90% of cases. The purpose of this research study is to correlate the levels of maternal procalcitonin as a subclinical predictor of amnionitis and its neonatal maternal outcome in pregnant women treated at the Alfredo G Paulson woman's hospital in the city of Guayaquil. For the type of research a study was proposed: Analytical - Correlational, retrospective, non-experimental, cross-sectional. The data obtained and test of hypothesis used showed a p value of (.002) for the maternal result and (.003) for the neonatal outcome, accepting the affirmative hypothesis that holds if there is a correlation. The significant procalcitonin value was (2 ng / ml), in the regression analysis it was observed that procalcitonin acted as a predictor 48 h (± 6 h) prior to the onset of symptoms, among the observed complications highlighted: Threat of preterm delivery ( 48.57%), rupture of preterm membranes (34.29%), endometritis (7.62%), surgical wound infection (6.67%). The main neonatal results observed were: Prematurity (50.48%), Respiratory distress of the newborn (35.24%), early neonatal sepsis (4.76%), Necrotizing enterocolitis (1.90%), Neonatal death (0.95%). In the regression analysis, it was observed that procalcitonin acts as a predictor of amnionitis 48 h prior to the onset of symptoms, which gives it adequate statistical validity as a diagnostic test for subclinical amnionitis. Finally, a sensitivity of (80.87%) and specificity of (92.31%) was observed for the total cases.
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Corioamnionitis, Procalcitonina, Resultante materno neonatal, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador