Incidencia y resultados de la episiotomía vs desgarros en primigestas de 15 19 años del Hospital Gineco Obstétrico Enrique C. Sotomayor de mayo 2014 a febrero 2015
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Obstetricia
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La episiotomía en la actualidad se la considera como la cirugía obstétrica que se realiza con mayor frecuencia. En este proyecto investigativo se exponen las principales indicaciones para la práctica de la episiotomía, así mismo cuando no usarla con el objeto de beneficiar a la paciente. Se concluye que la realización de la episiotomía debe ser realizada si el caso lo amerita, así lo señala la Organización Mundial de la Salud la cual menciona que esta no debería superar el 30%. (Martinez, s.f.) (12). OBJETIVO: Determinar la incidencia y resultados de episiotomía vs desgarros en primigestas de 15 a 19 años atendidas en el Hospital Gineco Obstétrico Enrique C. Sotomayor. METODOLOGIA: Este proyecto es un estudio descriptivo, analítico, prospectivo y no experimental, desarrollado en el área tocoquirurgica de parto del Hospital Enrique C. Sotomayor, en gestantes primigestas de 15 a 19 años atendidas en la institución del 5 mayo 2014 al 28 febrero 2015 con la finalidad de detectar la incidencia y resultados de episiotomía vs desgarros: para lo cual utilizaremos los Historiales clínicos de las gestantes. RESULTADOS: En el presente proyecto investigativo se llegó a la conclusión que de un universo de 652 gestantes se tomó una muestra de 108 primigestas, de las cuales a 72 (67%) se les realizo episiotomía, 28 (26%) tuvieron desgarros perineales y 8 (7%) tuvieron perinés íntegros. De las 28 primigestas el 13% presento desgarros grado I, él 9% presento desgarros grado II, el 3% presento desgarros grado III y el 1% presentaron desgarros grado IV. Cabe recalcar que al realizar una correcta maniobra de ritgen se conseguirá reducir el porcentaje de desgarros perineales, tal es así que de la muestra obtenida el 7% obtuvo resultados favorables. Dentro de las complicaciones postparto un total de 15 pacientes presentaron complicaciones como son: Hematomas (6%), Dehiscencia de Episiorrafia (4%), Fistulas rectovaginales (1%) e Infecciones (3%) logrando así cada uno de los objetivos propuestos en este proyecto de investigación.
The Episiotomy is now considered as obstetric surgery performed more frequently. In this research project the main indications for the practice of episiotomy are exposed and when not to use it in order to benefit the patient. It is concluded that the performance of episiotomy should be performed if the case warrants, so says the World Health Organization which states that this should not exceed 30%. (Martinez, s.f.) (12). OBJECTIVE: To determine the incidence and outcomes of episiotomy tears in primiparous vs 15 to 19 years treated at the Gynecology and Obstetrics Hospital Enrique C. Sotomayor. METHODOLOGY: This project is a descriptive, analytical, prospective and non-experimental study, developed in the area of labor tocoquirurgica Enrique C. Sotomayor Hospital in primipara pregnant women aged 15 to 19 years attended at the institution of May 5, 2014 to February 28, 2015 in order to detect the incidence and outcome of episiotomy vs tears: for which use medical records of pregnant women. RESULTS: In this research project was concluded that from a universe of 652 pregnant women a sample of 108 primiparous, of which 72 took (67%) underwent episiotomy, 28 (26%) had perineal tears and 8 (7%) had intact perineums. Of the 28 primigravid 13% showed grade I lacerations, 9% grade II tears present, 3% presented grade III tears and 1% had grade IV tears. It should be noted that a correct maneuver Ritgen be able to reduce the rate of perineal tears, so much so that the sample obtained 7% had favorable results. Among the postpartum complications a total of 15 patients had complications such as: Bruising (6%), dehiscence of episiotomy (4%), rectovaginal fistulas (1%) and infections (3%) achieving each of the objectives in this research project.
The Episiotomy is now considered as obstetric surgery performed more frequently. In this research project the main indications for the practice of episiotomy are exposed and when not to use it in order to benefit the patient. It is concluded that the performance of episiotomy should be performed if the case warrants, so says the World Health Organization which states that this should not exceed 30%. (Martinez, s.f.) (12). OBJECTIVE: To determine the incidence and outcomes of episiotomy tears in primiparous vs 15 to 19 years treated at the Gynecology and Obstetrics Hospital Enrique C. Sotomayor. METHODOLOGY: This project is a descriptive, analytical, prospective and non-experimental study, developed in the area of labor tocoquirurgica Enrique C. Sotomayor Hospital in primipara pregnant women aged 15 to 19 years attended at the institution of May 5, 2014 to February 28, 2015 in order to detect the incidence and outcome of episiotomy vs tears: for which use medical records of pregnant women. RESULTS: In this research project was concluded that from a universe of 652 pregnant women a sample of 108 primiparous, of which 72 took (67%) underwent episiotomy, 28 (26%) had perineal tears and 8 (7%) had intact perineums. Of the 28 primigravid 13% showed grade I lacerations, 9% grade II tears present, 3% presented grade III tears and 1% had grade IV tears. It should be noted that a correct maneuver Ritgen be able to reduce the rate of perineal tears, so much so that the sample obtained 7% had favorable results. Among the postpartum complications a total of 15 patients had complications such as: Bruising (6%), dehiscence of episiotomy (4%), rectovaginal fistulas (1%) and infections (3%) achieving each of the objectives in this research project.
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Parto, Primigestas, Episiotomía, Desgarro perineales, Maniobra de Ritgen, Maniobra de Mac Roberts, Profilaxis, Epidemiología descriptiva, Estudios prospectivos, Epidemiología analítica, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador