Complicaciones del Sindrome de Hellp, en pacientes ingresadas en el Hospital Gineco Obstétrico Enrique C. Sotomayor. Guayaquil 2014 - 2015
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Obstetricia
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El Síndrome de HELLP, es una grave complicación caracterizada por la presencia de hemolisis, disfunción hepática y trombocitopenia en una progresión evolutiva de los cuadros severos de hipertensión en el embarazo. La mortalidad materna asociada con este síndrome es de 1 - 24 %, y la perinatal hasta más del 40 %, ambas muy relacionadas con el momento del diagnóstico y las condiciones materno-fetales. El objetivo de esta investigación es determinar qué complicaciones se presentan en el Síndrome de HELLP en mujeres ingresadas en el Hospital Gineco - Obstétrico Enrique C. Sotomayor. Mayo 2014 – Marzo 2015, mediante el análisis de historias clínicas, con el propósito de actualizar el protocolo de clínico de las normas de manejo institucionales de la enfermedad hipertensiva del embarazo, para reducir el índice de mortalidad materno - infantil. El estudio es tipo Descriptivo, Prospectivo, Transversal, no experimental, con una muestra fueron las pacientes con Diagnostico confirmado y atendidas en el Hospital, el cual nos dio como resultado 38 pacientes. Los resultados indican que de las 38 pacientes con Síndrome de HELLP estudiadas se presentaron las siguientes complicaciones: Insuficiencia Renal Aguda (IRA) en 10 pacientes (26 %) Coagulación Intravascular Diseminada (CID) en 4 pacientes (10 %), Edema pulmonar en 6 pacientes (16 %), Abruptio placentae en 5 pacientes (13 %), Ascitis en 5 pacientes (13 %), Fallo Hepático en 3 pacientes (8 %), Sepsis en 1 paciente (3 %), Pancreatitis (3 %), Isquemia arterial (3 %); En ninguna se produjo un Hematoma hepático subcapsular. En nuestro estudio la tasa de Mortalidad materna fue del 5 % mientras que la tasa de Mortalidad Perinatal fue del 13 %.
HELLP syndrome is a serious complication characterized by the presence of hemolysis, liver dysfunction and thrombocytopenia in an evolutionary progression of severe cases of hypertension in pregnancy. Maternal mortality associated with this syndrome is 1-24%, and perinatal up more than 40%, both closely related to the time of diagnosis and maternal and fetal conditions. The objective of this research is to determine which complications occur in HELLP Syndrome in women admitted to the Gynecology Hospital - Enrique C. Sotomayor Obstetrics. May 2014 - April 2015 through analysis of medical records, with the purpose of updating the clinical protocol standards of institutional management of hypertensive disease of pregnancy, to reduce the rate of maternal mortality - Descriptive type children. The study, prospective, transversal and not experimental, with a sample were patients with a confirmed diagnosis and treated at the Hospital, which gave as a result pacientes. Los results indicate that 38 of the 38 patients with HELLP syndrome studied showed the following complications : Acute renal failure (ARF) in 10 patients (26%) disseminated intravascular coagulation (DIC) in 4 patients (10%) pulmonary edema in 6 patients (16%), placental abruption in 5 patients (13%), Ascites 5 patients (13%), Liver failure in 3 patients (8%), Sepsis in 1 patient (3%), pancreatitis (3%), blood (3%) Ischemia; Nowhere there was a hepatic subcapsular hematoma. In our study, the maternal mortality rate was 5 % while perinatal mortality rate was 13%.
HELLP syndrome is a serious complication characterized by the presence of hemolysis, liver dysfunction and thrombocytopenia in an evolutionary progression of severe cases of hypertension in pregnancy. Maternal mortality associated with this syndrome is 1-24%, and perinatal up more than 40%, both closely related to the time of diagnosis and maternal and fetal conditions. The objective of this research is to determine which complications occur in HELLP Syndrome in women admitted to the Gynecology Hospital - Enrique C. Sotomayor Obstetrics. May 2014 - April 2015 through analysis of medical records, with the purpose of updating the clinical protocol standards of institutional management of hypertensive disease of pregnancy, to reduce the rate of maternal mortality - Descriptive type children. The study, prospective, transversal and not experimental, with a sample were patients with a confirmed diagnosis and treated at the Hospital, which gave as a result pacientes. Los results indicate that 38 of the 38 patients with HELLP syndrome studied showed the following complications : Acute renal failure (ARF) in 10 patients (26%) disseminated intravascular coagulation (DIC) in 4 patients (10%) pulmonary edema in 6 patients (16%), placental abruption in 5 patients (13%), Ascites 5 patients (13%), Liver failure in 3 patients (8%), Sepsis in 1 patient (3%), pancreatitis (3%), blood (3%) Ischemia; Nowhere there was a hepatic subcapsular hematoma. In our study, the maternal mortality rate was 5 % while perinatal mortality rate was 13%.
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Sindrome de Hellp, Hipertensión en el embarazo, Preeclampsia, Insuficiencia renal aguda, Coagulación Intravascular diseminada, Epidemiología descriptiva, Estudios prospectivos, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Ecuador