Diagnóstico y control evolutivo de las circulares de cordón en el segundo y tercer trimestre de gestación mediante ecografía Doppler a realizarse en el Hospital Gineco-Obstétrico Enrique Sotomayor
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Obstetricia
Resumen
Durante el embarazo las circulares pueden producir accidentes; perturbaciones circulatorias, amputaciones, muertes por estrangulamiento y desprendimiento placentario, el diagnóstico antes del parto puede sospecharse, y radica en signos clínicos tales como el soplo funicular, alteraciones del ritmo de la frecuencia cardiaca fetal, disminución de los movimientos fetales percibidos por la madre, falta de encajamiento al término del embarazo o por imágenes ecográficas que revelan la presencia de circular de cordón umbilical. El presente trabajo se ubica en el Hospital Gineco-Obstétrico Enrique Sotomayor localizada en la ciudad de Guayaquil, con el objetivo de establecer la incidencia de circulares de cordón en el segundo y tercer trimestre de gestación, empleando para su diagnóstico la ecografía Doppler y realizar un control evolutivo que nos permita el pronóstico de estos casos, se realizó un estudio descriptivo, co-relacional, de corte transversal. Se evaluaron un total de 172 pacientes que fueron atendidas en el hospital mencionado con el diagnostico de circular de cordón, tomando en cuenta los criterios de inclusión y exclusión fijados. La información de cada una de las pacientes fue obtenida de las historias clínicas obteniéndose como resultado que de las 172 pacientes atendidas por circular de cordón, el 74% de ellas tuvieron un parto normal, mientras que el 26% fueron sometidas a cesárea. De los productos nacidos vivos con diagnostico de circular de cordón en el área de cesárea 4 de ellos tenían su frecuencia cardiaca aumentada mientras que el restante entraba dentro de los parámetros normales, mientas que en el área de parto solo un neonato tenía aumentada la frecuencia cardiaca.
Circulars during pregnancy can cause accidents; circulatory disturbances, amputations, death by strangulation and abruption, diagnosis before birth can be suspected, and is in clinical signs such as the funicular breath, rhythm disturbances of the fetal heart rate, decreased fetal movements perceived by the mother, lack of engagement at the end of pregnancy or ultrasound images that reveal the presence of circular umbilical cord. This work is located in the Obstetric-Gynecologic Hospital Enrique Sotomayor located in the city of Guayaquil, in order to establish the incidence of circular cord in the second and third trimester, using diagnosis Doppler ultrasound and perform advanced control that allows us the prognosis of these cases, a descriptive study, co-relational, cross-section was performed. A total of 172 patients were treated at the hospital mentioned the diagnosis of nuchal cord were evaluated, taking into account the inclusion and exclusion criteria set. The information of each of the patients was obtained from medical records result indicate that of the 172 patients treated by nuchal cord, 74% of them had a normal delivery, while 26% underwent cesarean section. Products born alive with a diagnosis of nuchal cord in the area of cesarean section 4 of them had their increased heart rate while the remaining was within normal parameters, you lie in the area of labor only one infant had increased heart rate
Circulars during pregnancy can cause accidents; circulatory disturbances, amputations, death by strangulation and abruption, diagnosis before birth can be suspected, and is in clinical signs such as the funicular breath, rhythm disturbances of the fetal heart rate, decreased fetal movements perceived by the mother, lack of engagement at the end of pregnancy or ultrasound images that reveal the presence of circular umbilical cord. This work is located in the Obstetric-Gynecologic Hospital Enrique Sotomayor located in the city of Guayaquil, in order to establish the incidence of circular cord in the second and third trimester, using diagnosis Doppler ultrasound and perform advanced control that allows us the prognosis of these cases, a descriptive study, co-relational, cross-section was performed. A total of 172 patients were treated at the hospital mentioned the diagnosis of nuchal cord were evaluated, taking into account the inclusion and exclusion criteria set. The information of each of the patients was obtained from medical records result indicate that of the 172 patients treated by nuchal cord, 74% of them had a normal delivery, while 26% underwent cesarean section. Products born alive with a diagnosis of nuchal cord in the area of cesarean section 4 of them had their increased heart rate while the remaining was within normal parameters, you lie in the area of labor only one infant had increased heart rate
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Embarazo, Ecografía Doppler, Cordón umbilical, Circulares de cordón, Epidemiología descriptiva, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador