Evaluación de nifedipina oral en amenaza de parto pretérmino y su impacto en el resultado neonatal, Hospital Gineco-Obstétrico Enrique C. Sotomayor
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La amenaza de parto pretérmino y el parto pretérmino continúan siendo una de las complicaciones más frecuentes en la obstetricia, a pesar de los grandes avances de la medicina moderna, por lo que constituye un reto y punto de atención continua. El tratamiento se basa en 3 pilares: el reposo físico y psíquico, la inhibición de las contracciones uterinas y la estimulación de la formación de surfactante pulmonar fetal. A lo largo del tiempo se han estudiado múltiples esquemas de tratamiento para la amenaza de parto pretérmino, Los fármacos como los bloqueantes de canales de calcio, entre esos el nifedipino, ha tomado el primer lugar como la droga de elección para el manejo del trabajo de parto prematuro, sin embargo se desconoce cuál es el régimen de tratamiento óptimo con nifedipino como tocolítico. Con el objetivo de evaluar el grado de utilidad que tiene la tocolisis con nifedipino en la amaneza de parto pretérmino y así reducir el impacto neonatal, se realizó un estudio de tipo descriptivo, de diseño no experimental y retrospectivo, en el que se incluyeron a las embarazadas con amenaza de parto pretérmino que se atendieron en sala de cuidados intermedios del Hospital GinecoObstétrico ”Enrique c. Sotomayor”, entre enero del 2010 a diciembre del 2011. Se obtuvo como resultado de 98 casos estudiados que el 73 % correspondieron a edades entre los 20 a 39 años, el 48 % fueron secundigestas, el 55 % se presentaron entre las 29 y 34 SG, el 34 % presentaron dilatación cervical de 1 cm, la dosis inicial de nifedipina fue de 20 mg, la dosis de mantenimiento de nifedipina cada 8 horas se utilizó en el 92 % de los casos. Luego de la administración de nifedipina en el 72 % de los casos se redujo el borramiento cervical al 0% y en el 89 % de los casos se presentaron cambios cervicales como cérvix cerrado. Los resultados obtenidos demostraron la utilidad del nifedipino en embarazadas con amenaza de parto pretérmino y en el impacto neonatal.
The preterm labor and preterm birth remains one of the most common complications in obstetrics , despite the great advances of modern medicine , so it is a challenge and continuing care point . The treatment is based on 3 pillars: physical and mental rest , inhibition of uterine contractions and stimulation of fetal lung surfactant formation . Over time many schemes have been studied for the treatment of preterm labor , drugs such as calcium channel blockers , including nifedipine such , has taken the top spot as the drug of choice for the management of work preterm birth , however it is unknown what the optimal treatment regimen with nifedipine as a tocolytic . In order to assess the degree of usefulness of nifedipine tocolysis in preterm labor amaneza and reduce neonatal impact , we conducted a descriptive study of non-experimental , retrospective design , which included the pregnant women with preterm labor who received care in intermediate care ward Obstetric-Gynecologic Hospital " Enrique c . Sotomayor " , from January 2010 to December 2011. The result was that 98 cases studied , 73 % were aged 20-39 years, 48 % were secundiparous , 55 % occurred between 29 and 34 SG , 34 % had cervical dilation of 1 cm nifedipine initial dose was 20 mg maintenance dose every 8 hours nifedipine was used in 92% of cases. After administration of nifedipine in 72% of cases cervical effacement decreased to 0% and 89 % of the cases were as closed cervix cervical changes . The results showed the usefulness of nifedipine in pregnant women with preterm labor and neonatal impact . We performed a descriptive analysis of the variables
The preterm labor and preterm birth remains one of the most common complications in obstetrics , despite the great advances of modern medicine , so it is a challenge and continuing care point . The treatment is based on 3 pillars: physical and mental rest , inhibition of uterine contractions and stimulation of fetal lung surfactant formation . Over time many schemes have been studied for the treatment of preterm labor , drugs such as calcium channel blockers , including nifedipine such , has taken the top spot as the drug of choice for the management of work preterm birth , however it is unknown what the optimal treatment regimen with nifedipine as a tocolytic . In order to assess the degree of usefulness of nifedipine tocolysis in preterm labor amaneza and reduce neonatal impact , we conducted a descriptive study of non-experimental , retrospective design , which included the pregnant women with preterm labor who received care in intermediate care ward Obstetric-Gynecologic Hospital " Enrique c . Sotomayor " , from January 2010 to December 2011. The result was that 98 cases studied , 73 % were aged 20-39 years, 48 % were secundiparous , 55 % occurred between 29 and 34 SG , 34 % had cervical dilation of 1 cm nifedipine initial dose was 20 mg maintenance dose every 8 hours nifedipine was used in 92% of cases. After administration of nifedipine in 72% of cases cervical effacement decreased to 0% and 89 % of the cases were as closed cervix cervical changes . The results showed the usefulness of nifedipine in pregnant women with preterm labor and neonatal impact . We performed a descriptive analysis of the variables
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Amenaza de parto prematuro, Nifedipina, Resultante neonatal, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador