Eficacia del cerclaje cervical para la prevención del parto pretérmino
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
Objetivo: Determinar la eficacia del cerclaje cervical para la prevención del parto pretérmino.
Métodología: Este es un estudio descriptivo en 59 mujeres gestantes que presentaron amenza de aborto o de parto pretérmino a quienes se les realizó cerclaje cervical en el Hospital de la Mujer Alfredo G. Paulson, durante el período de enero de 2016 a diciembre de 2017. Se tomaron en cuenta características maternas (edad, índice de masa corporal), eventos previos en la historia obstétrica (antecedente de aborto o de parto pretérmino) y características del embarazo en curso (longitud cervical, embarazo múltiple, preeclampsia) para establecer la influencia de los factores de riesgo. Todas las variables fueron comparadas según el desenlace (parto a término o pre-término), mediante la correspondiente prueba de contraste de hipótesis: t de Student o U de Mann-Whitney para las variables continuas; chi-cuadrado de Pearson (con o sin corrección de Yates) o prueba exacta de Fisher para las variables categóricas.
Resultados: No hubo asociación estadísticamente significativa entre ninguno de los antecedentes maternos, características del embarazo o su intervención, vs. el desenlace (parto a término o pre-término o aborto). Esta técnica previno en un 33,3% (IC 95% 21,3% – 45,3%) el número de partos pretérmino.
Conclusión: En el Hospital de la Mujer Alfredo Paulson la técnica de cerclaje cervical (de McDonald) resultó una estrategia eficaz que permitió prevenir el número de partos pre-término en una proporción 1:2.
Objective: To determine the efficacy of cervical cerclage for the prevention of premature birth. Methodology: This is a descriptive study of 59 pregnant women who presented a threatened abortion or premature delivery to those who underwent cervical cerclage at the Alfredo G. Paulson Women's Hospital, during the period between January 2016 and December 2017. Maternal characteristics (age, body mass index), previous events in the obstetric history (history of abortion or premature birth) and characteristics of the ongoing pregnancy (cervical length, multiple pregnancy, preeclampsia) were taken into account to establish the influence of the risk factor's. All the variables were compared according to the result (term or preterm delivery), by means of the corresponding hypothesis test: Student t test or Mann-Whitney U test for continuous variables; chi-square Pearson (with or without Yates correction) or Fisher's exact test for categorical variables. Results: There was no statistically significant association between any of the maternal history, the characteristics of the pregnancy or its intervention, versus the result (term or preterm delivery or abortion). This technique avoided in 33.3% (95% CI 21.3% - 45.3%) the number of premature births. Conclusion: At the Alfredo Paulson Women's Hospital, the cervical cerclage technique (McDonald's) was an effective strategy to prevent the number of premature births in a 1: 2 ratio.
Objective: To determine the efficacy of cervical cerclage for the prevention of premature birth. Methodology: This is a descriptive study of 59 pregnant women who presented a threatened abortion or premature delivery to those who underwent cervical cerclage at the Alfredo G. Paulson Women's Hospital, during the period between January 2016 and December 2017. Maternal characteristics (age, body mass index), previous events in the obstetric history (history of abortion or premature birth) and characteristics of the ongoing pregnancy (cervical length, multiple pregnancy, preeclampsia) were taken into account to establish the influence of the risk factor's. All the variables were compared according to the result (term or preterm delivery), by means of the corresponding hypothesis test: Student t test or Mann-Whitney U test for continuous variables; chi-square Pearson (with or without Yates correction) or Fisher's exact test for categorical variables. Results: There was no statistically significant association between any of the maternal history, the characteristics of the pregnancy or its intervention, versus the result (term or preterm delivery or abortion). This technique avoided in 33.3% (95% CI 21.3% - 45.3%) the number of premature births. Conclusion: At the Alfredo Paulson Women's Hospital, the cervical cerclage technique (McDonald's) was an effective strategy to prevent the number of premature births in a 1: 2 ratio.
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Cerclaje cervical, Trabajo de parto prematuro, Ecografía transvaginal, Servicios preventivos de salud, Hospital de la Mujer Alfredo Paulson, Cantón Guayaquil, Ecuador