Manejo quirúrgico de la placenta previa oclusiva total con acretismo placentareo y su resultante materno fetal Hospital Gineco-Obstétrico Enrique C. Sotomayor 2009-2010
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2011
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La placenta previa es una causa frecuente de hemorragia obstétrica en la segunda mitad de la gestación. Un alto porcentaje especialmente cuando son oclusivas totales se acompañan de acretismo placentario y culminan en una histerectomía de emergencia aumentando consecuentemente la morbi-mortalidad materna. La edad materna, el antecedente de aborto y cesáreas previas constituyen los principales factores de riesgo. El objetivo de este estudio es delinear su manejo quirúrgico y los factores involucrados en su etiología en pacientes del Hospital Ginecoobstétrico Enrique C. Sotomayor. Se comparo además las resultantes maternas y fetales de acuerdo al tipo de manejo (emergencia con Programadas). Se perfecciono un protocolo de manejo basado en los resultados obtenidos. La metodología empleada es de tipo exploratorio, descriptivo y correlacional, y de diseño no experimental, longitudinal y retrospectivo entre los años 2009-2010 con un universo de 100 pacientes con diagnostico de placenta previa, por métodos clínicos y auxiliares. Se demostró que la histerectomía obstétrica programada o de emergencia realizada por un equipo de salud con experiencia, multidisciplinario y con disponibilidad de derivados sanguíneos disminuye la mortalidad materna.
Placenta previa is a common cause of obstetric haemorrhage in the second half of pregnancy. A high percentage of total stops especially when accompanied by placenta accreta and culminate in an emergency hysterectomy consequently increasing the morbidity and mortality. Maternal age, previous abortion and previous caesarean sections are major risk factors. The aim of this study is to delineate its surgical management and the factors involved in its etiology in patients of gynecological and obstetric hospital Enrique C. Sotomayor. It also compared the resulting maternal and fetal according to type of management (Scheduled emergency). It honed a management protocol based on the results. The methodology is exploratory, descriptive and correlational and nonexperimental, longitudinal and retrospective study between 2009-2010 with a universe of 100 patients diagnosed with placenta previa, clinical and ancillary. Demonstrated that hysterectomy or emergency obstetric program conducted by a team of experienced health, multidisciplinary and availability of blood products reduces maternal mortality
Placenta previa is a common cause of obstetric haemorrhage in the second half of pregnancy. A high percentage of total stops especially when accompanied by placenta accreta and culminate in an emergency hysterectomy consequently increasing the morbidity and mortality. Maternal age, previous abortion and previous caesarean sections are major risk factors. The aim of this study is to delineate its surgical management and the factors involved in its etiology in patients of gynecological and obstetric hospital Enrique C. Sotomayor. It also compared the resulting maternal and fetal according to type of management (Scheduled emergency). It honed a management protocol based on the results. The methodology is exploratory, descriptive and correlational and nonexperimental, longitudinal and retrospective study between 2009-2010 with a universe of 100 patients diagnosed with placenta previa, clinical and ancillary. Demonstrated that hysterectomy or emergency obstetric program conducted by a team of experienced health, multidisciplinary and availability of blood products reduces maternal mortality
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Placenta previa, Acretismo placentario, Histerectomía, Mortalidad materna, Mortalidad fetal, Epiemiología descriptiva, Estudios retrospectivos, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador, Manejo quirúrgico