Resultante neonatal de prematuros de muy bajo peso al nacer de acuerdo a la vía de parto en el Hospital Gineco-Obstétrico Enrique C. Sotomayor período 2012-2013
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La cesárea ha sido el método de elección para el nacimiento de productos pretérminos de muy bajo peso, al parecer disminuye la morbimortalidad. Las dificultades técnicas para verificar esta asociación imposibilitan el desarrollo de grandes estudios de cohorte. A la luz de las evidencias actuales, tales afirmaciones se encuentran en tela de juicio y aquellos informes contradictorios deben ser dilucidados especialmente en instituciones como el Hospital Gineco- Obstetrico Enrique C. Sotomayor donde los neonatos pretérmino de muy bajo peso atendidos son numerosos.En el presente trabajo el objetivo es determinar si la vía del parto influye en el resultado neonatal de recién nacidos pretérmino de muy bajo peso para la edad gestacional. Se realizó un estudio caso control que incluyó aleatoriamente 89 neonatos MBPN con evolución desfavorable y 172 neonatos MBPN con evolución favorable atendidos entre el 1 – 01 - 2012 al 31 – 12 - 2013, nacidos de partos simples. Se excluyeron, neonatos con defectos congénito, embarazo complicados por trastornos del líquido amniótico, nacimiento de parto distócico. La metodología es observacional, analítico con diseño experimental-longitudinal retrospectivo. Los resultados obstenidos fueron: la mortalidad fue 34.4% y la morbilidad 88.9%. La puntuación del Apgar al min. / 5 min. y la morbilidad no se modificaron por la vía del parto (P > 0.05). Existió un número significativamente mayor de muertes en partos vaginales que por cesárea (42% vs 26.2%) ). La muerte se asocio significativamente por el peso. En el grupo de 1000 a 1499 g. existieron menos muertes que en productos de < 1000 g. (69.7% vs 30.0%). La mortalidad corregida por peso indicó una asociación significativa de muerte con el parto vaginal en productos de MBPN que por cesarea (20.3% vs 11.5%). Se concluye que la vía del parto influye sobre la resultante neonatal. El parto vaginal se asocia a un resultado adverso.
The cesarean has been the method of choice for preterm birth of low weight products. Apparently, this method reduces morbidity and mortality. The technical difficulties impossible to verify this association developing large cohort studies. In light of current evidence, such claims are challenged and those conflicting reports must be elucidated particularly in institutions such as the Enrique C. Sotomayor Hospital where preterm infants low serviced weight are numerous.The objetive to determine whether the birth canal influences neonatal outcome of preterm low birth weight for gestational age. The 01 - 2012 to 31 – 12 - 2013, born from single births, a case control study was performed, that randomized included 89 infants whit unfavorable developments and 172 infants to favorable developments. We excluded infants with congenital defects, pregnancy complicated by disorders of amniotic fluid, birth of dystocia. The methodology is observational, experimental-analytical retrospective longitudinal design.The mortality rate was 34.4% and 88.9% morbidity. Apgar score min. / 5 min. and morbidity were not modified by the birth canal (P> 0.05). There was a significantly greater number of deaths in vaginal births by caesarean section (42% vs 26.2%. The death was significantly association with weight. In the group of 1000-1499 g. there were fewer deaths than products of <1000 g. (69.7% vs 30.0%). Mortality corrected by weight indicated a signficativa asoción death with vaginal delivery in VLBW products (20.3% vs 11.5%). It is concluded the birth canal influences neonatal resulting. Vaginal delivery is associated with an adverse outcome.
The cesarean has been the method of choice for preterm birth of low weight products. Apparently, this method reduces morbidity and mortality. The technical difficulties impossible to verify this association developing large cohort studies. In light of current evidence, such claims are challenged and those conflicting reports must be elucidated particularly in institutions such as the Enrique C. Sotomayor Hospital where preterm infants low serviced weight are numerous.The objetive to determine whether the birth canal influences neonatal outcome of preterm low birth weight for gestational age. The 01 - 2012 to 31 – 12 - 2013, born from single births, a case control study was performed, that randomized included 89 infants whit unfavorable developments and 172 infants to favorable developments. We excluded infants with congenital defects, pregnancy complicated by disorders of amniotic fluid, birth of dystocia. The methodology is observational, experimental-analytical retrospective longitudinal design.The mortality rate was 34.4% and 88.9% morbidity. Apgar score min. / 5 min. and morbidity were not modified by the birth canal (P> 0.05). There was a significantly greater number of deaths in vaginal births by caesarean section (42% vs 26.2%. The death was significantly association with weight. In the group of 1000-1499 g. there were fewer deaths than products of <1000 g. (69.7% vs 30.0%). Mortality corrected by weight indicated a signficativa asoción death with vaginal delivery in VLBW products (20.3% vs 11.5%). It is concluded the birth canal influences neonatal resulting. Vaginal delivery is associated with an adverse outcome.
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Recién nacido prematuro, Recién nacido de bajo peso, Indicadores de morbimortalidad, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador