Valor predictivo anteparto de flujometría doppler arteria cerebral media/umbilical y morbi-mortalidad fetal
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Varios estudios nacionales e internacionales hacen énfasis en la importancia de la ecografía obstétrica Doppler como predictor de varias patologías, como RCIU, anemia, hipoxia fetal entre otras. En nuestro país el más representativo fue en la Ciudad de Cuenca que determinaron que hubo mayor porcentaje de capacidad diagnostica en la flujometría Doppler de la arteria cerebral media esto nos lleva al análisis de dos arteria principales que están en relación con el bienestar fetal. Pero hasta cuándo puede ser de utilidad para decidir continuar con la gestación o no. El presente trabajo de investigación tiene por finalidad valorar la utilidad de la ecografía Doppler de la arteria umbilical y arteria cerebral media como valor predictivo para morbi - mortalidad fetal. El objetivo del presente estudio es determinar si los valores obtenidos por flujometría Doppler tienen valor predictivo anteparto para morbimortalidad fetal. Para ello se realizó un estudio de tipo: Analítico, retrospectivo, de corte transversal. Para el análisis de datos se utilizaron tablas de contingencia de 2 por 2 para medidas de asociación con prueba de Chi cuadrado como prueba de hipótesis, siendo significativos valores (p < 0.005). Los resultados obtenidos demostraron que existe relación de asociación entre: "Valores de flujometría Doppler y morbi - mortalidad fetal". Siendo las principales patologías asociadas: Pre eclampsia severa, Distrés respiratorio del recién nacido, Restricción del crecimiento intrauterino y acidosis fetal. Los valores promedios para flujometría Doppler fueron: IP arteria umbilical (< 0.40 / > 1.60), IR arteria umbilical (< 0.40 / > 1.30). IP arteria cerebral media (< 0.63 / > 2.10) y IR arteria cerebral media ( < 0.47 / > 2.8). Aplicada la prueba de estadística correspondiente se aceptó la hipótesis afirmativa la cual sostiene que los índices de Flujometría Doppler IP e IR de las arterias: Cerebral Media/Umbilical, son predictivos de morbi-mortalidad fetal, en gestantes a término atendidas en el Hospital Alfredo G Paulson
Several national and international studies emphasize the importance of Doppler obstetric ultrasound as a predictor of several pathologies, such as RCIU, anemia, fetal hypoxia, among others. In our country the most representative was in the City of Cuenca that determined that there was a higher percentage of diagnostic capacity in the Doppler flowmetry of the middle cerebral artery, this leads us to the analysis of two main arteries that are related to fetal well-being. But how long can it be useful to decide whether to continue with pregnancy or not. The purpose of this research is to assess the usefulness of Doppler ultrasound of the umbilical artery and middle cerebral artery as a predictive value for fetal morbidity and mortality. The aim of the present study is to determine if the values obtained by Doppler flowmetry have an antepartum predictive value for fetal morbidity and mortality. To this end, a type study was carried out: Analytical, retrospective, cross-sectional. For the analysis of data, 2 by 2 contingency tables were used for measures of association with Chi square test as a hypothesis test, with significant values (p <0.005). The results obtained showed that there is an association relationship between: "Doppler flow and morbi - fetal mortality" values. The main associated pathologies are: Severe preeclampsia, Respiratory distress of the newborn, Restriction of intrauterine growth and fetal acidosis. The mean values for Doppler flowmetry were: IP umbilical artery (<0.40 /> 1.60), IR umbilical artery (<0.40 /> 1.30). IP middle cerebral artery (<0.63 /> 2.10) and IR middle cerebral artery (<0.47 /> 2.8). After applying the corresponding statistical test, the affirmative hypothesis was accepted, which holds that the IP and IR Doppler flow rates of the arteries: Cerebral Mean / Umbilical, are predictive of fetal morbidity and mortality, in term pregnant women attended at the Alfredo G Hospital Paulson
Several national and international studies emphasize the importance of Doppler obstetric ultrasound as a predictor of several pathologies, such as RCIU, anemia, fetal hypoxia, among others. In our country the most representative was in the City of Cuenca that determined that there was a higher percentage of diagnostic capacity in the Doppler flowmetry of the middle cerebral artery, this leads us to the analysis of two main arteries that are related to fetal well-being. But how long can it be useful to decide whether to continue with pregnancy or not. The purpose of this research is to assess the usefulness of Doppler ultrasound of the umbilical artery and middle cerebral artery as a predictive value for fetal morbidity and mortality. The aim of the present study is to determine if the values obtained by Doppler flowmetry have an antepartum predictive value for fetal morbidity and mortality. To this end, a type study was carried out: Analytical, retrospective, cross-sectional. For the analysis of data, 2 by 2 contingency tables were used for measures of association with Chi square test as a hypothesis test, with significant values (p <0.005). The results obtained showed that there is an association relationship between: "Doppler flow and morbi - fetal mortality" values. The main associated pathologies are: Severe preeclampsia, Respiratory distress of the newborn, Restriction of intrauterine growth and fetal acidosis. The mean values for Doppler flowmetry were: IP umbilical artery (<0.40 /> 1.60), IR umbilical artery (<0.40 /> 1.30). IP middle cerebral artery (<0.63 /> 2.10) and IR middle cerebral artery (<0.47 /> 2.8). After applying the corresponding statistical test, the affirmative hypothesis was accepted, which holds that the IP and IR Doppler flow rates of the arteries: Cerebral Mean / Umbilical, are predictive of fetal morbidity and mortality, in term pregnant women attended at the Alfredo G Hospital Paulson
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Flujometría por láser-Doppler, Arteria cerebral media, Arteria umbilical, Indicadores de morbimortalidad, Epidemiología analítica, Estudios retrospectivos, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador, Recién nacido, Feto