Valor de la flujometría doppler de la arteria cerebral media y umbilical fetal para pronóstico adverso perinatal en gestantes preeclámpticas, Hospital Regional del IESS Dr. Teodoro Maldonado Carbo, período 2010-2011
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La preeclampsia es una enfermedad que en un número importante de pacientes se relaciona con pronóstico perinatal y materno adverso. Sin embargo esta evolución no resulta fácil de predecir a pesar del empleo de varios métodos imagenológicos, clínicos y de laboratorio. La falta de precisión en la terminología empleada y fallas metodológicas de estudios sobre el tema, han afectado la aplicación sistemática de estos métodos predictores de toxemia gravídica. Se ha mencionado que la medición del flujo sanguíneo a través de la arteria cerebral media (ACM) y de la arteria umbilical (AU) mediante ultrasonografía doppler, pudiera proporcionar información valiosa para establecer el pronóstico perinatal. Sin embargo los estudios al respecto, son pocos y algunos con resultados poco contundentes. Siendo el Departamento de salud Materno-Fetal del hospital Regional 2 del IESS “Dr. Teodoro Maldonado Carbo” un área en donde se atienden miles de pacientes anualmente y considerando que la incidencia de preeclampsia se ha incrementado, se imponía la realización de este estudio en gestantes con preeclampsia. Para esto se ha propuesto la realización de un estudio de tipo observacional, descriptivo de diseño no experimental transversal en el que se incluirán 62 pacientes con preeclampsia las que serán sometidas a la medición del flujo a través de la ACM y AU, para luego ser clasificado y cotejado con el diagnóstico final del neonato para ver si acertó con el pronóstico. Para el análisis estadístico se calcularán sensibilidad, especificidad, valor predictivo positivo y negativo, razón de verosimilitud positiva y negativa, chance pretest positivo y negativo, valor global del método, tasa de falsos positivos y negativos. Se espera que el estudio sirva para establecer si este examen debe aplicarse sistemáticamente en mujeres preeclámpticas.
Preeclampsia is a disease in a significant number of pregnant patients is associated with adverse maternal and perinatal outcome. However, this evolution is not easy to predict despite the use of various imaging methods, clinical and laboratory. The lack of precision in terminology and methodological flaws in studies on the subject, have affected the systematic application of these methods predictors of preeclampsia. It has been mentioned that the measurement of blood flow through the middle cerebral artery (MCA) and umbilical artery (UA) using Doppler ultrasound, may provide valuable information for establishing perinatal prognosis. However, studies on the matter, are few and some with little conclusive results. As the Department of Maternal-Fetal Regional Hospital IESS 2 "Dr. Teodoro Maldonado Carbo " an area which treats thousands of patients each year and whereas the incidence of preeclampsia has increased, imposed conducting this study in pregnant women with preeclampsia. For this it is proposed to conduct a study of observational, descriptive, no experimental cross which included 62 patients with preeclampsia which will be submitted for flow measurement through ACM and AU, before being sorted and collated with the final diagnosis of the baby to see if you were right to prognosis. Statistical analysis was calculated sensitivity, specificity, positive and negative predictive value, positive likelihood ratio and negative, while positive and negative pretest, overall value method, rate of false positives and negatives. It is hoped that the study will serve to establish whether this test should be applied systematically in preeclamptic women.
Preeclampsia is a disease in a significant number of pregnant patients is associated with adverse maternal and perinatal outcome. However, this evolution is not easy to predict despite the use of various imaging methods, clinical and laboratory. The lack of precision in terminology and methodological flaws in studies on the subject, have affected the systematic application of these methods predictors of preeclampsia. It has been mentioned that the measurement of blood flow through the middle cerebral artery (MCA) and umbilical artery (UA) using Doppler ultrasound, may provide valuable information for establishing perinatal prognosis. However, studies on the matter, are few and some with little conclusive results. As the Department of Maternal-Fetal Regional Hospital IESS 2 "Dr. Teodoro Maldonado Carbo " an area which treats thousands of patients each year and whereas the incidence of preeclampsia has increased, imposed conducting this study in pregnant women with preeclampsia. For this it is proposed to conduct a study of observational, descriptive, no experimental cross which included 62 patients with preeclampsia which will be submitted for flow measurement through ACM and AU, before being sorted and collated with the final diagnosis of the baby to see if you were right to prognosis. Statistical analysis was calculated sensitivity, specificity, positive and negative predictive value, positive likelihood ratio and negative, while positive and negative pretest, overall value method, rate of false positives and negatives. It is hoped that the study will serve to establish whether this test should be applied systematically in preeclamptic women.
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Arterias cerebrales, Arterias umbilicales, Flujometría doppler, Embarazo, Preeclampsia, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Pronóstico