Valoración de concentración de meconio en el líquido amniótico y su relación con los resultados de ph del cordón umbilical en neonatos. Hospital Gineco-Obstétrico Enrique C. Sotomayor. Periodo 2008-2010
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2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Se ha señalado con frecuencia que las características del líquido meconial durante el parto reflejan un estado neonatal adverso y en este sentido puede utilizarse para estimar un mal pronóstico del recién nacido. Sin embargo estudios recientes parecen señalar que tal utilidad sería controvertida por cuanto no encuentran asociación entre estas variables. Como el hospital Gineco-Obstétrico “Enrique C. Sotomayor” es una institución que atiende miles de nacimientos anualmente, un número importante de estos presentarán líquido meconial, a pesar de lo cual aún no se había establecido el significado de este hallazgo. Con el propósito de confirmar si las diferentes características de la tinción del líquido amniótico con meconio se relacionan con diferentes niveles de pH de cordón se realizó un estudio de tipo descriptivo-correlacional, y diseño no experimentaltransversal en una muestra aleatoria y pareada de una población de 100 neonatos, en los que se evaluó comparativamente el pH de cordón con diferente intensidad de tinción con meconio del líquido amniótico. Se incluyeron partos a término, simples, con presentación cefálica, previo consentimiento informado de participación. Para el análisis descriptivo se emplearon estadígrafos. En el análisis de asociación se utilizó, la prueba de Kolmogorv Smirnov considerando significativo un valor de p < 0.05. Los resultados mostraron que el 37% de los casos tenían 39 semanas, 51% de sexo femenino. El 75% tuvo un trabajo de parto considerado con una duración normal. En el 33% se utilizó oxitocina. El 11% ingresó a UCI. En el 22% de los partos existió líquido amniótico meconial. El 13% de los neonatos tuvo un pH por debajo del nivel normal. El 2% fue diagnosticado con asfixia perinatal. La presencia del meconio en el líquido amniótico y la intensidad con que la tiñe no explican de manera importante los cambios en los valores del pH en el cordón ya que el índice R estuvo por debajo del 50%. (37,7%).
It has often been noted that the characteristics of meconium during labor reflect adverse neonatal state and in this sense can be used to estimate a poor prognosis of the newborn. However recent studies seem to indicate that such a utility would be controversial because they did not find an association between these variables. As the Enrique C. Sotomayor hospital, is an institution that serves thousands of births annually, a significant number of these meconium present, in spite of which had not yet established the significance of this finding. In order to confirm whether the different characteristics of the amniotic fluid stained with meconium are associated with different cord pH levels, a cross sectional studyin a random sample and a paired population of 100 newborns, which is assessed by comparing the pH of different intensity cord with meconium staining of amniotic fluid. Term deliveries were included, simple, cephalic presentation, informed consent for participation. For the descriptive analysis were used statisticians. In the association analysis is used, the Kolmogorov Smirnov test was considered significant ap value <0.05. The results showed that 37% of cases were 39 weeks, patients were female, 51%. 75% had a labor lasting considered normal. In 33% required oxytocin. 11% joined UCI. In 22% of births there was meconium. 13% of neonates had a pH below the normal level. 2% were diagnosed with asphyxia perinatal.La presence of meconium in the fluid meconical and the intensity with which the dye does not significantly explain changes in pH values in the cord as the R index was below 50% .(37.7%)..
It has often been noted that the characteristics of meconium during labor reflect adverse neonatal state and in this sense can be used to estimate a poor prognosis of the newborn. However recent studies seem to indicate that such a utility would be controversial because they did not find an association between these variables. As the Enrique C. Sotomayor hospital, is an institution that serves thousands of births annually, a significant number of these meconium present, in spite of which had not yet established the significance of this finding. In order to confirm whether the different characteristics of the amniotic fluid stained with meconium are associated with different cord pH levels, a cross sectional studyin a random sample and a paired population of 100 newborns, which is assessed by comparing the pH of different intensity cord with meconium staining of amniotic fluid. Term deliveries were included, simple, cephalic presentation, informed consent for participation. For the descriptive analysis were used statisticians. In the association analysis is used, the Kolmogorov Smirnov test was considered significant ap value <0.05. The results showed that 37% of cases were 39 weeks, patients were female, 51%. 75% had a labor lasting considered normal. In 33% required oxytocin. 11% joined UCI. In 22% of births there was meconium. 13% of neonates had a pH below the normal level. 2% were diagnosed with asphyxia perinatal.La presence of meconium in the fluid meconical and the intensity with which the dye does not significantly explain changes in pH values in the cord as the R index was below 50% .(37.7%)..
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MECONIO, LIQUIDO AMNIOTICO, PH, CORDON UMBILICAL, NEONATOS, HOSPITAL GINECO-OBSTETRICO ENRIQUE C. SOTOMAYOR, CANTON GUAYAQUIL, ECUADOR