Identificación de los factores de riesgo para el desarrollo de asfixia perinatal en Maternidad Enrique Sotomayor 2013 - 2014
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La asfixia perinatal es un problema importante que impacta a largo plazo en la
morbilidad y mortalidad de los pacientes ingresados en la unidad de neonatología. Su
incidencia es variable, pero se sugiere una incidencia mundial de asfixia severa de 1 - 10 x
1000 nacidos vivos y más de un millón de recién nacidos que sobreviven a la asfixia
desarrolla secuelas neurológicas, psicomotoras y del desarrollo. Múltiples factores de riesgo
maternos, intraparto y neonatal han sido asociados a la aparición de la asfixia perinatal,
siendo algunos de estos de características prevenibles. El objetivo general fue identificar la
relación de los factores de riesgo con el desarrollo de la asfixia perinatal. Se realizó un
estudio de diseño no experimental; de tipo analítico, descriptivo y transversal. El universo
fue constituido por 423 que fueron todos los recién nacidos asfixiados durante el periodo de
enero 2013 – diciembre 2014. Los resultados demuestran que la incidencia de asfixia
perinatal fue de 4,1/1000 nacidos vivos. Los factores de riesgo mayormente asociados con
asfixia fueron aspiración de líquido amniótico (67,4%), ruptura prematura de membranas
(48%), sufrimiento fetal (31,3%), parto prolongado (11,6%), prematurez (63%) con un
valor altamente significativo de asociación (p: 0,0019) y un intervalo de confianza del 95%.
La tasa de mortalidad fue de 33% y las secuelas más importantes fueron las neurológicas
como la encefalopatía hipoxico isquémica (7%) y la hemorragia intraventricular (53%). Se
concluye que existió evidencia para demostrar que la presencia de los factores de riesgo
como: sufrimiento fetal, líquido amniótico meconial, parto prolongado, ruptura prematura de
membranas y prematurez se asociaron fuertemente con el desarrollo de asfixia perinatal
The perinatal asphyxia is a major problem of morbidity and mortality in neonatal intensive care units. The incidence is variable, but the suggested global incidence of severe PA ranges in 1 – 10 per 1000 live births, and over a million of new borns who survive to the asphyxia will have neurologic, psychomotor, and developmental sequelae. Multiple maternal, intrapartum, and neonatal risk factors have been associated to the occurrence of perinatal asphyxia. Some of them have preventable features. The main aim was to identify the relationship of the risk factors with the development of perinatal asphyxia. We made an analytic, descriptive and transversal design study, non – experimental. The population studied were 423 patients that were all the asphyxiated newborns in the period of January 2013 to December 2014. The results show that the perinatal asphyxia incidence was 4.1 / 1000 live births. The risk factors mainly associated to perinatal asphyxia were amniotic fluid aspiration (62%), premature rupture of membranes (48%), fetal distress (33.7%), prolonged labor (11.6%), preterm infants (63%); with a highly significant value of association (p: 0,0019) and a confidence interval 95%. The mortality rate was 33%, and the most important complications were the neurological sequelae as hypoxic-ischemic encephalopathy (7%), and the intraventricular hemorrhage infection (53%). There was evidence to show that the presence of risk factors such as fetal distress, meconium aspiration, premature rupture of membranes, prolonged labor and preterm infants were strongly associated with the development of perinatal asphyxia.
The perinatal asphyxia is a major problem of morbidity and mortality in neonatal intensive care units. The incidence is variable, but the suggested global incidence of severe PA ranges in 1 – 10 per 1000 live births, and over a million of new borns who survive to the asphyxia will have neurologic, psychomotor, and developmental sequelae. Multiple maternal, intrapartum, and neonatal risk factors have been associated to the occurrence of perinatal asphyxia. Some of them have preventable features. The main aim was to identify the relationship of the risk factors with the development of perinatal asphyxia. We made an analytic, descriptive and transversal design study, non – experimental. The population studied were 423 patients that were all the asphyxiated newborns in the period of January 2013 to December 2014. The results show that the perinatal asphyxia incidence was 4.1 / 1000 live births. The risk factors mainly associated to perinatal asphyxia were amniotic fluid aspiration (62%), premature rupture of membranes (48%), fetal distress (33.7%), prolonged labor (11.6%), preterm infants (63%); with a highly significant value of association (p: 0,0019) and a confidence interval 95%. The mortality rate was 33%, and the most important complications were the neurological sequelae as hypoxic-ischemic encephalopathy (7%), and the intraventricular hemorrhage infection (53%). There was evidence to show that the presence of risk factors such as fetal distress, meconium aspiration, premature rupture of membranes, prolonged labor and preterm infants were strongly associated with the development of perinatal asphyxia.
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ASFIXIA PERINATAL, FACTORES DE RIESGO, EPIDEMIOLOGIA ANALITICA, EPIDEMIOLOGIA DESCRIPTIVA, HOSPITAL GINECO-OBSTETRICO ENRIQUE C. SOTOMAYOR, CANTON GUAYAQUIL, ECUADOR