Deteccción temprana de preeclampsia por microalbuminuria en embarazadas con gestación mayor de 20 semanas, estudio a realizar en el Hospital Gineco-Obstétrico Enrique C. Sotomayor de Guayaquil período 2013-2014
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
La preeclampsia es un trastorno multisistémico caracterizado por hipertensión arterial inducida al embarazo, edema y proteinuria que aparece en la segunda mitad de gestación y es reversible en el postparto. Es una patología común con alta tasa de mortalidad materno-fetal y con efectos irreversibles si pasa inadvertida y sin un tratamiento adecuado.
A pesar de ser una enfermedad frecuente no tiene una causa específica que nos indique la razón de esta patología, pero podemos conocer los múltiples factores de riesgos que pueden llevar a ello. Como siguiente objetivo es el determinar si la microalbuminuria es un examen útil para la detección temprana de preeclampsia en embarazadas con edad gestacional mayor de 20 semanas en el Hospital Gineco-Obstetico Enrique C. Sotomayor de Guayaquil en el periodo 2013-2014. Esta investigación es diseño retrospectivo, no experimental y de tipo descriptivo.
La prueba para microalbuminuria es una prueba confiable para la detección temprana de preeclampsia en aquellas pacientes que reúnen factores de riego para desarrollar la enfermedad. Uno de los factores de riesgo como la edad, tenemos que el 48% eran menores de 18 años, y el 55% era primigestas. Como antecedente el 38% tenía hipertensión arterial crónica. El 49% de estas pacientes tenía un IMC de entre 18-25.
De las 107 pacientes el 45% dio positivo a la prueba de microalbuminuria (48 Pctes), de estas 48 pacientes con microalbuminuria positiva el 71% llego a desarrollar preeclampsia y el 68% desarrollo preeclampsia leve. 15 pacientes desarrollaron preeclampsia severa, 80% progresó a Eclampsia y el 20% síndrome de Hellp.
Las pacientes con resultado positivo de la prueba tienen una posibilidad de 6.36 veces más de desarrollar preeclampsia que las pacientes con resultado negativo de la prueba
Palabras clave: Preeclampsia-microalbuminuria-sensibilidad-especificidad
Preeclampsia is a multisystem disorder characterized by proteinuria hypertension induced by pregnancy, edema and appearing in the second half of pregnancy and postpartum is reversible. It is a common disease with high rate of maternal and fetal mortality and irreversible effects if it goes unnoticed and without proper treatment. Despite being a common disease does not have a specific cause you tell us the reason for this condition, but we can meet the multiple risk factors that can lead to it. One of the most studied causes is poor maternal immune response to pregnancy, in which there systemic endothelial damage that causes increased vascular permeability to proteins and thus proteinuria. As a next aim is to determine whether microalbuminuria is a useful test for early detection of preeclampsia in pregnant women with gestational age greater than 20 weeks in the Ob-Obstetico Enrique C. Sotomayor Hospital of Guayaquil in 2013-2014. This research is retrospective, non-experimental and descriptive design. The test for microalbuminuria is a reliable tool for early detection of preeclampsia in those patients who meet risk factors for developing the disease test. One of the risk factors like age, we have 48% were under 18, and 55% were primiparous. As background 38% had chronic hypertension. 49% of these patients had a BMI between 18-25. Of the 107 patients, 45% tested positive for microalbuminuria test (48 pctes) of these 48 patients with positive microalbuminuria 71% came to develop preeclampsia and 68% develop mild preeclampsia. 15 patients developed severe preeclampsia, eclampsia progressed 80% and 20% HELLP syndrome. Patients with positive test result have a chance 6.36 times more to develop preeclampsia than patients with a negative test result
Preeclampsia is a multisystem disorder characterized by proteinuria hypertension induced by pregnancy, edema and appearing in the second half of pregnancy and postpartum is reversible. It is a common disease with high rate of maternal and fetal mortality and irreversible effects if it goes unnoticed and without proper treatment. Despite being a common disease does not have a specific cause you tell us the reason for this condition, but we can meet the multiple risk factors that can lead to it. One of the most studied causes is poor maternal immune response to pregnancy, in which there systemic endothelial damage that causes increased vascular permeability to proteins and thus proteinuria. As a next aim is to determine whether microalbuminuria is a useful test for early detection of preeclampsia in pregnant women with gestational age greater than 20 weeks in the Ob-Obstetico Enrique C. Sotomayor Hospital of Guayaquil in 2013-2014. This research is retrospective, non-experimental and descriptive design. The test for microalbuminuria is a reliable tool for early detection of preeclampsia in those patients who meet risk factors for developing the disease test. One of the risk factors like age, we have 48% were under 18, and 55% were primiparous. As background 38% had chronic hypertension. 49% of these patients had a BMI between 18-25. Of the 107 patients, 45% tested positive for microalbuminuria test (48 pctes) of these 48 patients with positive microalbuminuria 71% came to develop preeclampsia and 68% develop mild preeclampsia. 15 patients developed severe preeclampsia, eclampsia progressed 80% and 20% HELLP syndrome. Patients with positive test result have a chance 6.36 times more to develop preeclampsia than patients with a negative test result
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Preeclampsia, Microalbuminuria, Hipertensión inducida en el embarazo, Mortalidad, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador