Factores de riesgo para restricción del crecimiento intrauterino fetal en gestantes - Hospital Enrique C. Sotomayor 2012 - 2013
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La Restricción del Crecimiento Intrauterino (R.C.I.U.) fetal, es un término que describe una disminución del crecimiento fetal, haciendo que su peso esté por debajo del percentil 10 de la respectiva edad gestacional. Puede ser causado por mala nutrición materna o fetal, intoxicación por nocivos, genéticos, o infecciosos o por cualquier factor que cause supresión del desarrollo fetal. El conocer los factores de riesgo para desarrollar R.C.I.U., es de gran utilidad para mejorar la calidad del diagnóstico fetal oportuno. El objetivo del presente estudio fue obtener información sobre los factores de riesgo para R.C.I.U. en pacientes de nuestro medio y así se ayuda a mejorar la calidad en el diagnóstico fetal oportuno. En este contexto se realizó un estudio de tipo descriptivo y correlacional y de diseño no experimental y transversal. En el universo de estudio constan las pacientes, que tuvieron su parto en Hospital Enrique C. Sotomayor en Abril 2012- Marzo 2013, la muestra incluyó los 100 casos con R.C.I.U. , y su respectivos controles sin R.C.I.U., nacidos en el periodo mencionado en la guardia 1 del autor. A los dos grupos se les analizó los datos de una hoja de recolección donde constan la edad, procedencia, número de gesta, periodo intergenésico, instrucción, número de controles prenatales, controles institucionales, edad gestacional por fecha de última menstruación, por ecografía y por altura de fondo uterino; afectaciones prenatales y hospitalizaciones, patología obstétrica al momento del nacimiento, valoración neonatal de R.C.I.U. RESULTADOS: La edad media de las gestantes encontrada fue de 24 años de edad. La patología obstétrica al nacimiento de mayor significancia fue la Preeclampsia con un 43% en casos y en controles con un 7%, con un OR 10.02 y un IC 95% de 19.02-22.33. Controles prenatales realizados menos de 5 en un 27% en casos y un 24% en controles con un OR 1.17 y un IC 95% de 1.84-2.50; mientras que los controles institucionales se realizaron en un 27% en los casos, y en los controles en un 39% con un OR 0.57 con un IC 95% de 0.79-1.2. La vía de nacimiento fue en los casos un 31 % para parto vaginal y un 69% para parto por cesárea; en los controles fue de 42% para parto vaginal y de 58% para parto por cesárea. El 45% de pacientes fue Primigesta en los casos y 42% en los controles con un OR 1.1. Gran multíparas de 2% en casos y de 1% en los controles. Se encontró un periodo intergenésico de menos de 2 años en el 59% de casos y
controles, un periodo intergenésico de más de 9 años en el 10% de casos y en el 5% de los controles. Un 57% proveniente de área rural y un 43% proveniente de área urbana en casos, mientras que en controles un 19% de área rural y un 81% de área urbana; con un OR de 5.6 y un IC 95% de 8.82-11.97. Se encontró 63% de Oligohidramnios en casos y un 21% en controles con un OR 6.4 y un IC 95% de IC 95% 9.3-13.9. Afectaciones prenatales como Infecciones del tracto urinario en un 60% de casos con un OR de 2.25 un IC 95% de 2.9 a 5.03 mientras que en los controles de encontró un 40%, sangrado transvaginal en un 24% de casos versus un 8% en controles con un OR 3.63. Leucorrea en un 21% de casos y un 20% en controles con un OR 1.06. Pacientes que necesitaron hospitalización prenatalmente un 18% en casos y un 3% en controles con un OR 7.09 y un IC 95% de 10.55 – 23.7. CONCLUSIONES: Entre los factores de R.C.I.U. de las gestantes del Hospital Gineco- Obtétrico Enrique C. Sotomayor la patología mas encontrada al nacimiento fue la preeclampsia. Se encontró cierto factor de protección al realizarse los controles institucionales. La vía mayor escogida para terminar el embarazo fue la de cesárea. No hubo relación entre el número de gestas ni en el periodo intergenésico de las pacientes. Las pacientes de áreas rurales fueron estadísticamente las más afectadas. Entre las afectaciones prenatales el Oligohidramnios, infecciones del tracto urinario, sangrado transvaginal estuvieron fuertemente relacionadas con la R.C.I.U., mientras que la leucorrea no tuvo valor estadístico significante. Las pacientes que estuvieron hospitalizadas prenatalmente desarrollaron R.C.I.U. que las que no estuvieron.
The Intrauterine Growth Restriction (IUGR) fetus, is a term that describes a decreased fetal growth, making your weight is below the 10th percentile of the respective gestational age. It can be caused by maternal or fetal malnutrition, harmful poisoning, genetic, or infectious or anything that causes suppression of fetal development. Knowing the risk factors for developing IUGR is useful to improve the quality of fetal diagnosis time. The aim of this study is to obtain information on risk factors for IUGR in patients of our environment and help improve the quality of fetal diagnosis time. In this context, a study of descriptive and correlational and cross-sectional nonexperimental design. In the universe of study consists of patients who gave birth at Hospital Henry C. Sotomayor in April 2012 - March 2013, the sample included 100 cases with IUGR And their respective controls without IUGR, born in the period mentioned in the guard 1 author. Both groups were analyzed for data collection sheet which records the age, origin, number of pregnancies, intergenesic, education, number of prenatal visits, institutional controls, gestational age by last menstrual period, ultrasound and fundal height; affectations prenatal and hospitalizations, obstetric pathology at birth, neonatal assessment of IUGR RESULTS: The average age of pregnant women found was 24 years old. The birth obstetric pathology of preeclampsia was more significant with 43% in cases and controls with 7%, with an OR 10.02 and 95% CI 19.02-22.33. Prenatal checkups done within 5 to 27% in cases and 24% in controls with an OR 1.17 and 95% CI 1.84-2.50, while institutional controls were performed in 27% of cases, and in the controls by 39% with an OR 0.57 with 95% CI 0.79-1.2. The route was where 31% for vaginal delivery and 69% for cesarean delivery, in controls was 42% for vaginal delivery and 58% for cesarean delivery. The 45% of patients were primigravida in cases and 42% in controls with an OR 1.1. Multiparous large cases 2% and 1% in the controls. There was a period between births of less than 2 years in 59% of cases and controls, a period between births of over 9 years in 10% of cases and in 5% of controls. 57% from rural areas and 43% from urban areas in cases, whereas in controls 19% of rural and 81% urban area, with an OR of 5.6 and 95% CI 8.82-11.97 . We found 63% of Oligohydramnios in cases and 21% in controls with an OR 6.4, 95% CI 95% 9.3-13.9. Damages prenatal as urinary tract infections in 60% of cases with an OR of 2.25 95% CI 2.9 to 5.03 while controls found in 40%, vaginal bleeding in 24% of cases versus 8% in controls with an OR 3.63. Leucorrhea in 21% of cases and 20% in controls with an OR 1.06. Patients who required hospitalization prenatally 18% in cases and 3% in controls with an OR 7.09 and 95% CI 10.55 - 23.7. CONCLUSIONS: Among the factors R.C.I.U. of pregnant women in the Gynecology Hospital Obtetrico Enrique C. Sotomayor pathology found at birth was more preeclampsia. We found some protection factor made institutional controls. the most chosen way to end the pregnancy was the cesarean. There was no relationship between the number of gestations or intergenesic period of patients. Patients from rural areas were statistically the most affected. The impacts on Oligohydramnios prenatal, urinary tract infections, vaginal bleeding were strongly related to IUGR, while leucorrhoea had no significant statistical value. Patients who developed IUGR prenatally were hospitalized than those who were not.
The Intrauterine Growth Restriction (IUGR) fetus, is a term that describes a decreased fetal growth, making your weight is below the 10th percentile of the respective gestational age. It can be caused by maternal or fetal malnutrition, harmful poisoning, genetic, or infectious or anything that causes suppression of fetal development. Knowing the risk factors for developing IUGR is useful to improve the quality of fetal diagnosis time. The aim of this study is to obtain information on risk factors for IUGR in patients of our environment and help improve the quality of fetal diagnosis time. In this context, a study of descriptive and correlational and cross-sectional nonexperimental design. In the universe of study consists of patients who gave birth at Hospital Henry C. Sotomayor in April 2012 - March 2013, the sample included 100 cases with IUGR And their respective controls without IUGR, born in the period mentioned in the guard 1 author. Both groups were analyzed for data collection sheet which records the age, origin, number of pregnancies, intergenesic, education, number of prenatal visits, institutional controls, gestational age by last menstrual period, ultrasound and fundal height; affectations prenatal and hospitalizations, obstetric pathology at birth, neonatal assessment of IUGR RESULTS: The average age of pregnant women found was 24 years old. The birth obstetric pathology of preeclampsia was more significant with 43% in cases and controls with 7%, with an OR 10.02 and 95% CI 19.02-22.33. Prenatal checkups done within 5 to 27% in cases and 24% in controls with an OR 1.17 and 95% CI 1.84-2.50, while institutional controls were performed in 27% of cases, and in the controls by 39% with an OR 0.57 with 95% CI 0.79-1.2. The route was where 31% for vaginal delivery and 69% for cesarean delivery, in controls was 42% for vaginal delivery and 58% for cesarean delivery. The 45% of patients were primigravida in cases and 42% in controls with an OR 1.1. Multiparous large cases 2% and 1% in the controls. There was a period between births of less than 2 years in 59% of cases and controls, a period between births of over 9 years in 10% of cases and in 5% of controls. 57% from rural areas and 43% from urban areas in cases, whereas in controls 19% of rural and 81% urban area, with an OR of 5.6 and 95% CI 8.82-11.97 . We found 63% of Oligohydramnios in cases and 21% in controls with an OR 6.4, 95% CI 95% 9.3-13.9. Damages prenatal as urinary tract infections in 60% of cases with an OR of 2.25 95% CI 2.9 to 5.03 while controls found in 40%, vaginal bleeding in 24% of cases versus 8% in controls with an OR 3.63. Leucorrhea in 21% of cases and 20% in controls with an OR 1.06. Patients who required hospitalization prenatally 18% in cases and 3% in controls with an OR 7.09 and 95% CI 10.55 - 23.7. CONCLUSIONS: Among the factors R.C.I.U. of pregnant women in the Gynecology Hospital Obtetrico Enrique C. Sotomayor pathology found at birth was more preeclampsia. We found some protection factor made institutional controls. the most chosen way to end the pregnancy was the cesarean. There was no relationship between the number of gestations or intergenesic period of patients. Patients from rural areas were statistically the most affected. The impacts on Oligohydramnios prenatal, urinary tract infections, vaginal bleeding were strongly related to IUGR, while leucorrhoea had no significant statistical value. Patients who developed IUGR prenatally were hospitalized than those who were not.
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Embarazo, Factores de riesgo, Restricción del crecimiento intrauterino fetal, Epidemiología descriptiva, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador