Efectividad y seguridad del acido ursodesoxicólico en colestasis gravidica resultante obstétrica y neonatal
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La colestasis intrahepática del embarazo se caracteriza por prurito y elevación de los ácidos biliares generando complicaciones materno-neonatales como: Prematurez, Ruptura de Membranas anteparto y Hemorragia Obstétrica; razón por la que se desarrolló la presente investigación cuyo objetivo fue: Determinar la utilidad del tratamiento con ácido ursodesoxicólico en mujeres con Colestasis gravídica; para ello se planteó un estudio: Analítico - Correlacional, retrospectivo, no experimental, de corte transversal. Para la validez estadística se usó pruebas de Chi cuadrado de asociación y T de Student para comparación de medias. La significación asintótica fue 0.00; sustentándose la hipótesis afirmativa donde se establece que el tratamiento con Ácido Ursodesoxicólico es útil y seguro. La incidencia de colestasis fue del 1.08 %, en mujeres entre los 20 a 29 años, entre las 32 a 34 semanas de gestación. Los síntomas observados fueron: Prurito, ictericia y coluria. Los factores de riesgo fueron: Multiparidad 73.21 % y colestasis gravídica previa 6.4 %. Se observó una reducción de las cifras de función hepática pre y postratamiento validándose por prueba T de Student con una significación asintótica de 0.000. Los resultantes obstétricos y neonatales fueron: Amenaza de parto prematuro en un 48.21 %, muerte fetal con un 3.57 %, hiperbilirrubinemia neonatal con el 46.43 %, hipoglicemia neonatal con el 10.71 %. En conclusión, el Ácido Ursodesoxicólico fue útil en el tratamiento de colestasis gravídica a razón de 1500 mg/día, prolongando el embarazo en una media de 6 semanas permitiendo realizar acciones como: Maduración pulmonar y Neuroprotección fetal.
Intrahepatic cholestasis of pregnancy is characterized by itching and elevation of bile acids, generating maternal-neonatal complications such as: Prematurity, Antepartum Rupture of Membranes and Obstetric Hemorrhage; reason why the present investigation was developed whose objective was: To determine the usefulness of treatment with ursodeoxycholic acid in women with cholestasis gravidarum; For this, a study was proposed: Analytical - Correlational, retrospective, non-experimental, cross-sectional. For statistical validity, Chisquare tests of association and Student's t tests were used for comparison of means. The asymptotic significance was 0.00; supporting the affirmative hypothesis where it is established that treatment with Ursodeoxycholic Acid is useful and safe. The incidence of cholestasis was 1.08%, in women between 20 to 29 years old, between 32 to 34 weeks of gestation. The symptoms observed were: Pruritus, jaundice and coluria. The risk factors were: Multiparity 73.21% and previous cholestasis of pregnancy 6.4%. A reduction in liver function figures was observed before and after treatment, validated by Student's T test with an asymptotic significance of 0.000. The obstetric and neonatal results were: Threat of premature birth in 48.21%, fetal death with 3.57%, neonatal hyperbilirubinemia with 46.43%, neonatal hypoglycemia with 10.71%. In conclusion, Ursodeoxycholic Acid was useful in the treatment of cholestasis gravidarum at a rate of 1500 mg / day, prolonging the pregnancy by an average of 6 weeks, allowing actions such as: Lung maturation and fetal neuroprotection.
Intrahepatic cholestasis of pregnancy is characterized by itching and elevation of bile acids, generating maternal-neonatal complications such as: Prematurity, Antepartum Rupture of Membranes and Obstetric Hemorrhage; reason why the present investigation was developed whose objective was: To determine the usefulness of treatment with ursodeoxycholic acid in women with cholestasis gravidarum; For this, a study was proposed: Analytical - Correlational, retrospective, non-experimental, cross-sectional. For statistical validity, Chisquare tests of association and Student's t tests were used for comparison of means. The asymptotic significance was 0.00; supporting the affirmative hypothesis where it is established that treatment with Ursodeoxycholic Acid is useful and safe. The incidence of cholestasis was 1.08%, in women between 20 to 29 years old, between 32 to 34 weeks of gestation. The symptoms observed were: Pruritus, jaundice and coluria. The risk factors were: Multiparity 73.21% and previous cholestasis of pregnancy 6.4%. A reduction in liver function figures was observed before and after treatment, validated by Student's T test with an asymptotic significance of 0.000. The obstetric and neonatal results were: Threat of premature birth in 48.21%, fetal death with 3.57%, neonatal hyperbilirubinemia with 46.43%, neonatal hypoglycemia with 10.71%. In conclusion, Ursodeoxycholic Acid was useful in the treatment of cholestasis gravidarum at a rate of 1500 mg / day, prolonging the pregnancy by an average of 6 weeks, allowing actions such as: Lung maturation and fetal neuroprotection.
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Colestasis, Embarazo, Recien nacido, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador