Complicaciones materno neonatales del manejo activo versus expectante de la ruptura prematura de membranas en gestantes de 34-36 semanas atendidas en el centro materno infantil Bastión Popular periodo 2010- 2011. Propuesta de mejora
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2015
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Universidad de Guayaquil. Facultad Piloto de Odontología. Escuela de Postgrado "Dr. José Apolo Pineda".
Resumen
Se incluyeron pacientes hospitalizadas con diagnóstico de
ruptura prematura de membranas de 34-36 semanas que
cumplieron con los criterios de inclusión y exclusión en el
periodo de Enero 2010-Diciembre 2011, encontrando un total de
100 pacientes, que constituye la población de estudio, de las
cuales a 30 se les realizó el manejo activo y a 52 el manejo
expectante.
Resultados: Del total de la población estudiada, al 36.59% se le
realizó el manejo activo y al 63.41% se le realizó el manejo
expectante. Se halló asociación entre la mayor duración del
periodo de latencia y la instalación de la infección materna y
neonatal encontrándose un promedio de 78 horas para
corioamnionitis y 70 horas para endometritis.
Respecto a las complicaciones neonatales tenemos: SDR leve un
26.7% en el manejo activo y un 21.1% en el manejo expectante.
Bajo peso al nacer 13.3% en el manejo activo y 32.7% en el
manejo expectante. Sepsis Neonatal se encontró 6.7% en el
manejo activo y 21.1% en el manejo expectante. Sufrimiento
fetal agudo se obtuvo 16.7 % en el manejo activo y 7.7% en el
manejo expectante.
La morbilidad materna en el manejo activo no tuvo diferencia
significativa con el manejo expectante (10. % vs 7.6%). En
cuanto a la morbilidad neonatal es mayor en el manejo
expectante que en el manejo activo. El manejo activo incrementa
la tasa de cesáreas a diferencia del manejo expectante (70% vs
42.3%)
Hospitalized patients with a diagnosis of premature rupture of membranes at 34-36 weeks who met the criteria for inclusion and exclusion in the period January 2010-December 2011, finding a total of 100 patients, who constitute the study population of which 30 underwent 52 active management and expectant management. Results: Of the study population, to 36.59% will be made active management and 63.41% underwent expectant management. Association between longer duration of latency and installation of maternal infection was found and neonatal found an average of 78 hours to 70 hours for chorioamnionitis and endometritis. Regarding neonatal complications include: mild SDR 26.7% in asset management and 21.1% in the expectant management. LBW 13.3% in the active management and 32.7% in the expectant management. Neonatal Sepsis 6.7% was found in the active management and 21.1% in the expectant management. Acute fetal distress 16.7% was obtained in the active management and 7.7% in the expectant management. Maternal morbidity in the active management had no significant difference with expectant management (10% vs 7.6%). Regarding neonatal morbidity is highest in the asset management that expectant management. Active management increases the cesarean rate unlike the expectant management (70% vs 42.3%)
Hospitalized patients with a diagnosis of premature rupture of membranes at 34-36 weeks who met the criteria for inclusion and exclusion in the period January 2010-December 2011, finding a total of 100 patients, who constitute the study population of which 30 underwent 52 active management and expectant management. Results: Of the study population, to 36.59% will be made active management and 63.41% underwent expectant management. Association between longer duration of latency and installation of maternal infection was found and neonatal found an average of 78 hours to 70 hours for chorioamnionitis and endometritis. Regarding neonatal complications include: mild SDR 26.7% in asset management and 21.1% in the expectant management. LBW 13.3% in the active management and 32.7% in the expectant management. Neonatal Sepsis 6.7% was found in the active management and 21.1% in the expectant management. Acute fetal distress 16.7% was obtained in the active management and 7.7% in the expectant management. Maternal morbidity in the active management had no significant difference with expectant management (10% vs 7.6%). Regarding neonatal morbidity is highest in the asset management that expectant management. Active management increases the cesarean rate unlike the expectant management (70% vs 42.3%)
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TRATAMIENTO QUIRURGICO, TRABAJO DE PARTO