Placenta previa acreta, resultante obstétrica y neonatal
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La placenta previa acreta es una causa importante de morbimortalidad materno
fetal razón por la cual se la considera un problema de salud pública. El objetivo general
de este trabajo de investigación es analizar la relación entre pacientes con diagnóstico de
placenta previa acreta, y su resultante obstétrica y neonatal, Para ello se realizó un
estudio de tipo: Descriptivo, correlacional, retrospectivo, de corte transversal en el
Hospital de la Mujer Alfredo G. Paulson en el período: Enero 2017 - Enero 2018,
tomando como población de estudio a mujeres con diagnóstico de placenta previa acreta.
Para la selección de la muestra se aplicó fórmulas para media muestral de tipo aleatorio
simple, obteniéndose un total de 71 pacientes. Los resultados obtenidos demuestran que
el acretismo placentario tuvo mayor incidencia en: Mujeres entre los 26 a 35 años de
edad (60.56%), Multíparas (70.42%), con antecedente de cesárea previa (63.38%).
Entre los resultantes neonatales se obtuvieron: Prematurez (13 casos), Distres
respiratorio del recién nacido (8 casos), Hipoglicemia neonatal (6 casos), Muerte
neonatal (3 casos). En relación a los procedimientos quirúrgicos realizados se observó
que: La cesárea con resección de segmento fue la cirugía con mayor preservación
uterina con un total de (38 casos / 53.52%), seguido de cesárea segmentaria (13 casos /
18.31%) y finalmente cesárea corporal (8 casos / 11.27%). Se reportaron además 12
casos de histerectomía lo que representa al (16.90 % de la población de estudio), seguido
de shock hipovolémico (14.08 %), lesión de vejiga (7.04 %). Finalmente, la ecografía
como prueba diagnóstica de acretismo placentario tuvo una sensibilidad del (85%) y
especificidad del (72%), lo que indica es una prueba adecuada para tamizaje de
pacientes con trastornos placentarios.
The accreta placenta previa is an important reason of morbility and mortality mother fetal reason by which it is considered to be a problem of public health. The general objective of this research work is to analyze the relationship between patients diagnosed with accreta placenta previa and its resultant obstetric and neonatal. For this purpose, a descriptive, correlational, retrospective, cross-sectional study was carried out in the Hospital de the Alfredo G. Paulson woman in the period: January 2017- January 2018, taking as a study population women diagnosed with accreta placenta previa. For the selection of the sample, we applied formulas for simple random sample mean, obtaining a total of 71 patients. The results obtained show that placental accreta was more frequent in: Women between 26 and 35 years of age (60.56%), Multiparous women (70.42%) with a previous history of caesarean section (63.38%). Among the neonatal results were obtained: Prematurity (13 cases), Respiratory distress of the newborn (8 cases), Neonatal hypoglycemia (6 cases), Neonatal death (3 cases). Regarding the surgical procedures performed, it was observed that: Caesarean with segment resection was surgery with greater uterine preservation with a total of (38 cases / 53.52%), followed by finally segmental Caesarean section (13 cases / 18.31%) and finally Cesarean section body condition (8 cases / 11.27%). In addition, 12 cases of hysterectomy were reported (representing 16.90% of the study population), followed by hypovolemic shock (14.08%), bladder injury (7.04%). Finally, ultrasound as a diagnostic test of placental accretion had a sensitivity of (85%) and specificity of (72%), which indicates an adequate test for screening of patients with placental disorders.
The accreta placenta previa is an important reason of morbility and mortality mother fetal reason by which it is considered to be a problem of public health. The general objective of this research work is to analyze the relationship between patients diagnosed with accreta placenta previa and its resultant obstetric and neonatal. For this purpose, a descriptive, correlational, retrospective, cross-sectional study was carried out in the Hospital de the Alfredo G. Paulson woman in the period: January 2017- January 2018, taking as a study population women diagnosed with accreta placenta previa. For the selection of the sample, we applied formulas for simple random sample mean, obtaining a total of 71 patients. The results obtained show that placental accreta was more frequent in: Women between 26 and 35 years of age (60.56%), Multiparous women (70.42%) with a previous history of caesarean section (63.38%). Among the neonatal results were obtained: Prematurity (13 cases), Respiratory distress of the newborn (8 cases), Neonatal hypoglycemia (6 cases), Neonatal death (3 cases). Regarding the surgical procedures performed, it was observed that: Caesarean with segment resection was surgery with greater uterine preservation with a total of (38 cases / 53.52%), followed by finally segmental Caesarean section (13 cases / 18.31%) and finally Cesarean section body condition (8 cases / 11.27%). In addition, 12 cases of hysterectomy were reported (representing 16.90% of the study population), followed by hypovolemic shock (14.08%), bladder injury (7.04%). Finally, ultrasound as a diagnostic test of placental accretion had a sensitivity of (85%) and specificity of (72%), which indicates an adequate test for screening of patients with placental disorders.
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Placenta previa, Acretismo placentario, Epidemiología descriptiva, Estudios retrospectivos, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador, Resultante materno, Resultante neonatal