Utilidad del sistema de clasificación Mississipi y Tennessee en la severidad del síndrome Hellp
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El síndrome HELLP es una complicación grave del embarazo con elevada morbimortalidad materna. La presente investigación ha sido realizada en respuesta a las necesidades de investigación nacional. Por el tipo y diseño de invesgigación se realizó un estudio: Analítico - Correlacional, retrospectivo, no experimental, de corte transversal. El objetivo fue: Determinar la utilidad del sistema de clasificación Mississipi y Tennessee en la severidad del síndrome HELLP. Durante el periodo de investigación se registraron un total de 1075 atenciones denominadas como trastornos hipertensivos del embarazo, de estas 72 casos correspondieron a síndrome HELLP con una incidencia del (29.63 %), las complicaciones observadas fueron: Hemorragia obstétrica (38.89 %), hipotonia uterina (13.89 %) y desprendimiento placentario (5.56 %), fallo renal agudo (6.94 %), edema agudo de pulmón (2.78 %). Un (1.39 %) de casos presentaron fallo hepático agudo, hematoma hepático subcapsular y síndrome de encefalopatía hepática posterior reversible. Las complicaciones según escala Mississipi fueron del (59.92 % - Clase I), (26.19 % - Clase II) y (14.29 %- Clase III). Según Tennessee el (66.47 %) se categorizó como completo y (33.33 %) como incompleto. Los niveles de plaquetas críticos fueron: (84.694 /mm3), AST (415 U/l) y LDH (1070). La sensibilidad de ambas escalas fueron del (96.00 %) y especificidad del (85.71 %). Mediante prueba de Chi cuadrado se obtuvieron valores de probabilidad de (0.021) para escala Misissipi y (0.017) para Tennessee aceptándose la hipótesis afirmativa. Se concluye que ambas escalas son útiles para la estadificación de severidad del síndrome de HELLP.
HELLP syndrome is a serious complication of pregnancy with high maternal morbidity and mortality. This research has been conducted in response to national research needs. Due to the type and design of the investigation, a study was carried out analytical - Correlational, retrospective, non-experimental, cross-sectional. The objective was: To determine the usefulness of the Mississipi and Tennessee classification system in the severity of HELLP syndrome. During the investigation period there were a total of 1075 attentions called hypertensive disorders of pregnancy, of these 72 cases corresponded to HELLP syndrome with an incidence of (29.63%), the complications observed were: Obstetric hemorrhage (38.89%), uterine hypotonia (13.89%) and placental abruption (5.56%), acute renal failure (6.94%), acute lung edema (2.78%). (1.39%) of cases presented acute liver failure, subcapsular liver hematoma and reversible posterior hepatic encephalopathy syndrome. The complications according to the Mississipi scale were (59.92% - Class I), (26.19% - Class II) and (14.29% - Class III). According to Tennessee, (66.47%) was categorized as complete and (33.33%) as incomplete. The levels of critical platelets were: (84,694 / mm3), AST (415 U / l) and LDH (1070). The sensitivity of both scales was (96.00%) and specificity (85.71%). The Chi square test obtained probability values of (0.021) for the Mississippi scale and (0.017) for Tennessee, accepting the affirmative hypothesis. It is concluded that both scales are useful for staging severity of HELLP syndrome
HELLP syndrome is a serious complication of pregnancy with high maternal morbidity and mortality. This research has been conducted in response to national research needs. Due to the type and design of the investigation, a study was carried out analytical - Correlational, retrospective, non-experimental, cross-sectional. The objective was: To determine the usefulness of the Mississipi and Tennessee classification system in the severity of HELLP syndrome. During the investigation period there were a total of 1075 attentions called hypertensive disorders of pregnancy, of these 72 cases corresponded to HELLP syndrome with an incidence of (29.63%), the complications observed were: Obstetric hemorrhage (38.89%), uterine hypotonia (13.89%) and placental abruption (5.56%), acute renal failure (6.94%), acute lung edema (2.78%). (1.39%) of cases presented acute liver failure, subcapsular liver hematoma and reversible posterior hepatic encephalopathy syndrome. The complications according to the Mississipi scale were (59.92% - Class I), (26.19% - Class II) and (14.29% - Class III). According to Tennessee, (66.47%) was categorized as complete and (33.33%) as incomplete. The levels of critical platelets were: (84,694 / mm3), AST (415 U / l) and LDH (1070). The sensitivity of both scales was (96.00%) and specificity (85.71%). The Chi square test obtained probability values of (0.021) for the Mississippi scale and (0.017) for Tennessee, accepting the affirmative hypothesis. It is concluded that both scales are useful for staging severity of HELLP syndrome
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Síndrome de Hellp, Escala Mississipi, Escala Tennessee, Epidemiología analítica, Hospital de la Mujer Alfredo G. Paulson, Cantón Guayaquil, Ecuador