Complicaciones maternas y perinatales asociadas al sídrome Hellp Hospital Gineco-Obstétrico Enrique C. Sotomayor 2008-2012
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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El síndrome HELLP representa una variedad de preeclampsia s, cuyo substrato patológico es una microangiopatía generalizada, de etiología desconocida, con anemia hemolítica, activación y consumo de plaquetas y depósitos de fibrina en los sinusoides hepáticos. El presente estudio fue retrospectivo, descriptivo, longitudinal, no experimental y correlacional. El universo de estudio lo conformaron 5871 historias clínicas de pacientes diagnosticadas con preeclampsia severa y eclampsia. La muestra estuvo constituida 130 casos que reunieron los criterios de inclusión y exclusión, la información fue obtenida de historias clínicas del departamento de estadísticas. La incidencia del síndrome de HELLP durante el periodo comprendido de 2008-2012 fue 2,20% en el Hospital Enrique C. Sotomayor. La edad promedio fue 28,1 años. Dentro de las complicaciones maternas, la más frecuentes fueron insuficiencia renal 27,1%, eclampsia 19,4%, y de las perinatales fueron distrés respiratorio 42,7%, hemorragia intraventricular 29%. La edad gestacional promedio fue 33,51 ± 4,29, La tasa de restricción de crecimiento intrauterino fue 61,4%. El APGAR a los 5 minutos < 7 con 33,3%. Concluimos que el síndrome de HELLP tiene una alta de mortalidad perinatal 30,3%, de los cuales 18,5% fueron óbitos y la mortalidad materna fue de 10%.
HELLP syndrome represents a variety of severe preeclampsia, which is a pathological substrate generalized microangiopathy of unknown etiology, with hemolytic anemia, activation and consumption of platelets and fibrin deposits in the hepatic sinusoids. The present study was retrospective, descriptive, longitudinal, non-experimental and correlacional. The study group was made up 5871 medical records of patients diagnosed with severe preeclampsia and eclampsia. The sample consisted of 130 cases who met the inclusion and exclusion criteria, information was obtained from medical records of the department of statistics. The incidence of HELLP syndrome during the period of 2008-2012 was 2.20% in the Hospital Enrique C. Sotomayor. The average age was 28, 1 years. Within maternal complications, the most frequent being renal failure 27, 1%, 19, 4% eclampsia, perinatal and 42.7% were respiratory distress, intraventricular hemorrhage 29%. The mean gestational age was 33.51 ± 4.29, the rate of intrauterine growth restriction was 61.1%. The APGAR score at 5 minutes <7 with 33, 3%. We conclude that HELLP syndrome has a high perinatal mortality 30, 3%, of which 18, 5% - were deaths and maternal mortality was 10%. .
HELLP syndrome represents a variety of severe preeclampsia, which is a pathological substrate generalized microangiopathy of unknown etiology, with hemolytic anemia, activation and consumption of platelets and fibrin deposits in the hepatic sinusoids. The present study was retrospective, descriptive, longitudinal, non-experimental and correlacional. The study group was made up 5871 medical records of patients diagnosed with severe preeclampsia and eclampsia. The sample consisted of 130 cases who met the inclusion and exclusion criteria, information was obtained from medical records of the department of statistics. The incidence of HELLP syndrome during the period of 2008-2012 was 2.20% in the Hospital Enrique C. Sotomayor. The average age was 28, 1 years. Within maternal complications, the most frequent being renal failure 27, 1%, 19, 4% eclampsia, perinatal and 42.7% were respiratory distress, intraventricular hemorrhage 29%. The mean gestational age was 33.51 ± 4.29, the rate of intrauterine growth restriction was 61.1%. The APGAR score at 5 minutes <7 with 33, 3%. We conclude that HELLP syndrome has a high perinatal mortality 30, 3%, of which 18, 5% - were deaths and maternal mortality was 10%. .
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Microangiopatía, Sinusoides hepática, Síndrome de Hellp, Obito fetal, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador, Complicaciones del embarazo