Morbimortalidad materno perinatal asociada a eclampsia propuesta de protocolo predictivo-preventivo y de manejo
No hay miniatura disponible
Fecha
2016
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La eclampsia un trastorno hipertensivo del embarazo, complica un porcentaje significativo de los embarazos. siendo la principal causa de morbi-mortalidad materna y fetal. El Objetivo del presente estudio es determinar la morbi-mortalidad materno perinatal asociada a la eclampsia en el Hospital Gineco-Obstétrico Enrique C. Sotomayor en el año 2015. El Método de estudio fue cuantitativo, analítico, correlacional, no experimental, transversal y de tipo retrospectivo, que analizó de 81 pacientes con diagnóstico de eclampsia. Los resultados fueron incidencia de eclampsia fue de 0.3%, rango mayor de edad fue de 18 a 25 años, las complicaciones maternas: desprendimiento de placenta en el 10%, HELLP 11%, ascitis materna 6%, convulsiones anteparto 99%, complicaciones fetales oligoamnios 30%, Líquido teñido 14%, óbito fetal 4%, Neonatales: distress respiratorio 41%, Apgar < de 7 al min. 49%, asfixia perinatal 20%, con el análisis bivariado se determinó que las complicaciones en la eclampsia precoz fueron 62% fetales, maternas 50% y neonatales 60% y en tardías fetales 38%, maternas 50%, neonatal 40%, la eclampsia precoz mayor probabilidad de complicaciones: neonatales 2.17 OR (IC=95% v=p 0.0011), fetales 5,09 OR (IC=95% v=p 0.0033) y maternas 2,89 OR (IC=95% v=p 0.147). Como Conclusión se determinó que la eclampsia tiene un impacto negativo en el bienestar materno perinatal, en especial la de aparición precoz por lo que las medidas deben ser aplicadas basadas en la predicción y prevención en el primer trimestre de embarazo, recomendamos la utilización del protocolo propuesto para el tamizaje con enfoque de riesgo, seguimiento y el tratamiento preventivo antes de las 16 semanas de gestación.
Eclampsia a hypertensive disorder of pregnancy, complicates a significant percentage of pregnancies and remains a leading cause of maternal and fetal morbidity and mortality. The aim of the present study was to determine the perinatal maternal morbidity and mortality associated with eclampsia in the Gineco-Obstetrics Hospital Enrique C. Sotomayor in 2015. The Method of study was quantitative, analytical, correlational, non-experimental, transversal and retrospective , Who analyzed 81 patients with a diagnosis of eclampsia. The results were eclampsia incidence was 0.3%, age range was 18 to 25 years, maternal complications: placenta detachment in 10%, HELLP 11%, maternal ascites 6%, antepartum convulsions 99%, fetal complications Oligoamnios 30%, Fluid stained 14%, fetal death 4%, Neonatal: respiratory distress 41%, Apgar <from 7 to min. 49%, perinatal asphyxia 20%, with bivariate analysis it was determined that the complications in early eclampsia were 62% fetal, maternal 50% and neonatal 60% and in late fetal 38%, maternal 50%, neonatal 40%, eclampsia Precocious increased probability of complications: neonatal 2,17 OR (CI = 95% v = p 0.0011), fetal 5,09 OR (CI = 95% v = p 0.0033) and maternal 2.89 OR (CI = 95% v = P 0.147). As a conclusion it was determined that eclampsia has a negative impact on maternal perinatal especially in early-onset eclampsia. Therefore, measures should be applied based on prediction and prevention in the first trimester of pregnancy, we recommend the use of the proposed protocol for screening with a risk and follow-up approach and the administration of preventive treatment before 16 weeks.
Eclampsia a hypertensive disorder of pregnancy, complicates a significant percentage of pregnancies and remains a leading cause of maternal and fetal morbidity and mortality. The aim of the present study was to determine the perinatal maternal morbidity and mortality associated with eclampsia in the Gineco-Obstetrics Hospital Enrique C. Sotomayor in 2015. The Method of study was quantitative, analytical, correlational, non-experimental, transversal and retrospective , Who analyzed 81 patients with a diagnosis of eclampsia. The results were eclampsia incidence was 0.3%, age range was 18 to 25 years, maternal complications: placenta detachment in 10%, HELLP 11%, maternal ascites 6%, antepartum convulsions 99%, fetal complications Oligoamnios 30%, Fluid stained 14%, fetal death 4%, Neonatal: respiratory distress 41%, Apgar <from 7 to min. 49%, perinatal asphyxia 20%, with bivariate analysis it was determined that the complications in early eclampsia were 62% fetal, maternal 50% and neonatal 60% and in late fetal 38%, maternal 50%, neonatal 40%, eclampsia Precocious increased probability of complications: neonatal 2,17 OR (CI = 95% v = p 0.0011), fetal 5,09 OR (CI = 95% v = p 0.0033) and maternal 2.89 OR (CI = 95% v = P 0.147). As a conclusion it was determined that eclampsia has a negative impact on maternal perinatal especially in early-onset eclampsia. Therefore, measures should be applied based on prediction and prevention in the first trimester of pregnancy, we recommend the use of the proposed protocol for screening with a risk and follow-up approach and the administration of preventive treatment before 16 weeks.
Descripción
PDF
Palabras clave
Embarazo, Eclampsia, Morbilidad, Mortalidad materna, Mortalidad perinatal, Epidemiología analítica, Estudios retrospectvos, Protocolos, Medicina preventiva, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador