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Desenlaces maternos y fetales en el manejo expectante de la preeclampsia lejos del término

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dc.contributor.advisorFlórez Betancourt, Clara Jimena
dc.contributor.advisorChuaire-Noack, Lilian
dc.contributor.advisorVillaveces, Mariana
dc.creatorFranco Chuaire, María Liliana
dc.creatorCalderón Díaz, Ivonne
dc.creator.degreeEspecialista en Ginecología y Obstericia
dc.date.accessioned2014-01-16T18:01:18Z
dc.date.available2014-01-16T18:01:18Z
dc.date.created2013-12-16
dc.date.issued2013
dc.descriptionIntroducción La preeclampsia hace parte del espectro de los trastornos hipertensivos asociados al embarazo y es causa de alta morbimortalidad materna. La edad gestacional ha sido relacionada con la presentación más severa de esta cuando ocurren lejanas al término. Hoy en día existe la posibilidad de proporcionar manejo expectante en estos casos en unidades de cuidado obstétrico especializadas, con el fin de disminuir el riesgo de morbimortalidad asociada a la prematurez extrema. Metodología Se realizó un estudio de corte transversal que incluyó pacientes con preeclampsia lejos del término entre las 24 y 34 semanas que recibieron manejo expectante entre 2009 y 2012 en la Unidad de Cuidado Intensivo Obstétrico de la Clínica Colsubsidio Orquídeas. Resultados Se incluyeron 121 pacientes con preeclampsia lejos del término, quienes recibieron manejo expectante. La edad promedio fue 29.8, el promedio de días de manejo expectante fue 4 días, con una mediana de tres días. La edad gestacional de ingreso fue 30 1/7 semanas y la edad promedio de terminación 30 5/7 semanas. El 88.4% recibieron esquema de maduración completo. El 81.6% presentaron preeclampsia severa. El desenlace materno más frecuente fue Síndrome Hellp (37%) y el desenlace fetal fue restricción de crecimiento intrauterino (29%). Discusión Se debe considerar el manejo expectante en toda paciente con preeclampsia previa a la semana 34 para manejo antenatal con corticoesteroides, el cual demostró ser un factor protector para muerte perinatal temprana. No se encontraron diferencias significativas entre la aparición de complicaciones y la cantidad de días de manejo expectante.spa
dc.description.abstractIntroduction Preeclampsia is part of the spectrum of hypertensive disorders associated with pregnancy and it causes high maternal morbidity and mortality. Gestational age has been linked with severe presentations of the disease when preeclampsia occurs far from the end of pregnancy. However, nowadays exists the possibility of providing expectant management for these patients in obstetric care units of high complexity to minimize the risk of disease and mortality in extreme preterm infants. Methods We performed a cross-sectional study which included all patients with preeclampsia remote from term between 24 and 34 weeks who received expectant management between 2009 and 2012 in Clínica Orquideas. Results A total of 121 patients diagnosed with preeclampsia remote from term and received expectant management, were recruited. The average age of the patients was 29.8 years the average days of expectant management were 4 days with a median of three days. Average gestational age at admission was 30 1/7 weeks and finalization of pregnancy age was 30 5/7 weeks. 88.4% received antenatal corticosteroids. 81.6% were severe preeclampsia. The most frequent maternal outcome was Hellp Syndrome (37%) and the most frequent fetal outcome was intrauterine fetal restriction (29.5%). Discussion Expectant management of preeclampsia should be considered in any patient with preeclampsia below the 34 week to receive antenatal corticosteroid, which proved to be a protective factor for early perinatal death. No significant difference was found between the occurrence of complications and the number of days of expectant management.eng
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dc.identifier.doihttps://doi.org/10.48713/10336_4823
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/4823
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Ginecología y Obstericiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.ccAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectPreeclampsiaspa
dc.subjectdesenlacesspa
dc.subjectmaternosspa
dc.subjectfetalesspa
dc.subjectlejos del términospa
dc.subjectmanejo expectantespa
dc.subjectcomplicacionesspa
dc.subject.decsComplicaciones del embarazospa
dc.subject.decsPreeclampsiaspa
dc.subject.keywordPreeclampsiaeng
dc.subject.keywordoutcomeseng
dc.subject.keywordmaternaleng
dc.subject.keywordfetaleng
dc.subject.keywordremote from termeng
dc.subject.keywordexpectant managementeng
dc.subject.keywordcomplicationseng
dc.titleDesenlaces maternos y fetales en el manejo expectante de la preeclampsia lejos del términospa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/submittedVersion
dc.type.spaTrabajo de gradospa
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Especialización en Ginecología y Obstetricia