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Efectividad del tratamiento inmunomodulador con leucocitos alogénicos, en aborto involuntario recurrente. Revisión sistemática y metaanálisis

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dc.contributor.advisorIbáñez Pinilla, Milcíades
dc.creatorPolaina Macías, Andrea Lorena
dc.creatorGonzález Medina, Luz Elena
dc.creator.degreeEspecialista en Ginecología y Obstericia
dc.date.accessioned2016-03-07T22:25:46Z
dc.date.available2016-03-07T22:25:46Z
dc.date.created2016-02-12
dc.date.issued2016
dc.descriptionDentro del marco del aborto involuntario recurrente (AIR), se han propuesto causas autoinmunes y alogénicas, e implementación de terapias como la inmunización activa con leucocitos alogénicos de la pareja o de donantes. La evidencia disponible en cuanto a la efectividad de estos tratamientos es contradictoria, por lo que se desea realizar una revisión sistemática para evaluar la efectividad de la inmunización activa con leucocitos alogénicos de la pareja o de donantes para esta condición. Se realizó un estudio tipo revisión sistemática de la literatura, usando las siguientes bases de datos: Medline, Embase, Cochrane Library y Scielo. Se realizó una búsqueda a través del registro de ensayos clínicos del Instituto Nacional de Salud de los Estados Unidos (www.clinicaltrials.gov) y, una búsqueda manual a través de las referencias de los estudios seleccionados siguiendo la estrategia de bola de nieve. Se seleccionaron ensayos clínicos y estudios de cohorte analítica, en idioma inglés y español. Se realizó un análisis cuantitativo de la información por medio de un metaanálisis. El tratamiento inmunomodulador con linfocitos puede considerarse como una terapia efectiva para mantener la gestación y lograr recién nacido vivo según resultados estadísticos; sin embargo la calidad de los estudios incluidos es baja, por lo que no se aconseja para la práctica rutinaria. Se sugiere la realización de estudios con metodologías robustas y que apoyen los resultados presentados en esta investigación.spa
dc.description.abstractInvoluntary recurrent abortion (IRA) is defined as the history of three or more abortions before 20 weeks of gestation. Within its etiology has been proposed and allogeneic or autoimmune causes, with the implementation of therapies that try to immunize women against "foreign" cells of a future pregnancy like the trophoblast membrane immunization, active immunization with allogeneic leukocytes partner or donor and the use of intravenous immunoglobulin (IVIG). The available evidence regarding their effectiveness is scarce and contradictory, which is why we want to conduct a systematic review to assess the effectiveness of this treatment, measured by the rate of live births in women with AIR, who were treted by immunomodulator, and the adverse events presented in the mother and child. Asystematic review of the literature will be conducted. First, a search will be make through the following databases: Medline, Embase, Cochrane Library and Scielo. Also a search made through the registration of clinical trials at the National Institute of Health in the United States (www.clinicaltrials. gov) and finally manual search will be made through the references of the selected studies following the snowball strategy. The following search terms will be used: Human, pregnancy, involuntary recurrent abortion, prevention, control, immunotherapy, immunization, allogeneic leukocytes, trophoblast, newborn, controlled clinical trials, cohort, in different combinations. If the studies allow a quantitative analysis of the information will be made. This systematic review will provide evidence about the effectiveness of immunomodulatory treatments to achieve pregnancy and live birth and assess gestational week at birth and complications in the newborn. The results will serve to discuss the use of inmunomodulator treatment in cases of IRA. It will serve as a starting point for the implementation of a treatment strategy that is beneficial to patients and complement existing clinical practice protocols.eng
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dc.identifier.doihttps://doi.org/10.48713/10336_11848
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/11848
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
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectHumanosspa
dc.subjectEmbarazospa
dc.subjectAborto involuntario recurrentespa
dc.subjectPrevenciónspa
dc.subjectControlspa
dc.subjectInmunoterapiaspa
dc.subjectInmunizaciónspa
dc.subjectLeucocitos alogénicosspa
dc.subjectTrofoblastospa
dc.subjectRecién nacidospa
dc.subjectEnsayos clínicos controladosspa
dc.subjectCohortespa
dc.subject.ddcGinecología & otras especialidades médicas
dc.subject.decsEmbarazospa
dc.subject.decsAborto espontáneospa
dc.subject.decsInmunoterapiaspa
dc.subject.decsInmunizaciónspa
dc.subject.decsTrofoblastosspa
dc.subject.decsRecién nacidospa
dc.subject.keywordHumaneng
dc.subject.keywordPregnancyeng
dc.subject.keywordRecurrent miscarriageeng
dc.subject.keywordPreventioneng
dc.subject.keywordControleng
dc.subject.keywordImmunotherapyeng
dc.subject.keywordImmunizationeng
dc.subject.keywordAllogeneic leukocyteseng
dc.subject.keywordTrophoblasteng
dc.subject.keywordNewborneng
dc.subject.keywordControlled clinical trialseng
dc.subject.keywordCohorteng
dc.titleEfectividad del tratamiento inmunomodulador con leucocitos alogénicos, en aborto involuntario recurrente. Revisión sistemática y metaanálisisspa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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