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Caracterización de óbito fetal tardío en la Clínica Maternidad Rafael Calvo de Cartagena de indias entre los años 2012 a 2013
| Content Provider | Semantic Scholar |
|---|---|
| Author | Monsalve-Montoya, Rosa Edith Méndez-Rodríguez, Rogelio Salcedo-Ramos, Francisco |
| Copyright Year | 2016 |
| Abstract | Introduccion: el obito fetal tardio tiene connotaciones de salud publica y es indispensable su estudio, aun cuando no hace parte de los objetivos del milenio. El amplio subregistro, la gran variedad de clasificaciones, la dificultad en la unificacion de conceptos han hecho que su busqueda sea inespecifica. Los estudios sobre sus causas arrojan datos variables. Objetivo: describir las causas de obito fetal tardio en las pacientes que consultaron a una clinica obstetrica Materiales y metodos: estudio descriptivo transversal. La poblacion de estudio fueron 108 casos de pacientes que tuvieron parto en la Clinica Maternidad Rafael Calvo (CMRC), Cartagena de Indias-Colombia, entre los anos 2012 a 2013 con diagnostico de obito fetal tardio. Se analizaron las siguientes variables: caracteristicas sociodemograficas (edad, estado civil, zona, escolaridad, ocupacion, raza), antecedente obstetrico y clinico de la madre (edad de la paciente, paridad, numero de abortos, numero de obitos, numero de prematuros, periodo intergenesico, patologias maternas) y variables obstetricas de su embarazo actual (edad gestacional al momento del diagnostico de obito fetal tardio, indice de masa corporal (IMC), numero de controles prenatales, momento de ocurrencia, alteraciones del liquido amniotico, alteraciones de la placenta, anomalia del cordon, hemoglobina materna, infecciones, ruptura prematura de membranas, percentil del indice ponderal del feto, caracteristicas del liquido amniotico). En aquellas con resultados de necropsia se analizo la causa de muerte dada por el laboratorio de patologia. Los datos se recolectaron en un formato con las variables estudiadas y el analisis de las variables cualitativas y cuantitativas se realizo con el programa estadistico IBM SPSS (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.). Resultados: se encontro con mayor frecuencia edad materna de 15-20 anos (34.3%), estado civil: union libre (86.1%), zona de residencia urbana (58.3%), escolaridad secundaria completa (42.6%), ocupacion ama de casa (89.8%) y raza mestiza (75.9%). El 43.5% de las pacientes reportaron entre 2-3 embarazos previos, sin antecedente de obito (55.6%), ni restriccion de crecimiento intrauterino previo (RCIU) (58.3%), ni partos pretermino (50.9%). Periodo intergenesico entre 12-24 meses (39.8%), numero de controles prenatales entre 1-4 (44.4%). El 67.6% de las pacientes tenian entre 28- 36.6 semanas de gestacion; en el 95.4% la ocurrencia de la muerte fue en el anteparto, sexo del feto masculino (52.8%); el peso materno fue normal con un 33.3%, solo el 12% de las paciente eran obesas. El indice ponderal de los fetos fue del 50% en el percentil <10 y la hemoglobina materna 50.9% sin anemia. De patologias maternas las infecciones genitourinarias (20.3%) y los trastornos hipertensivos (16.2%) fueron las mas frecuentes. De las pacientes que reportaron patologias, 14 (29.7%) presentaban 2 o mas. Se encontro con mayor frecuencia la causa materna 51.4%: placentaria 35.2%, inexplicada 7.5% y fetales 5.7%. Conclusion: las causas de obito fetal tardio de las pacientes analizadas en CMRC de Cartagena de Indias – Colombia en orden de frecuencia son: causa materna, placentaria, inexplicada y fetal. Rev.cienc.biomed. 2016;7(1):68-79. PALABRAS CLAVE Obito fetal tardio; Mortinato; Factores de riesgo; Etiologia. SUMMARY Introduction: late stillbirth is a public health problem and it is necessary its study, even when it is not included in the millennium development goals. The wide under-reporting, variety of classifications, difficulty in the unification of the concepts have made the late stillbirth search something unspecific. The studies about its causes generate variable data. Objective: to describe the late stillbirth causes in the female patients that consulted an obstetric clinic. Methods: this is a descriptive-transversal study. The study population was 108 cases of female patients that gave birth in Clinica Maternidad Rafael Calvo (CMRC) in Cartagena de Indias-Colombia between 2012 and 2013 with late stillbirth diagnosis. The following variables were analyzed: sociodemographic characteristics (age, marital status, zone, education, occupation, and race), obstetrical-clinical history of the mother (age of the patient, parity, number of miscarriages, number of deaths, number of premature babies, intergenesic periods and mother´s pathologies) and obstetrical variables of the current pregnancy (gestational age at the moment of late stillbirth diagnosis, body-mass index (BMI), number of attendances to prenatal care, moment in which it happened, alterations in amniotic fluid, alterations in the placenta, umbilical cord abnormalities, maternal hemoglobin, infections, premature rupture of membranes, percentile rank of the fetus and amniotic fluid characteristics). The causes of death were analyzed in those women who had necropsy results given by pathological laboratory. Data were collected by means of a survey with the studied variables; the analysis of quantitative and qualitative variables was carried out with the statistical program IBM SPSS (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.). Results: the most frequent maternal age was 15-20 (34.3%), marital status: cohabiting (86.1%), residential area (58.3%), complete high school (42.6%), housewife (89.8%) and mixed race (75.9%). The 43.5% of the female patients affirmed have had between two and three previous pregnancies without clinical record of deaths (55.6%) or previous intrauterine growth restriction (58.3%), no preterm birth (50.9%). Intergenesic period between 12-24 months (39.8%), number of attendances to prenatal care between one and four (44.4%). The 67.6% of the female patients had between 28 and 36 weeks of gestation; the death was in antepartum period in the 95.4%, male fetus (52.8%); maternal weight was normal with 33.3%, only 12% of the female patients were obese. The ponderal index of the fetuses was 50% in the percentile <10 and maternal hemoglobin 50.9% without anemia. The most frequent maternal pathologies were genitourinary infections (20.3%) and hypertensive disorders (16.2%). Among the female patients that presented pathologies 14 (29.7%) of them presented two or more. The most frequent causes were maternal (51.4%): placental 35.2%, unexplained 7.5% and fetal 5.7%. Conclusion: the most frequent causes of late stillbirth in the female patients analyzed at CMRC in Cartagena-Colombia were maternal cause, placental, unexplained and fetal. Rev.cienc.biomed. 2016;7(1):68-79. KEYWORDS Late fetal death; Late stillbirth; Risk factors; Etiology. |
| File Format | PDF HTM / HTML |
| Volume Number | 7 |
| Alternate Webpage(s) | http://190.242.62.234:8080/jspui/bitstream/11227/5318/1/TRABAJO%20FINAL%20DE%20ROSA%20MONSALVE.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
