Corioamnionitis: repercusión perinatal

2010 
Determinar en las gestantes complicadas con corioamnionitis las caracteristicas, factores maternos y las repercusiones maternas y perinatales. Estudio descriptivo, retrospectivo, epidemiologico y analitico. Departamento de Obstetricia y Ginecologia, Hospital "Dr. Adolfo Prince Lara", Universidad de Carabobo, Puerto Cabello, Estado Carabobo. En las 44 pacientes las caracteristicas maternas que predominaron fueron: residentes en barrios (45,45 por ciento), solteras y concubinas (77,27 por ciento), edad materna 20-24 anos (40,91 por ciento) y antecedente personal hipertension (20,45 por ciento). El diagnostico de ingreso destaco la rotura prematura de membranas 50 por ciento e infeccion uro-vaginal 13,6 por ciento; eran multigestas 50,0 por ciento, y en 52,28 por ciento la edad del embarazo fue de 36 semanas y menos, en 84,08 por ciento hubo conduccion-induccion del trabajo de parto, terminaron en cesarea 45,45 por ciento. Factores de riesgo: multiples tactos (4 y mas) 40,9 por ciento y tiempo entre rotura de membranas e inicio de trabajo de parto mayor de 12 horas 18,44 por ciento. El diagnostico se hizo por la clinica y laboratorio; tratadas con antibioticos en su totalidad, acompanadas por oxitocicos 68,18 por ciento. Recien nacidos de sexo femeninos 48,84 por ciento, peso entre 3 000- 3 499 g 31,31 por ciento y tallas 45-49 cm 28,89 por ciento; indice Apgar 6 o menos 28,94 por ciento. La morbilidad perinatal neonatal fue 39,47 por ciento, especialmente por sepsis y patologia respiratoria; la morbilidad materna 56,81 por ciento, por sepsis y anemia; la perinatal global 28,88 por ciento, la fetal 15,55 por ciento y la neonatal 13,13 por ciento. La corioamninitis se relaciono con multiples tactos intraparto, el tiempo de rotura prematura de membranas al inicio del parto y las infecciones uro-vaginales; sus repercusiones revelaron elevadas cifras de morbimortalidad materna. Toda senala a implemantar programas preventivos y mejorar la atencion materno-neonatal To study the pregnant women complicated with chorioamnionitis, knowing its impact, identify characteristics and factors related maternal and establish maternal and perinatal impact. Observational, descriptive, retrospective, epidemiological and analytical study of 44 pregnant women complicated with chorioamnionitis, which occurred during the period 2005-2009. Department of Obstetrics and Gynecology, Hospital "Dr. Adolfo Prince Lara ", Universidad de Carabobo, Puerto Cabello, Estado Carabobo. Maternal characteristics were predominant in patients living in urban region (45.45 percent), single and concubines (77.27 percent), maternal age between 20-24 years (40.91 percent) and personal history hypertension (20.45 percent). In obstetrical situation, first admission diagnosis of premature rupture of membranes 50 percent and infection urology and vaginal 13.6 percent, were multiparous 50 percent, with 52.28 percent of gestational age 36 weeks and less, in 84.08 percent were induction-conduction of labor, ending 45.45 percent cesarean. Outstanding risk factors, vaginal digital exam (4 and more) 40.9 percent, exam gynecology and time between rupture of membranes at the onset of labor more than 12 hours 18.44 percent, diagnosis was mainly clinical and laboratory, were treated with antibiotics in its entirety accompanied by oxytocic 68.18 percent. The neonates were 48.84 percent female, weighing between 3 000 and 3 499 g, 31.31 percent and 28.89 percent height 45-49 cm, Apgar Index 6 or less 28.94 percent. Neonatal perinatal morbidity was 39.47 percent, represented especially by sepsis and respiratory disease, maternal morbidity 56.81 percent, given by sepsis and anemia in various forms, the overall perinatal mortality 28.88 percent, fetal mortality 15.55 percent, neonatal mortality 13.13 percent, was decisive sepsis and prematurity in all these deaths. The chorioamnionitis related to exam gynecology, premature rupture of membranes at the start time delivery..
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