Marcadores ecográficos de corioamnionitis e infección fetal in utero. Revisión de la literatura

  • Saulo Molina-Giraldo
  • Jesús Bermúdes-Roa
  • Edgar Acuña-Osorio
  • Alejandro Franco-Hernández
  • José Luis Rojas-Arias

Resumen

Introducción: el diagnóstico de corioamnionitis se basa en criterios clínicos que no alcanzan una sensibilidad mayor al 60%, y que tienen poca utilidad para predecir el compromiso fetal. El ultrasonido surge como una alternativa útil en el diagnóstico. Al mejorar el diagnóstico con la búsqueda de marcadores ecográficos de infección fetal podemos impactar en la morbimortalidad perinatal al poder intervenir de forma temprana a las gestantes en riesgo de compromiso fetal, especialmente corioamnionitis con curso subclínico. El objetivo de esta revisión es conocer la evidencia que soporta la asociación entre los hallazgos ecográficos del ultrasonido y la presencia de corioamnionitis e infección fetal in utero.

Materiales y métodos: se realizó una revisión de la literatura existente en las bases de datos medline, ovid, ebsco, ProQuest, lilacs, SciELO desde enero de 1985 hasta octubre de 2012. Se incluyeron los artículos de revisión e investigaciones originales.

Resultados: en las gestantes con parto pretérmino y ruptura prematura de membranas ovulares el acortamiento cervical, la presencia de "sludge", el oligohidramnios y la involución del timo son los marcadores que han mostrado mayor asociación con infección amniótica.

Conclusiones: el ultrasonido es una herramienta por considerar en el diagnóstico de infección materna y fetal in utero.

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Biografía del autor/a

Saulo Molina-Giraldo
Especialista en Medicina Materno-Fetal, Hospital de San José - Fundación Universitaria de Ciencias de la Salud (FUCS). Fellow Intervención Fetal, Baylor College of Medicine, Texas Children’s Fetal Center del Texas Children´s Hospital. Especialista en Docencia Universitaria. Magíster en Investigación. Director Programa de Terapia, Cirugía Fetal y Fetoscopia, Clínica Colsubsidio y Clínica de la Mujer. Especialista Unidad de Terapia Fetal, Hospital de San José. Profesor Asociado de Medicina Materno-Fetal, Fundación Universitaria de Ciencias de la Salud. Bogotá, Colombia.
Jesús Bermúdes-Roa
Médico Ginecoobstetra, Universidad del Cauca. Fellow de Medicina Materno-Fetal, Hospital de San José - Fundación Universitaria de Ciencias de la Salud (FUCS). Bogotá, Colombia.
Edgar Acuña-Osorio
Médico Ginecoobstetra, Universidad del Rosario. Especialista en Medicina Materno-Fetal, Hospital San José - Fundación Universitaria de Ciencias de la Salud (FUCS). Fellow en Perinatología y Diagnóstico Prenatal, Yale University. Fellow en Intervencionismo Fetal, Saint Josephs Hospital, Tampa Fl. Jefe Servicio de la Unidad de Diagnóstico Prenatal y Medicina Materno-Fetal, Fundación Universitaria de Ciencias de la Salud, Hospital de San José. Coordinador del Posgrado de Medicina Materno-Fetal de la Fundación Universitaria de Ciencias de la Salud (FUCS). Bogotá, Colombia.
Alejandro Franco-Hernández
 Médico Ginecoobstetra, Universidad del Cauca. Especialista en Medicina Materno-Fetal, Hospital San José - Fundación Universitaria de Ciencias de la Salud (FUCS). Especialista, Unidad de Medicina Materno-Fetal, Hospital de San José. Bogotá, Colombia.
José Luis Rojas-Arias
Especialista en Medicina Materno-Fetal, Hospital de San José (FUCS). Especialista en Epidemiología Clínica, Universidad del Rosario. Candidato a Magíster en Educación. Jefe Departamento de Obstetricia, Hospital de San José. Especialista Unidad de Terapia Fetal, Hospital de San José. Profesor Asociado de Ginecología y Obstetricia y de Medicina Materno-Fetal, Fundación Universitaria de Ciencias de la Salud (FUCS). Bogotá, Colombia.

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Publicado
2012-11-27
Cómo citar
1.
Molina-Giraldo S, Bermúdes-Roa J, Acuña-Osorio E, Franco-Hernández A, Rojas-Arias JL. Marcadores ecográficos de corioamnionitis e infección fetal in utero. Revisión de la literatura. Rev. Colomb. Obstet. Ginecol. [Internet]. 27 de noviembre de 2012 [citado 17 de agosto de 2019];63(4):356-67. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/140
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Articulo de Revisión