Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo

Javier Andrés Mora-Arteaga; Diego Camilo Reyes; Daniela Saa González; Isabella Rivera Tobar

doi:10.18597/rcog.4358

Autores/as

Javier Andrés Mora-Arteaga Departamento de Medicina Interna, Unidad de Cuidados Intensivos, Hospital Universitario San Ignacio. Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá (Colombia). https://orcid.org/0000-0001-5552-9292
Diego Camilo Reyes Medicina Crítica y Cuidado Intensivo, Fundación Santafé de Bogotá. Bogotá (Colombia). https://orcid.org/0009-0003-5713-4173
Daniela Saa González Medicina Crítica y Cuidado Intensivo, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá (Colombia). https://orcid.org/0000-0002-0318-156X
Isabella Rivera Tobar Ginecología y Obstetricia, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana. Bogotá (Colombia). https://orcid.org/0000-0002-0944-309X

DOI:

https://doi.org/10.18597/rcog.4358

Palabras clave:

Trauma craneoencefálico, Embarazo, Hipertensión intracraneal, Obstetricia, Ginecología

Resumen Autores/as Referencias bibliográficas Cómo citar Descargas

Resumen

Objetivo: ofrecer un marco conceptual para el abordaje del trauma craneoencefálico (TCE) en gestantes, integrando los fundamentos fisiopatológicos, la evidencia científica disponible y las estrategias clínicas actuales que apoyen la toma de decisiones.

Materiales y métodos: a partir de un caso hipotético que ilustra de manera práctica el tema, se desarrolla un documento explicativo basado en una revisión narrativa estructurada. En él se describen los cambios fisiológicos del embarazo relevantes para el TCE, los principios de reanimación inicial, el manejo de la hipertensión intracraneal, el uso del neuromonitoreo, el abordaje obstétrico y las implicaciones éticas asociadas a la muerte materna por criterios neurológicos.

Resultados: el embarazo conlleva adaptaciones anatómicas y funcionales que alteran la respuesta materna al trauma. Estas modificaciones impactan la vía aérea, la hemodinamia, la oxigenación y la autorregulación cerebral, lo que requiere ajustar el abordaje clínico. Se destacan aspectos clave como el manejo inicial, el control de la hipertensión intracraneal, la neuromonitorización, el cuidado obstétrico y las implicaciones éticas en escenarios de muerte materna por criterios neurológicos.

Conclusiones: el manejo del TCE en gestantes es un desafío clínico que requiere conocer la fisiología materna y su impacto en la lesión cerebral aguda. Dada la falta de guías y recomendaciones específicas, se deben adoptar las recomendaciones de la población general teniendo presentes los cambios fisiológicos del embarazo.

Biografía del autor/a

Diego Camilo Reyes, Medicina Crítica y Cuidado Intensivo, Fundación Santafé de Bogotá. Bogotá (Colombia).

Medicina Crítica y Cuidado Intensivo, Hospital Universitario Nacional de Colombia. Bogotá (Colombia).

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Mora-Arteaga JA, Reyes DC, Saa González D, Rivera Tobar I. Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo. Rev. colomb. obstet. ginecol. [Internet]. 15 de agosto de 2025 [citado 14 de abril de 2026];76(3). Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/4358

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Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo

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Diego Camilo Reyes, Medicina Crítica y Cuidado Intensivo, Fundación Santafé de Bogotá. Bogotá (Colombia).

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