Incompetencia cervical: diagnóstico y tratamiento
DOI:
https://doi.org/10.18597/rcog.1609Keywords:
Cervical cerclaje, cervical incompetence, McDonald technique, Shirodkar technique, abdominal cervical isthmic cerclaje, repeled spontaneus abortion, habitual abortion, preterm birthAbstract
La incompetencia cervical es una causa relativamente poco frecuente de pérdida gestacional, que se considera se ha sobrediagnosticado, más sinembargo es una importante razón para aborto repetido en el segundo trimestre de la gestación. El diagnóstico debe sustentarse en los antecedentes obstétricos y tratar de evidenciar su existencia de forma preconcepcional para simultáneamente descartar otras causas de pérdidas repetidas. Alcanzada la gestación y de forma temprana debe realizarse cerclaje cervical, utilizando técnica de Shirodkar o McDonald, que presentan iguales ratas de supervivencia fetal e iguales ratas de complicaciones. En nuestra experiencia hemos tenido buenos resultados con técnica de McDonald y seda en forma de trenza, como material de sutura, pasando la rata de supervivencia fetal del 10 % pre-cerclaje al 88% post-cerclaje. En aquellas pacientes en que no se puede realizar cerclaje cervical, se recomienda cerclaje cérvico-istmico vía abdominal.
Author Biography
Alvaro Monterrosa Castro, Universidad de Cartagena. Colombia.
Instructor. Departamento de Ginecología y Obstetricia. Facultad de Medicina. Universidad de Cartagena. Colombia.
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