Prevalencia de corioamnionitis histológica en pacientes con trabajo de parto pretérmino espontáneo. Popayán, Colombia, 2014–2016
DOI:
https://doi.org/10.18597/rcog.934Palabras clave:
trabajo de parto pretérmino, corioamnionitis histológica, estudio de corte transversalResumen
Objetivo: determinar la prevalencia de la corioamnionitis histológica en gestantes con trabajo de parto pretérmino espontáneo, evaluar posibles factores de riesgo y la asociación con signos clínicos y paraclínicos.
Materiales y métodos: estudio descriptivo de prevalencia, con análisis secundario exploratorio en gestantes con embarazo menor a 37 semanas de gestación, con parto espontáneo, en quienes se dispuso de sus placentas para estudio histopatológico, durante un periodo de 2 años, en un hospital de alta complejidad en Popayán, Colombia. Se excluyeron partos pretérmino secundarios. Muestreo consecutivo, con tamaño muestral de 166 gestantes; se midieron variables sociodemográficas, clínicas, de laboratorio e imágenes diagnósticas, y resultado histopatológico de la placenta. En el análisis se estimó la prevalencia de periodo de corioamnionitis histológica. Se obtuvo la razón de prevalencias como medida de asociación y el OR diagnóstico (ORD) con su respectivo intervalo de confianza al 95 %.
Resultados: en un periodo de 2 años se analizaron 160 gestantes y sus placentas, 110 placentas fueron reportadas como positivas para corioamnionitis histológica con una prevalencia de 68,75 % (IC 95 %: 61,49-76,00), esta fue más prevalente en gestaciones menores de 34 semanas (RP = 1,48; IC 95 %: 1,20-1,83). En cuanto a la asociación de los síntomas y signos se encontró asociación significativa con la fiebre (ORD = 4,7; IC 95 %: 1,05-21,09), la taquicardia materna (ORD = 4,22; IC 95 %: 1,81-9,81), la taquicardia fetal (ORD = 3,74; IC 95 %: 1,23-11,35), movimientos respiratorios ausentes (ORD = 5,16; IC 95 %: 1,43-18,60), lago de líquido amniótico menor a 2 cm (ORD = 5,67; IC 95 %: 1,24-25,98), y presencia de neutrofilia (ORD = 2,97; IC 95 %: 1,44-6,12).
Conclusiones: la prevalencia de corioamnionitis histológica es del 67% en los partos pretérmino y varió en función de la edad gestacional.
Biografía del autor/a
Carolina Arias-Peláez
Cristal Ximena Gallego-Betancourt
Geovanni Alexander Mera-Ijaji
Roberth Alirio Ortiz-Martínez
José Enrique Chagüendo-García
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