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Embolia pulmonar en el embarazo
Ghada Bourjeily1, Michael Paidas, Hanan Khalil
1Department of Medicine, The Warren Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI 02905, USA. GBourjeily@wihri.org
Lancet (London, England)
|November 6, 2009
Resumen
La embolia pulmonar (EP) es una de las principales causas de muerte en mujeres embarazadas. El diagnóstico y el tratamiento tempranos son vitales, a pesar de los riesgos, para mejorar los resultados para la salud materna.
Área de la Ciencia:
- Obstetricia y Ginecología.
- Cardiología Cardiología.
- Hematología Hematología.
Sus antecedentes:
- La embolia pulmonar (EP) es la principal causa de mortalidad materna en todo el mundo.
- El embarazo inherentemente aumenta el riesgo de tromboembolismo venoso debido a la hipercoagulabilidad, la estasis venosa y el daño vascular (triada de Virchow).
- Los cambios fisiológicos durante el embarazo pueden imitar los síntomas de la EP, lo que complica el diagnóstico.
Objetivo del estudio:
- Para resaltar la necesidad crítica de estrategias efectivas de prevención, diagnóstico y tratamiento para la embolia pulmonar en el embarazo.
- Para enfatizar el equilibrio entre los riesgos de diagnóstico / tratamiento y la necesidad de un manejo preciso de la EP en pacientes embarazadas.
Principales métodos:
- Revisión de la literatura existente sobre la embolia pulmonar en el embarazo.
- Análisis de los desafíos de diagnóstico y consideraciones de tratamiento.
- Discusión de la estratificación del riesgo para la profilaxis.
Principales resultados:
- La embolia pulmonar representa un riesgo significativo de mortalidad para las personas embarazadas.
- Las intervenciones diagnósticas y terapéuticas conllevan riesgos (teratogenicidad fetal, oncogenicidad, efectos secundarios farmacológicos) que deben gestionarse.
- La estratificación del riesgo es esencial para guiar las medidas profilácticas adecuadas.
Conclusiones:
- El diagnóstico preciso y oportuno de la EP en el embarazo es crucial para reducir la mortalidad materna.
- Las intervenciones deben sopesar cuidadosamente los riesgos potenciales frente a los beneficios del tratamiento de la EP.
- Se recomienda la profilaxis personalizada basada en la evaluación de riesgos.
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