Resultados adversos del embarazo y la calidad de la atención obstétrica
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Lancet (London, England)
|October 13, 1984
Resumen
La atención obstétrica subóptima se relacionó con un mayor riesgo de muerte fetal, convulsiones y apnea en recién nacidos. Sin embargo, la mayoría de los resultados adversos se produjeron a pesar de la atención adecuada, y la parálisis cerebral no se asoció con la calidad de la atención.
Área de la Ciencia:
- Obstetricia y Ginecología.
- Medicina Neonatal La medicina neonatal es una especialidad de la medicina neonatal.
- Salud Pública La salud pública.
Sus antecedentes:
- Los resultados adversos del embarazo plantean riesgos significativos para la salud de la madre y el bebé.
- La identificación de factores prevenibles en la atención obstétrica es crucial para mejorar los resultados.
- La relación entre la atención obstétrica subóptima y los resultados neonatales adversos específicos requiere más investigación.
Objetivo del estudio:
- Investigar la asociación entre la atención obstétrica subóptima anteparto e intraparto y los resultados adversos del embarazo.
- Para determinar si los resultados adversos específicos como la muerte fetal, las convulsiones neonatales y la apnea están relacionados con la calidad de la atención.
- Explorar la relación entre la parálisis cerebral y la calidad de la atención obstétrica.
Principales métodos:
- Se empleó un diseño de estudio de casos y controles.
- Los casos incluyeron fetos con muertes atribuidas a asfixia o trauma, y bebés a término con convulsiones dentro de las 48 horas posteriores al parto.
- Los controles se emparejaron con los casos, y la calidad de la atención obstétrica se evaluó por consenso clínico.
Principales resultados:
- La atención obstétrica subóptima se asoció significativamente con muertes fetales debido a asfixia / trauma y convulsiones neonatales.
- Los bebés con convulsiones y apnea terminal tenían más probabilidades de nacer después de una respuesta inadecuada a la angustia fetal durante el parto.
- La mayoría de los bebés que recibieron atención subóptima no experimentaron resultados adversos, y la mayoría de los resultados adversos ocurrieron con atención satisfactoria.
Conclusiones:
- Si bien la atención obstétrica subóptima está vinculada a ciertos resultados neonatales adversos, no es la única o principal causa de la mayoría de los casos.
- El hecho de no manejar adecuadamente la angustia fetal severa durante el parto es un factor de riesgo significativo para las convulsiones neonatales y la apnea.
- No se encontró ninguna asociación entre la atención obstétrica subóptima y la parálisis cerebral.
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