ABSTRACT
Resumen OBJETIVO: cuantificar el número de ecografías durante la gestación y evaluar la calidad de los estudios del segundo y tercer trimestres en pacientes de bajo riesgo del área metropolitana de la Ciudad de México. MATERIALES Y MÉTODOS: estudio prospectivo, observacional y descriptivo de mujeres con control prenatal fuera de nuestra unidad que acudieron a la Clínica Perinatal de Embarazo de Alto riesgo, Hospital de la Mujer de la Ciudad de México, para la finalización del embarazo. Cuantificación de las ecografías tomadas durante la gestación, identificación del profesional encargado del estudio y evaluación de la calidad de los estudios del segundo y tercer trimestres mediante una lista de cotejo basada en guías internacionales; obtención del porcentaje de apego a las mismas. RESULTADOS: se estudiaron 199 pacientes a quienes se tomaron, en promedio, 3.7 ecografías; al 80% tres o más ultrasonidos. El análisis de las ecografías del segundo trimestre arrojó un promedio de 13.8 parámetros evaluados, con 43% de apego a las normas. En las ecografías del tercer trimestre, el promedio de parámetros evaluados fue de 10 con un porcentaje de apego de 66.7%. Los médicos ultrasonografistas fueron quienes realizaron el mayor número de estudios en ambos trimestres. CONCLUSIONES: la ecografía es un recurso accesible a la población del área metropolitana; sin embargo, debe insistirse en la calidad de los estudios.
Abstract OBJECTIVE: To quantify the number of ultrasound scans during pregnancy and evaluate the quality of ultrasound in the second and third trimester of gestation in the low risk obstetric population in the metropolitan area. MATERIAL AND METHODS: we conducted a prospective, observational and descriptive study in 199 women that arrived to the hospital for delivery without prenatal care in our unit, quantified the number of ultrasound scans performed during pregnancy, and evaluate the quality of the second and third trimester echographies with a check list based on international guidelines. The percentage of adherence was obtained and analyzed by the professional in health responsible of the study. RESULTS: The average scan per patient was 3.37, 80% had three or more. Analysis of ultrasound for the second trimester showed an average of 13.8 parameters evaluated with 43% of adherence to standards; in the ultrasounds of the third trimester, the evaluated parameters averaged 10 with a percentage of attachment of 66.7%. The largest number of studies was performed by sonographists. CONCLUSIONS: The ultrasound is a tool accessible to the population of the metropolitan area; however, it should be emphasized in the quality of studies.
ABSTRACT
For definitive antenatal diagnosis of fetal aneuploidy, invasive tests such as chorionic villous sampling, amniocentesis and cordocentesis are required for chromosome analysis. However, to reduce the risk of miscarriage associated with procedural complications, it is important to detect pregnant women with high risk of fetal aneuploidy. Recently, there have been advances in maternal serum and sonographic markers for screening of chromosomal defects in the first and second trimester. The serum screening methods include first trimester screening with nuchal translucency and second trimester multi marker screening. Particularly, combining first and second trimester results can increase the detection rate of Down syndrome with lower false-positive rates. In addition to biochemical markers, second trimester sonogram to detect major and minor sonographic markers for chromosomal defects is important to identify the high risk pregnancy. To detect the fetal aneuploidy with high specificity and sensitivity, we need to interpret the maternal age, the results of first and second trimester serum markers and genetic sonographic findings all together.