ABSTRACT
A anemia no puerpério é bastante prevalente, estando principalmente relacionada à ocorrência de anemia não corrigida durante a gestação e às hemorragias agudas durante o parto. Essas situações aumentam significativamente a probabilidade de anemia grave no período pós-parto, gerando manifestações orgânicas e psicológicas que trazem prejuízo ao binômio materno-fetal. A forma grave da doença é caracterizada laboratorialmente por hemoglobina < 7 g/dL e suas manifestações clínicas variam na dependência de diversos fatores. O objetivo do tratamento é corrigir a hipóxia tecidual, revertendo as alterações adaptativas relacionadas à carência de oxigênio. Enquanto o tratamento agressivo de perdas volêmicas agudas diminui a morbimortalidade por esses eventos, políticas restritivas de transfusão sanguínea em pacientes hemodinamicamente estáveis mostram-se benéficas. Se não houver indicação de transfusão, a reposição de ferro atuará na correção das principais etiologias, pelas vias endovenosa ou oral, na dependência de disponibilidade, custo e tolerância individual aos medicamentos disponíveis.(AU)
Anemia is quite prevalent in puerperium; in this population, the disease is mainly related to the occurrence of uncorrected anemia during pregnancy and to acute bleeding during childbirth. These situations significantly increase the likelihood of severe anemia in the postpartum period, generating organic and psychological manifestations that cause damage to the maternal-fetal binomial. The severe form of anemia is characterized by hemoglobin < 7 g/dL and its clinical manifestations vary depending on several factors. The goal of treatment is to correct tissue hypoxia, reversing adaptive changes related to oxygen deficiency. While the aggressive treatment of acute blood losses decreases the morbidity and mortality of these events, restrictive blood transfusion policies in hemodynamically stable patients are beneficial. If there is no indication for transfusion, iron replacement will act to correct the main etiologies, through the intravenous or oral routes, depending on availability, cost and individual tolerance to the available drugs.(AU)
Subject(s)
Humans , Female , Pregnancy , Blood Transfusion , Postpartum Period , Anemia/etiology , Anemia/drug therapy , Anemia, Iron-Deficiency/physiopathology , Postpartum Hemorrhage/physiopathology , Monitoring, PhysiologicABSTRACT
In this study the effect of intraumbilical vein oxytocin on duration and amount of blood loss in third stage of labour was studied. Pregnant women were randomized into two groups of fifty each. Study group was managed with 10 units of oxytocin diluted with 10 ml of normal saline given through umbilical vein while control group was managed with 10 units of oxytocin in 500 ml of normal saline through intravenous infusion after delivery of the baby. The mean blood loss in the third stage of labour was 143.30 ml for the control group and 151.43 ml for the study group while the duration of the third stage of labour was 6.02 and 5.42 minutes for each group. There was no significant difference in the duration and amount of blood loss between the two groups.
Subject(s)
Adolescent , Adult , Female , Humans , Labor Stage, Third , Oxytocics/administration & dosage , Oxytocin/administration & dosage , Postpartum Hemorrhage/physiopathology , Pregnancy , Pregnancy Complications , Risk Factors , Time Factors , Umbilical Veins/drug effectsABSTRACT
La hemorragia genital grave en la mujer, casi siempre se presenta durante el estado grávido puerperal, por lo que es importante recordar los cambios hemodinámicos y metabólicos que fisiológicamente se presentan durante la gestación: hipovolemia, hemodilución, taquicardia, modificaciones en los factores de la coagulación sanguínea y en el electrocardiograma. Se expone una clasificación del sangrado genital en 4 clases, de acuerdo a la magnitud de la pérdidad sanguínea, donde las clases III y IV corresponden al estado de choque hipovolémico y ameritan cuidados intensivos. Se enfatiza en la necesidad de contar con todos los recursos materiales necesarios para el manejo de estos casos y con la participación de un equipo humano multidisciplinario. Se recuerda la necesidad de preservar también la vida y la integridad del producto de la concepción en los casos en que sea viable y todavía se encuentre in utero
Subject(s)
Pregnancy , Humans , Female , Anemia/metabolism , Anemia/physiopathology , Hemodynamics/physiology , Postpartum Hemorrhage/physiopathology , Postpartum Period , Pregnancy Complications/metabolism , Pregnancy Complications/physiopathology , Shock/metabolism , Shock/physiopathology , Uterine Hemorrhage/classification , Uterine Hemorrhage/complications , Uterine Hemorrhage/metabolismABSTRACT
Durante el embarazo es casi siempre conservador, se lo debe realizar siempre bajo internacion y debe buscar los siguientes objetivos. Evitar el esfuerzo fisico, sedar la fibra uterina, procurar la madurez pulmonar fetal. Con este proposito se indica dieta blanda, reposo absoluto, Indocid supositorios de 100 mg. (accion antiprostaglandinica); Alupent 1 tab 0,5 mg sub lingual cada 6 horas (B bloqueante); Diazepan, Ampicilina, Betametasona y otros complementarios examenes de laboratorio y ultrasonico