Resultados perinatales del embarazo gemelar en un Hospital de Alta Complejidad / Perinatal results of twin pregnancy in a high complexity hospital

The objective of this study was to describe the epidemiology and the perinatal outcomes of twin pregnancy in the Maternal-Infantile Departament of the National Hospital "Alejandro Posadas". During the period studied there were 2825 births. The prevalence of twin pregnancies was 3.2% (N= 91). From the total of twin pregnancies, 88 were doubles and 3 were triples. It is postulated that the monochorial monovular twins constitutes a different clinical entity, because of a higher proportion of complicatioms, and that the adequate planification of the actions and working connected the perinatal team will improve the care process

Manejo del acretismo placentario en Servicios de Obstetricia de hospitales de alta complejidad Aplicación de un Proyecto de atención integral multidisciplinario / PLACENTA ACCRETA: MANAGEMENT AT OBSTETRIC SERVICES IN HIGH COMPLEXITY HOSPITALS

Objetivo: El objetivo del estudio fue describir el manejo de los Trastornos Adherenciales de la Placenta en la Maternidad de alta complejidad recabando los datos tanto del servicio de Obstetricia del Hospital Nacional Profesor Alejandro Posadas y Hospital Naval Pedro Mallo Buenos Aires. Diseño: Estudio de tipo observacional, descriptivo y transversal. Análisis estadístico mediante Stata 12.0. Resultados: Durante el período comprendido entre enero de 2010 y diciembre de 2014 fueron atendidas 30 pacientes con trastornos adherenciales placentarios. La incidencia de acretismo placentario en ese periodo fue de 0.18 (30/16210 nacimientos). El 56.67% (17/30) de las cirugías fueron programadas con Hemodinamia. En el 96.67% (N=29) el resultado anátomo-patológico final fue Acretismo Placentario. Hubo un caso falso positivo. Cuatro casos presentaron complicaciones potencialmente graves "near miss". No se presentaron muertes maternas. Conclusiones: Los trastornos adherenciales placentarios se presentan como un nuevo desafío para los Servicios de Obstetricia por la aparición en forma "epidémica" de una enfermedad que era infrecuente. El manejo multidisciplinario es la clave para un correcto tratamiento. El Obstetra cumple el rol de coordinación del mismo, convocando a las diferentes especialidades. Será entonces, de capital importancia el aporte de todos para la correcta resolución de los casos.

The aim of the present report was to describe the management of the adherencial disorders of the placenta in a high complexity maternity. During the period between January 2010 and December 2014, 30 patients with placental adherencial disorders were assisted. The incidence of placenta accreta during that period, was 0.18 (30/16210 deliveries). The 96.67 % of surgeries were programmed with Hemodinamia. In the 96.67 % (N= 29) the final anatomo-pathological result was Placentary Accretism. There was a false positive case. Four cases presented complications potentially severe "near miss". None maternal deaths were observed in the survey. The placental adherencial disorders present as a new challenge for the Obstetric Services because of their apparition in an "epidemic" way of a disease that was unfrequent. The multidisciplinary management is the key for an adequate treatment. Obstetricians play a roll for coordination of the team, convoking the different specialities. There will be then, of great importance, the contribution of the totality for the proper resolution of the cases