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Aspectos bioéticos de la conducta expectante en la gestante con preeclampsia grave / Bioethical aspects of expectant management in pregnant with severe preeclampsia
Cabrera Lozada, Carlos; Uzcátegui, Ofelia.
  • Cabrera Lozada, Carlos; UCV. Maternidad Concepción Palacios. Programa de Medicina Materno Fetal. Caracas. VE
  • Uzcátegui, Ofelia; s.af
Rev. obstet. ginecol. Venezuela ; 74(2): 87-102, jun. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-740380
RESUMEN

Objetivo:

Describir los aspectos bioéticos que interactúan en la conducta expectante de la gestante con hipertensión arterial inducida por el embarazo en el Servicio de Medicina Materno Fetal de la Maternidad “Concepción Palacios”. Caracas, Venezuela 2011.

Métodos:

Se aplicó consentimiento informado a 188 pacientes a quien se les propuso conducta expectante, se indagó mediante cuestionario su opinión y de los médicos que actuaron en cada caso aplicando los cuatro principios básicos de la bioética.

Resultados:

A mayor nivel educativo, la paciente tiene mayor disponibilidad de aceptar los riesgos para la conducta expectante. Hubo 168 pacientes dispuestas a continuar el embarazo y 20 a interrumpirlo, todas las que aceptaron continuarlo a pesar de los riesgos, mostraron confianza en la información recibida. Desde la óptica del médico, se pudo apreciar que para determinar la jerarquía de los principios bioéticos en el siguiente orden autonomía, justicia, beneficencia y no maleficencia. Cuando la conducta era negada la jerarquía cambiaba al siguiente orden no maleficencia, beneficencia, justicia y autonomía. Diferentes opiniones se obtuvo según el estatus del médico.

Conclusiones:

La preeclampsia es causa importante de morbimortalidad por lo que la conducción médica, debe ser realizada a través de la aplicación de un consentimiento informado, y no involucrar los sentimientos del médico en la toma de decisiones de las pacientes.
ABSTRACT

Objective:

To describe the bioethics aspects that interact in the expectant conduct of the pregnant woman with arterial hypertension induced by pregnancy at the Maternal Fetal Medicine Service of the Maternity “Concepcion Palacios”, Caracas Venezuela 2011.

Methods:

Informed consent was implemented to 188 patients that were proposed of expectant conduct, it was elicited by questionnaire their opinion and of the medical personal that acted in each case implementing the four bioethical principles.

Results:

At higher educational level, the patient has mayor availability of accepting the risks for the expectant conduct. 168 patients were willing to continue the pregnancy and 20 were willing to interrupt it, all of the patients that accepted continuing their pregnancy although risks, revealed trust in the received information. From the medical personal view, it was revealed that in order to determine the hierarchy of the bioethical principles they state in a first place the autonomy, then justice, then beneficence and lastly nonmaleficence. When the conduct was negated the hierarchy was changed to Non-maleficence, beneficence, justice and autonomy. Different opinions were obtained according to the status of the medical personal.

Conclusions:

Preeclampsia is an important cause of morbidity and mortality for that purpose medical conduction must be realized through the application of the informed consent, not involving the medical personal’s feelings in the decisions of the patient.
Assuntos

Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Pré-Eclâmpsia / Proteinúria / Bioética / Gravidez / Hipertensão Limite: Feminino / Humanos / Masculino / Gravidez Idioma: Espanhol Revista: Rev. obstet. ginecol. Venezuela Assunto da revista: Ginecologia / Obstetrícia Ano de publicação: 2014 Tipo de documento: Artigo País de afiliação: Venezuela Instituição/País de afiliação: UCV/VE

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Pré-Eclâmpsia / Proteinúria / Bioética / Gravidez / Hipertensão Limite: Feminino / Humanos / Masculino / Gravidez Idioma: Espanhol Revista: Rev. obstet. ginecol. Venezuela Assunto da revista: Ginecologia / Obstetrícia Ano de publicação: 2014 Tipo de documento: Artigo País de afiliação: Venezuela Instituição/País de afiliação: UCV/VE