ABSTRACT
En 91 casos de desprendimiento prematuro de placenta estudiados, se encontro que la incidencia de la mortalidad perinatal es de 65.93 por ciento, porcentaje del que la mayor parte (51.65 por ciento) corresponde a muertes fetales. Hubo 14.28 por ciento de mortalidad neonatal , siendo las causas principales de muerte la insuficiencia respiratoria y las grandes malformaciones congenitas incompatibles con la vida. La mayoria de los ninos estudiados fueron prematuros (peso de 1.001 a 2.500 g y gestacion de 29 a 36 semanas) por lo que no llamo la atencion ver el gran indice de problemas respiratorios encontrados, sobre todo por la adicion del factor hipoxia a la condicion organica de prematurez. Se concluye que el mejor control de las pacientes durante el embarazo y el trabajo de parto, asi como la oportuna resolucion del mismo por via abdominal y la atencion pediatrica integral, pueden reducir notablemente el porcentaje correspondiente a mortalidad perinatal
Subject(s)
Pregnancy , Infant, Newborn , Humans , Infant Mortality , Abruptio Placentae , Fetal DeathABSTRACT
In order to establish relationship between premature rupture of membranes (RPM) and neonatal infection, together with the importance of other factors during this process, 50 newborns with history of RPM were studied. In a control group and in groups of newborns with less than and more than 24 hours of plain RPM, related to clinically healthy and vigorous infants, no case of infection was found. On the other hand, 30% and 60% respectively of infections were found in groups less than and more than 24 hours of RPM, but with the presence of other contaminating factors that impair immunological response of the newborn, such as: acute maternal infection, prolonged delivery, unexpected birth, pediatric reanimation procedures, organic immaturity, fetal suffering, immediatie neonatal depression and intercurrent pathology. There were two deaths: a case with RPM of 5 hours and another one with 38 hours, but both with high rating due to the presence and intensity of "aggravating factors" mentioned having internal action mechanism that apparently of restrains to the perpetuation of the hypoxia-acidosis cycle. A provisional sheet is presented to evaluate such "aggravating factors" considering that an RPM associated to them represents a high risk of neonatal infection. In cases of clinically healthy newborns with plain RPM, we advice only to watch over them for 3--5 day, but no antimicrobial treatment at all.