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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Número 05

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Ginecol Obstet Mex 2020; 88 (05)


Hallazgos ecocardiográficos en el embarazo y posparto tardío en mujeres mexicanas sanas

Íñigo-Riesgo CA, Gómez-Vargas JR, Gutiérrez-Fajardo P, Torres-Gómez LG

Idioma: Español
Referencias bibliográficas: 33
Paginas: 296-305
Archivo PDF: 370.00 Kb.


RESUMEN

Objetivo: Evaluar y comparar la adaptación cardiovascular materna mediante variables antropométricas y parámetros hemodinámicos con ecocardiografía Doppler en mujeres mexicanas sanas, con embarazo único.
Materiales y Métodos: Estudio prospectivo, observacional, longitudinal, efectuado de enero de 2014 a enero de 2017 en mujeres que cursaban el segundo y tercer trimestres del embarazo. A los 6 meses posparto se practicaron ecosonogramas obstétricos y registros ecocardiográficos Doppler a todas las pacientes del estudio. Cada paciente fue su propio control. Se aplicó el análisis estadístico con SPSS Windows v17, ANOVA para comparar los 3 grupos, con valor significativo de p ‹ 0.05, y correlación no paramétrica de Pearson.
Resultados: Se estudiaron 30 embarazadas con edad promedio de 22.5 ± 3.1 años. Las semanas de embarazo se corroboraron con ultrasonido obstétrico. En el ecocardiograma transtorácico se observaron cambios significativos entre el segundo trimestre y los 6 meses posparto: el ventrículo izquierdo en diástole (cm), 4.5 ± 2.5 vs 4.2 ± 3.3, p ‹ 0.01. El volumen diastólico final del ventrículo izquierdo (mL) fue de 93 ± 14.8 vs 78 ± 17.8 (p ‹ 0.05), el volumen latido (mL): 99.5 ± 15.7 vs 86 ± 11.8 (p ‹ 0.01). Las resistencias vasculares sistémicas (dinas/seg/cm-5), 870 ± 108 vs 1262 ± 176 (p ‹ 0.01). Del segundo al tercer trimestres y posnatal hubo incrementos en la aurícula izquierda (cm): 3.1 ± 4.6, 3.3 ± 4.4, 2.9 ± 4.3 (p ‹ 0.001), gasto cardiaco (L/m): 6.8 ± 0.4, 7.0 ± 0.4, 4.7 ± 0.4 (p ‹ 0.001).
Conclusiones: El embarazo es un estado de sobrecarga transitoria de volumen con importantes efectos orgánicos y funcionales, sobre todo en el segundo trimestre.


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