Zavala BB, Viruez SJA, Vallejo NCM, Briones VCG, Briones GJC

Language: Spanish
References: 13
Page: 30-33
PDF size: 69.96 Kb.

ABSTRACT

Introduction: Advanced maternal age is directly associated with maternal and fetal morbidity and mortality. Objective: To provide knowledge in the management of superimposed preeclampsia and other comorbidities in advanced maternal age. Case report: A 52 year old female with a history of hyperuricemia and diagnosed with primary infertility at 42 years of age. She manages to get pregnant through egg donation, at 31.4 weeks gestation attends antenatal care with uncontrolled blood pressure values of 140/90 mmHg. On admission, E-MATER ultrasonographic assessment is performed finding criteria consistent with chronic hypertension with superimposed preeclampsia without signs of severity, also gestational diabetes. Hemodynamic monitorization was mantained, optimizing cardiac output with digoxin, as well as antihypertensive treatment, improvement was observed through thoracic bioimpendance. Conservative management of preeclampsia was given for 23 days, and when were added the severity sings associated with IUGR stage I (COMEGO) appeared, the interruption of pregnancy was decided, obtaining male fetus, 1 700 g weight, Apgar 7/8, Capurro 36.3. The patient remained stable postpartum 72 hours and discharged without complications. The newborn takes 40 days in NICU in weight gain and management of nosocomial neonatal sepsis, he was discharged from the Hospital without apparent complications. Conclusions: It is clear that the multidisciplinary management gives pregnant patients at high risk better maternal and fetal outcomes. However it is recommended to submit to council pregnancy advanced maternal age for the high incidence of complications that threaten the binomial.

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