Macrosomía: un reto para la perinatología. Macrosomia: A Challange to Neonatology
Abstract
Con el objetivo de conocer la epidemiología y la evaluación materno-perinatal del macrosómico, se realizo un estudio retroperstivo, transversal y analítico a una muestra de 178 fetos y recién nacidos de 4000 gramos y mas ya un grupo control de 200 recién nacidos con peso entre 2500-3500 gramos, en el Hospital Docente Provincial Gineco-Obstétrico "Justo Legón Padilla de Pinar del Río, en el periodo de 8 meses comprendido de julio 1996- febrero 1997. Se estudiaron variables maternas como: talla, valoración ponderal inicial, ganancia de peso total en el embarazo, antecedentes de diabetes, de obesidad y de macrosomía anterior, variables fetales al nacimiento como: sexo. Presentación, edad gestacional, liquido amniótico y tipo de nacimiento. Los resultados se agruparon en cuadros aplicándose pruebas estadísticas como: porciento, media, chi cuadrado y odds ratio con un nivel de significación de p<0.05. Fueron factores de riesgo alto: la macrosomía anterior, la talla materna de 170 cm y más y el sobrepeso materno inicial. Hubo relación estadísticamente significativa del macrosómico con: sexo masculino, embarazo prolongado, presentación cefálica en occípito posterior y las distocias en el parto. Hubo una baja incidencia y un diagnostico anteparto del macrosómio. Se recomienda un control glicémico y nutricional materno en general para disminuir la morbimortalidad del binomio madre- hijo.
DeCS: MACROSOMIA FETAL Epidemiología, CESAREA, TRAUMATISMOS DEL NACIMIENTO, MORBILIDAD, MORTALIDAD PERINATAL, MORTALIDAD MATERNA.
A retrospective cross-sectional analytic study was out aiming to know epidemiology and maternal-perinatal of the macrosomic infant. Samples of the macrosomic infant. Samples of 178 fetus and newborns (4000 g and over) and a control group (2500-3500 g) were taken from Justo Legon Padilla Gyneco-0bstetric provincial Hospital, Pinar del Rio, betwen july, 1996 and february, 1997. Maternal variables such as size, inicial weight assesment, total weight gain during pregnancy, a history of diabetes, obesity and procedent macrosomia, as well as fetal variables after birth like sex, presentation, gestational age, amniotic fluid and type or birth were analyzed in the work. results werw listed in tables according to statistical test such percent, chi-square and odds ratio with a significant level of p<0.05. A history of macrosomia, maternal size of 170 cm and more, and initial maternal overweight were the hight-risk factors. There was a significant correlation the macrosomic infant and masculine sex, long lasting pregnancy, occipito-posterior position and dystocia. There was a low incidence and pre-partum subdiagnosis of the macrosomic child. A glicemia and nutritional control of the mother is suggested to decrease this incidence, that added to a better delivery care may reduce morbidity and mortality of both mother and child.
DeCS: FETAL MACROSOMIA, CESAREAN SECTION, BIRTH INJURIES, MORBIDITY, PERINATAL MORTALITY, MATERNAL MORTALITY.
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