Publication: Relación entre los registros cardiotocográficos, el Test de Apgar y el pH de arteria umbilical. Estudio multicéntrico
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2017-06-20
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Universidad Complutense de Madrid
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Abstract
La asfixia perinatal es una causa importante de mortalidad perinatal y morbilidad neurológica. Debido a que no existe un consenso sobre su definición, algunos de los criterios adoptados por distintos autores para definir la asfixia perinatal son: bajas puntuaciones en el test de Apgar, acidosis en gasometría de cordón umbilical, registro cardiotocográfico (RCTG) patológico, retraso en establecerse la respiración espontánea, signos clínicos de lesión cerebral…, siendo la definición más aceptada la propuesta el Colegio Americano de Obstetricia y Ginecología donde determinaron los 4 criterios que deben existir para que la asfixia perinatal pueda ser considerada la causa de déficit neurológico: acidemia metabólica o mixta intensa (pH<7,00), persistencia de puntuación Apgar de 0-3 más de 5 minutos, secuelas neurológicas neonatales inmediatas y disfunción de múltiples sistemas en el periodo neonatal inmediato. El presente estudio tiene como finalidad aportar datos actuales sobre la relación que existe entre el RCTG, el test de Apgar y el pH de arteria umbilical. A pesar de estar documentada la validez de los tres indicadores de asfixia perinatal, generalmente en los procedimientos médicos-legales se da mayor importancia al resultado del pH de arteria umbilical que a los otros dos criterios. Por lo que se pretende demostrar que todos ellos tienen la misma validez, e incluso el test de Apgar refleja mejor el estado del recién nacido en el momento del nacimiento que el resultado del pH umbilical. OBJETIVO: Evaluar la relación del test de Apgar y los resultados del pH de arteria umbilical con respecto a la gravedad de los registros cardiotocográficos en el periodo expulsivo y la necesidad de reanimación neonatal en los tres hospitales seleccionados para el estudio...
Perinatal asphyxia is one of the most important causes of perinatal mortality and neurological morbidity. Since there is no agreement on its definition, some of the criteria taken by different authors in order to describe perinatal asphyxia are the following ones: low Apgar score, acidosis in the blood gas analysis from the umbilical cord, pathological cardiotocography (CTG) records, delay in spontaneous breathing, clinical signs of brain damage, etc. The most widely accepted definition is the one The American College of Obstetricians and Gynecologists suggests, where they pointed out the 4 criteria that need to be present in order to consider perinatal asphyxia as a cause of neurological deficit: intense metabolic or mixed acidemia (pH<7.00), persistence of an Apgar score 0-3 over 5 minutes, clinical neurological sequelae in the immediate neonatal period and multi-organ system dysfunction in the immediate neonatal period. This dissertation aims to provide current data about the existing relationship between CTG records, the Apgar score and the pH of the umbilical artery. In spite of the literature which validates the three signs of perinatal asphyxia, in general terms in legal and medical procedures, more emphasis is placed on the results of the pH of the umbilical artery than on the other two criteria. Therefore, we aim to show that they are all equally valid, and that even the Apgar score reflects the state of the new-born child at the time of birth better than the pH umbilical results. OBJECTIVE: The aim of this dissertation is to assess the relationship between the Apgar score and the pH of umbilical artery results regarding the seriousness of the cardiotocography records during the second stage of labour and the need for neonatal resuscitation in the three hospitals selected for the study...
Perinatal asphyxia is one of the most important causes of perinatal mortality and neurological morbidity. Since there is no agreement on its definition, some of the criteria taken by different authors in order to describe perinatal asphyxia are the following ones: low Apgar score, acidosis in the blood gas analysis from the umbilical cord, pathological cardiotocography (CTG) records, delay in spontaneous breathing, clinical signs of brain damage, etc. The most widely accepted definition is the one The American College of Obstetricians and Gynecologists suggests, where they pointed out the 4 criteria that need to be present in order to consider perinatal asphyxia as a cause of neurological deficit: intense metabolic or mixed acidemia (pH<7.00), persistence of an Apgar score 0-3 over 5 minutes, clinical neurological sequelae in the immediate neonatal period and multi-organ system dysfunction in the immediate neonatal period. This dissertation aims to provide current data about the existing relationship between CTG records, the Apgar score and the pH of the umbilical artery. In spite of the literature which validates the three signs of perinatal asphyxia, in general terms in legal and medical procedures, more emphasis is placed on the results of the pH of the umbilical artery than on the other two criteria. Therefore, we aim to show that they are all equally valid, and that even the Apgar score reflects the state of the new-born child at the time of birth better than the pH umbilical results. OBJECTIVE: The aim of this dissertation is to assess the relationship between the Apgar score and the pH of umbilical artery results regarding the seriousness of the cardiotocography records during the second stage of labour and the need for neonatal resuscitation in the three hospitals selected for the study...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Enfermería, Fisoterapia y Podología, leída el 05/07/2016