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Federación Mexicana de Ginecología y Obstetricia, A.C.

2015, Número 02

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Ginecol Obstet Mex 2015; 83 (02)


Parto después de cesárea ¿una opción segura?

García-Benítez CQ, López-Rioja MJ, Monzalbo-Núñez DE

Idioma: Español
Referencias bibliográficas: 39
Paginas: 69-87
Archivo PDF: 599.33 Kb.


RESUMEN

Objetivo: comparar el inicio y evolución del trabajo de parto, analizar las variables: características demográficas, resultados obstétricos y perinatales de las pacientes con parto después de cesárea.
Material y métodos: estudio observacional, retrospectivo y retrolectivo. Para el análisis comparativo las pacientes se dividieron según el inicio del trabajo de parto: espontáneo contra inducción, y en cuanto a evolución: espontáneo contra conducción. El análisis se efectuó con t de Student y prueba de Fisher.
Resultados: se estudiaron 136 pacientes aptas para trabajo de parto, según los criterios del ACOG. El antecedente de cesárea por causa no recurrente fue la indicación electiva más frecuente. En 78% de las pacientes el inicio del trabajo de parto fue espontáneo y en 22% hubo inducción. Entre las características demográficas de las pacientes con inducción y conducción del trabajo de parto destacan: mayor número de embarazos, antecedente de parto, puntaje de Bishop mayor, peso fetal estimado menor y periodo intergenésico mayor. El pronóstico materno y perinatal reveló ser seguro.
Conclusiones: el parto después de cesárea reveló ser un método seguro, que debe ofrecerse a todas las mujeres con una incisión transversal baja, periodo intergenésico mayor de 18 meses, y que estén cursando un embarazo único, en presentación cefálica, con adecuado peso fetal y sin complicaciones obstétricas que impidan el parto.


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