Briones-Vega CG, Gómez-Bravo-Topete E, Rodríguez-Roldan M, Zavala-Barrios B, Díaz de León-Ponce M, Briones-Garduño JC, Carrillo-Esper R

Language: Spanish
References: 22
Page: 284-290
PDF size: 238.70 Kb.

ABSTRACT

Background: Pre-eclampsia affects maternal mortality worldwide, this has led to investigate the effects of poor placental adaptation and its systemic and fetal effects from the first quarter and try to predict events that can use existing management tools of maternal and fetal hemodynamic changes. Here is a case in point of these results is exposed. Case report: Patient 33 years old, Gesta 4, 3 abortions, she consults with 20 weeks pregnancy with blood pressure of 113/79 mmHg and asymptomatic. hemodynamic evaluation is performed with niccomo team cardiac index of 1.1 and peripheral vascular resistance of 5291 dyne/cm⁵ to report healthy fetus, about 25 weeks inotropic starts (digoxin 0.25 mg every 24 hours) to optimize cardiac output and manages to recover a normal hemodynamic curve (cardiac index › 3.5 L/min and vascular resistance ‹ 1500 din/cm⁵). However a week 29 the fetus develops an early intrauterine growth restriction type IV, abdominal pregnancy is terminated via a single fetus, female 900 g, Apgar 6/7, height 32 cm, required mechanical ventilation support 24 is obtained hours later with weight gain was discharged and stable, as the patient. Discussion: The pathophysiology of severe intrauterine growth restriction and preeclampsia is closely related to the imbalance between angiogenic and antiangiogenic proteins systemically, these mechanisms have been described by our group observing a pattern that is characterized by high vascular resistance and low cardiac output, and has shown improvement with this pattern optimization based inotropic third quarter. Conclusions: Hemodynamic measurement is a useful tool for predicting adverse perinatal outcomes and useful for the administration of drugs that improve maternal hemodynamics so targeted and individualized more research supporting the results are required.

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