Factores predictores para atonía uterina en puérperas del Hospital Regional de Trujillo

Abstract

Objetivo: determinar cuales son los factores predictores para hemorragia posparto(HPP) por atonía uterina en pacientes puérperas. Material y métodos: se realizó un estudio de casos y controles retrospectivo. La población de estudio estuvo constituida por 3024 pacientes que fueron atendidas en el servicio de Obstetricia del Hospital Regional Docente de Trujillo en el período enero del 2010 hasta diciembre del 2017, que cumplieron con los criterios de selección. Resultados: al realizar el análisis bivariado la variable cesárea previa [OR 3.27 (IC 95%: 3.10-3.89)], multiparidad [OR 3.41 (IC 95%: 2.82-4.11)], macrosomía fetal [OR: 1.29 (IC 95%: 1.09-1.52)], corioamnionitis [OR 1.95 (IC 95%: 1.64-2.32)] y miomatosis uterina [OR 1.43 (IC 95%: 1.18-1.73)] presentaron significancia estadística (p=0.001). Con el análisis multivariado se obtuvo que los factores independientemente asociados a la HPP por atonía uterina fueron la cesárea previa [OR2.80 (IC 95% 2.20-3.54)], multiparidad [OR 6.24 (IC 95% 4.68-8.33)], macrosomía fetal [OR 4.79 (IC 95%: 3.37-6.80)], corioamnionitis [OR 21.56 (IC 95%: 13.88-33.48)] y miomatosis uterina [OR 8.25 (IC 95%: 5.10-13.37)]. Conclusiones: se comprobó que los factores predictores para HPP por atonía uterina en pacientes puérperas del Hospital Regional Docente de Trujillo fueron la cesárea previa, multiparidad, macrosomía fetal, corioamnionitis y miomatosis uterina.

Objective: to determine the predictive factors for postpartum hemorrhage (HPP) for uterine atony in puerperal women of the Regional Hospital of Trujillo in the 2010-2017 period. Material and methods: a type of observational, analytical and retrospective case- control study design was carried out. The study population consisted of 3024 patients who were treated in the obstetrics service of the regional hospital of Trujillo during the period January 2010 to December 2017, that fulfilled selection criteria. Results: when we performing the univariate analysis, previous caesarean [OR3.27 (95%CI:3.10-3.89)], multiparity [OR3.41 (95%CI:2.82-4.11)], birth weight more than 4 kg [OR:1.29 (95% CI:1.09-1.52)] , chorioamnionitis [OR1.95 (95% CI: 1.78-2.32)], and uterine fibroids [OR1.43 (95%CI:1.18-1.73)] had statistical significance (p = 0.00). With multivariate analysis, we found that previous caesarean [OR 2.80 (95% CI: 2.20-3.54)], multiparity (p = 0.001, OR 6.24, IC 95% 4.67-8.33), birth weight more than 4 kg (p = 0.001, OR 4.79, 95% CI: 3.37-6.80), chorioamnionitis (p = 0.001, OR 21.56, 95% CI: 13.88-33.48) and uterine fibroids (p = 0.001, OR 8.25, 95% CI: 5.10-13.37) was predictive. Conclusions: it was found that the predictive factors for HPP for uterine atony in puerperal women at the Regional Hospital of Trujillo were previous cesarean, multiparity, birth weight more than 4 kg, chorioamnionitis and uterine fibroids.