RESUMO
RESUMEN ANTECEDENTES: la hemorragia posparto, secundaria o tardía, es un tema que requiere estudiarse aún más; quizá no ha despertado el interés suficiente por su baja asociación con la mortalidad materna, pero sí alta morbilidad que puede determinar múltiples complicaciones y necesidad de hospitalización. OBJETIVO: con base en la evidencia científica disponible profundizar en el conocimiento de las diferentes condiciones que forman parte del concepto hemorragia posparto secundaria. METODOLOGÍA: estudio retrospectivo mediante la búsqueda de artículos originales y revisiones sistemáticas en: PubMed, EMBASE, ScienceDirect y Biblioteca Cochrane. Para todos los sitios se utilizaron las palabras clave: "secondary postpartum hemorrhage", "delayed postpartum hemorrhage". Se seleccionaron los artículos de mayor nivel de evidencia. CONCLUSIONES: a diferencia de lo que ocurre en la hemorragia posparto primaria, la hemorragia posparto tardía rara vez amenaza la vida de la mujer sin por ello dejar de afectarla seriamente, cuando así sucede suele deberse a padecimientos poco frecuentes y conocidos. En estos últimos es prioritario el diagnóstico temprano junto con el tratamiento multidisciplinario.
ABSTRACT BACKGROUND: Secondary or late postpartum hemorrhage is a disease poorly represented in the literature and research studies; probably due to low association with maternal mortality, but high morbidity it implies that can determine a number of complications as well as increased hospital admissions. OBJECTIVE: To deepen the knowledge of the different entities that are part of postpartum hemorrhage secondary concept based on the available scientific evidence. METHODOLOGY: Was a search for original articles and systematic reviews published in the databases: PubMed, EMBASE, Cochrane Library and ScienceDirect. Included in the different search engines, keywords: "secondary postpartum hemorrhage", "delayed postpartum hemorrhage". Greater level of evidence selected and collected information from 52 documents CONCLUSIONS: Unlike what happens in primary postpartum hemorrhage, postpartum hemorrhage late rarely life threatening women but sometimes it can seriously compromise when this occurs often due to rare diseases and little known. In the latter, early diagnosis is a priority with a multidisciplinary approach.
RESUMO
BACKGROUND: Some disorders of pregnancy and newborn have been associated with vitamin D deficiency (25 (OH) D) in maternal serum. The pathophysiology of this relationship is unknown today. OBJECTIVE: The aim of this study was to determine whether serum levels of vitamin D at the beginning of pregnancy are associated with gestational diabetes, hypertensive disorders of pregnancy, preterm birth and fetal growth restriction. MATERIAL AND METHOD: We conducted a prospective cohort study in 370 pregnant women at low obstetric risk randomly selected in our area (latitude 42 ° 20'N). The level of 25-hydroxy vitamin D was determinate between 8 and 14 weeks of pregnancy. We studied the relationship between the status of vitamin D and gestational diabetes, preeclampsia, preterm birth, intrauterine growth restriction and small for gestational age. The statistic analysis was performed using SPSS 15.0 and 3.1 Epidat programs. RESULTS: The prevalence of vitamin D deficiency in pregnant women in this serie was 96.8%, 34.6% had severe deficiency. After adjusting for maternal and seasonal variables, we haven't found association between first trimester maternal serum vitamin D levels and pregnancy outcomes studied. CONCLUSIONS: The pregnancy outcome was independent of the first trimester maternal serum 25(OH)D status.
