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Actual. SIDA. infectol ; 21(80): 53-62, jul. 2013. tab
Artigo em Espanhol | LILACS | ID: lil-781699

RESUMO

Introducción: el diagnóstico de influenza en gestantes está asociado a un alto riesgo de morbi-mortalidad. Objetivos: describir características clínico-epidemiológicas de embarazadas/puérperas cursando enfermedad tipo influenza (ETI) y el compromiso respiratorio durante la pandemia de influenza A (H1N1) pdm09. Comparar severidad según edad gestacional. Material y métodos: estudio retrospectivo, descriptivo mediante revisión de historias clínicas de embarazadas/puérperas internadas por ETI en dos maternidades, período: 27/06/09-14/08/09. Se tabularon en dos grupos: G1, n= 35 (1º y 2º trimestre); G2, n= 49 (3º trimestre/puerperio). Resultados: se incluyeron 84 pacientes, edad promedio 25 años (R: 14-42). 81% sin comorbilidades. 20% ingresaron a Unidad de Terapia Intensiva (UTI). El 54% consultó tardíamente. Presentaron neumonía el 50%. Recibió tratamiento antiviral el 89%. El 23% terminó su embarazo durante la internación por indicación obstétrica. El 94% del total presentó evolución favorable. Comparando G1 vs G2: necesidad de UTI (5/35 vs 12/49, p=0.25), roncus/sibilancias (8/35 vs. 18/49, p= 0,17), saturación de oxígeno menor de 96 % (6/35 vs 15/49 p=0,15), número de muertes (1/35 vs. 4/49, p= 0,30). Internación prolongada (3/35 vs 14/49, p= 0,02). La mortalidad general fue 6%. Conclusiones: la mayoría de las pacientes no presentaba comorbilidades y se encontraba cursando el tercer trimestre de embarazo o puerperio al momento de la internación. Hubo mayor frecuencia de compromiso respiratorio severo, internación en UTI y mortalidad en las pacientes en este grupo, sin diferencia significativa respecto al primer y segundo trimestre de embarazo. La mortalidad fue comparable a la reportada en la bibliografía.


Introduction: diagnosis of influenza in pregnant women is associated with a high risk of morbidity and mortality. Objectives: To describe clinical and epidemiological characteristics and respiratory compromise of hospitalized pregnant/postpartum women suffering from influenza like illness, assisted during the pandemic of influenza A (H1N1)pdm09 and compare serverity of respiratory compromise according to gestational age. Material and methods: retrospective, descriptive study through a review of medical charts of pregnant/postpartum women asisted in two maternity hospitals, period: 27/June to 14/August 2009. The data was tabulated into two groups: G1, n=35 (1st and 2nd Trimester), and G2, n=49, 3rd Trimester/puerperium. Results: 84 patients was included. Average age 25 years (R: 15-42). 81% without comorbidities. 20% was admitted on Intensive Care Unit (ICU). Pneumonia was diagnosed in 50%. 89% received antiviral treatment. 23% ended their pregnancy during the hospitalization for obstetric indication. 94% of the population presents favorable clinical evolution. Comparing G1 vs. G2: need for ICU admission (5/35 vs 12/49, p=0.25), presence of rhonchi/wheezing (8/35 vs 18/49, p=0.17), oxygen saturation < 96% (6/35 vs 15/49, p=0.15), mortality (1/35 vs 4/49, p=0.30), prolonged hospitalization (3/35 vs 14/49, p=0.02). Overall mortality was 6%. Conclusions: Most patientes had not comorbidities and was enrolled in the third trimester of pregnancy or puerperium at the time of hospitalization. There was a higher frequency of severe respiratory compromise, hospitalization in ICU and mortality in patients in this group, without significant difference compared to the first and second trimester. Mortality was comparable to that reported in the literature.


Assuntos
Humanos , Feminino , Adulto Jovem , Comorbidade , Vírus da Influenza A Subtipo H1N1 , Infecções Respiratórias/complicações , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/mortalidade , Período Pós-Parto , Gestantes , Estudos Retrospectivos
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