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RN y Cesárea

RN y Cesárea. Que falta Inteligencia del feto (estoy maduro ?) Catecolaminas durante el parto Líquido pulmonar Aumentan reabsorción Disminuyen producción Descarga de surfactante. Que hay de malo ?. Herida al feto: 1.9 % (6% si no es cefálica) Síndrome de dificultad respiratoria

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RN y Cesárea

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  1. RN y Cesárea • Que falta • Inteligencia del feto (estoy maduro ?) • Catecolaminas durante el parto • Líquido pulmonar • Aumentan reabsorción • Disminuyen producción • Descarga de surfactante eurman@api.org.ar

  2. Que hay de malo ? • Herida al feto: • 1.9 % (6% si no es cefálica) • Síndrome de dificultad respiratoria • Prematurez iatrogénica • Norte Inglaterra 1988-92 179.000 RN • 36 RN > 37sem SDR ARM 2 Muertos • 1:300 entre 37-38sem 120 > ARM que 39-41s • 1 c/241 cesárea repetida SDR severo • Hipert.pulmonar 4.5 > (3.7%o vs 0.8%o) eurman@api.org.ar

  3. Más de lo malo Sem. EG Vaginal Ces. Elect SDR 37 1.8% 10% RR 12 (7-21) 38 1.5% 5.8% RR 7 (5-11) 39 0.4% 2.8 RR 3 (2-8) 48 0.4% 3.5 eurman@api.org.ar

  4. Sigue lo malo • Admisión cuidados especiales neonatales • 5 veces mayor (6.3% vs. 1.6%) • 5 veces mayor ARM (1.5% vs. 0.3%) • Taquipnea transitoria 6% vs. 3% • Gasto innecesario de U$S 16.000.000/año eurman@api.org.ar

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