PREVENCIÓN DE PARTO PRETÉRMINO

Kelly Ramírez Murillo

Kelly Ramírez Murillo Médica General, Universidad de Costa Rica, Costa Rica.

Palabras clave: Parto pretérmino – Factores de riesgo – prevención – embarazo – progesterona – cerclaje

Resumen

Tradicionalmente, el parto pretérmino se considera aquel que ocurre después de las 20 semanas y antes de completar las 37 semanas de gestación; sin embargo, esta definición está siendo reevaluada. Actualmente, el parto pretérmino constituye la primera causa de mortalidad infantil en países desarrollados y aumenta significativamente su morbilidad. Debido a ello, es de suma importancia determinar sus factores predisponentes, con el objetivo de detectar a las madres en riesgo y consecuentemente, evitar este desenlace.

Existen muchos factores de riesgo conocidos para parto pretérmino y algunos de estos son: parto pretérmino previo, longitud cervical corta, características demográficas, antecedente de cirugía cervical, sangrado vaginal durante primer trimestre, obesidad, infecciones, tabaquismo, bajo peso preconcepcional, abuso de sustancias y periodo intergenésico corto.

Algunas medidas de prevención de parto pretérmino efectivas pueden ser: mejor control prenatal, tratamiento antibiótico de ciertas infecciones genitales y en las pacientes con ruptura prematura de membranas, tratamiento de bacteriuria asintomática, la suplementación con progesterona en pacientes con parto pretérmino previo o sin antecedente pero con longitud cervical muy corta antes de la semana 24 de gestación, el cerclaje en mujeres con antecedente de parto pretérmino previo menor a 34 semanas y longitud cervical menor a 25 mm antes de las 24 semanas de gestación, el uso de pesario en pacientes asintomáticas sin antecedentes de parto pretérmino con diagnóstico incidental de cérvix corto a las 18-22 semanas, la suplementación con zinc en mujeres de bajos ingresos y mala nutrición, y finalmente, el aumento de intervalo intergenésico a más de 12 meses.

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