Factores asociados a complicaciones obstétricas antes y durante la pandemia de COVID-19: Análisis en un hospital de referencia en Cajamarca
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Vive Rev. Salud
Abstract
La investigación tuvo como objetivo establecer una asociación entre los factores sociodemográficos, obstétricos y clínicos con las complicaciones obstétricas durante el embarazo, parto y puerperio antes y durante la pandemia COVID-19 en pacientes atendidas en el Hospital Regional Docente de Cajamarca, 2019 - 2020. Materiales y métodos: estudio cuantitativo de diseño no experimental, corte transversal, correlacional, retrospectivo. Se analizaron 200 historias clínicas. Resultados: en 2019, la complicación más frecuente durante el embarazo fue enfermedades hipertensivas, las cuales aumentaron en 2020. Durante el parto las complicaciones más frecuentes fueron los desgarros vulvo-perineales, la hipoactividad uterina y los trastornos hipertensivos. Durante el puerperio, la hemorragia postparto pasó del 10% en 2019 al 16% en 2020, las complicaciones más frecuentes fueron la retención placentaria, la corioamnionitis y la sepsis materna. Los factores asociados, significativamente, a complicaciones obstétricas (p < 0.005) en 2019 fueron: edad materna, tipo de parto, distocia de presentación, infección urinaria, anemia y diabetes gestacional. En 2020, se sumaron procedencia, estado civil, trastorno hipertensivo del embarazo, parto pretérmino, distocias céfalo-pélvicas y obesidad. Conclusión: Las complicaciones obstétricas aumentaron durante la pandemia, con mayor incidencia de trastornos hipertensivos, hemorragia postparto y sepsis materna. Se evidenció una asociación significativa entre las complicaciones y los factores sociodemográficos, obstétricos y clínicos, resaltando la necesidad de fortalecer la atención materna mediante un seguimiento prenatal riguroso, detección temprana de factores de riesgo y optimización del manejo perinatal.
The research aimed to establish an association between sociodemographic, obstetric and clinical factors with obstetric complications during pregnancy, delivery and puerperium before and during the COVID-19 pandemic in patients attended at the Regional Teaching Hospital of Cajamarca, 2019 - 2020. Materials and methods: quantitative study of non-experimental design, cross-sectional, correlational, retrospective. Two hundred medical records were analyzed. Results: in 2019, the most frequent complication during pregnancy was hypertensive diseases, which increased in 2020. During delivery, the most frequent complications were vulvo-perineal tears, uterine hypoactivity and hypertensive disorders. During the puerperium, postpartum hemorrhage increased from 10% in 2019 to 16% in 2020, and the most frequent complications were retained placenta, chorioamnionitis, and maternal sepsis. Factors significantly associated with obstetric complications (p < 0.005) in 2019 were maternal age, type of delivery, presentation dystocia, urinary tract infection, anemia, and gestational diabetes. In 2020, provenance, marital status, hypertensive disorder of pregnancy, preterm delivery, cephalo-pelvic dystocia, and obesity were added. Conclusion: Obstetric complications increased during the pandemic, with higher incidence of hypertensive disorders, postpartum hemorrhage and maternal sepsis. There was a significant association between complications with sociodemographic, obstetric and clinical factors, highlighting the need to strengthen maternal care through rigorous prenatal follow-up, early detection of risk factors and optimization of perinatal management.
The research aimed to establish an association between sociodemographic, obstetric and clinical factors with obstetric complications during pregnancy, delivery and puerperium before and during the COVID-19 pandemic in patients attended at the Regional Teaching Hospital of Cajamarca, 2019 - 2020. Materials and methods: quantitative study of non-experimental design, cross-sectional, correlational, retrospective. Two hundred medical records were analyzed. Results: in 2019, the most frequent complication during pregnancy was hypertensive diseases, which increased in 2020. During delivery, the most frequent complications were vulvo-perineal tears, uterine hypoactivity and hypertensive disorders. During the puerperium, postpartum hemorrhage increased from 10% in 2019 to 16% in 2020, and the most frequent complications were retained placenta, chorioamnionitis, and maternal sepsis. Factors significantly associated with obstetric complications (p < 0.005) in 2019 were maternal age, type of delivery, presentation dystocia, urinary tract infection, anemia, and gestational diabetes. In 2020, provenance, marital status, hypertensive disorder of pregnancy, preterm delivery, cephalo-pelvic dystocia, and obesity were added. Conclusion: Obstetric complications increased during the pandemic, with higher incidence of hypertensive disorders, postpartum hemorrhage and maternal sepsis. There was a significant association between complications with sociodemographic, obstetric and clinical factors, highlighting the need to strengthen maternal care through rigorous prenatal follow-up, early detection of risk factors and optimization of perinatal management.
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Vol. 8, No. 24