Conducta obstétrica en el embarazo posfechado
Resumen
El embarazo posfechado es aquel que supera las 40 semanas de gestación según la fecha probable de parto. Lastimosamente, no se tienen estadísticas exactas de la prevalencia de este. Sin embargo, se ha reportado en la literatura que hasta el 65 % de los embarazos en Estados Unidos superan las 39 semanas, lo cual abarcaría los embarazos posfechados. Se ha descrito la asociación entre las pacientes que superan las 40 semanas de gestación y los desenlaces adversos maternos y perinatales. A pesar de esto, no hay consenso en cuanto al manejo en estos escenarios. El objetivo de este artículo es realizar una revisión descriptiva, no sistemática, en las principales bases de datos como lo son: PubMed, Cochrane Library y Scielo, con el fin de resumir la evidencia actual de las diferentes conductas obstétricas tomadas en pacientes que cursan un embarazo posfechado, para así proponer algunas directrices en torno al manejo de esta situación.
Descargas
Disciplinas:
postterm pregnancy, morbidity, labor, risk factors, prevention (MeSH)Referencias bibliográficas
Rodriguez-Donado A, Gomez-Meneses MA. Guía de atención del embarazo prolongado. Secretaría Distrital de Salud de Bogotá. Disponible en: http://www.saludcapital.gov.co/DDS/Publicaciones/GUIA%204.%20%20ATENCION%20DEL%20EMBARAZO%20PROLONGADO.pdf
Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final Data for 2018. Natl Vital Stat Rep. 2019;68(13):1-47.
Briscoe D, Nguyen H, Mencer M, Gautam N, Kalb D. Management of pregnancy beyond 40 weeks’ gestation. Am Fam Physician. 2005;15;71(10).
ACOG Committee Opinion No 579: Definition of term pregnancy. Obstet Gynecol. 2013;122(5). DOI: 10.1097/01.AOG.0000437385.88715.4a
Smith R. Parturition. N Engl J Med. 2007;18:356(3). DOI: 10.1056/NEJMra061360
Ravanos K, Dagklis T, Petousis S, Margioula-Siarkou C, Prapas Y, Prapas N. Factors implicated in the initiation of human parturition in term and preterm labor: a review. J Int Soc Gynecol Endocrinol. 2015;31(9). DOI: 10.3109/09513590.2015.1076783. Epub 2015 Aug 24.
Hertelendy F, Zakár T. Prostaglandins and the myometrium and cervix. Prostaglandins Leukot Essent Fatty Acids. 2004;70(2). DOI: 10.1016/j.plefa.2003.04.009
Kortekaas J, Kazemier B, Ravelli A, De Boer K, Van Dillen J, Mol B, et al. Recurrence rate and outcome of postterm pregnancy, a national cohort study. Eur J Obstet Gynecol Reprod Biol. 2015;193. DOI: 10.1016/j.ejogrb.2015.05.021
Caughey AB, Stotland NE, Washington AE, Escobar GJ. Who is at risk for prolonged and postterm pregnancy? Am J Obstet Gynecol. 2009;200(6). DOI: 10.1016/j.ajog.2009.02.034
Morken N, Melve K, Skjaerven R. Recurrence of prolonged and post-term gestational age across generations: maternal and paternal contribution. BJOG Int J Obstet Gynaecol. 2011;118(13). DOI: 10.1111/j.1471-0528.2011.03154.x
Cheng Y, Nicholson J, Nakagawa S, Bruckner T, Washington A, Caughey A. Perinatal outcomes in low-risk term pregnancies: do they differ by week of gestation? Am J Obstet Gynecol. 2008;199(4). DOI: 10.1016/j.ajog.2008.08.008
Wang M, Fontaine P. Common questions about late-term and postterm pregnancy. Am Fam Physician. 2014;90(3).
Caughey AB, Snegovskikh VV, Norwitz ER. Postterm pregnancy: how can we improve outcomes? Obstet Gynecol Surv. 2008;63(11). DOI: 10.1097/OGX.0b013e318186a9c7
Vayssière C, Haumonte J, Chantry A, Coatleven F, Mp M, Gomez C, et al. Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2013;169(1). DOI: 10.1016/j.ejogrb.2013.01.026
Illa M, Bogunya J, Figueras F, Gomez M. Protocolo: Manejo de la gestación >41 semanas. Clinic Barcelona, Hospital Sant Joan de Déu. 2019. Disponible en: https://medicinafetalbarcelona.org/protocolos/es/obstetricia/gcp.html
Melamed N, Baschat A, Yinon Y, Athanasiadis A, Mecacci F, Figueras F, et al. FIGO (international Federation of Gynecology and obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction. Int J Gynaecol Obstet. 2021;152(1). DOI: 10.1002/ijgo.13522
Rodriguez-Donado A. Guía de manejo: Inducción del trabajo de parto. Secretaría Distrital de Salud de Bogotá, D. C. Asociación Bogotana de Obstetricia y Ginecología (Asbog). Disponible en: http://www.saludcapital.gov.co/DDS/Publicaciones/GUIA%206.%20%20MANEJO%20DE%20INDUCCION%20FRL%20TRABAJO%20DE%20PARTO.pdf
Carlson N, Ellis J, Page K, Dunn Amore A, Phillippi J. Review of Evidence-Based Methods for Successful Labor Induction. J Midwifery Womens Health. 2021;66(4). DOI: 10.1111/jmwh.13238
Finucane Em, Murphy Dj, Biesty Lm, Gyte Gm, Cotter Am, Em R, et al. Membrane sweeping for induction of labour. Cochrane Database Syst Rev. 2020;2(2). DOI: 10.1002/14651858.CD000451.pub3
Avdiyovski H, Haith-Cooper M, Scally A. Membrane sweeping at term to promote spontaneous labour and reduce the likelihood of a formal induction of labour for postmaturity: a systematic review and meta-analysis. J Obstet Gynaecol. 2019;39(1). DOI: 10.1080/01443615.2018.1467388
Hernandez S, Peguero A, Meler E. Protocolo: Maduración cervical e inducción del parto. Clinic Barcelona. 2018. Disponible en: https://medicinafetalbarcelona.org/protocolos/es/obstetricia/inducci%C3%B3n%20del%20parto.pdf
Practice bulletin no. 146: Management of late-term and postterm pregnancies. Obstet Gynecol. 2014;124. DOI: 10.1097/01.AOG.0000452744.06088.48
Kortekaas JC, Bruinsma A, Keulen JKJ, Vandenbussche FPHA, Dillen J van, Miranda E. Management of late-term pregnancy in midwifery- and obstetrician-led care. BMC Pregnancy Childbirth. 2019;19. DOI: 10.1186/s12884-019-2294-7
Mandruzzato G, Alfirevic Z, Chervenak F, Gruenebaum A, Heimstad R, SH, et al. Guidelines for the management of postterm pregnancy. J Perinat Med. 2010;38(2). DOI: 10.1515/jpm.2010.057
Alfirevic Z, Walkinshaw Sa. A randomised controlled trial of simple compared with complex antenatal fetal monitoring after 42 weeks of gestation. Br J Obstet Gynaecol. 1995;102(8). DOI: 10.1111/j.1471-0528.1995.tb11402.x
Sénat Mv. [Management of post-term pregnancies: the role for AFI, biophysical score and doppler]. J Gynecol Obstet Biol Reprod. 2011;40(8). DOI: 10.1016/j.jgyn.2011.09.020
Morris Jm, Thompson K, Smithey J, Gaffney G, Cooke I, P C, et al. The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study. BJOG Int J Obstet Gynaecol. 2003;110(11).
Fisiología materna. In: Cunningham F, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. Eds. Williams Obstetricia, 26e. McGraw Hill. 2021.
Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, et al. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. N Engl J Med. 2018 Sep 8;379(6). DOI: 10.1056/NEJMoa1800566
Souter V, Painter I, Sitcov K, Caughey AB. Maternal and newborn outcomes with elective induction of labor at term. Am J Obstet Gynecol. 2019;220(3). DOI: 10.1016/j.ajog.2019.01.223
Grobman WA, Caughey AB. Elective induction of labor at 39 weeks compared with expectant management: a meta-analysis of cohort studies. Am J Obstet Gynecol. 2019;221(4):304-310. DOI: 10.1016/j.ajog.2019.02.046
Darney BG, Snowden JM, Cheng YW, Jacob L, Nicholson JM, Kaimal A, et al. Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes. Obstet Gynecol. 2013;122(4). DOI: 10.1097/AOG.0b013e3182a6a4d0
SMFM Statement on Elective Induction of Labor in Low-Risk Nulliparous Women at Term: the ARRIVE Trial. Am J Obstet Gynecol. 2019;221(1). DOI: 10.1016/j.ajog.2018.08.009
Sinkey RG, Blanchard CT, Szychowski JM, Ausbeck E, Subramaniam A, Neely CL, et al. Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women. Obstet Gynecol. 2019;134(2). DOI: 10.1097/AOG.0000000000003371
Indications for Outpatient Antenatal Fetal Surveillance: ACOG Committee Opinion, Number 828. Obstet Gynecol. 2021;137(6). DOI: 10.1097/AOG.0000000000004407
Lamont K, Scott NW, Jones GT, Bhattacharya S. Risk of recurrent stillbirth: systematic review and meta-analysis. BMJ. 2015;350. DOI: 10.1136/bmj.h3080
Yao R, Ananth CV, Park BY, Pereira L, Plante LA. Obesity and the risk of stillbirth: a population-based cohort study. Am J Obstet Gynecol. 210(5):457.e1-9. DOI: 10.1016/j.ajog.2014.01.044
Reddy Um, Ko CW, Willinger M. Maternal age and the risk of stillbirth throughout pregnancy in the United States. Am J Obstet Gynecol. 2006;195(3). DOI: 10.1016/j.ajog.2006.06.019
Gibbs Pickens CM, Kramer MR, Howards PP, Badell Ml, Caughey AB, Hogue CJ. Term Elective Induction of Labor and Pregnancy Outcomes Among Obese Women and Their Offspring. Obstet Gynecol. 2018;131(1). DOI: 10.1097/AOG.0000000000002408
Committee Opinion No. 688: Management of Suboptimally Dated Pregnancies. Obstet Gynecol. 2017;129(3). DOI: 10.1097/AOG.0000000000001949
Derechos de autor 2024 Universidad del Cauca
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
.png)
