Fibrinógeno como Factor Pronóstico para Hemorragia Posparto en Pacientes del Hospital General de Zona No. 20
Resumen
Objetivo: Evaluar la utilidad del fibrinógeno como factor pronóstico para hemorragia posparto en pacientes de un hospital de segundo nivel de atención. Métodos: Estudio de casos y controles, transversal, analítico y retrospectivo basado en expedientes de pacientes atendidas entre marzo-diciembre de 2023. Se incluyeron aquellas pacientes que contaban con los datos completos de edad, historial obstétrico, características del parto (vía de resolución y volumen de sangrado por estimación visual), hemorragia posparto (presencia, severidad) y parámetros de coagulación al ingreso (niveles de fibrinógeno, tiempo de protrombina, tromboplastina parcial e INR) y tratamiento. Se utilizaron estadísticas descriptivas, pruebas de t de Student y U de Mann-Whitney para la comparación de medias y medianas, área bajo la curva y regresión logística para evaluar la sensibilidad, especificidad y capacidad predictiva del fibrinógeno. El procesamiento se realizó con IBM SPSS v.26, considerando significativo un valor de p<0.05. Resultados: Se analizaron 114 pacientes con edad promedio de 28±6 años. El 96.5% de las pacientes finalizaron el embarazo por cesárea. Un 24.6% de las pacientes presentó hemorragia posparto y presentaron un nivel de plaquetas de 205.7±74, estadísticamente significativo en comparación con aquellas que sin hemorragia. Se encontró que las pacientes con hemorragia tuvieron una menor cantidad de fibrinógeno 587.50 vs 627 mg/dL (p<0.05). Un nivel de fibrinógeno <637 mg/dL mostró una sensibilidad del 75% y especificidad del 43%. Conclusión: El fibrinógeno se identificó como un factor pronóstico de la hemorragia posparto y podría emplearse para identificar a pacientes con mayor riesgo de esta complicación.
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Derechos de autor 2025 Isaac Gervacio Rosas Ruiz, María Isabel Lobatón Paredes , Miriam Cabrera Jiménez , Jorge Osvaldo Rodríguez Tovar
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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