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Patrones morfológicos cardiotocográficos asociados con asfixia perinatal

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dc.contributor.advisorFranco Ayala, Luis Carlos
dc.contributor.authorMozo Acevedo, Diana Alejandra
dc.contributor.orcid0000-0002-4558-0200
dc.date.accessioned2025-07-22T16:30:49Z
dc.date.available2025-07-22T16:30:49Z
dc.date.issued2025-06
dc.description.abstractLa asfixia perinatal (AP) es un evento que produce acidosis neonatal durante el periodo periparto, con una incidencia general en Colombia de 40 -45 casos por cada 1000 nacidos vivos incluyendo AP leve, moderada y severa (1). Para su predicción se utiliza la cardiotocografía (CTG) interpretada con base en la clasificación propuesta por el Colegio Americano de Ginecología y Obstetricia (ACOG), a pesar de reportar una baja capacidad predictiva de AP. Objetivo: Analizar los patrones morfológicos cardiotocográficos asociados a AP. Metodología: Estudio retrospectivo de casos y controles. Mujeres gestantes con edad gestacional mayor a 32 semanas a quienes se les realizó CTG en trabajo de parto durante el periodo comprendido entre 2018-2021. Resultados: Se incluyeron 410 pacientes en el estudio, 37 casos y 373 controles. En el análisis bivariado el estrato socioeconómico bajo, el parto instrumentado, la triple I y en la CTG la variabilidad mínima, la ausencia de aceleraciones, las desaceleraciones de respuesta lenta y la velocidad de tendencia al cambio se asociaron con mayor riesgo de AP. En el análisis multivariado, el estrato socioeconómico, el parto instrumentado, la reanimación in útero y la variabilidad mínima en la CTG se identificaron como factores de riesgo para AP. Conclusiones: Algunos patrones morfológicos cardiotográficos específicos podrían asociarse con AP y no hacen parte de las clasificaciones actuales de la CTG. Se requieren estudios de mayor potencia estadística y muestra con mayor frecuencia del evento para evaluar estas posibles asociaciones.
dc.description.abstractenglishPerinatal asphyxia (PA) is an event that leads to neonatal acidosis during the peripartum period, with an general incidence of 40-45 cases per 1000 live births in Colombia including mild, moderate, and severe PA (1). Cardiotocography (CTG) is used to predict PA, interpreted based on the classification proposed by the American College of Obstetricians and Gynecologists (ACOG), despite its reported low predictive capacity for PA. Objective: To analyze CTG morphological patterns associated with PA. Methods: A retrospective case-control study. Pregnant women with a gestational age greater than 32 weeks, who underwent CTG during labor between 2018-2021 were included. Results: A total of 410 patients were included in the study, 37 cases and 373 controls. In the bivariate analysis, low socioeconomic status, instrumental delivery, triple I, and CTG findings such as minimal variability, absence of accelerations, slow response decelerations, and trend change rate were associated with a higher risk of PA. In the multivariate analysis, socioeconomic status, assisted vaginal delivery, in-utero resuscitation, and minimal CTG variability were identified as risk factors for PA. Conclusions: Certain specific CTG morphological patterns may be associated with PA and are not currently included in existing CTG classifications. Further studies with larger sample sizes and greater event frequency are needed to establish these associations.
dc.description.degreelevelEspecializaciónspa
dc.description.degreenameEspecialista en Ginecología y Obstetriciaspa
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/15018
dc.language.isoes
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programEspecialización en Ginecología y Obstetriciaspa
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dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.localAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectCardiotocografía
dc.subjectMonitoria fetal
dc.subjectAsfixia perinatal
dc.subject.keywordsCardiotocography
dc.subject.keywordsPerinatal asphyxia
dc.subject.keywordsFetal monitoring
dc.subject.nlmWP 100
dc.titlePatrones morfológicos cardiotocográficos asociados con asfixia perinatal
dc.title.translatedCardiotocographic morphological patterns associated with perinatal asphyxia
dc.type.coarhttps://purl.org/coar/resource_type/c_7a1f
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/bachelorThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Especializaciónspa

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