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Embarazo pretérmino ¿a qué se debe?

It is considered pregnancy preterm to everyone who completed prior to 37 weeks of gestation.

Expert: Eghon Guzman, obstetrician-gynecologist of Integramédica.

Level premature births have an incidence of close to 10% of the total births. In Chile since 1980 the rate of 5% has not changed, however, is a matter of concern since according to the Ministry of Health -excluding congenital malformations, 75% of the perinatal deaths are attributable to prematurity.

A newborn weighing less than 1,500 grams has a risk of dying in their first year of life 180 times higher than that of a neonate with a weight greater than 2,500 grams. According to the obstetrician-gynecologist of Integramédica, Eghon Guzman, for a long time tried to define which patients have risk factors for preterm birth, but it was impossible to determine a pattern of age, socioeconomic level or marital status, so not managed to determine an effect of these factors. The only event that qualifies a woman as a risk of having a preterm birth is that have previously had a pregnancy associated with preterm previously.

Also, those women that in the routine tests shed asymptomatic bacteriuria, that is to say, the bacteria of a urinary tract infection without showing any symptoms of having it, are also part of the population at risk. Also, who during pregnancy have vaginosis (bacteria in the vagina) and the people who have dental infections during gestation fall into the category of risk of preterm delivery.

Dr. Guzmán, who was recently appointed Master Chilean Ultrasonography by the Chilean Society of Ultrasonography in Medicine and Biology (Sochumb), explains that through the ultrasound you can measure the neck of the uterus. The patients who have a history of risk, and a neck 25 millimeters can benefit from a therapy with progesterone gel, which has shown excellent results, recording a decline in the incidence of preterm delivery. Those without a history of or risk factors turn to this therapy when the neck of the uterus recorded less than 15 mm.

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The doctor Eghon Guzmán, who in addition to integrating the team of specialists of Integramédica serves as advisor to the Ministry of Health, is considering the possibility of making measurement of the neck of the uterus at 24 weeks routinely and explains that “in this way, women with or without a history of preterm birth, will be able to know if to go or not to the therapy of progesterone gel until you arrive where possible at a full-term delivery”.

It is important to note that it is considered pregnancy preterm all women with a gestational age less than 37 weeks, and special emphasis is given to the birth that occurs prior to 34 weeks. When it is foreseen a threat of preterm delivery, we resort to the use of corticosteroids, since they allow fetal lung maturity, and ensure a better prognosis for the fetus.


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