Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael

La restricción de crecimiento intrauterino trae consigo grandes retos en la obstetricia con alta tasa de eventos perinatales adversos y incluso la muerte fetal. En varias publicaciones se ha visto como aún se encuentran muchos vacíos respecto a cuando es el mejor momento para el nacimiento y antes d...

Full description

Autores:
Castelblanco Rojas, Andrés Mauricio
Montoya Hurtado, Laura Cristina
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2022
Institución:
Universidad Militar Nueva Granada
Repositorio:
Repositorio UMNG
Idioma:
spa
OAI Identifier:
oai:repository.unimilitar.edu.co:10654/42236
Acceso en línea:
http://hdl.handle.net/10654/42236
Palabra clave:
Intrauterine growth restriction, childbirth, cesarean section, condition unsatisfactory fetus, perinatal asphyxia, neonatal death
Intrauterine growth restriction
childbirth
cesarean
condition unsatisfactory fetus
perinatal asphyxia
neonatal death
GINECOLOGIA
OBSTETRICIA
ULTRASONOGRAFÍA PRENATAL
RETARDO DEL CRECIMIENTO FETAL
ULTRASONOGRAFÍA DOPPLER
ENFERMEDADES FETALES
Restricción del crecimiento intrauterino, parto, cesárea, estado fetal no satisfactorio, asfixia perinatal, muerte neonatal
Restricción del crecimiento intrauterino
parto
cesárea
estado fetal no satisfactorio
asfixia perinatal
muerte neonatal
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/4.0/
id UNIMILTAR2_1b1d74f24ec4b3f47bc05f7930bad468
oai_identifier_str oai:repository.unimilitar.edu.co:10654/42236
network_acronym_str UNIMILTAR2
network_name_str Repositorio UMNG
repository_id_str
dc.title.spa.fl_str_mv Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
dc.title.translated.spa.fl_str_mv Association between the route of delivery and outcomes perinatals in growth-restricted fetuses intrauterine with normal fetal doppler or in stage 1 in the hospital universitario clinica San Rafael
title Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
spellingShingle Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
Intrauterine growth restriction, childbirth, cesarean section, condition unsatisfactory fetus, perinatal asphyxia, neonatal death
Intrauterine growth restriction
childbirth
cesarean
condition unsatisfactory fetus
perinatal asphyxia
neonatal death
GINECOLOGIA
OBSTETRICIA
ULTRASONOGRAFÍA PRENATAL
RETARDO DEL CRECIMIENTO FETAL
ULTRASONOGRAFÍA DOPPLER
ENFERMEDADES FETALES
Restricción del crecimiento intrauterino, parto, cesárea, estado fetal no satisfactorio, asfixia perinatal, muerte neonatal
Restricción del crecimiento intrauterino
parto
cesárea
estado fetal no satisfactorio
asfixia perinatal
muerte neonatal
title_short Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
title_full Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
title_fullStr Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
title_full_unstemmed Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
title_sort Asociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san Rafael
dc.creator.fl_str_mv Castelblanco Rojas, Andrés Mauricio
Montoya Hurtado, Laura Cristina
dc.contributor.advisor.none.fl_str_mv Geney Montes, María Cristina
dc.contributor.author.none.fl_str_mv Castelblanco Rojas, Andrés Mauricio
Montoya Hurtado, Laura Cristina
dc.subject.keywords.spa.fl_str_mv Intrauterine growth restriction, childbirth, cesarean section, condition unsatisfactory fetus, perinatal asphyxia, neonatal death
Intrauterine growth restriction
childbirth
cesarean
condition unsatisfactory fetus
perinatal asphyxia
neonatal death
topic Intrauterine growth restriction, childbirth, cesarean section, condition unsatisfactory fetus, perinatal asphyxia, neonatal death
Intrauterine growth restriction
childbirth
cesarean
condition unsatisfactory fetus
perinatal asphyxia
neonatal death
GINECOLOGIA
OBSTETRICIA
ULTRASONOGRAFÍA PRENATAL
RETARDO DEL CRECIMIENTO FETAL
ULTRASONOGRAFÍA DOPPLER
ENFERMEDADES FETALES
Restricción del crecimiento intrauterino, parto, cesárea, estado fetal no satisfactorio, asfixia perinatal, muerte neonatal
Restricción del crecimiento intrauterino
parto
cesárea
estado fetal no satisfactorio
asfixia perinatal
muerte neonatal
dc.subject.decs.spa.fl_str_mv GINECOLOGIA
OBSTETRICIA
ULTRASONOGRAFÍA PRENATAL
RETARDO DEL CRECIMIENTO FETAL
ULTRASONOGRAFÍA DOPPLER
ENFERMEDADES FETALES
dc.subject.proposal.spa.fl_str_mv Restricción del crecimiento intrauterino, parto, cesárea, estado fetal no satisfactorio, asfixia perinatal, muerte neonatal
Restricción del crecimiento intrauterino
parto
cesárea
estado fetal no satisfactorio
asfixia perinatal
muerte neonatal
description La restricción de crecimiento intrauterino trae consigo grandes retos en la obstetricia con alta tasa de eventos perinatales adversos y incluso la muerte fetal. En varias publicaciones se ha visto como aún se encuentran muchos vacíos respecto a cuando es el mejor momento para el nacimiento y antes de que los cambios secundarios a hipoxia crónica y acidosis sean irreversibles. El seguimiento con ecografía y doppler fetoplacentario a un feto con desaceleración en la curva de crecimiento son una gran herramienta en la toma de decisiones y evitar eventos adversos con mejoría de sobrevida y pronostico a estos fetos
publishDate 2022
dc.date.issued.none.fl_str_mv 2022-11-22
dc.date.accessioned.none.fl_str_mv 2023-02-07T13:41:28Z
dc.date.available.none.fl_str_mv 2023-02-07T13:41:28Z
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.coar.*.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
format http://purl.org/coar/resource_type/c_7a1f
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10654/42236
dc.identifier.instname.spa.fl_str_mv instname:Universidad Militar Nueva Granada
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad Militar Nueva Granada
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unimilitar.edu.co
url http://hdl.handle.net/10654/42236
identifier_str_mv instname:Universidad Militar Nueva Granada
reponame:Repositorio Institucional Universidad Militar Nueva Granada
repourl:https://repository.unimilitar.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv Gratacós E, Figueras F. (2014). Fetal growth restriction as a perinatal and long-term health problem. Clinical challenges and opportunities for future (4P) fetal medicine. Fetal diagnosis and therapy, 36(2), 85.
Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. (2018). Diagnosis and surveillance of late-onset fetal growth restriction. American journal of obstetrics and gynecology, 218(2S), S790–S802.e1.
Lin C, Moawad A, Rosenow P, River P. (1980). Acid-base characteristics of fetuses with intrauterine growth retardation during labor and delivery. Am J Obstet Gynecol;137:553-9.
Boers K, Vijgen S, Bijlenga D, van der Post J , et al. (2010). Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ (Clinical research ed.), 341, c7087.
Dijxhoorn M, Visser G, Touwen B, Huisjes H. (1987). Apgar score, meconium and acidaemia at birth in small-for-gestational age infants born at term, and their relation to neonatal neurological morbidity. British journal of obstetrics and gynaecology, 94(9), 873–879.
Cruz R, Figueras F, Hernandez E, Oros D, Gratacos E. (2011) Fetal Brain Doppler to Predict Cesarean Delivery for Nonreassuring Fetal Status in Term Small-for-Gestational-Age Fetuses, Obstetrics & Gynecology. Volume 117 - Issue 3 - p 618-626
Molina S, Benavides J, Pérez J, Galvis P, et al. (2018). Consenso de la federación colombiana de asociaciones de perinatología y medicina Universitario Clínica San Rafael Carrera 8 N. 17-45 Sur | Bogotá | Colombia Teléfono: +57 1 3282300 clinicasanrafael.com.co 66 materno fetal (FECOPEN). Enfoque y manejo de la restricción del crecimiento fetal.
UNICEF. (2006). Progreso para la infancia. Balance sobre la nutrición. Pages 32.
Bamfo J, Odibo A. (2011) Diagnosis and management of fetal growth restriction. J Pregnancy, 2011:640715.
Rebollar E, Ávila J, Gutiérrez V. (2010). Factores de riesgo asociados al bajo peso al nacer. Arch Inv Mat Inf; 2 (3): 117-22.
Ortiz E. (2001) Estrategias para la prevención del bajo peso al nacer en una población de alto riesgo, según la medicina basada en la evidencia. Colomb Med; 32:159-62.
American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics and the Society for Maternal-FetalMedicin (2019). ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstetrics and gynecology, 133(2), e97–e109.
Madden J, Flatley C, Kumar S. (2018).Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes. Am J Obstet Gynecol;218:525.e1-.e9.
Chauhan S, Rice M, Grobman W, Bailit J, Reddy U, Wapner R, Varner M. (2017). Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies. Obstetrics and gynecology, 130(3), 511–519.
Palloto E, Kilbride H. (2006). Perinatal outcome and later implications of intrauterine growth restriction. Clin Obstet Gynecol;49(2):257-69.
Jacobsson B, Ahlin K, Francis A, Hagberg G, Hagberg H, Gardosi J. (2008). Cerebral palsy and restricted growth status at birth: population-based case- control study. BJOG : an international journal of obstetrics and gynaecology, 115(10), 1250–1255.
Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. (2013). Maternal and fetal risk factors for stillbirth: population based study. BMJ;346:f108
MacDonald T, McCarthy E, Walker S. (2015) Shining light in dark corners: diagnosis and management of late-onset fetal growth restriction. Aust N Z J Obstet Gynaecol; 55(1):3-10.
Molina S, Correa D, Rojas J, Acuña E. (2014) Orígenes fetales de la patología del adulto: la restricción del crecimiento intrauterino como factor de riesgo. Rev Chil Obstet Ginecol; 79(6): 546 – 53.
Vasak B, Koenen S, Koster M, Hukkelhoven C, Franx A, Hanson M A, Visser G. (2015). Human fetal growth is constrained below optimal for perinatal survival. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 45(2), 162–167.
McIntire D, Bloom S, Casey B, Leveno K. (1999). Birth weight in relation to morbidity and mortality among newborn infants. The New England journal of medicine, 340(16), 1234–1238.
Kramer M, Olivier M, McLean F, Willis D, Usher R. (1990). Impact of intrauterine growth retardation and body proportionality on fetal and neonatal outcome. Pediatrics, 86(5), 707–713.
Khali A, Morales J. Elsaddig M, Khan N, Papageorghiou A, Bhide A, Thilaganathan B. (2015). The association between fetal Doppler and admission to neonatal unit at term. American journal of obstetrics and gynecology, 213(1), 57.e1–57.e7.
Sibai B, Spinnato J, Watson D, Hill G, Anderson G. (1984) Pregnancy outcome in 303 cases with severe preeclampsia. Obstet Gynecol ;64:319- 25.
Maulik D. (2006)Fetal Growth Restriction: The Etiology. Clin Obstet Gynecol;49(2):228-35.
Hendrix N, Berghella V. (2008). Non-placetal causes of intrauterine growth restriction. Semin Perinatol
Monk D, Moore G. (2004). Intrauterine growth restriction genetic causes and consequences. Semin Fetal Neonatal Med;9:371-8.
Ville Y, Nyberg D. Growth, Doppler and fetal assessment. En: Nyberg D, McGahan J, Pretorius D, Pilu G, editors. Diagnostic imaging of fetal anomalies. Philadelphia: Lippincott Williams & Wilkins; 2003. pp 31-58.
Offenbacher S, Lieff S, Boggess K, Murtha A, Madianos P, Champagne C, et al. (2001). Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. Ann Periodontol;6:164-74.
Gardosi J. (2005). Prematurity and fetal growth restriction. Early Hum Dev;81:43-9.
Nardozza, L, Caetano A, Zamarian A, Mazzola J, Silva C, Marçal V, Araujo E. (2017) Fetal growth restriction: current knowledge. Archives of Gynecology and Obstetrics, 295(5), 1061–1077.
Shah P. (2010). Parity and low birth weight and preterm birth: a systematic review and meta-analyses. Acta Obstet Gynecol Scand;89(7):862–75.
Odibo A, Nelson D, Stamilio D, Sehdev H, Macones G. (2006). Advanced maternal age is an independent risk factor for intrauterine growth restriction. Am J Perinatol. 2006 Jul;23(5):325–8.
Han Z, Mulla S, Beyene J, Liao G, McDonald S. (2011). Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol. Feb;40(1):65–101.
Jaddoe V, Bakker R, Hofman A, Mackenbach J, Moll H, Steegers E, et al. (2007) Moderate alcohol consumption during pregnancy and the risk of low birth weight and preterm birth. The generation R study. Ann Epidemiol.;17(10):834–40.
McCowan L, Dekker G, Chan E, Stewart A, Chappell L, Hunter M, et al. (2009) Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. Mar;338:b1081.
Gouin K, Murphy K, Shah P. (2011) Effects of cocaine use during pregnancy on low birthweight and preterm birth: systematic review and metaanalyses. Am J Obstet Gynecol. Apr;204(4):340.e1-12.
Silver R. (2018) Examining the link between placental pathology, growth restriction, and stillbirth. Best Pract Res Clin Obstet Gynaecol. May;49:89–102.
Arroyo J, Winn V. (2008). Vasculogenesis and angiogenesis in the IUGR placenta. Semin Perinatol;32(3):172-7. doi: 10.1053/j.semperi.2008.02.006.
Chaddha V, Viero S, Huppertz B, Kingdom J. (2004). Developmental biology of the placenta and the origins of placental insufficiency. Semin Fetal Neonatal Med;9(5):357-69.
Otrock Z, Makarem J, Shamseddine A. (2007). Vascular endothelial growth factor family of ligands and receptors: Review. Blood Cells Mol Dis;38(3):258-68
Saffer C, Olson G, Boggess K, Beyerlein R, Eubank C, Sibai B. (2013). Determination of placental growth factor (PlGF) levels in healthy pregnant women without signs or symptoms of preeclampsia. Pregnancy Hypertens;3(2):124-32.
Barut, F., Barut, A., Gun B, Kandemir N, Harma, M, & Harma, M. (2010). Intrauterine growth restriction and placental angiogenesis. .Diagnostic Pathology, 12–14.
Dimasuay K, Boeuf P, Powell T, Jansson T. (2016). Placental Responses to Changes in the Maternal Environment Determine Fetal Growth. Front. Physiol. 7:12.
Pacheco J. (1995). Retardo de crecimiento intrauterino. Ginecología y Obstetricia - Vol. 41 Nº2
Baschat A. (2018). Planning management and delivery of the growth- restricted fetus. Best practice & research. Clinical obstetrics & gynaecology, 49, 53–65.
Roberts M. (2014) Pathophysiology of ischemic placental disease, Seminars in Perinatology 38 139 –145.
Gino G. (2016) The fetal brain sparing response to hypoxia: physiological mechanisms. J Physiol 594.5. pp 1215–1230.
Molina S, Ramirez J. (2008). Restriccion de crecimiento intrauterino. Una aproximación. Controversias en Ginecol y Obstet, 5, 110-123
Sepulveda E, Crispi F, Pons A, Gratacos E. (2014).Restriccion de crecimiento intrauterino. Rev Med Clin Condes; 25(6):958-63.
American College of Obstetricians and Gynecologists. (2013). ACOG Practice bulletin no. 134: fetal growth restriction. Obstet Gynecol;121(5):1122-1133.
Berkley E, Chauhan S, Abuhamad A, Committee SfM-FMP. (2012). Doppler assessment of the fetus with intrauterine growth restriction. Am J Obstet Gynecol;206(4):300-8.
Lausman A, Kingdom J, COMMITTEE MFM. (2013). Intrauterine growth restriction: screening, diagnosis, and management. J Obstet Gynaecol Can;35(8):741-8.
Vayssiere C, Sentilhes L, Ego A, Bernard C, Cambourieu D, Flamant C, et al. (2015). Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol;193:10-8.
Figueras F, Gratacos E. (2014). Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther; 36(2):86-98.
American College of Obstetricians and Gynecologists. Committee Opinion No. 700: (2017). Methods for estimating the due date. Obstet Gynecol;129:e150-e4.
H. P. Robinson, J. E. E. Fleming. (1975) A CRITICAL EVALUATION OF SONAR “CROWN‐RUMP LENGTH” MEASUREMENTS. BJOG. Volume82, Issue9. September Pages 702-710
Papageorghiou A, Ohuma E, Altman D, et al. (2014). International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of theINTERGROWTH- 21st Project. Lancet;384(9946):869-79.
Abuhamad A, Minton K, Benson C, et al. (2018). Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs: consensus report. Am J Obstet Gynecol;218:29-67.
Bardach N, Asteria P, Boscardin W, Dudley R. (2013). The relationship between commercial website ratings and traditional hospital performance measures in the USA. BMJ Qual Saf;22:194-202.
Hadlock F, Harrist R, Martinez J. (1991). In utero analysis of fetal growth: a sonographic weight standard. Radiology;181:129-33.
Hanley G, Janssen P. (2013). Ethnicity-specific birthweight distributions improve identification of term newborns at risk for short term morbidity. Am J Obstet Gynecol;209:428.e1-6.
Callen P. (2008). Ultrasonography in Obstetrics and Gynecology. Philadelphia:Saunders Elsevier
Hernandez E, Lopez J., Figueroa H, Sanin J, Carreras E, Cabero, L. et al. (2005). A modified myocardial performance (Tei) index based on the use of valve clicks improves reproducibility of fetal left cardiac function assessment. Ultrasound Obstet Gyneco, 26, 227-232.
Soothill P, Ajayi R, Campbell S, Nicolaides K. (1993). Prediction of morbidity in small and normally grown fetuses by fetal heart rate variability, biophysical profile score and umbilical artery Doppler studies. British journal of obstetrics and gynaecology, 100(8), 742–745.
Khalil A, Townsend R, Morales J, Bhide A, Papageorghiou A, Thilaganathan B. (2015), OC22.06: Are fetal cerebroplacental ratio and impaired placental perfusion recorded in the third trimester predictors of stillbirth and perinatal loss?. Ultrasound Obstet Gynecol, 46: 49-49.
Conde A, Villar J, Kennedy S, Papageorghiou A. (2018). Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: systematic review and meta-analysis. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 52(4), 430–441.
Figueras F, Savchev S, Triunfo S, Crovetto F, Gratacos E. (2015). An integrated model with classification criteria to predict small-for-gestational- age fetuses at risk of adverse perinatal outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 45(3), 279–285.
Valiño N, Giunta G, Gallo D, Akolekar R, Nicolaides K. (2016). Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 47(3), 308–315.
Savchev S, Figueras F, Sanz-Cortes M, et al. (2014). Evaluation of an optimal gestational age cutoff for the definition of early- and late-onset fetal growth restriction. Fetal Diagn Ther;36:99-105.
Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. (2018). Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obstet Gynecol;218:S790-S802.e1.
Parra M, Crovetto F, Triunfo S, et al. (2014). Neurodevelopmental outcomes of nearterm small for gestational age infants with and without signs of placental underperfusion. Placenta;35:269-74.
Severi F, Bocchi C, Visentin A, et al. (2002). Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol;19:225-8.
Savchev S, Figueras F, Cruz R, Botet F, Gratacos E. (2012). Estimated weight centile as a predictor of perinatal outcome in small-for-gestational- age pregnancies with normal fetal and maternal Doppler indices. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 39(3), 299–303.
Figueras F, Figueras J, Meler E, Eixarch E, Coli O, Gratacos E, Gardosi J & Carbonell X. (2007). Customised birthweight standards accurately predict perinatal morbidity. Arch Dis Child Fetal Neonatal Ed, 92, 277-280
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No.743: Low-dose aspirin use during pregnancy. Obstet Gynecol 2018;132:e44-e52.
Visser G, Bilardo C, Lees C. (2014). Fetal growth restriction at the limits of viability. Fetal Diagn Ther;36:162-5.
Pimiento L, Beltrán M. (2015). Restricción del crecimiento intrauterino: una aproximación al diagnóstico, seguimiento y manejo. Revista chilena de obstetricia y ginecología, 80(6), 493-502.
Jesus L, Pappas A, Shankaran S, et al. (2013). Outcomes of small for gestational age infants born at <27 weeks' gestation. J Pediatr;163:55- 60.e1-3.
Maggio L, Dahlke J, Mendez H, Albright C, Chauhan S, Wenstrom K.(2015). Perinatal outcomes with normal compared with elevated umbilical artery systolic-to-diastolic ratios in fetal growth restriction. Obstet Gynecol;125:863-9.
Kahn B, Lumey L, Zybert P, et al. (2003). Prospective risk of fetal death in singleton, twin, and triplet gestations: implications for practice. Obstet Gynecol;102:685-92.
Oros D, Figueras F, Cruz R, Meler E, Munmany M, Gratacos E. (2011). Longitudinal changes in uterine, umbilical and fetal cerebral Doppler indices in late-onset small-for-gestational age fetuses. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 37(2), 191–195.
Rojas Arias, J, González Carrillo, V, Acuña Rubiano, S, Acuña Osorio, E y Molina Giraldo, S. (2018-01-31.). Incidencia de estado fetal no satisfactorio en restricción de crecimiento intrauterino y feto pequeño para la edad gestacional: estudio de una cohorte. Bogotá: Fundación Universitaria de Ciencias de la Salud
Ajah, L. O., Ibekwe, P. C., Onu, F. A., Onwe, O. E., Ezeonu, T. C., & Omeje, I. (2016). Evaluation of Clinical Diagnosis of Fetal Distress and Perinatal Outcome in a Low Resource Nigerian Setting. Journal of clinical and Universitario Clínica San Rafael Carrera 8 N. 17-45 Sur | Bogotá | Colombia Teléfono: +57 1 3282300 clinicasanrafael.com.co 74 diagnostic research : JCDR, 10(4), QC08–QC11.
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.accessrights.*.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.creativecommons.spa.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.local.spa.fl_str_mv Acceso abierto
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
Acceso abierto
eu_rights_str_mv openAccess
dc.format.mimetype.spa.fl_str_mv applicaction/pdf
dc.coverage.spatial.spa.fl_str_mv Hospital Universitario Clínica San Rafael
dc.coverage.temporal.spa.fl_str_mv 2017 - 2019
dc.coverage.sede.spa.fl_str_mv Medicina
dc.publisher.program.spa.fl_str_mv Ginecología y obstetricia
dc.publisher.faculty.spa.fl_str_mv Facultad de Medicina
dc.publisher.grantor.spa.fl_str_mv Universidad Militar Nueva Granada
institution Universidad Militar Nueva Granada
bitstream.url.fl_str_mv http://repository.unimilitar.edu.co/bitstream/10654/42236/1/castelblancorojasandresmauricio2022.pdf
http://repository.unimilitar.edu.co/bitstream/10654/42236/2/comiteetica.pdf
http://repository.unimilitar.edu.co/bitstream/10654/42236/3/license.txt
bitstream.checksum.fl_str_mv e6b39bc2382a9b38c07feeddd6a26177
83f2739ecb146bf23a8a8136727b8754
a609d7e369577f685ce98c66b903b91b
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositorio Institucional UMNG
repository.mail.fl_str_mv bibliodigital@unimilitar.edu.co
_version_ 1837098367872663552
spelling Geney Montes, María CristinaCastelblanco Rojas, Andrés MauricioMontoya Hurtado, Laura CristinaEspecialista en Ginecología y obstetriciaHospital Universitario Clínica San Rafael2017 - 2019Medicina2023-02-07T13:41:28Z2023-02-07T13:41:28Z2022-11-22http://hdl.handle.net/10654/42236instname:Universidad Militar Nueva Granadareponame:Repositorio Institucional Universidad Militar Nueva Granadarepourl:https://repository.unimilitar.edu.coLa restricción de crecimiento intrauterino trae consigo grandes retos en la obstetricia con alta tasa de eventos perinatales adversos y incluso la muerte fetal. En varias publicaciones se ha visto como aún se encuentran muchos vacíos respecto a cuando es el mejor momento para el nacimiento y antes de que los cambios secundarios a hipoxia crónica y acidosis sean irreversibles. El seguimiento con ecografía y doppler fetoplacentario a un feto con desaceleración en la curva de crecimiento son una gran herramienta en la toma de decisiones y evitar eventos adversos con mejoría de sobrevida y pronostico a estos fetos1. FORMULACIÓN DEL PROBLEMA 8 1.1. Planteamiento del problema 8 1.2. Justificación 9 1.3. Pregunta de investigación 10 2. MARCO TEÓRICO 11 3. OBJETIVOS 31 4. HIPÓTESIS 32 5. METODOLOGÍA 33 6. RESULTADOS 51 7. DISCUSIÓN 68 8. CONCLUSIONES 72 9. BIBLIOGRAFIA 73 10. ANEXOS 82Intrauterine growth restriction brings with it great challenges in obstetrics with a high rate of adverse perinatal events and even fetal death. In several publications, it has been seen how there are still many gaps regarding when is the best time for birth and before the changes secondary to chronic hypoxia and acidosis are irreversible. Follow-up with ultrasound and fetoplacental Doppler to a fetus with a slowdown in the growth curve are a great tool for decision-making and to avoid adverse events with improved survival and prognosis for these fetuses.Especializaciónapplicaction/pdfspahttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 InternationalAcceso abiertoAsociación entre la vía del parto y los desenlaces perinatales en fetos con restricción del crecimiento intrauterino con doppler fetal normal o en estadio 1 en el hospital universitario clínica san RafaelAssociation between the route of delivery and outcomes perinatals in growth-restricted fetuses intrauterine with normal fetal doppler or in stage 1 in the hospital universitario clinica San RafaelTesis/Trabajo de grado - Monografía - Especializacióninfo:eu-repo/semantics/bachelorThesishttp://purl.org/coar/resource_type/c_7a1fIntrauterine growth restriction, childbirth, cesarean section, condition unsatisfactory fetus, perinatal asphyxia, neonatal deathIntrauterine growth restrictionchildbirthcesareancondition unsatisfactory fetusperinatal asphyxianeonatal deathGINECOLOGIAOBSTETRICIAULTRASONOGRAFÍA PRENATALRETARDO DEL CRECIMIENTO FETALULTRASONOGRAFÍA DOPPLERENFERMEDADES FETALESRestricción del crecimiento intrauterino, parto, cesárea, estado fetal no satisfactorio, asfixia perinatal, muerte neonatalRestricción del crecimiento intrauterinopartocesáreaestado fetal no satisfactorioasfixia perinatalmuerte neonatalGinecología y obstetriciaFacultad de MedicinaUniversidad Militar Nueva GranadaGratacós E, Figueras F. (2014). Fetal growth restriction as a perinatal and long-term health problem. Clinical challenges and opportunities for future (4P) fetal medicine. Fetal diagnosis and therapy, 36(2), 85.Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. (2018). Diagnosis and surveillance of late-onset fetal growth restriction. American journal of obstetrics and gynecology, 218(2S), S790–S802.e1.Lin C, Moawad A, Rosenow P, River P. (1980). Acid-base characteristics of fetuses with intrauterine growth retardation during labor and delivery. Am J Obstet Gynecol;137:553-9.Boers K, Vijgen S, Bijlenga D, van der Post J , et al. (2010). Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ (Clinical research ed.), 341, c7087.Dijxhoorn M, Visser G, Touwen B, Huisjes H. (1987). Apgar score, meconium and acidaemia at birth in small-for-gestational age infants born at term, and their relation to neonatal neurological morbidity. British journal of obstetrics and gynaecology, 94(9), 873–879.Cruz R, Figueras F, Hernandez E, Oros D, Gratacos E. (2011) Fetal Brain Doppler to Predict Cesarean Delivery for Nonreassuring Fetal Status in Term Small-for-Gestational-Age Fetuses, Obstetrics & Gynecology. Volume 117 - Issue 3 - p 618-626Molina S, Benavides J, Pérez J, Galvis P, et al. (2018). Consenso de la federación colombiana de asociaciones de perinatología y medicina Universitario Clínica San Rafael Carrera 8 N. 17-45 Sur | Bogotá | Colombia Teléfono: +57 1 3282300 clinicasanrafael.com.co 66 materno fetal (FECOPEN). Enfoque y manejo de la restricción del crecimiento fetal.UNICEF. (2006). Progreso para la infancia. Balance sobre la nutrición. Pages 32.Bamfo J, Odibo A. (2011) Diagnosis and management of fetal growth restriction. J Pregnancy, 2011:640715.Rebollar E, Ávila J, Gutiérrez V. (2010). Factores de riesgo asociados al bajo peso al nacer. Arch Inv Mat Inf; 2 (3): 117-22.Ortiz E. (2001) Estrategias para la prevención del bajo peso al nacer en una población de alto riesgo, según la medicina basada en la evidencia. Colomb Med; 32:159-62.American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics and the Society for Maternal-FetalMedicin (2019). ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstetrics and gynecology, 133(2), e97–e109.Madden J, Flatley C, Kumar S. (2018).Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes. Am J Obstet Gynecol;218:525.e1-.e9.Chauhan S, Rice M, Grobman W, Bailit J, Reddy U, Wapner R, Varner M. (2017). Neonatal Morbidity of Small- and Large-for-Gestational-Age Neonates Born at Term in Uncomplicated Pregnancies. Obstetrics and gynecology, 130(3), 511–519.Palloto E, Kilbride H. (2006). Perinatal outcome and later implications of intrauterine growth restriction. Clin Obstet Gynecol;49(2):257-69.Jacobsson B, Ahlin K, Francis A, Hagberg G, Hagberg H, Gardosi J. (2008). Cerebral palsy and restricted growth status at birth: population-based case- control study. BJOG : an international journal of obstetrics and gynaecology, 115(10), 1250–1255.Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. (2013). Maternal and fetal risk factors for stillbirth: population based study. BMJ;346:f108MacDonald T, McCarthy E, Walker S. (2015) Shining light in dark corners: diagnosis and management of late-onset fetal growth restriction. Aust N Z J Obstet Gynaecol; 55(1):3-10.Molina S, Correa D, Rojas J, Acuña E. (2014) Orígenes fetales de la patología del adulto: la restricción del crecimiento intrauterino como factor de riesgo. Rev Chil Obstet Ginecol; 79(6): 546 – 53.Vasak B, Koenen S, Koster M, Hukkelhoven C, Franx A, Hanson M A, Visser G. (2015). Human fetal growth is constrained below optimal for perinatal survival. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 45(2), 162–167.McIntire D, Bloom S, Casey B, Leveno K. (1999). Birth weight in relation to morbidity and mortality among newborn infants. The New England journal of medicine, 340(16), 1234–1238.Kramer M, Olivier M, McLean F, Willis D, Usher R. (1990). Impact of intrauterine growth retardation and body proportionality on fetal and neonatal outcome. Pediatrics, 86(5), 707–713.Khali A, Morales J. Elsaddig M, Khan N, Papageorghiou A, Bhide A, Thilaganathan B. (2015). The association between fetal Doppler and admission to neonatal unit at term. American journal of obstetrics and gynecology, 213(1), 57.e1–57.e7.Sibai B, Spinnato J, Watson D, Hill G, Anderson G. (1984) Pregnancy outcome in 303 cases with severe preeclampsia. Obstet Gynecol ;64:319- 25.Maulik D. (2006)Fetal Growth Restriction: The Etiology. Clin Obstet Gynecol;49(2):228-35.Hendrix N, Berghella V. (2008). Non-placetal causes of intrauterine growth restriction. Semin PerinatolMonk D, Moore G. (2004). Intrauterine growth restriction genetic causes and consequences. Semin Fetal Neonatal Med;9:371-8.Ville Y, Nyberg D. Growth, Doppler and fetal assessment. En: Nyberg D, McGahan J, Pretorius D, Pilu G, editors. Diagnostic imaging of fetal anomalies. Philadelphia: Lippincott Williams & Wilkins; 2003. pp 31-58.Offenbacher S, Lieff S, Boggess K, Murtha A, Madianos P, Champagne C, et al. (2001). Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. Ann Periodontol;6:164-74.Gardosi J. (2005). Prematurity and fetal growth restriction. Early Hum Dev;81:43-9.Nardozza, L, Caetano A, Zamarian A, Mazzola J, Silva C, Marçal V, Araujo E. (2017) Fetal growth restriction: current knowledge. Archives of Gynecology and Obstetrics, 295(5), 1061–1077.Shah P. (2010). Parity and low birth weight and preterm birth: a systematic review and meta-analyses. Acta Obstet Gynecol Scand;89(7):862–75.Odibo A, Nelson D, Stamilio D, Sehdev H, Macones G. (2006). Advanced maternal age is an independent risk factor for intrauterine growth restriction. Am J Perinatol. 2006 Jul;23(5):325–8.Han Z, Mulla S, Beyene J, Liao G, McDonald S. (2011). Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol. Feb;40(1):65–101.Jaddoe V, Bakker R, Hofman A, Mackenbach J, Moll H, Steegers E, et al. (2007) Moderate alcohol consumption during pregnancy and the risk of low birth weight and preterm birth. The generation R study. Ann Epidemiol.;17(10):834–40.McCowan L, Dekker G, Chan E, Stewart A, Chappell L, Hunter M, et al. (2009) Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. Mar;338:b1081.Gouin K, Murphy K, Shah P. (2011) Effects of cocaine use during pregnancy on low birthweight and preterm birth: systematic review and metaanalyses. Am J Obstet Gynecol. Apr;204(4):340.e1-12.Silver R. (2018) Examining the link between placental pathology, growth restriction, and stillbirth. Best Pract Res Clin Obstet Gynaecol. May;49:89–102.Arroyo J, Winn V. (2008). Vasculogenesis and angiogenesis in the IUGR placenta. Semin Perinatol;32(3):172-7. doi: 10.1053/j.semperi.2008.02.006.Chaddha V, Viero S, Huppertz B, Kingdom J. (2004). Developmental biology of the placenta and the origins of placental insufficiency. Semin Fetal Neonatal Med;9(5):357-69.Otrock Z, Makarem J, Shamseddine A. (2007). Vascular endothelial growth factor family of ligands and receptors: Review. Blood Cells Mol Dis;38(3):258-68Saffer C, Olson G, Boggess K, Beyerlein R, Eubank C, Sibai B. (2013). Determination of placental growth factor (PlGF) levels in healthy pregnant women without signs or symptoms of preeclampsia. Pregnancy Hypertens;3(2):124-32.Barut, F., Barut, A., Gun B, Kandemir N, Harma, M, & Harma, M. (2010). Intrauterine growth restriction and placental angiogenesis. .Diagnostic Pathology, 12–14.Dimasuay K, Boeuf P, Powell T, Jansson T. (2016). Placental Responses to Changes in the Maternal Environment Determine Fetal Growth. Front. Physiol. 7:12.Pacheco J. (1995). Retardo de crecimiento intrauterino. Ginecología y Obstetricia - Vol. 41 Nº2Baschat A. (2018). Planning management and delivery of the growth- restricted fetus. Best practice & research. Clinical obstetrics & gynaecology, 49, 53–65.Roberts M. (2014) Pathophysiology of ischemic placental disease, Seminars in Perinatology 38 139 –145.Gino G. (2016) The fetal brain sparing response to hypoxia: physiological mechanisms. J Physiol 594.5. pp 1215–1230.Molina S, Ramirez J. (2008). Restriccion de crecimiento intrauterino. Una aproximación. Controversias en Ginecol y Obstet, 5, 110-123Sepulveda E, Crispi F, Pons A, Gratacos E. (2014).Restriccion de crecimiento intrauterino. Rev Med Clin Condes; 25(6):958-63.American College of Obstetricians and Gynecologists. (2013). ACOG Practice bulletin no. 134: fetal growth restriction. Obstet Gynecol;121(5):1122-1133.Berkley E, Chauhan S, Abuhamad A, Committee SfM-FMP. (2012). Doppler assessment of the fetus with intrauterine growth restriction. Am J Obstet Gynecol;206(4):300-8.Lausman A, Kingdom J, COMMITTEE MFM. (2013). Intrauterine growth restriction: screening, diagnosis, and management. J Obstet Gynaecol Can;35(8):741-8.Vayssiere C, Sentilhes L, Ego A, Bernard C, Cambourieu D, Flamant C, et al. (2015). Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol;193:10-8.Figueras F, Gratacos E. (2014). Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther; 36(2):86-98.American College of Obstetricians and Gynecologists. Committee Opinion No. 700: (2017). Methods for estimating the due date. Obstet Gynecol;129:e150-e4.H. P. Robinson, J. E. E. Fleming. (1975) A CRITICAL EVALUATION OF SONAR “CROWN‐RUMP LENGTH” MEASUREMENTS. BJOG. Volume82, Issue9. September Pages 702-710Papageorghiou A, Ohuma E, Altman D, et al. (2014). International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of theINTERGROWTH- 21st Project. Lancet;384(9946):869-79.Abuhamad A, Minton K, Benson C, et al. (2018). Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs: consensus report. Am J Obstet Gynecol;218:29-67.Bardach N, Asteria P, Boscardin W, Dudley R. (2013). The relationship between commercial website ratings and traditional hospital performance measures in the USA. BMJ Qual Saf;22:194-202.Hadlock F, Harrist R, Martinez J. (1991). In utero analysis of fetal growth: a sonographic weight standard. Radiology;181:129-33.Hanley G, Janssen P. (2013). Ethnicity-specific birthweight distributions improve identification of term newborns at risk for short term morbidity. Am J Obstet Gynecol;209:428.e1-6.Callen P. (2008). Ultrasonography in Obstetrics and Gynecology. Philadelphia:Saunders ElsevierHernandez E, Lopez J., Figueroa H, Sanin J, Carreras E, Cabero, L. et al. (2005). A modified myocardial performance (Tei) index based on the use of valve clicks improves reproducibility of fetal left cardiac function assessment. Ultrasound Obstet Gyneco, 26, 227-232.Soothill P, Ajayi R, Campbell S, Nicolaides K. (1993). Prediction of morbidity in small and normally grown fetuses by fetal heart rate variability, biophysical profile score and umbilical artery Doppler studies. British journal of obstetrics and gynaecology, 100(8), 742–745.Khalil A, Townsend R, Morales J, Bhide A, Papageorghiou A, Thilaganathan B. (2015), OC22.06: Are fetal cerebroplacental ratio and impaired placental perfusion recorded in the third trimester predictors of stillbirth and perinatal loss?. Ultrasound Obstet Gynecol, 46: 49-49.Conde A, Villar J, Kennedy S, Papageorghiou A. (2018). Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: systematic review and meta-analysis. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 52(4), 430–441.Figueras F, Savchev S, Triunfo S, Crovetto F, Gratacos E. (2015). An integrated model with classification criteria to predict small-for-gestational- age fetuses at risk of adverse perinatal outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 45(3), 279–285.Valiño N, Giunta G, Gallo D, Akolekar R, Nicolaides K. (2016). Uterine artery pulsatility index at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 47(3), 308–315.Savchev S, Figueras F, Sanz-Cortes M, et al. (2014). Evaluation of an optimal gestational age cutoff for the definition of early- and late-onset fetal growth restriction. Fetal Diagn Ther;36:99-105.Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. (2018). Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obstet Gynecol;218:S790-S802.e1.Parra M, Crovetto F, Triunfo S, et al. (2014). Neurodevelopmental outcomes of nearterm small for gestational age infants with and without signs of placental underperfusion. Placenta;35:269-74.Severi F, Bocchi C, Visentin A, et al. (2002). Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol;19:225-8.Savchev S, Figueras F, Cruz R, Botet F, Gratacos E. (2012). Estimated weight centile as a predictor of perinatal outcome in small-for-gestational- age pregnancies with normal fetal and maternal Doppler indices. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 39(3), 299–303.Figueras F, Figueras J, Meler E, Eixarch E, Coli O, Gratacos E, Gardosi J & Carbonell X. (2007). Customised birthweight standards accurately predict perinatal morbidity. Arch Dis Child Fetal Neonatal Ed, 92, 277-280American College of Obstetricians and Gynecologists. ACOG Committee Opinion No.743: Low-dose aspirin use during pregnancy. Obstet Gynecol 2018;132:e44-e52.Visser G, Bilardo C, Lees C. (2014). Fetal growth restriction at the limits of viability. Fetal Diagn Ther;36:162-5.Pimiento L, Beltrán M. (2015). Restricción del crecimiento intrauterino: una aproximación al diagnóstico, seguimiento y manejo. Revista chilena de obstetricia y ginecología, 80(6), 493-502.Jesus L, Pappas A, Shankaran S, et al. (2013). Outcomes of small for gestational age infants born at <27 weeks' gestation. J Pediatr;163:55- 60.e1-3.Maggio L, Dahlke J, Mendez H, Albright C, Chauhan S, Wenstrom K.(2015). Perinatal outcomes with normal compared with elevated umbilical artery systolic-to-diastolic ratios in fetal growth restriction. Obstet Gynecol;125:863-9.Kahn B, Lumey L, Zybert P, et al. (2003). Prospective risk of fetal death in singleton, twin, and triplet gestations: implications for practice. Obstet Gynecol;102:685-92.Oros D, Figueras F, Cruz R, Meler E, Munmany M, Gratacos E. (2011). Longitudinal changes in uterine, umbilical and fetal cerebral Doppler indices in late-onset small-for-gestational age fetuses. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 37(2), 191–195.Rojas Arias, J, González Carrillo, V, Acuña Rubiano, S, Acuña Osorio, E y Molina Giraldo, S. (2018-01-31.). Incidencia de estado fetal no satisfactorio en restricción de crecimiento intrauterino y feto pequeño para la edad gestacional: estudio de una cohorte. Bogotá: Fundación Universitaria de Ciencias de la SaludAjah, L. O., Ibekwe, P. C., Onu, F. A., Onwe, O. E., Ezeonu, T. C., & Omeje, I. (2016). Evaluation of Clinical Diagnosis of Fetal Distress and Perinatal Outcome in a Low Resource Nigerian Setting. Journal of clinical and Universitario Clínica San Rafael Carrera 8 N. 17-45 Sur | Bogotá | Colombia Teléfono: +57 1 3282300 clinicasanrafael.com.co 74 diagnostic research : JCDR, 10(4), QC08–QC11.ORIGINALcastelblancorojasandresmauricio2022.pdfcastelblancorojasandresmauricio2022.pdfTRABAJO DE GRADOapplication/pdf1323059http://repository.unimilitar.edu.co/bitstream/10654/42236/1/castelblancorojasandresmauricio2022.pdfe6b39bc2382a9b38c07feeddd6a26177MD51comiteetica.pdfcomiteetica.pdfcarta autorizacion comite eticaapplication/pdf1660231http://repository.unimilitar.edu.co/bitstream/10654/42236/2/comiteetica.pdf83f2739ecb146bf23a8a8136727b8754MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83420http://repository.unimilitar.edu.co/bitstream/10654/42236/3/license.txta609d7e369577f685ce98c66b903b91bMD5310654/42236oai:repository.unimilitar.edu.co:10654/422362023-02-07 08:41:29.794Repositorio Institucional UMNGbibliodigital@unimilitar.edu.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

Publicaciones similares