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      Monitoreo hemodinámico no invasivo y mínimamente invasivo en la paciente obstétrica grave Translated title: Monitorização hemodinâmica não-invasiva e minimamente invasiva na paciente obstétrica grave Translated title: Non-invasive and minimally invasive hemodynamic monitoring in the severe obstetric patient

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          Abstract

          Resumen: El embarazo es un estado que impone un verdadero desafío para el sistema cardiovascular materno. Las pacientes obstétricas que se complican con preeclampsia, enfermedad cardiaca, sepsis, hemorragia y tromboembolia pulmonar, se caracterizan por profundas alteraciones hemodinámicas, las cuales representan las principales causas de morbilidad y mortalidad materna extrema, por lo que existe la necesidad de una correcta evaluación y monitoreo validado de estos parámetros en este tipo de pacientes. El objetivo de esta revisión es describir la tecnología disponible a la cabecera del enfermo para la implementación de este monitoreo hemodinámico en la paciente embarazada de alto riesgo.

          Translated abstract

          Resumo: A gravidez é um estado que representa um verdadeiro desafio para o sistema cardiovascular materno. A paciente obstétrica que apresenta complicações como pré-eclâmpsia, doenças cardíacas, sepse, hemorragia e tromboembolismo pulmonar, se caracterizam por profundas alterações hemodinâmicas que representam as principais causas de morbimortalidade materna extrema, por isso é necessária uma avaliação correta e a monitorização desses parâmetros, que esteja validado nesse tipo de pacientes. O objetivo desta revisão é descrever a tecnologia disponível à beira do leito para a realização da monitorização hemodinâmica na paciente obstétrica de alto risco.

          Translated abstract

          Abstract: Pregnancy is a state, which poses a real challenge to the maternal cardiovascular system. Obstetric patients who are complicated by preeclampsia, heart disease, sepsis, hemorrhage and pulmonary thromboembolism are characterized by profound hemodynamic alterations, which represent the main causes of morbidity and extreme maternal mortality, so there is a need for a correct evaluation and monitoring of these parameters, which is validated in this type of patients. The objective of this review is to describe the technology available at the patient’s bedside for the performance of this hemodynamic monitoring in the high-risk pregnant patient.

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          Most cited references17

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          Cardiac output assessment in pregnancy: comparison of two automated monitors with echocardiography.

          To compare non-invasive hemodynamic measurements obtained in pregnant and postpartum women using two automated cardiac output monitors against those obtained by two-dimensional (2D) transthoracic echocardiography (TTE).
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            Impaired maternal hemodynamics in morbidly obese women: a case-control study.

            Maternal obesity is associated with significant pregnancy complications and is a risk factor for the development of hypertensive disorders of pregnancy as well as other adverse outcomes. There are few data regarding the hemodynamic aberrations observed in maternal obesity. The aim of this study was to investigate maternal hemodynamics in morbidly obese women.
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              Why non-invasive maternal hemodynamics assessment is clinically relevant in early pregnancy: a literature review

              Background The maternal cardiovascular system adapts quickly when embryo implantation is recognized by the body. Those adaptations play an important role, as a normal cardiovascular adaptation is a requirement for a normal course of pregnancy. Disturbed adaptations predispose to potential hypertensive disorders further in pregnancy [1–3]. This report aims to briefly inform the obstetricians, general practitioners and midwives, who are the key players in detecting and treating hypertensive disorders during pregnancy. Methods The PubMed database was used as main tool to find studies involving clearly defined first trimester hemodynamic changes in normal pregnancies and hypertensive pregnancies. In addition, the bibliographies of these studies were investigated for further relevant literature. Results A comprehensive overview is given concerning the normal adaptations in the cardiovascular tree in a first trimester pregnancy. Additionally, signs of abnormal cardiovascular changes observed in first trimester are described together with the normal reference range for each non-invasive, easily applicable technique for maternal hemodynamics assessment. Conclusions With a combination of techniques, it is possible to integrate and evaluate the maternal heart, veins and arteries at 12 weeks of pregnancy. Applying those techniques into the daily clinic opens perspectives to prevention and prophylactic treatment, aiming for a reduction of the risk for hypertension during pregnancy.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mccmmc
                Medicina crítica (Colegio Mexicano de Medicina Crítica)
                Med. crít. (Col. Mex. Med. Crít.)
                Colegio Mexicano de Medicina Crítica, A.C. (Ciudad de México, Ciudad de México, Mexico )
                2448-8909
                October 2017
                : 31
                : 5
                : 275-284
                Affiliations
                [1] Ciudad de México orgnameHospital General de México "Dr. Eduardo Liceaga" orgdiv1Grupo Mexicano para el Estudio de la Medicina Intensiva orgdiv2Terapia Intensiva Obstétrica México
                [3] Ciudad de México orgnameAcademia Mexicana de Cirugía orgdiv1Academia Nacional de Medicina México
                [2] Ciudad de México orgnameSecretaría de Salud orgdiv1Ginecología y Obstetricia/Alta Especialidad en Medicina Crítica Obstétrica México
                Article
                S2448-89092017000500275
                a86bfe23-02eb-49ae-8f48-e1152d0cc847

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 07 August 2017
                : 30 September 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 10
                Product

                SciELO Mexico

                Categories
                Tema de revisión

                hemodinamia,obstetricia crítica,Monitoreo,Monitorização,obstetrícia crítica,hemodinâmica,Monitoring,critical care obstetrics

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