Diagnóstico prenatal de cardiopatías congénitas

Las cardiopatías congénitas son las malformaciones congénitas más frecuentes y las menos frecuentemente diagnosticadas. La incorporación de examenes de cribado, utilizando guías clínicas, han permitido una mejoría en el diagnóstico prenatal. El examen de ecocardiografía fetal, realizado por un equipo de cardiología perinatal, permite identificar con gran certeza el tipo de alteración estructural, del ritmo, y/o de la función, del corazón fetal. El diagnóstico prenatal de las cardiopatías ductus dependientes permite la derivación a centros terciarios para manejo neonatal y cirugía cardíaca en mejor tiempo y lugar. En suma, el diagnóstico prenatal en pacientes cardiópatas no nacidos mejora la morbi-mortalidad perinatal. En este capítulo revisaremos el cribado de cardiopatías congénitas, y analizaremos el diagnóstico las malformaciones cardíacas más frecuentes, con énfasis en las denominadas ductus dependientes.Facultad de Ciencias Médica

Mothers' Views ofTheir Childbirth Experiences 2 Years Mter Planned Caesarean Versus Planned Vaginal Birth for Breech Presentation at Term, in the International Randomized Term Breech Trial

Objective: To compare mothers' views at 2 years postpartum after participation in a randomized trial of planned Caesarean and planned vaginal birth for a singleton fetus in breech presentation at term.Study Design: In selected centres in the Term Breech Trial, mothers completed a structured questionnaire at approximately 2 years postpartum to assess their likes and dislikes about their childbirth experiences and their views about their intrapartum care and care providers.Results: Of 1159 mothers from 85 centres, 917 (79.1%) completed a follow-up questionnaire at 2 years postpartum. Baseline information was similar for both the planned Caesarean and planned vaginal birth groups. Planned Caesarean was associated with less worry about the baby's health (P < 0.001 ). While other differences were noted in likes and dislikes about their childbirth experiences, women's evaluations of the quality of intrapartum care, the helpfulness of staff, and their involvement in decision-making did not differ in the planned Caesarean delivery and planned vaginal birth groups.Conclusion: Planned mode of delivery influences aspects of women's evaluations of their childbirth experiences but does not affect evaluations of the quality of intrapartum care, support from care providers, or amount of involvement in decision-making