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Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
VAZQUEZ-RODRIGUEZ, Juan Gustavo y SILVA-RUIZ, Diana Graciela. Long-term creatinine clearance in patients with obstetric hemorrhage. Ginecol. obstet. Méx. [online]. 2021, vol.89, n.12, pp.919-926. Epub 23-Mayo-2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v89i12.6879.
OBJECTIVE:
To determine and compare long-term creatinine clearance with baseline creatinine clearance in patients with obstetric hemorrhage.
MATERIALS AND METHODS:
Observational, longitudinal, retrospective, comparative and analytical study carried out in a series of patients with obstetric hemorrhage (loss ≥ 1000 mL) hospitalized in the intensive care unit. Creatinine clearance was calculated with the CKD-EPI formula at two time points: on admission to intensive care after the end of pregnancy complicated by hemorrhage (baseline measurement) and from their last recorded medical consultation (long-term measurement). Descriptive statistics and Student's t-test were used with SPSS version 20, p < 0.05 was considered significant.
RESULTS:
Forty-nine patients with mean age of 30.48 ± 6.06 years and 32.20 ± 8.24 weeks of pregnancy were studied. Cesarean section was performed in 39 of 49, 5 of 49 delivered, 4 of 49 required hysterotomy and only one required instrumental curettage. The mean estimated bleeding was 2744.89 ± 1474.65 mL. Creatinine clearance: initial measurement 159.09 ± 46.62 and long-term (22.27 ± 1.55 months later) 112.23 ± 30.91 mL of min of 1.73 m2 body surface area. The difference was significant (p = 0.002). On long-term measurement, chronic kidney disease was found in 1 of the 49 patients.
CONCLUSIONS:
Long-term creatinine clearance resulted lower, perhaps due to regression of gestational changes over time, but without significant functional impairment, except for one case with chronic kidney disease found as a finding not necessarily related to obstetric hemorrhage.
Palabras llave : Creatinine clearance; Obstetric hemorrhage; Chronic kidney disease; Hysterotomy; Intensive care; Pregnancy; Cesarean section; Renal insufficiency chronic.