RESUMEN
La hemorragia es una de las causas más frecuentesy potencialmente más graves en la consulta de urgenciasdurante la gestación. En esta revisión hemos realizadoun enfoque global para el manejo de una gestante queacude a urgencias por un sangrado vaginal, y posteriormentede manera más específica el manejo de algunasde las entidades más frecuentes de la hemorragia obstétrica.En cuanto a las hemorragias del primer trimestrese ha hecho mayor hincapié en el manejo del aborto,puesto que otras entidades que también son frecuentesse valoran de manera específica en otros capítulos. Enel segundo trimestre se ha realizado una revisión detres entidades que abarcan el mayor porcentaje de hemorragiasen ese periodo, como son la placenta previa,el desprendimiento prematuro de placenta normalmenteinserta y la rotura uterina. Hemos valorado en cadauna de ellas la etiopatogenia, la actitud diagnóstica y elmanejo de la forma más sistemática posible(AU)
A haemorrhage is one of the most frequent, and potentiallymost serious, causes for emergency consultationduring gestation. In this review we offer an overallapproach to managing a pregnant woman who attendsAccidents and Emergencies due to vaginal bleeding andthen, in a more specific way, we consider how to managesome of the most frequent entities of the obstetrichaemorrhage. With respect to haemorrhages in thesecond trimester, we give greater attention to how tomanage a miscarriage, since other entities that are alsofrequent receive a specific evaluation in other chapters.In the second trimester three entities account for thegreatest percentage of haemorrhages, such as placentapraevia, the premature detachment of the normallyinserted placenta and uterine rupture. In each case wehave evaluated the etiopathology, diagnostic attitudeand management in the most systematic way possible(AU)
Asunto(s)
Humanos , Femenino , Hemorragia Uterina/complicaciones , Amenaza de Aborto/diagnóstico , Complicaciones del Embarazo/diagnóstico , Placenta Previa/diagnóstico , Desprendimiento Prematuro de la Placenta/diagnósticoRESUMEN
A haemorrhage is one of the most frequent, and potentially most serious, causes for emergency consultation during gestation. In this review we offer an overall approach to managing a pregnant woman who attends Accidents and Emergencies due to vaginal bleeding and then, in a more specific way, we consider how to manage some of the most frequent entities of the obstetric haemorrhage. With respect to haemorrhages in the second trimester, we give greater attention to how to manage a miscarriage, since other entities that are also frequent receive a specific evaluation in other chapters. In the second trimester three entities account for the greatest percentage of haemorrhages, such as placenta praevia, the premature detachment of the normally inserted placenta and uterine rupture. In each case we have evaluated the etiopathology, diagnostic attitude and management in the most systematic way possible.