Browsing by Author "Carrillo, Jorge"
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Item Betametasona Fosfato para la prevención de Síndrome de Dificultad Respiratoria (SDR) del recién nacido de pretérmino(2019) Insunza, Álvaro; Novoa, José; Carrillo, Jorge; Latorre, Rodrigo; Rubio, Tania; Paiva, EnriqueABSTRACT: The standard for induction of lung maturity in fetuses at risk of being born prematurely is the administration of 12 mg of betamethasone acetate/phosphate two doses separated by 24 hours. The established use in some public hospitals in Chile is with two doses of 12 mg betamethasone phosphate although there are no studies published with betamethasone phosphate alone on the incidence of respiratory distress syndrome (RDS). Objective: To evaluate the effect of betamethasone in its phosphate form as antenatal treatment for the induction of fetal lung maturity in the incidence of RDS due to hyaline membrane in preterm infants less than 34 weeks of gestational age. To compare the effect of betamethasone phosphate with the published effect of betamethasone acetate/phosphate. Material and method: Analysis of the incidence of RDS in preterm infants born at Hospital Padre Hurtado between 24 + 0 and 34 + 0 weeks who received betamethasone phosphate for lung maturity and those who did not receive it. Results: Of 1,265 infants studied, 722 completed two doses (57.5%); 436 only one dose (34.5%) and 107 (8.5%) did not receive antenatal corticosteroids. The incidence of RDS due to hyaline membrane in the group with two doses was 8.7%, one dose 25.3% and 32.7% in the untreated ones (p <0.001). For severe RDS, incidences were 6.7%, 12.6% and 16.8% respectively (p <0.001). Conclusions: Induction of fetal lung maturity with betamethasone phosphate in two doses of 12 mg IM separated by 24 hours gives a significant reduction in the incidence of RDS similar to that published with betamethasone acetate/phosphate in equal doses.Item Cesarean rates in a Chilean public hospital and the use of a new prioritization criteria: The relevance index(2019) Yamamoto, Masami; Latorre, Rodrigo; Rojas, Juan; Walker, Bernardita; Jordán, Felipe; Carrillo, Jorge; Paiva, Enrique; Insunza, AlvaroAim:Cesarean section rates are increasing worldwide and Robson’s classification system allows a practicalapproach to study this phenomenon. C-section in Chile has been indicated as unexpectedly high, withimportant variability within the country and payment systems. The aim was to report our data using Rob-son’s system and the evolution of local C-section rate in a public hospital during a 9-year period.Methods:Retrospective analysis (2005–April 2014), in a metropolitan hospital in Santiago. All deliverieswere classified into Robson groups. Time changes were analyzed with Pearson’s correlation.Pvalue <0.05was considered significant. A‘relevance index’(RI) for each group was calculated as 100×C-S rate×rela-tive contribution.Results:The overall C-section rate increased from 24 to 27% (P< 0.05) in 53 571 deliveries, with a greaterincrease in groups 1 (nulliparous, single, term cephalic, spontaneous labor), 3 (multiparous, single, no previ-ous C-S, term cephalic, spontaneous labor) and 4 (multiparous, single, no previous C-S, term cephalic,induced or no labor). Despite no increase in Group 5 (women with one or more previous C-S) this grouphad the highest RI (20.3), which defined priority for intervention over others.Conclusion:C-S rate was lower than that reported in other centers from Chile and Latin America. Robson’sclassification and the RI allowed prioritization. Although increase in groups 1, 3 and 4, group 5 needs atten-tion because of stronger impact on overall C-S rate. This analysis allowed to define how to lower C-S rate inour institutionItem Enfermedad hemolítica perinatal: manejo de la embarazada RhD negativo(2011) Insunza, Álvaro; Behnke, Ernesto; Carrillo, JorgeEn solo 50 años la enfermedad hemolítica perinatal por isoinmunización anti D pasó de ser una enfermedad sin etiología conocida, incurable y no prevenible, a la situación actual en que por las técnicas de prevención, diagnóstico oportuno y tratamiento especializado tiene baja incidencia y altas expectativas de sobrevida, incluso en los casos más severos. Se describe la historia, las técnicas de prevención, diagnóstico, manejo y tratamiento de la enfermedad.