Neuroprotección fetal
DOI:
https://doi.org/10.47187/cssn.Vol14.Iss1.220Palabras clave:
neuroprotección, feto, sulfato de magnesioResumen
Introducción. La parálisis cerebral infantil involucra a un grupo de alteraciones del sistema nervioso central que producen disfunción motora que afecta el tono muscular, la postura y el movimiento. Objetivo. Determinar el mejor tratamiento preventivo de la parálisis cerebral infantil en la gestante con alto riesgo de parto prematuro inminente. Metodología. Se utilizó la pregunta clínica bajo el formato PICO ¿Cuál es el tratamiento preventivo más eficaz para la prevención de la parálisis cerebral infantil en pacientes con alto riesgo de parto prematuro inminente?. La población son las embarazadas con alto riesgo de parto prematuro inminente, la intervención es la administración de neuroprotección, la comparación es la no administración de neuroprotección y el resultado la disminución de parálisis cerebral infantil. Resultados. Para realizar esta revisión no sistemática se obtuvieron 213 artículos, de los cuales se descartan 178 por no estar dentro de los criterios de inclusión y se obtienen 35 artículos, para el proceso de elaboración de esta investigación. Discusión. La administración de sulfato de magnesio como neuroprotección infantil, disminuye el riesgo de parálisis cerebral en los recién nacidos que nacen entre las 24 a 31 semanas con 6 días. Conclusiones. El sulfato de magnesio es el medicamento con mayor eficacia para la prevención de parálisis cerebral infantil si se administra por lo menos durante cuatro horas en las pacientes con alto riesgo de parto prematuro inminente entre las 24 y 31 semanas con 6 días.
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DynaMed. Cerebral Palsy (CP) [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/condition/cerebral-palsy-cp
Barkoudah E, Aravamuthan B. Cerebral palsy: Epidemiology, etiology, and prevention [Internet]. UpToDate. 2022 [cited 2023 Jan 5]. Available from: https://www.uptodate.com/contents/cerebral-palsy-epidemiology-etiology-and-prevention/print?search=neuroprotección fetal&source=search_result&selectedTitle=10~150&usage_type=default&display_rank=10
Barkoudah E, Aravamuthan B. Cerebral palsy: Classification and clinical features [Internet]. UpToDate. 2022 [cited 2023 Jan 9]. Available from: https://www.uptodate.com/contents/cerebral-palsy-classification-and-clinical-features/print?search=paralisis cerebral&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Jahan I, Muhit M, Hardianto D, Laryea F, Chhetri AB, Smithers-Sheedy H, et al. Epidemiology of cerebral palsy in low- and middle-income countries: preliminary findings from an international multi-centre cerebral palsy register. Dev Med Child Neurol [Internet]. 2021 Nov 1 [cited 2023 Jan 9];63(11):1327–36. Available from: https://onlinelibrary.wiley.com/doi/10.1111/dmcn.14926
Kakooza-Mwesige A, Andrews C, Peterson S, Mangen FW, Eliasson AC, Forssberg H. Prevalence of cerebral palsy in Uganda: a population-based study. Lancet Glob Heal [Internet]. 2017 Dec 1 [cited 2023 Jan 9];5(12):e1275–82. Available from: https://pubmed.ncbi.nlm.nih.gov/29102350/
Forthun I, Wilcox AJ, Strandberg-Larsen K, Moster D, Nohr EA, Lie RT, et al. Maternal prepregnancy BMI and risk of cerebral palsy in offspring. Pediatrics [Internet]. 2016 Oct 1 [cited 2023 Jan 9];138(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051208/
Villamor E, Tedroff K, Peterson M, Johansson S, Neovius M, Petersson G, et al. Association Between Maternal Body Mass Index in Early Pregnancy and Incidence of Cerebral Palsy. JAMA [Internet]. 2017 Mar 7 [cited 2023 Jan 9];317(9):925–36. Available from: https://pubmed.ncbi.nlm.nih.gov/28267854/
Ayubi E, Sarhadi S, Mansori K. Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis. J Child Neurol [Internet]. 2021 Apr 1 [cited 2023 Jan 9];36(5):385–402. Available from: https://pubmed.ncbi.nlm.nih.gov/33231118/
Strøm MS, Tollånes MC, Wilcox AJ, Lie RT, Forthun I, Moster D. Maternal chronic conditions and risk of cerebral palsy in offspring: A national cohort study. Pediatrics [Internet]. 2021 Mar 1 [cited 2023 Jan 9];147(3). Available from: https://pubmed.ncbi.nlm.nih.gov/33602799/
Stavsky M, Mor O, Mastrolia SA, Greenbaum S, Than NG, Erez O. Cerebral Palsy-Trends in Epidemiology and Recent Development in Prenatal Mechanisms of Disease, Treatment, and Prevention. Front Pediatr [Internet]. 2017 Feb 13 [cited 2023 Jan 10];5. Available from: https://pubmed.ncbi.nlm.nih.gov/28243583/
DynaMed. Preterm Labor [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 6]. Available from: https://www.dynamed.com/condition/preterm-labor
Simhan H, Himes K. Neuroprotective effects of in utero exposure to magnesium sulfate [Internet]. UpToDate. 2022 [cited 2023 Jan 5]. Available from: https://www.uptodate.com/contents/neuroprotective-effects-of-in-utero-exposure-to-magnesium-sulfate/print?search=neuroprotección fetal&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
DynaMed. Preterm Premature Rupture of Membranes (PPROM) [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 5]. Available from: https://www.dynamed.com/condition/preterm-premature-rupture-of-membranes-pprom
DynaMed. Tocolytics for Treatment of Preterm Labor [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/management/tocolytics-for-treatment-of-preterm-labor
Horton AL, Lai Y, Rouse DJ, Spong CY, Leveno KJ, Varner MW, et al. Effect of magnesium sulfate administration for neuroprotection on latency in women with preterm premature rupture of membranes. Am J Perinatol [Internet]. 2015 [cited 2023 Jan 9];32(4):387–92. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1387930
Gupta N, Garg R, Gupta A, Mishra S. Magnesium sulfate for fetal neuroprotection in women at risk of preterm birth: Analysis of its effect on cerebral palsy. J SAFOG. 2021 May 1;13(3):90–3.
Magnesium Sulfate. In: IBM Micromedex® DRUGDEX® (electronic version) [Internet]. IBM Watson Health/EBSCO Information Services, Greenwood Village, Colorado; Cambridge, Massachusetts, USA. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/drug-monograph/magnesium-sulfate
Vilchez G, Dai J, Lagos M, Sokol RJ. Maternal side effects & fetal neuroprotection according to body mass index after magnesium sulfate in a multicenter randomized controlled trial. J Matern Neonatal Med [Internet]. 2017 Jan 17 [cited 2023 Jan 9];31(2):178–83. Available from: https://cogentoa.tandfonline.com/doi/abs/10.1080/14767058.2017.1279143
Johnston M, Singhi S. Recent advances in perinatal neuroprotection. F1000Research [Internet]. 2019 [cited 2023 Jan 5];8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979470/
Schatz M, Weinberger S. Management of asthma during pregnancy [Internet]. UpToDate. 2022 [cited 2023 Jan 5]. Available from: https://www.uptodate.com/contents/management-of-asthma-during-pregnancy/print?search=neuroprotección fetal&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4
Simhan H, Caritis S. Inhibition of acute preterm labor [Internet]. UpToDate. 2022 [cited 2023 Jan 5]. Available from: https://www.uptodate.com/contents/inhibition-of-acute-preterm-labor/print?search=neuroprotección fetal&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
DynaMed. Acute Abdominal Pain in Pregnancy and Postpartum - Approach to the Patient [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/approach-to/acute-abdominal-pain-in-pregnancy-and-postpartum-approach-to-the-patient
DynaMed. Cerebrovascular Complications of Pregnancy [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/condition/cerebrovascular-complications-of-pregnancy
DynaMed. COVID-19 and Pregnant Patients [Internet]. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/condition/covid-19-and-pregnant-patients
Dynamed. Hypertensive Disorders of Pregnancy [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/condition/hypertensive-disorders-of-pregnancy
DynaMed. Intrauterine Growth Restriction (IUGR) [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 5]. Available from: https://www.dynamed.com/condition/intrauterine-growth-restriction-iugr
DynaMed. Placental Abruption [Internet]. EBSCO Information Services. 2022 [cited 2023 Jan 9]. Available from: https://www.dynamed.com/condition/placental-abruption
Smith DD, Sagaram D, Miller R, Gyamfi-Bannerman C. Risk of cerebral palsy by gestational age among pregnancies at-risk for preterm birth. Obstet Gynecol Surv [Internet]. 2020 Nov 1 [cited 2023 Jan 9];75(11):659–61. Available from: https://journals.lww.com/obgynsurvey/Fulltext/2020/11000/Risk_of_Cerebral_Palsy_by_Gestational_Age_Among.6.aspx
Kaandorp JJ, Benders MJNL, Schuit E, Rademaker CMA, Oudijk MA, Porath MM, et al. Maternal allopurinol administration during suspected fetal hypoxia: a novel neuroprotective intervention? A multicentre randomised placebo controlled trial. Arch Dis Child - Fetal Neonatal Ed [Internet]. 2015 May 1 [cited 2023 Jan 9];100(3):F216–23. Available from: https://fn.bmj.com/content/100/3/F216.abstract
Wilkinson D, Shepherd E, Wallace EM. Melatonin for women in pregnancy for neuroprotection of the fetus. Cochrane Database Syst Rev [Internet]. 2016 Mar 29 [cited 2023 Jan 5];2016(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081745/
Lien R. Author reply to letter to editor “melatonin as fetal neuroprotection: Links and risks.” Biomed J [Internet]. 2020 Dec 1 [cited 2023 Jan 5];43(6):498. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804175/
Gano D, Ho ML, Partridge JC, Glass HC, Xu D, Barkovich AJ, et al. Antenatal Exposure to Magnesium Sulfate Is Associated with Reduced Cerebellar Hemorrhage in Preterm Newborns. J Pediatr [Internet]. 2016 Nov 1 [cited 2023 Jan 10];178:68–74. Available from: https://pubmed.ncbi.nlm.nih.gov/27453378/
Wolf HT, Brok J, Henriksen TB, Hegaard HK, Greisen G, Weber T, et al. Authors’ reply re: Antenatal magnesium sulphate for the prevention of cerebral palsy in infants born preterm: a double-blind, randomised, placebo-controlled, multi-centre trial. BJOG An Int J Obstet Gynaecol [Internet]. 2020 Sep 1 [cited 2023 Jan 9];127(10):1296–7. Available from: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16267
Wolf HT, Huusom LD, Henriksen TB, Hegaard HK, Brok J, Pinborg A. Magnesium sulphate for fetal neuroprotection at imminent risk for preterm delivery: a systematic review with meta-analysis and trial sequential analysis. BJOG [Internet]. 2020 Sep 1 [cited 2023 Jan 10];127(10):1180–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32237069/
Gentle SJ, Carlo WA, Tan S, Gargano M, Ambalavanan N, Chawla S, et al. Association of Antenatal Corticosteroids and Magnesium Sulfate Therapy With Neurodevelopmental Outcome in Extremely Preterm Children. Obstet Gynecol [Internet]. 2020 Jun 1 [cited 2023 Jan 10];135(6):1377–86. Available from: https://pubmed.ncbi.nlm.nih.gov/32459430/