Resumen

RODRIGUEZ-VILLORIA, Rafael E; VEROES MENDEZ, Jesús; FERNANDEZ DIAZ, Sergio  y  RODRIGUEZ-VILLORIA, Enrique. Eficacia del parche hemático transvaginal endocervical autólogo en ruptura prematura de membranas pretérmino. Rev Obstet Ginecol Venez [online]. 2015, vol.75, n.4, pp.225-231. ISSN 0048-7732.

Objective: To compare the therapeutic effectiveness of the autologous endocervical transvaginal blood patch, in cases of preterm premature rupture of membranes, versus the so called expectant treatment. Methods: Controlled, randomized and prospective trial having latency time of the break and survival of newborns as determining variables. In a 12-week period, only 35 patients aged between 16 and 37 and averaging 26,5 years, met the inclusion criteria. Gestational age had an average of 23.5 ± 3.92 weeks. With a random distribution, two independent and statistically comparable groups where formed; where the first one, with nine cases (25.7 %), was treated with the blood patch; and the second one, with 26 (74.2.%), and considered the control group, received expectant treatment. Results: With a significance level of 0.05, there was a significant difference in both the latency period (P = 0.002) and the survival of newborns (P = 0.006), demonstrating the therapeutic effectiveness of the patch as compared with the expectant treatment. There was no difference regarding maternal age and gestational age. With the blood patch treatment, Absolute Risk Reduction (ARR) was 54.70 %; the relative risk of death (RR), of 0.289; the reduction of the relative risk of death (RRR), of 71.11 %; the number needed to treat (NNT) was 1.83 patients; and the “Odds ratio” (OR) = 0.09 (0.086).The blood patch did not report adverse effects, complications and was inexpensive. Conclusions: The results show a significant therapeutic effectiveness of the blood patch versus the expectant treatment, improving both the latency period of pregnancy and the survival of infants in cases of preterm rupture of ovular membranes.

Palabras clave : Premature rupture of membranes; Preterm; Autologous endocervical transvaginal hematic patch; Membrane sealers.

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