Indicaciones para la realización de cerclaje profiláctico en la prevención de parto pretérmino del embarazo de feto único.
Indications to perform a prophylactic cerclage to prevent preterm delivery of single fetus pregnancy.
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Introducción: el parto pretérmino es una problemática a nivel mundial, la cual lleva a morbimortalidad de los neonatos a corto y a largo plazo. Se han descrito diferentes medidas que favorecen mayor tiempo fetal in útero, favoreciendo un mejor pronóstico neonatal como lo es la sutura cervical denominada cerclaje. Objetivo: consolidar información sobre las indicaciones de la realización del cerclaje profiláctico en la prevención de parto pretérmino del embarazo de feto único. Métodos: se realizó una revisión narrativa de la literatura con búsqueda sistemática en bases de datos como Pubmed, Embase y Science Direct. Con términos DeCS: Cerclaje cervical y trabajo de parto prematuro. Aplicando criterios de inclusión y exclusión, así como lectura crítica con herramienta CASPe, fueron seleccionados veintisiete artículos. Resultados: trece de los artículos revisados artículos consideran el antecedente obstétrico sugestivo de incompetencia cervical como requisito para considerar la prevención con cerclaje, de estos, siete lo consideran indicación única del cerclaje cervical profiláctico y seis consideran este antecedente asociado a disminución de la longitud cervical como indicación del mismo. Los catorce artículos. Conclusiones: en toda paciente con antecedente obstétrico de riesgo se debe valorar la longitud cervical por ecografía cada semana hasta llegar a término, en caso de longitud menor a 25 mm o descenso progresivo de la longitud, se debe realizar cerclaje cervical profiláctico. Se pueden considerar medidas farmacológicas como medida de prevención y en caso de antecedentes de alto riesgo se puede considerar indicación única para cerclaje cervical.
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