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patologia hepatica critica durante el embarazo - IntraMed

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evitar la evaluación radiológica para no someter al feto a la exposición radiante. La ultrasonografia<br />

es <strong>el</strong> examen complementario de <strong>el</strong>ección debido a que puede reconocer la patología biliar en más<br />

d<strong>el</strong> 90% de los casos.<br />

Siempre que sea posible, <strong>el</strong> tratamiento debe ser médico, tratando de retardar la operación<br />

hasta <strong>el</strong> segundo o tercer trimestre. Se debe tener particular cuidado con <strong>el</strong> empleo de antibióticos,<br />

recomendando en caso necesario <strong>el</strong> empleo de penicilinas y cefalosporinas. Hasta <strong>el</strong> 90% de los<br />

padecimientos biliares <strong>durante</strong> <strong>el</strong> <strong>embarazo</strong> pueden ser tratados clínicamente, requiriéndose la<br />

cirugía en <strong>el</strong> 5 al 15% restante.<br />

BIBLIOGRAFIA<br />

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study. Intensive Care Med 18:274-1992<br />

Barton J., Sibai B.: Care of the pregnancy complicated by HELLP syndrome. Gastroent Clin North<br />

Amer 21:937-1992<br />

Baxter J., Weinstein L.: HELLP Syndrome: the state of the art. Obst Gynecol Survey 59:838-2004<br />

Caroline A., Ri<strong>el</strong>y P., Lathan S.: Acute fatty liver of pregnancy. Ann Inter Med 106:703-1987<br />

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Dinsmoor M.: Hepatitis in the obstetric patient. Infec Dis Clin North Amer 11:77-1997<br />

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Ebert E., Sun E.: Does early diagnosis and d<strong>el</strong>ivery in acute fatty liver of pregnancy lead to<br />

improvement in maternal and infant survival? Dig Dis and Science 29:453-1984<br />

Everson G.: Pregnancy and gallstones. Hepatology 17:156-1993<br />

Fesenmeier M., Coppage K., Lambers D.: Acute fatty liver of pregnancy in 3 terciary care centers.<br />

Amer J Obst Gynecol 192:1416-2005<br />

Gray J.: Liver disease and pregnancy. Gastroent Intern 2:217-1989<br />

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management. Crit Care Med 33:Suppl 10:S332-2005<br />

Hawker F.: The liver: <strong>critica</strong>l care management. W B Saunders Co Ltd London 1993

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