Amniocentesis para estudio citogenético y sus principales indicaciones en La Habana, Cuba (2007 – 2016) - Vázquez Martínez, Yovany Enrique; Lemus Valdés, María Teresa (Revista Cubana de Obstetricia y Ginecología, 2023)
<span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.0281);" role="presentation">Introducción: <span dir="ltr" style="left: calc(var(–scale-factor)*151.76px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.911575);" role="presentation">El diagnóstico prenatal <span dir="ltr" style="left: calc(var(–scale-factor)*265.60px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.880541);" role="presentation">de alteraciones <span dir="ltr" style="left: calc(var(–scale-factor)*340.36px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.895162);" role="presentation">cromosómicas <span dir="ltr" style="left: calc(var(–scale-factor)*412.74px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.875372);" role="presentation">en Cuba <span dir="ltr" style="left: calc(var(–scale-factor)*455.52px); top: calc(var(–scale-factor)*423.84px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.91163);" role="presentation">se inició en <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*444.54px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.911087);" role="presentation">La Habana en 1984, mediante análisis del <span dir="ltr" style="left: calc(var(–scale-factor)*287.14px); top: calc(var(–scale-factor)*444.54px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.929224);" role="presentation">líquido amniótico obtenido por amniocentesis <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*465.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.89604);" role="presentation">en el segundo trimestre del embarazo<span dir="ltr" style="left: calc(var(–scale-factor)*258.64px); top: calc(var(–scale-factor)*465.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.932198);" role="presentation">. E<span dir="ltr" style="left: calc(var(–scale-factor)*272.32px); top: calc(var(–scale-factor)*465.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.885576);" role="presentation">n 1987 se <span dir="ltr" style="left: calc(var(–scale-factor)*322.36px); top: calc(var(–scale-factor)*465.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.923555);" role="presentation">introdujo el diagnóstico por análisis de <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*485.88px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.92338);" role="presentation">vellosidades coriónicas en el primer trimestre, <span dir="ltr" style="left: calc(var(–scale-factor)*306.04px); top: calc(var(–scale-factor)*485.88px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.910707);" role="presentation">como parte de un subprograma dentro del <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*506.58px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.907222);" role="presentation">Programa Nacional de Diagnóstico y Prevención de Enfermedades Genéticas dirigido por <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*527.28px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.907848);" role="presentation">el Centro Nacional de Genética Médica. <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*547.98px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.0279);" role="presentation">Objetivo: D<span dir="ltr" style="left: calc(var(–scale-factor)*139.28px); top: calc(var(–scale-factor)*547.98px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.917322);" role="presentation">emostrar que la edad materna avanzada sigue siendo la principal indicación <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*568.68px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.956573);" role="presentation">de estudio citogenético en las gestantes de alto riesgo en la provincia de La Habana. <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*589.38px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.972638);" role="presentation">Métodos: <span dir="ltr" style="left: calc(var(–scale-factor)*131.30px); top: calc(var(–scale-factor)*589.38px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.970162);" role="presentation">Se realizó un estudio descriptivo, retrospectivo y de corte longitudinal que <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*610.08px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.937972);" role="presentation">abarcó 12 <span dir="ltr" style="left: calc(var(–scale-factor)*134.12px); top: calc(var(–scale-factor)*610.08px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.952806);" role="presentation">909 historias clínicas de gestantes <span dir="ltr" style="left: calc(var(–scale-factor)*315.10px); top: calc(var(–scale-factor)*610.08px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.975148);" role="presentation">a las <span dir="ltr" style="left: calc(var(–scale-factor)*345.94px); top: calc(var(–scale-factor)*610.08px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.936747);" role="presentation">que se realizaron amniocentesis, <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*630.78px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.90953);" role="presentation">indicadas <span dir="ltr" style="left: calc(var(–scale-factor)*127.70px); top: calc(var(–scale-factor)*630.78px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.942858);" role="presentation">en la consulta del Centro Provincial de Genética Médica <span dir="ltr" style="left: calc(var(–scale-factor)*413.40px); top: calc(var(–scale-factor)*630.78px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.913782);" role="presentation">de la Habana<span dir="ltr" style="left: calc(var(–scale-factor)*478.68px); top: calc(var(–scale-factor)*630.78px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.966973);" role="presentation">, en el <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*651.48px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.985195);" role="presentation">período comprendido entre enero 2007 y diciembre <span dir="ltr" style="left: calc(var(–scale-factor)*353.80px); top: calc(var(–scale-factor)*651.48px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.961327);" role="presentation">2016. Se analizaron diferentes <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*672.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.883228);" role="presentation">par<span dir="ltr" style="left: calc(var(–scale-factor)*93.38px); top: calc(var(–scale-factor)*672.18px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.900083);" role="presentation">ámetros relacionados con la cantidad de casos por años según diferentes criterios y se <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.92755);" role="presentation">calculó <span dir="ltr" style="left: calc(var(–scale-factor)*120.58px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.927872);" role="presentation">la <span dir="ltr" style="left: calc(var(–scale-factor)*137.06px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.914026);" role="presentation">sensibilidad, <span dir="ltr" style="left: calc(var(–scale-factor)*205.26px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.911975);" role="presentation">especificidad, <span dir="ltr" style="left: calc(var(–scale-factor)*279.47px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.948006);" role="presentation">valor <span dir="ltr" style="left: calc(var(–scale-factor)*312.04px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.946683);" role="presentation">predictivo <span dir="ltr" style="left: calc(var(–scale-factor)*368.53px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.950267);" role="presentation">positivo y <span dir="ltr" style="left: calc(var(–scale-factor)*428.98px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.945699);" role="presentation">valor <span dir="ltr" style="left: calc(var(–scale-factor)*461.53px); top: calc(var(–scale-factor)*692.90px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.946216);" role="presentation">predictivo <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*713.60px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.895987);" role="presentation">negativo de la edad materna como predictor de la ocurrencia de anomalías cromosómica<span dir="ltr" style="left: calc(var(–scale-factor)*502.80px); top: calc(var(–scale-factor)*713.60px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.816064);" role="presentation">s. <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*734.30px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.947124);" role="presentation">Resultados: <span dir="ltr" style="left: calc(var(–scale-factor)*141.56px); top: calc(var(–scale-factor)*734.30px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.939412);" role="presentation">El principal criterio de indicación del estudio invasivo lo constituyó la edad <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*755.00px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.884784);" role="presentation">materna avanzada con 82 <span dir="ltr" style="left: calc(var(–scale-factor)*204.32px); top: calc(var(–scale-factor)*755.00px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.892469);" role="presentation">% de los casos, mostrando <span dir="ltr" style="left: calc(var(–scale-factor)*336.46px); top: calc(var(–scale-factor)*755.00px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.907434);" role="presentation">una sensibilidad <span dir="ltr" style="left: calc(var(–scale-factor)*418.02px); top: calc(var(–scale-factor)*755.00px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.885522);" role="presentation">de 86 % <span dir="ltr" style="left: calc(var(–scale-factor)*461.58px); top: calc(var(–scale-factor)*755.00px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.881354);" role="presentation">y una tasa <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*73.82px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.903403);" role="presentation">de falsos positivos que alcanzó el 95,<span dir="ltr" style="left: calc(var(–scale-factor)*257.68px); top: calc(var(–scale-factor)*73.82px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.898876);" role="presentation">85 <span dir="ltr" style="left: calc(var(–scale-factor)*272.92px); top: calc(var(–scale-factor)*73.82px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.915384);" role="presentation">%. Sería de utilidad <span dir="ltr" style="left: calc(var(–scale-factor)*371.44px); top: calc(var(–scale-factor)*73.82px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.913527);" role="presentation">actualizar el <span dir="ltr" style="left: calc(var(–scale-factor)*433.20px); top: calc(var(–scale-factor)*73.82px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.882986);" role="presentation">subprograma de <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*94.52px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.930147);" role="presentation">diagnóstico prenatal mediante herramientas que permitan recalcular el riesgo a priori, a <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*115.22px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.92786);" role="presentation">un riesgo individualizado y <span dir="ltr" style="left: calc(var(–scale-factor)*212.00px); top: calc(var(–scale-factor)*115.22px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.910085);" role="presentation">reclasificar la población de alto riesgo genético. <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*135.94px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.946468);" role="presentation">Conclusiones: <span dir="ltr" style="left: calc(var(–scale-factor)*154.58px); top: calc(var(–scale-factor)*135.94px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.976093);" role="presentation">A partir del estudio realizado <span dir="ltr" style="left: calc(var(–scale-factor)*308.26px); top: calc(var(–scale-factor)*135.94px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.886135);" role="presentation">se puede <span dir="ltr" style="left: calc(var(–scale-factor)*357.22px); top: calc(var(–scale-factor)*135.94px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.939952);" role="presentation">concluir que la avanzada edad <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*156.64px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.999359);" role="presentation">materna constituye el principal criterio de indicación para estudio citogenético por <span dir="ltr" style="left: calc(var(–scale-factor)*78.00px); top: calc(var(–scale-factor)*177.34px); font-size: calc(var(–scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.879443);" role="presentation">amniocentesis en las gestantes de alto riesgo de La Habana