Riesgos y recomendaciones para la realización de broncoscopia flexible en la paciente embarazada

Risks and recomendations to perform flexible bronchoscopy in pregnant woman

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Adnan Majid
Armin Ernst
Melissa Begolli
Alejandra Cañas

Resumen

En lo posible se recomienda diferir la Broncoscopia Flexible hasta después del parto o si esto no es posible por lo menos hasta después de la semana 28. La broncoscopia se debe realizar por el neumólogo de mayor experiencia y en un hospital que tenga los servicios de anestesia, obstetricia y neonatología. Consultas a estos especialistas se recomiendan. Se debe consultar al farmaceuta acerca del potencial teratogenico de los medicamentos que se van a emplear durante la broncoscopia. Para la sedacion se deben utilizar las dosis más bajas posibles y no deben usarse medicamentos de categoría D o X. Durante el procedimiento se recomienda monitoreo continuo del ritmo cardiaco, oximetría de pulso y medición intermitente de la presión arterial. Se debe monitorear al feto si esto es posible. La paciente se debe posicionar en el decúbito lateral izquierdo y si esto no es posible el procedimiento se debe realizar con la paciente en posición sentada. Se debe minimizar el tiempo del procedimiento y terminar aquellos en los cuales la paciente no lo tolera bien. El uso de fluoroscopia se debe individualizar para cada paciente dependiendo del riesgo y beneficio de esta. Avances tecnológicos en el diagnóstico y tratamiento de enfermedades pulmonares y de las vías respiratorias como, por ejemplo, ultrasonido endobronchial, TAC con fluoroscopia y la broncoscopia virtual se pueden combinar con la Broncoscopia Flexible BF para minimizar los riesgos a la madre y al feto.

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Referencias (VER)

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