FisiologíA Y Farmacologia Perinatal 1

FISIOLOGÍA Y FARMACOLOGIA PERINATAL VIVIANA P. CASTILLO R. RESIDENTE ANESTESIOLOGÍA Y REANIMACIÓN UNIVERSIDAD NACIONAL DE COLOMBIA

Contenido. ,[object Object],[object Object],[object Object],[object Object]

Panorama general de la placenta.

La placenta. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Desarrollo del lado materno de la placenta. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conversión de las arterias espirales y flujo sanguíneo placentario Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Fisiología y farmacología perinatal ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007 Sincitiotrofoblasto Matriz mesodérmica de las vellosidades Endotelio capilar del feto

Fisiología y farmacología perinatal Conversión de las arterias espirales y flujo sanguíneo placentario ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Fisiología de la placenta. ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Transporte placentario. Mecanismos ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Fisiología y farmacología perinatal Difusión ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Fisiología y farmacología perinatal Transporte placentario. Mecanismos ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Transporte placentario. Mecanismos ,[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Transporte de anestésicos a la placenta. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ronald D. Miller M.D, Miller's Anesthesia, Sexta edición, cap 58

TRANSFERENCIA OPIOIDES. Combinación teratogénico. Propoxifeno + Acetaminofén Acidosis fetal con variación, alto con pentazocina y bajo con butrofanol. Pentazocina, Nalbufina, Butrofanol Abstinencia neonatal, insuficiencia respiratoria, hipoglucemia, ictericia. Hidrocloruro de paroxetina efecto en la frecuencia cardiaca Nalbufina Abstinencia a narcótico, pequeños para la edad gestacional, perímetro cefálico pequeño, síndrome de muerte súbita. Metadona Disminución de la frecuencia cardiaca fetal. Meperidina + Prometazina Depresión del actividad fetal, caso reportado: ritmo cardiaco sinusoidal Meperidina bradicardia fetal, depresión de muchos parámetros biofísicos Fentanil Caso reportado: artrogrifosis congénita, infarto mesencefálico bilateral. Coproxamol Ritmo sinusoidal cardiaco Alfaprodina Opiodes:

Cordón umbilical. ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Volumen de líquido amniótico ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Fisiología fetal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

SHUNT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seminars in Fetal & Neonatal Medicine (2005) 10, 493e503 TAO2 lo cierra, PE2 lo abre.

Regulación de la función cardiovascular ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Hemoglobina fetal Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Riñón fetal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Riñón fetal ,[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Sistema gastrointestinal fetal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Actividad endocrina ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Sistema nervioso fetal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Teratogenicidad Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

Teratogenicidad ,[object Object],[object Object],[object Object],[object Object]

Categorías FDA. Fármacos en la gestación Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed . 2007

COMO? ,[object Object],[object Object],[object Object],[object Object],[object Object],K.M. Tran / Seminars in Fetal & Neonatal Medicine xxx (2009) 1–6

Transferencia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

FisiologíA Y Farmacologia Perinatal 1

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