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CASO CLÍNICO
RESUMEN
El pa rto extra hospita la rio constituye a ctua lmente una rea lida d. En los pa íses desa rrolla dos
existen sistema s pa ra determina r la a usencia de fa ctores de riesgo y por lo ta nto la s pa cientes
que son ca ndida ta s a pa rto en domicilio. En Chile en ca mbio, en genera l éste ocurre sin
media r pla nifica ción.
Se presenta el ca so de una mujer de 33 a ños, multípa ra de 3 pa rtos va gina les, quien inició y
completó tra ba jo de pa rto en su domicilio. El a lumbra miento es a sistido en el consultorio
correspondiente, después de lo cua l es deriva da a l Servicio de Obstetricia y Ginecología del
Hospita l Dr. Luis Tisné Brousse. Ingresó en ma la s condiciones, hipotensa , rea lizá ndose
rea nima ción vigorosa . En pa bellón quirúrgico se sutura ron desga rros va gina les, sin detener la
hemorra gia , rea liza ndo a continua ción histerectomía obstétrica debido a inercia uterina
refra cta ria a tra ta miento médico y sutura de desga rro de la pa red posterior de la va gina .
Debido a persistencia de sa ngra do va gina l, tra s pa cking frustro, se insta la ba lón de Ba kri en la
va gina , con 200 cm 3 de solución fisiológica . A la s 48 hora s se retira sin rea pa rición del
sa ngra do. Es da da de a lta con su hija 7 día s después, a mba s en buena s condiciones genera les.
En Chile la hemorra gia ma terna es una ca usa importa nte de morta lida d ma terna . La s
hemorra gia s del pospa rto inmedia to se dividen en uterina s y no uterina s. Entre la s no uterina s
desta ca n la s lesiones del tra cto genita l inferior. Ba kri desa rrolló recientemente un ba lón de
ta pona miento, que ha demostra do ser útil pa ra logra r hemosta sia en ca sos de hemorra gia del
pospa rto, principa lmente debido a a ltera ciones de la inserción pla centa ria .
En el ca so que se presenta se utilizó el ba lón de Ba kri pa ra detener la hemorra gia va gina l, con
resulta dos sa tisfa ctorios.
Palabr as clave: Pa rto en domicilio, ba lón de Ba kri, hemorra gia va gina l.
ABSTRACT
Nowa da ys homebirth constitutes a rea lity. In developed countries, hea lth systems a re orga nized
in order to determine the a bsence of risk fa ctors in pregna nt women a nd when a bsent women
a re offered the possibility to deliver a t home. In Chile, homebirth ocurres genera lly in a non
pla ned scena rio.
The present ca se refers to a woma n a ged 33, with three previous pregna ncies, a ll resolved
va gina lly. Who initia ted a nd completed la bour a t home. After wich she wa s derived to the
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REV. OBSTET. GINECOL. - HOSP. SANTIAGO ORIENTE DR. LUIS TISNÉ B ROUSSE. 2007; VOL 2 (3): 221-226
emergency room of the Luis Tisné Brousse Hospita l, Sa ntia go, Chile. When a dmited, wa s in ba d
conditions, hypotense, needing vigorous resuscita tion. Va gina l ruptures were stitched, without
stopping the ha emorrha ge. In order to stop the bleeding a n obstetrica l hysterectomy wa s
performed, observing uterine inertia during the procedure. The uterine a rteries were sutured a s
long a s the posterior va gina l wa ll. Due to va gina l bleeding persistence, a fer frustra te va gina l
pa cking, a Ba kri Ba lloon wa s insta lled in the va gina , filled with 200 cm 3 of physiologica l
solution. 48 hours la ter it wa s removed, with no bleeding rea ppea ra nce. The pa cient a nd her
da ughter were discha rged 7 da ys la ter, both in good condition.
In Chile the ma terna l ha emorrha ge is a n importa nt ca use of ma terna l morta lity. The
ha emorrha ges of post pa rtum a re divided into uterine a nd nonuterine hemorra ges. Among the
nonuterine ones in this ca se it is importa n to empha size the injuries of the inferior genita l tra ct.
Ba kri recently developed a ta mpona ge ba lloon, tha t ha s demonstra ted to be useful in obta ining
hemosta sia in ca ses of postpa rtum ha emorrha ge, ma inly due to previous pla centa .
In this ca se it wa s used theBa kri Ba lloon to stop the va gina l ha emorrha ge, with sa tisfa ctory
results.
Key words: Homebirth, Ba kri Ba lloon, va gina l ha emorrha ge.
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HEMORRAGIA DEL POSPARTO: COMPLICACIÓN DE UN PARTO EXTRAHOSPITALARIO
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REV. OBSTET. GINECOL. - HOSP. SANTIAGO ORIENTE DR. LUIS TISNÉ B ROUSSE. 2007; VOL 2 (3): 221-226
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HEMORRAGIA DEL POSPARTO: COMPLICACIÓN DE UN PARTO EXTRAHOSPITALARIO
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