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Preeclampsia is one of the main causes of serious maternal-fetal complications and in Ecuador it is the leading cause of maternal mortality. Thus, a prevention method has been specified, the most accepted being low-dose aspirin. However, several aspects of its administration are still controversial due to the heterogeneity of the results in the investigations carried out. Objectives: to describe the current knowledge on the administration of aspirin (dose, week of gestation and interpersonal factors) for the prevention of preeclampsia in high-risk women. Methods: Comprehensive review of randomized controlled clinical trials, systematic reviews, meta-analyses, and cohort studies. The included articles were published in the period from January 2019 to January 2023, in English and Spanish, and extracted from the PubMed and Cochrane platforms. Results obtained: 24 articles were selected for data extraction and qualitative synthesis. A range of doses from 50 mg to 160 mg was obtained; being the doses greater than 80 mg those that showed greater effectiveness. Starting before 16 weeks showed a significant effect but not before 11; after 20 there is conflicting evidence. Personal characteristics and comorbidities interfere with the preventive effect. Conclusions: Even when there is no established consensus, doses equal to or greater than 80 mg of aspirin administered before 16 weeks indicate greater efficacy; however, obesity and chronic hypertension seem to determine the need for a higher dose.

Preeclampsia is one of the main causes of serious maternal-fetal complications and in Ecuador it is the leading cause of maternal mortality. Thus, a prevention method has been specified, the most accepted being low-dose aspirin. However, several aspects of its administration are still controversial due to the heterogeneity of the results in the investigations carried out. Objectives: to describe the current knowledge on the administration of aspirin (dose, week of gestation and interpersonal factors) for the prevention of preeclampsia in high-risk women. Methods: Comprehensive review of randomized controlled clinical trials, systematic reviews, meta-analyses, and cohort studies. The included articles were published in the period from January 2019 to January 2023, in English and Spanish, and extracted from the PubMed and Cochrane platforms. Results obtained: 24 articles were selected for data extraction and qualitative synthesis. A range of doses from 50 mg to 160 mg was obtained; being the doses greater than 80 mg those that showed greater effectiveness. Starting before 16 weeks showed a significant effect but not before 11; after 20 there is conflicting evidence. Personal characteristics and comorbidities interfere with the preventive effect. Conclusions: Even when there is no established consensus, doses equal to or greater than 80 mg of aspirin administered before 16 weeks indicate greater efficacy; however, obesity and chronic hypertension seem to determine the need for a higher dose.

Preeclampsia is one of the main causes of serious maternal-fetal complications and in Ecuador it is the leading cause of maternal mortality. Thus, a prevention method has been specified, the most accepted being low-dose aspirin. However, several aspects of its administration are still controversial due to the heterogeneity of the results in the investigations carried out. Objectives: to describe the current knowledge on the administration of aspirin (dose, week of gestation and interpersonal factors) for the prevention of preeclampsia in high-risk women. Methods: Comprehensive review of randomized controlled clinical trials, systematic reviews, meta-analyses, and cohort studies. The included articles were published in the period from January 2019 to January 2023, in English and Spanish, and extracted from the PubMed and Cochrane platforms. Results obtained: 24 articles were selected for data extraction and qualitative synthesis. A range of doses from 50 mg to 160 mg was obtained; being the doses greater than 80 mg those that showed greater effectiveness. Starting before 16 weeks showed a significant effect but not before 11; after 20 there is conflicting evidence. Personal characteristics and comorbidities interfere with the preventive effect. Conclusions: Even when there is no established consensus, doses equal to or greater than 80 mg of aspirin administered before 16 weeks indicate greater efficacy; however, obesity and chronic hypertension seem to determine the need for a higher dose.

Background: Tranexamic acid (TXA) is a synthetic analogue of lysine, which inhibits fibrinolysis by reducing the conversion of plasminogen into plasmin, thereby promoting the preservation of the clot formed in the operated area and reducing the risk of bleeding. It is eventually used as a complement in oral surgery. Purpose: To analyze the evidence on the effectiveness in hemostasis, appropriate dose, safety margin, benefits, and postoperative evolution of TXA used in oral surgery. Methods: The systematic review was structured from a search tree (PubMed, Google Scholar, ProQuest, and Scopus), with the keywords and Boolean connector: Tranexamic Acid AND Oral Surgery. The search was limited to the English, Portuguese, and Spanish languages; open-access articles; systematic reviews, meta-analyses, randomized clinical trials, and case reports. We established a secondary selection based on the title and abstract of the articles according to the purpose of the study. Findings: The literature reports an efficacy of 80 % of TXA in reducing bleeding risk during and after surgical procedures, which optimizes the procedures. Conclusions: Topical or intravenous TXA in doses not exceeding 20 mg has proven to be effective to reduce the risk of bleeding in oral surgery.

Background: Tranexamic acid (TXA) is a synthetic analogue of lysine, which inhibits fibrinolysis by reducing the conversion of plasminogen into plasmin, thereby promoting the preservation of the clot formed in the operated area and reducing the risk of bleeding. It is eventually used as a complement in oral surgery. Purpose: To analyze the evidence on the effectiveness in hemostasis, appropriate dose, safety margin, benefits, and postoperative evolution of TXA used in oral surgery. Methods: The systematic review was structured from a search tree (PubMed, Google Scholar, ProQuest, and Scopus), with the keywords and Boolean connector: Tranexamic Acid AND Oral Surgery. The search was limited to the English, Portuguese, and Spanish languages; open-access articles; systematic reviews, meta-analyses, randomized clinical trials, and case reports. We established a secondary selection based on the title and abstract of the articles according to the purpose of the study. Findings: The literature reports an efficacy of 80 % of TXA in reducing bleeding risk during and after surgical procedures, which optimizes the procedures. Conclusions: Topical or intravenous TXA in doses not exceeding 20 mg has proven to be effective to reduce the risk of bleeding in oral surgery.

Background: Tranexamic acid (TXA) is a synthetic analogue of lysine, which inhibits fibrinolysis by reducing the conversion of plasminogen into plasmin, thereby promoting the preservation of the clot formed in the operated area and reducing the risk of bleeding. It is eventually used as a complement in oral surgery. Purpose: To analyze the evidence on the effectiveness in hemostasis, appropriate dose, safety margin, benefits, and postoperative evolution of TXA used in oral surgery. Methods: The systematic review was structured from a search tree (PubMed, Google Scholar, ProQuest, and Scopus), with the keywords and Boolean connector: Tranexamic Acid AND Oral Surgery. The search was limited to the English, Portuguese, and Spanish languages; open-access articles; systematic reviews, meta-analyses, randomized clinical trials, and case reports. We established a secondary selection based on the title and abstract of the articles according to the purpose of the study. Findings: The literature reports an efficacy of 80 % of TXA in reducing bleeding risk during and after surgical procedures, which optimizes the procedures. Conclusions: Topical or intravenous TXA in doses not exceeding 20 mg has proven to be effective to reduce the risk of bleeding in oral surgery.

Introducción: el parto representa la forma más severa de dolor experimentado en la vida de una mujer, su manejo adecuado se asocia con una experiencia satisfactoria. Objetivo: determinar los efectos colaterales del tramadol versus paracetamol durante la labor de parto en gestantes a término que ingresaron al Hospital José Carrasco Arteaga durante el periodo 2014 a 2019. Materiales y métodos: se realizó un estudio descriptivo de corte transversal; se recolectó información de 216 historias clínicas electrónicas del sistema AS-400. Para el análisis de los datos se usó el programa estadístico SPSS v. 15; las variables fueron presentadas con los valores de frecuencia (f), porcentaje (%); medidas de tendencia central y de dispersión (Media, Mediana/Desviación Estándar). Resultados: la media de la edad materna fue 30 años (94%); el 34,25% fueron multíparas; 94,91% presentó controles prenatales adecuados (≥ 5); la duración promedio de la labor de parto fue ≥ 7 horas en primíparas (63,15%), y ≥ 4 horas en multíparas (50,62%). El tramadol se administró en el 42,59% de los casos, la dosis fue 100 mg., por infusión continua (95,65%), y produjo efectos colaterales maternos como náusea (57,61%), cefalea (47,83%), vómito (9,78%) e insomnio (9,78%). El paracetamol se empleó en un 57,41%, en dosis de 1000 mg vía intravenosa (91,23%), pero produjo menos efectos adversos. Las complicaciones perinatales, el estado fetal no tranquilizador (38,05%), taquicardia fetal (29,34%), se observaron con mayor frecuencia con tramadol. Conclusión: el tramadol ocasionó más efectos adversos maternos y fetales que el paracetamol al administrase durante el trabajo de parto.

Introducción: el parto representa la forma más severa de dolor experimentado en la vida de una mujer, su manejo adecuado se asocia con una experiencia satisfactoria. Objetivo: determinar los efectos colaterales del tramadol versus paracetamol durante la labor de parto en gestantes a término que ingresaron al Hospital José Carrasco Arteaga durante el periodo 2014 a 2019. Materiales y métodos: se realizó un estudio descriptivo de corte transversal; se recolectó información de 216 historias clínicas electrónicas del sistema AS-400. Para el análisis de los datos se usó el programa estadístico SPSS v. 15; las variables fueron presentadas con los valores de frecuencia (f), porcentaje (%); medidas de tendencia central y de dispersión (Media, Mediana/Desviación Estándar). Resultados: la media de la edad materna fue 30 años (94%); el 34,25% fueron multíparas; 94,91% presentó controles prenatales adecuados (≥ 5); la duración promedio de la labor de parto fue ≥ 7 horas en primíparas (63,15%), y ≥ 4 horas en multíparas (50,62%). El tramadol se administró en el 42,59% de los casos, la dosis fue 100 mg., por infusión continua (95,65%), y produjo efectos colaterales maternos como náusea (57,61%), cefalea (47,83%), vómito (9,78%) e insomnio (9,78%). El paracetamol se empleó en un 57,41%, en dosis de 1000 mg vía intravenosa (91,23%), pero produjo menos efectos adversos. Las complicaciones perinatales, el estado fetal no tranquilizador (38,05%), taquicardia fetal (29,34%), se observaron con mayor frecuencia con tramadol. Conclusión: el tramadol ocasionó más efectos adversos maternos y fetales que el paracetamol al administrase durante el trabajo de parto.