Mastitis puerperal
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La mastitis puerperal es un problema de salud importante en el posparto, la incidencia varía del 2% al 33%. Se define como la inflamación de los lóbulos glandulares, siendo la infección la etiología más frecuente y el puerperio, en las primeras semanas, el periodo de mayor prevalencia. La mayoría de las mujeres experimentan algún grado de congestión mamaria, al preparar la glándula para la eyección láctea durante el amamantamiento, pero cuando la técnica es inadecuada y lleva a fisuras del pezón, se genera riesgo de colonización bacteriana de los ductos mamarios con sobreinfección e, incluso, formación de abscesos, que van a requerir manejo hospitalario, antibioticoterapia e intervenciones quirúrgicas. Es esta la causa más importante de suspensión de la lactancia y su repercusión en la alimentación y desarrollo del recién nacido. No hay uniformidad en los criterios y el diagnóstico sigue siendo fundamentalmente clínico. El microrganismo más implicado es el estafilococo, su confirmación microbiológica se hace a partir del Gram y cultivo del drenaje de abscesos o de cultivos de leche, siendo estos, pocas veces realizados, a menos que el cuadro se complique con repercusión sistémica (sepsis) o no haya respuesta a la antibioticoterapia empírica. El tratamiento fundamental es el drenaje del seno, por lo que debe mantenerse la lactancia.
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