Manejo en cirugía oral de la paciente embarazada.

Abstract

Pregnancy involves complex physiological, physical, and psychological changes mediated by female sex hormones which can exacerbate already existing oral pathological conditions, such as gingivitis, periodontitis and carious lesions. When planning oral care for pregnant women, the main goal is to establish a healthy oral environment free of inflammation and infection. The objective was to determine the management that should be applied in a pregnant patient who requires oral surgery. A systematic review was carried out. The oral surgery management of the pregnant patient must be carried out following parameters both in the preoperative time and in the operative and postoperative period. Regarding the first of them, you must categorize the moment of pregnancy (first, second or third trimester), take the medical history, obtain informed consent, consult with the treating doctor to know the patient's status and order blood tests. During the operating time, vital signs such as oxygen saturation, pulse rate, respiratory rate and blood pressure must be monitored, as well as the patient's position preventing pressure on the inferior vena cava. The ideal anesthetic is 2% lidocaine with epinephrine as it is the safest for these patients. Medication will depend on drugs in FDA risk category B. For decision making related to the care of pregnant patients in oral surgery, a decision tree was developed taking into consideration a simple extraction procedure and the case of a patient with odontogenic infection.