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El uso de antisépticos yodados es una práctica aún extendida en nuestras maternidades. La aplicación de antisépticos yodados tanto a la madre en los momentos previos al parto como al recién nacido provoca una sobrecarga yodada incontrolada.
La absorción del yodo a través de la piel de la madre es tan rápida que la yodemia en sangre de cordón aumenta en un 50% tras la aplicación en los momentos previos al expulsivo de antisépticos yodados a la madre.
La sobrecarga yodada en la madre se manifiesta con aumento de la yoduria y del contenido de yodo en la leche hasta 10 veces en los días inmediatamente posteriores al parto, si las curas de la episiotomía se realizan con povidona yodada. La elevada concentración de yodo en la leche agrava la sobrecarga al recién nacido.
Especialmente en zonas con déficit nutricional de yodo, esta sobrecarga yodada puede provocar un bloqueo transitorio del tiroides neonatal que tiene repercusiones negativas sobre el programa de detección del hipotiroidismo congénito, aumentando el número de falsos positivos, y sus inmediatas consecuencias: ansiedad de los padres y un importante aumento de los costes del programa. Más graves son las consecuencias que este bloqueo puede producir en el desarrollo del recién nacido.
Parece ineludible realizar una llamada de atención sobre las alteraciones que provocan los antisépticos yoda-dos y desaconsejar su uso en el período perinatal
Palabras clave:
Povidona-yodada
Yodo
Hormonas tiroideas
Hipotiroidismo
Recién nacido
The use of iodine-containing antiseptics is still common in obstetrics and neonatology. Topical iodine given both to the mother before delivery and to the neonate causes iodine overload.
The absorption of maternal iodine through the skin is so fast that iodine in the blood of the umbilical cord increases by 50% a few minutes before delivery.
Iodine overload also occurs in the mother. Urinary and breast-milk iodine are increased more than 10-fold in the days after delivery if providone-iodine is used in episiotomy.
The overload in the neonate is even higher if breast-fed. Particularly in iodine-deficient areas, this overload can produce thyroid blockade with undesirable effects in congenital hypothyroidism screening, raising the number of false positives and its consequences: parental anxiety and screening costs. The potential effects that this thyroid blockade can produce in the neonate are even more serious.
Attention should be drawn to the undesirable effects of iodine antiseptics and their use in the perinatal period should be avoided
Key words:
Providone-iodine
Iodine
Thyroid hormones
Hypothyroidism
Newborn
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