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Salazar-Pousada D.,Hospital Gineco Obstetrico Enrique C Sotomayor | Salazar-Pousada D.,Catholic University of Santiago de Guayaquil | Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor | Chedraui P.,Catholic University of Santiago de Guayaquil | And 3 more authors.
Enfermeria Clinica | Year: 2014

Objective: To assess obstetrical outcomes in a sample of nulliparous gestations with preeclampsia, as compared to gestations without preeclampsia, attended in the Enrique C. Sotomayor Hospital of Guayaquil, Ecuador. Method: This was a comparative study of maternal and perinatal outcome data of gestations with late onset preeclampsia (n = 150; gestational age = 36.7 ± 3.3 weeks) with that of normal gestations (n = 150; gestational age 38.7 ± 1.7 weeks). Results: Almost three-quarters (73.3%) of preeclampsia cases were defined as severe. Compared to normal gestations, preeclampsia cases had higher anthropometric indices (neck and mid-arm circumference) and had more oligohydramnios, cesarean sections, transfusions, distressed fetuses, and adverse perinatal outcomes such as, lower Apgar scores at birth, and more preterm births, lower birth weight and small for gestational age infants. Conclusion: Gestations with preeclampsia had a negative impact on maternal and perinatal outcomes compared to gestations without preeclampsia. © 2014 Elsevier España, S.L.U.


Salazar-Pousada D.,Enrique C Sotomayor Obstetrics And Gynecology Hospital | Astudillo C.,Enrique C Sotomayor Obstetrics And Gynecology Hospital | Gonzaga M.,Enrique C Sotomayor Obstetrics And Gynecology Hospital | Hidalgo L.,Enrique C Sotomayor Obstetrics And Gynecology Hospital | And 4 more authors.
International Journal of Gynecology and Obstetrics | Year: 2012

Objective: To assess intimate partner violence (IPV) and psychoemotional disturbance among pregnant women in a low-income setting. Methods: In total, 283 pregnant women with high-risk prenatal complications were surveyed via the 20-item Self-Reporting Questionnaire (SRQ-20) and the Violence against Women screening tool. A total SRQ-20 score of at least 7 was defined as indicating psychoemotional disturbance. Results: Median age of participants was 24 years, 65 (23.0%) came from marginal areas, 6 (2.1%) had no education, and 75 (26.5%) had fewer than 5 prenatal visits. Median gestational age at survey was 33 weeks, with 224 (79.2%) admitted for treatment of threatened preterm labor. Median age of partner was 27 years, and 72 (25.5%) consumed alcohol on a daily basis. Ninety-eight (34.6%) pregnant women experienced at least 1 type of physical abuse or violence during the current pregnancy. Median total SRQ-20 score was 7. Overall, 145 (51.2%) had scores of 7 or higher. Total SRQ-20 scores positively correlated with the presence of IPV (number of positive items) and parity, and inversely correlated with maternal education level and gestational age at survey. Conclusion: IPV was highly prevalent and significantly correlated with female psychoemotional disturbance. © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.


Rodrguez M.C.,Hospital Gineco Obstetrico Enrique C Sotomayor | Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor | Schwager G.,Hospital Gineco Obstetrico Enrique C Sotomayor | Hidalgo L.,Hospital Gineco Obstetrico Enrique C Sotomayor | Perez-Lopez F.R.,University of Zaragoza
Journal of Obstetrics and Gynaecology | Year: 2012

The present study aimed at assessing sexuality after hysterectomy using the Female Sexual Function Index (FSFI). A telephone survey was conducted among women 1 year after a hysterectomy for benign cause. The FSFI and a general questionnaire containing personal and partner sociodemographic data were applied. A total of 100 sexually active women participated. Bilateral oophorectomy was performed among 41%. Upon survey, 63% were on hormone therapy (HT) and 2% on psychotropic drugs. Regarding the partner (n = 100), 32% abused alcohol; 11% had erectile dysfunction; 67% premature ejaculation and 11% were unfaithful. Total FSFI score was 19.4 ± 3.6 (median 19.8) and for the domains: 3.2 ± 0.9 (desire); 3.2 ± 0.9 (arousal); 3.1 ± 0.6 (lubrication); 3.1 ± 0.7 (orgasm); 3.5 ± 1.1 (satisfaction) and 3.2 ± 1.2 (pain/dyspareunia). All women displayed sexual dysfunction (total FSFI score ≤ 26.55). A total of 53% presented FSFI scores equal to or below the calculated median for the series. Logistic regression determined that among women who had had a hysterectomy, male premature ejaculation was related to an overall poorer female sexual function (lower total FSFI scorings), whereas sometime oral contraceptive use decreased this risk. Age (female or male) and male sexual dysfunction were factors related to lower individual FSFI domain scores. © 2012 Informa UK, Ltd.


Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor | Chedraui P.,University of Guayaquil | Perez-Lopez F.R.,University of Zaragoza | Mendoza M.,University of Guayaquil | And 5 more authors.
Maturitas | Year: 2010

Background: Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning. Objective: To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS). Methods: In this cross-sectional study 149 women aged 40-59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data. Results: Mean age of surveyed women was 47.6 ± 5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe-very severe in 42.8% of cases. Regarding the partner (n = 132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8 ± 4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score ≥10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51-17.23], p = 0.001), sedentarism (OR 3.43, CI 95% [1.14-10.26], p = 0.02) and hot flush presence (OR 2.61, CI 95% [1.02-6.65], p = 0.04) among women were risk factors for increased daytime sleepiness (ESS total score ≥10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24-0.90], p = 0.02). Conclusion: Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention. © 2009 Elsevier Ireland Ltd. All rights reserved.


Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor | Chedraui P.,University of Guayaquil | Perez-Lopez F.R.,University of Zaragoza | Mendoza M.,University of Guayaquil | And 5 more authors.
Maturitas | Year: 2010

Objective: To assess self-esteem and affecting factors in a middle-aged Ecuadorian female population using the Rosenberg Self-Esteem Scale (RSES). Study design: This was a cross-sectional study in which 149 women (40-59 years) were requested to fill out the RSES and a general socio-demographic form containing personal and partner data. Results: Mean age of sample was 47.6 ± 5.5 years, a 67.8% had less than 12 years of schooling and 33.6% were postmenopausal. At the moment of the survey 2.7% were on hormone therapy, and 2% were taking psychotropic drugs. Mean total RSES score was 26.6 ± 3.1 (median 26, range 17-35). A 35.6% and 18.1% of women respectively presented total RSES scores below 26 (median) and 25 (25th percentile) suggesting lower self-esteem. Total scores did not differ when comparing older age, menopausal phases or time since the menopause. Logistic regression analysis determined that women with lower parity and an unhealthy partner were related to lower total RSES scores (below the 25th percentile) suggesting lower self-esteem. Conclusions: In this mid-aged series lower self-esteem was not related to the aging process per se yet to socio-demographic female/male aspects. More research is needed in this regard that incorporates other sociological aspects. © 2010 Elsevier Ireland Ltd. All rights reserved.


Perez-Lopez F.R.,University of Zaragoza | Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor
Archives of Gynecology and Obstetrics | Year: 2010

Background: Chagas disease, caused by the Trypanosoma cruzi infection, is an endemic cause of morbidity and mortality in Latin America. Infection during pregnancy may increase the risk for adverse maternal-foetal outcome. Methods: Review of significant articles regarding maternal-foetal T. cruzi infection in free-vector non-endemic regions. Results: Vertical transmission, even in vector-free world regions, occurs in 1 out of 20 seropositive mothers. T. cruzi infection increases the risk of miscarriage, preterm birth and neonatal infection which may cause infant death or severe sequelae. Prevention of T. cruzi vertical transmission is not feasible, although early diagnosis allows appropriate treatment of newborns with a 100% efficacy. The present document will recall the importance of T. cruzi mother-to-child transmission and maternal-foetal consequences in non-endemic areas. Conclusion: It is highly recommended that infected pregnant women in non-endemic regions be accurately assessed. © 2010 Springer-Verlag.


PubMed | Instituto Aragones Of Ciencias Of La Salud, Catholic University of Santiago de Guayaquil and Hospital Gineco Obstetrico Enrique C Sotomayor
Type: Journal Article | Journal: Enfermeria clinica | Year: 2014

To assess obstetrical outcomes in a sample of nulliparous gestations with preeclampsia, as compared to gestations without preeclampsia, attended in the Enrique C. Sotomayor Hospital of Guayaquil, Ecuador.This was a comparative study of maternal and perinatal outcome data of gestations with late onset preeclampsia (n=150; gestational age=36.73.3 weeks) with that of normal gestations (n=150; gestational age 38.71.7 weeks).Almost three-quarters (73.3%) of preeclampsia cases were defined as severe. Compared to normal gestations, preeclampsia cases had higher anthropometric indices (neck and mid-arm circumference) and had more oligohydramnios, cesarean sections, transfusions, distressed fetuses, and adverse perinatal outcomes such as, lower Apgar scores at birth, and more preterm births, lower birth weight and small for gestational age infants.Gestations with preeclampsia had a negative impact on maternal and perinatal outcomes compared to gestations without preeclampsia.


Perez-Lopez F.R.,Hospital Clnico Of Zaragoza | Chedraui P.,Hospital Gineco Obstetrico Enrique C Sotomayor | Troyano-Luque J.M.,Hospital Universitario Of Canarias
Gynecological Endocrinology | Year: 2010

Adnexal masses are common among peri-and post-menopausal women. Although ovarian cancer is a significant cause of mortality in menopausal women, large population-based studies demonstrate that the majority of adnexal masses are benign. Despite this, the appearance of an adnexal mass is a concern for the patient and an insight exercise for physicians. In most cases, an adnexal enlargement is an incidental finding, generally corresponding to a benign cyst and easily diagnosed by conventional ultrasound. Exceptionally an ovarian tumour may be malignant and should be treated as early as possible. When conventional ultrasound renders complex morphology other diagnostic tools must be used such as: colour Doppler and functional tumour vessel properties, serum CA 125 levels, nuclear magnetic resonance imaging and in some cases laparoscopy. Several new tumour markers are being studied for clinical application, although there are presently no clear recommendations. Adnexal masses with benign morphological and functional properties must be periodically monitored as an alternative to surgery since malignant transformation is exceptional. © 2010 Informa UK Ltd.


PubMed | Hospital Gineco Obstetrico Enrique C Sotomayor
Type: Journal Article | Journal: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology | Year: 2012

The present study aimed at assessing sexuality after hysterectomy using the Female Sexual Function Index (FSFI). A telephone survey was conducted among women 1 year after a hysterectomy for benign cause. The FSFI and a general questionnaire containing personal and partner sociodemographic data were applied. A total of 100 sexually active women participated. Bilateral oophorectomy was performed among 41%. Upon survey, 63% were on hormone therapy (HT) and 2% on psychotropic drugs. Regarding the partner (n = 100), 32% abused alcohol; 11% had erectile dysfunction; 67% premature ejaculation and 11% were unfaithful. Total FSFI score was 19.4 3.6 (median 19.8) and for the domains: 3.2 0.9 (desire); 3.2 0.9 (arousal); 3.1 0.6 (lubrication); 3.1 0.7 (orgasm); 3.5 1.1 (satisfaction) and 3.2 1.2 (pain/dyspareunia). All women displayed sexual dysfunction (total FSFI score 26.55). A total of 53% presented FSFI scores equal to or below the calculated median for the series. Logistic regression determined that among women who had had a hysterectomy, male premature ejaculation was related to an overall poorer female sexual function (lower total FSFI scorings), whereas sometime oral contraceptive use decreased this risk. Age (female or male) and male sexual dysfunction were factors related to lower individual FSFI domain scores.


PubMed | Hospital Gineco Obstetrico Enrique C Sotomayor
Type: Evaluation Studies | Journal: Maturitas | Year: 2010

Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning.To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS).In this cross-sectional study 149 women aged 40-59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data.Mean age of surveyed women was 47.6+/-5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe-very severe in 42.8% of cases. Regarding the partner (n=132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8+/-4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score >or=10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51-17.23], p=0.001), sedentarism (OR 3.43, CI 95% [1.14-10.26], p=0.02) and hot flush presence (OR 2.61, CI 95% [1.02-6.65], p=0.04) among women were risk factors for increased daytime sleepiness (ESS total score >or=10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24-0.90], p=0.02).Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.

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