Servicio de Ginecologia y Obstetricia


Servicio de Ginecologia y Obstetricia

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Marquez A. J.J.,University of Antioquia | Garcia V. V.,Servicio de Ginecologia y Obstetricia
Revista Chilena de Obstetricia y Ginecologia | Year: 2012

Obesity and type 2 diabetes are increasing worldwide and generate high morbidity and mortality and affect the patient, family and the health system. Low levels of physical activity are contributing to the epidemic of obesity and type 2 diabetes in women of childbearing age. Most women are sedentary or stop exercising when they realize the pregnancy, which predisposes to the development of gestational diabetes and excessive weight gain during pregnancy. There is ample evidence that exercise during pregnancy is safe for mother and fetus and provides physiological, psychological, metabolic benefits, and improving physical capacity in a manner similar to the preconception period. Although not defined the exact exercise prescription during pregnancy, achieve currently recommended level of physical activity at least 16 MET H per week, or preferably 28 MET H per week, and increase the intensity of exercise over 60% of heart rate reserve to reduce the risk of obesity or gain excessive weight during pregnancy, gestational diabetes and perhaps hypertensive disorders of pregnancy. Therefore, exercise may be an appropriate strategy to prevent these pathologies leading to morbidity and mortality maternal and fetal.

Asthenia (or fatigue) is one of the most common symptoms in palliative patients. Methylphenidate is currently being assessed for treating this condition. A review of related literature published to date was performed, revealing methylphenidate to be a safe drug which could decrease fatigue in palliative patients with a tolerable side-effects profile.

Noguera-Sanchez M.F.,Subdireccion General de Tnnovacion y Calidad | Arenas-Gomez S.,Servicio de GinecologIa y Obstetricia | Rabadan-Martinez C.E.,Hospital General Dr Aurelio Valdivieso | Antonjo-Sanchez P.,Subdireccion General de Tnnovacion y Calidad
Cirugia y Cirujanos | Year: 2013

Background: In Mexico, the maternal mortality has a diminishing rate in the country the last decades, except in the estate of Oaxaca. Oaxaca is located amongst the entities with the highest ratios of maternal mortality. Objective: To analyzed the behavior and epidemiology tendencies of 10 years period of maternal mortality at the Dr. Aurelio Valdivieso General Hospital. Methods: In a retrospective, descriptive, and transversal analysis, there were reviewed the maternal mortality files from the gynecology and obstetrics division. Three sets of variables were designed, socials, obstetrical and circumstantial. We used general and descriptive statistical tools. Results: From January first to December 3lth of 2009 it was registered 109 maternal deaths, excluding 2 non-obstetrical. Resulting in a 107 maternal deaths; divided in 75 direct maternal deaths and 32 indirect maternal deaths, the maternal mortality rate was 172.14 × 100,000 livebirths. Eighty nine maternal deaths were foreseeable (83%) and 18 were not foreseeable (17%) as was stated by the ad hoc Committee within the Dr. Aurelio Valdivieso's General Hospital. The pregnancy-related hypertension takes account for the highest pathology in relationship with maternal deaths, the low literacy and puerperium correlated for the higher risk. Conclusions: Low human development index, low literacy, were the accountable variables that confined higher mortality risk. Also was found that the higher occurrence of maternal deaths appeared during the puerperium and within hospital wards. The maternal mortality rate founded was the higher amongst the country.

Background: Biliary pathology is the second cause of abdominal acute pain during pregnancy. The surgical approach most often used for the treatment of acute cholecystitis during pregnancy is laparoscopy. Some aspects have made this approach during pregnancy controversial. Objectives: To analyze the maternal-fetal benefits and complications of laparoscopic cholecystectomy during pregnancy and compare these results with the medical literature. Material and Methods: It is a retrospective, transverse study. Laparoscopic cholecystectomy cases and pregnancy from 2005 to 2009 at Hospital Español de Mexico city were reed. The following information was obtained: maternal age, gestational age, signs and symptoms, medical department that made the diagnosis, the laparoscopic entry techniques, the monitoring of CO2 for the pressure of pneumoperitoneum, the complications in the peri and postoperatory state, the use of tocolytics medication and other medicines in the hospital stay, maternal and perinatal morbi-morbility, days of hospitable stay, follow-up surgical postintervention in the office. We did a comparation of our results with the medical literature. Results: 10 laparoscopic cholecystectomies were performed. Gestational ages were from 15 to 25 weeks. The incidence was 1:995. All the cases were diagnosed by doctors of the department of general surgery, and also the surgeries. 2/10 patients were in preterm delivery risk at 35 weeks of gestation. There was not any fetal loss or maternal death. Conclusions: Our results are similar with the literature research, and we confirm that laparoscopic cholecystectomy is a safe therapeutic option for gravid patients, which has minimal fetal-maternal morbidity.

Hernandez-Martinez A.,Servicio de Paritorio | Pascual-Pedreno A.I.,Servicio de Ginecologia y Obstetricia | Bano Garnes A.B.,Servicio de Paritorio | Melero-Jimenez M.D.R.,Servicio de Paritorio | Molina Alarcon M.,University of Castilla - La Mancha
Enfermeria Clinica | Year: 2014

Objective: To determine the variability in the use of episiotomy among midwives and its relation to third and fourth-degree tears, and the impact on neonatal morbidity. Method: A study was conducted on historical groups from a total of 2,366 eutocic births with a single live fetus greater than or equal to 37 weeks gestation and 18 midwives over a three year period (2009, 2010 and 2011) in «Mancha-Centro» Hospital (Alcázar de San Juan).The outcomes variables for this analysis were the incidence of episiotomy, perineal lacerations, and neonatal morbidity. Results: The variability in the use of episiotomy ranged from 19.5% to 50.1% among the 18 midwives in the study, with an average rate of 34.9% (824). Grouped at intervals, 22.1% (524) had a rate of ≤. 25%, 26.1% (621) between 26-35%, 38% (898) between 36-44%, and 13.7% (323) a rate of ≥. 45%, with homogeneity between the groups for all the confounding factors. There was no statistical association between higher rates of episotomy and pH of umbilical artery. <. 7.10, Apgar score after 5. min. <. 7, and the level of neonatal resuscitation type iii and iv. There was also no relationship between the rate of episiotomy with perineal integrity and third and fourth-degree tears. Discussion: The variability in the rate of episiotomy is high, and it is not related to the increased presence of third and fourth-degree tears or increased neonatal morbidity. Episiotomy rates should not be greater than 25%, in order to prevent perineal trauma or loss of fetal well-being. © 2013 Elsevier España, S.L.U.

PubMed | Servicio de Ginecologia y Obstetricia, Servicio de Neonatologia and Servicio de Oncologia Ginecologica
Type: Journal Article | Journal: Cirugia y cirujanos | Year: 2016

The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200.To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results.A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II 200 or greater than this.The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266.The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%.

PubMed | Laboratorio Clinica Davila, Clinical Research Laboratories, Andrés Bello University and Servicio de Ginecologia y Obstetricia
Type: | Journal: The Journal of infectious diseases | Year: 2016

Epithelial shedding and scarring of Fallopian tube mucosa are the main consequences of sexually transmitted Neisseria gonorrhoeae infection and likely involves an imbalance of host extracellular matrix components (ECM) and their regulators such as matrix metalloproteinases (MMPs). In this brief report, primary human Fallopian tube epithelial cells were infected with N. gonorrhoeae and MMP patterns examined. Gonococcal infection induced a significant increase in secreted MMP-9 and an accumulation of cytoplasmic MMP-2 over time, but no significant MMP-3 or MMP-8 production was observed. Thus, MMP-9 in particular could play a role in tubal scarring in response to gonococcal infection.

Ortiz Movilla R.,Hospital Universitario Of Getafe | Acevedo Martin B.,Servicio de Ginecologia y Obstetricia
Pediatria de Atencion Primaria | Year: 2011

Vulvovaginitis is the most common gynecological problem in prepubertal girls, helped by their lower introitus protection to external agents and the presence of anatomical (proximity of anus, less developed minor and major labia,...) and hormonal factors (low estrogen concentration). This is added to the effect of local irritants and sometimes co-existence of poor hygiene. Most vulvovaginitis in girls are nonspecific, although specific pathogenic bacteria (enteric, respiratory, or sexually transmitted) can be isolated and they can be also secondary to other causes as oxiurasis, or intravaginal foreign bodies. In this article we will analyze the etiology, pathogenesis, clinical features and management of this disorder in childhood, and we will have some clinical and microbiological considerations of different diseases with specific etiology.

Luengo A.,Servicio de Ginecologia y Obstetricia | Zornoza V.,Servicio de Ginecologia y Obstetricia | Fernandez-Corona A.,Servicio de Ginecologia y Obstetricia | Gonzalez-Garcia C.,Servicio de Ginecologia y Obstetricia
Clinica e Investigacion en Ginecologia y Obstetricia | Year: 2012

Objective: To determine the obstetric results of labor induction in relation to body mass index (BMI) and gestational weight gain at the Leon Hospital between January and March, 2008. Material and method: We conducted a prospective cohort study of 127. labor inductions. The variables included were the medical reason for induction, the procedures employed for cervical ripening and induction, maternal age at the end of pregnancy, type of labor, parity, initial Bishop's score, BMI, weight, height, gestational weight gain, neonatal weight and Apgar test at 1 and 5. minutes. Results: Inductions were performed in 21.3% of births, while vaginal delivery was achieved in 81.1%. A total of 36.2% of the patients were overweight, 21.2% were obese and 4.7% were morbidly obese. Conclusions: A non-statistically significant association was observed between failure of vaginal delivery and BMI (P= 08) and body weight gain (P= 07). These two variables seem to increase the chances of failure of cervical ripening and induction of labor, increasing the percentage of cesarean sections. © 2010 Elsevier España, S.L..

PubMed | Servicio de Ginecologia y Obstetricia
Type: Case Reports | Journal: Medicina | Year: 2016

A 37-year-old nulligravida infertile female had a cervical heterotopic pregnancy following an in vitro fertilization procedure. Early intervention on the 6th week of gestation with a manual vacuum aspirator reached to remove the cervical pregnancy. Ligation of the descending cervical branches of the uterine arteries and a cervical cerclage, were placed before the aspiration, for prevention of possible hemorrhage. Successful removal of the cervical pregnancy was achieved with only mild bleeding. An intrauterine pregnancy progressed to viability without complications, resulting in a vaginal delivery of a preterm live-birth at 35.4 weeks, of a male that weighted 2740 g.

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