Examen Complexivo-Obstetricia
http://dspace.utb.edu.ec/handle/49000/2029
2024-03-28T20:48:13ZDiagnóstico y tratamiento terapéutico de óbito fetal secundigesta en paciente de 28 años con 28 semanas de gestación.
http://dspace.utb.edu.ec/handle/49000/15128
Diagnóstico y tratamiento terapéutico de óbito fetal secundigesta en paciente de 28 años con 28 semanas de gestación.
Cevallos Peralta, Belky Katiuska
El óbito fetal es un problema de salud grave se da con 28 semanas de gestación o más es un caso que se presenta como óbito fetal tardío, ocurre antes del parto; repercute en los padres del recién nacido y en el ámbito familiar; a nivel mundial existe 3,9 millones al año por muerte fetal tardía es una situación trágica que puede tener diversas causas, como son anomalías cromosómicas, problemas placentarios, infecciones, trastornos maternos entre otros, en su mayoría la causa es desconocida. Para este estudio la metodología utilizada fue la observación, la historia clínica del paciente y la teoría científica de óbito fetal. Tras la valoración respectiva de la paciente secundigesta de 28 semanas de gestación fue atendida y sometida a un plan de inducción, como una opción comúnmente utilizada en casos de muerte fetal tardía, para la elección del método se consideró la edad gestacional y las condiciones obstétricas, también se hizo una evaluación completa del feto muerto, se brinde el apoyo psicológico y emocional a la madre y a la familia durante todo el proceso. Se concluye que el escaso control prenatal puede ser uno de los factores a los que estuvo expuesta la paciente ante la falta de acceso a servicios de salud y poca conciencia de acudir a revisión para evitar consecuencias negativas para la madre y el feto; pues el control prenatal garantiza un embarazo saludable y prevención de complicaciones, por lo tanto, la detección de factores de riesgo obstétricos, perinatales y socioeconómicos asociados; además de un control adecuado durante todo el embarazo puede reducir la incidencia de muerte fetal.
Fetal death is a serious health problem, it occurs at 28 weeks of gestation or more, it is a case that presents as late fetal death, it occurs before delivery; It affects the parents of the newborn and the family environment; Worldwide, there are 3.9 million late fetal deaths per year. It is a tragic situation that can have various causes, such as chromosomal anomalies, placental problems, infections, maternal disorders, among others, for the most part the cause is unknown. For this study, the methodology used was observation, the patient's clinical history and the scientific theory of fetal death. After the respective evaluation of the second-digested patient at 28 weeks of gestation, she was treated and subjected to an induction plan, as an option used in cases of late fetal death. For the choice of method, the gestational age and obstetric conditions were demonstrated. A complete evaluation of the dead fetus was carried out, psychological and emotional support was provided to the mother and family throughout the process. It is concluded that the case of prenatal control may be one of the factors to which the patient was exposed due to the lack of access to health services and little awareness of going for a check-up to avoid negative consequences for the mother and fetus; since prenatal control guarantees a healthy pregnancy and prevention of complications, therefore, the detection of associated obstetric, perinatal and socioeconomic risk factors; In addition to adequate monitoring throughout pregnancy, it can reduce the incidence of fetal death.; Fetal death is a serious health problem, it occurs at 28 weeks of gestation or more, it is a case that presents as late fetal death, it occurs before delivery; It affects the parents of the newborn and the family environment; Worldwide, there are 3.9 million late fetal deaths per year. It is a tragic situation that can have various causes, such as chromosomal anomalies, placental problems, infections, maternal disorders, among others, for the most part the cause is unknown. For this study, the methodology used was observation, the patient's clinical history and the scientific theory of fetal death. After the respective evaluation of the second-digested patient at 28 weeks of gestation, she was treated and subjected to an induction plan, as an option used in cases of late fetal death. For the choice of method, the gestational age and obstetric conditions were demonstrated. A complete evaluation of the dead fetus was carried out, psychological and emotional support was provided to the mother and family throughout the process. It is concluded that the case of prenatal control may be one of the factors to which the patient was exposed due to the lack of access to health services and little awareness of going for a check-up to avoid negative consequences for the mother and fetus; since prenatal control guarantees a healthy pregnancy and prevention of complications, therefore, the detection of associated obstetric, perinatal and socioeconomic risk factors; In addition to adequate monitoring throughout pregnancy, it can reduce the incidence of fetal death.
2023-01-01T00:00:00ZConducta obstétrica en la estenosis mitral moderada en paciente de 30 años con 36 semanas de embarazo.
http://dspace.utb.edu.ec/handle/49000/15055
Conducta obstétrica en la estenosis mitral moderada en paciente de 30 años con 36 semanas de embarazo.
Miranda Acurio, Sindy Nathaly
El embarazo con estenosis mitral moderada plantea desafíos en el Hospital Martín Icaza. Se requiere un enfoque multidisciplinario para garantizar un embarazo seguro. La estenosis mitral es una afección cardíaca que dificulta el flujo sanguíneo. La investigación aborda la conducta obstétrica y el cuidado prenatal. El marco teórico explora la estenosis mitral moderada durante el embarazo, incluyendo la evaluación cardíaca y los estudios de imagen. El objetivo es mejorar la atención médica y el bienestar materno fetal. La investigación se basa en la relevancia clínica de la estenosis mitral moderada durante el embarazo, la necesidad de un enfoque multidisciplinario y la mejora de la calidad de atención. Busca identificar estrategias de manejo para minimizar riesgos. El objetivo general es determinar la conducta obstétrica adecuada en pacientes embarazadas con estenosis mitral moderada. Los objetivos específicos incluyen analizar la incidencia de mortalidad materno fetal, identificar factores de riesgo y complicaciones, y caracterizar las recomendaciones médicas.
Pregnancy with moderate mitral stenosis presents challenges at Hospital Martín Icaza. A multidisciplinary approach is required to ensure a safe pregnancy. Mitral stenosis is a cardiac condition that hinders blood flow. The research addresses obstetric management and prenatal care. The theoretical framework explores moderate mitral stenosis during pregnancy, including cardiac assessment and imaging studies. The aim is to enhance medical care and maternal-fetal well-being. The research is based on the clinical relevance of moderate mitral stenosis during pregnancy, the need for a multidisciplinary approach, and the improvement of the quality of care. It seeks to identify management strategies to minimize risks. The general objective is to determine appropriate obstetric conduct in pregnant patients with moderate mitral stenosis. Specific objectives include analyzing the incidence of maternal-fetal mortality, identifying risk factors and complications, and characterizing medical recommendations.; Pregnancy with moderate mitral stenosis presents challenges at Hospital Martín Icaza. A multidisciplinary approach is required to ensure a safe pregnancy. Mitral stenosis is a cardiac condition that hinders blood flow. The research addresses obstetric management and prenatal care. The theoretical framework explores moderate mitral stenosis during pregnancy, including cardiac assessment and imaging studies. The aim is to enhance medical care and maternal-fetal well-being. The research is based on the clinical relevance of moderate mitral stenosis during pregnancy, the need for a multidisciplinary approach, and the improvement of the quality of care. It seeks to identify management strategies to minimize risks. The general objective is to determine appropriate obstetric conduct in pregnant patients with moderate mitral stenosis. Specific objectives include analyzing the incidence of maternal-fetal mortality, identifying risk factors and complications, and characterizing medical recommendations.
2023-01-01T00:00:00ZConducta obstétrica en gestante de 16 semanas con abdomen agudo.
http://dspace.utb.edu.ec/handle/49000/15020
Conducta obstétrica en gestante de 16 semanas con abdomen agudo.
Vera Solorzano, Valeria María
El presente estudio tiene como objetivo examinar la conducta obstétrica en gestantes de 16 semanas que presentan abdomen agudo en el Hospital General Martín Icaza. Se abordan las causas, factores de riesgos y consecuencias más comunes, manifestaciones clínicas y la importancia del diagnóstico temprano y tratamiento oportuno. Se enfoca especialmente en el manejo de las gestantes con quistes ovárico torcido, analizando métodos diagnósticos, opciones terapéuticas y cuidados obstétricos especiales. Se describen las características del sistema reproductor femenino, así como los cambios fisiológicos durante el embarazo que pueden contribuir al desarrollo de quistes ováricos. El estudio se basa en el análisis un caso atendido en el Hospital Martín Icaza y revisión de la literatura médica relevante para obtener conocimiento actualizados de esta afección. Se presentarán conclusiones, recomendaciones para la práctica médica y posibles direcciones para futuras investigaciones
The present study aims to examine obstetric management in pregnant women at 16 weeks gestation who present with acute abdominal pain at General Hospital Martín Icaza. It addresses the most common causes, risk factors, and consequences, clinical manifestations, and the importance of early diagnosis and timely treatment. It specifically focuses on the management of pregnant women with twisted ovarian cysts, analyzing diagnostic methods, therapeutic options, and special obstetric care. It describes the characteristics of the female reproductive system, as well as the physiological changes during pregnancy that may contribute to the development of ovarian cysts. The study is based on the analysis of a case treated at Martín Icaza Hospital and a review of relevant medical literature to obtain updated knowledge about this condition. Conclusions, recommendations for medical practice, and possible directions for future research will be presented.; The present study aims to examine obstetric management in pregnant women at 16 weeks gestation who present with acute abdominal pain at General Hospital Martín Icaza. It addresses the most common causes, risk factors, and consequences, clinical manifestations, and the importance of early diagnosis and timely treatment. It specifically focuses on the management of pregnant women with twisted ovarian cysts, analyzing diagnostic methods, therapeutic options, and special obstetric care. It describes the characteristics of the female reproductive system, as well as the physiological changes during pregnancy that may contribute to the development of ovarian cysts. The study is based on the analysis of a case treated at Martín Icaza Hospital and a review of relevant medical literature to obtain updated knowledge about this condition. Conclusions, recommendations for medical practice, and possible directions for future research will be presented.
2023-01-01T00:00:00ZConducta obstétrica a seguir en paciente con mola invasiva, manejo terapéutico.
http://dspace.utb.edu.ec/handle/49000/15019
Conducta obstétrica a seguir en paciente con mola invasiva, manejo terapéutico.
Vargas Ponce, Angie Isabel
La mola invasiva es un evento poco común que se distingue por una proliferación trofoblástica excesiva y una penetración del trofoblasto en el miometrio, pero no muestra propensión a la propagación metastásica. Se presenta el caso clínico de una paciente de 48 años de edad que acude al área de emergencia del Hospital General Babahoyo por presentar el cuadro clínico de dolor abdominal, sangrado transvaginal, náuseas y vértigo. La sospecha de embarazo molar se generó tras la primera ecografía que reveló características indicativas. Además, se detectó el aumento en la fracción beta de la gonadotropina coriónica humana. Se determinó preparar a la paciente para su primer legrado uterino instrumental (LUI). Después de diez días, la paciente regresó y se realizaron estudios ecográficos y análisis de laboratorio adicionales. Estos resultados respaldaron la necesidad de un segundo LUI. Durante esta intervención, la paciente presentó un sangrado persistente que resultó en un compromiso hemodinámico, lo que desencadenó la activación de un protocolo de emergencia. Se tomaron medidas, incluyendo la inserción de un balón intrauterino y la técnica Zea, junto con la administración de hemoderivados para estabilizarla. Se dialogó con la familia acerca de las complicaciones y se sugirió una panhisterectomía debido al sangrado continuo. Los familiares entendieron la explicación sobre las condiciones clínicas obstétricas de la paciente y procedieron a firmar la hoja del consentimiento informado. La intervención fue realizada con éxito y se salvaguardo la vida de la paciente.
Invasive mole is a rare event characterized by excessive trophoblastic proliferation and infiltration of the trophoblast into the myometrium but shows no propensity for metastatic spread. We present a clinical case of a 48-year-old patient who came to the emergency area of General Hospital Babahoyo with symptoms of abdominal pain, transvaginal bleeding, nausea, and dizziness. The suspicion of a molar pregnancy arose after the first ultrasound, which revealed indicative features. Additionally, an elevation in the beta fraction of human chorionic gonadotropin was detected. It was decided to prepare the patient for her first instrumental uterine curettage (LUI). Ten days later, the patient returned, and additional ultrasound and laboratory studies were performed. These results supported the need for a second LUI. During this procedure, the patient experienced persistent bleeding, leading to hemodynamic compromise, triggering an emergency protocol. Measures were taken, including the insertion of an intrauterine balloon and the Zea technique, along with the administration of blood products to stabilize her. Discussions with the family regarding the complications took place, and a panhysterectomy was suggested due to continuous bleeding. The family members comprehended the explanation of the patient's obstetric clinical conditions and proceeded to sign the informed consent form. The intervention was successfully performed in a timely manner, and the patient's life was saved. The samples obtained during the surgery were sent for pathological examination.; Invasive mole is a rare event characterized by excessive trophoblastic proliferation and infiltration of the trophoblast into the myometrium but shows no propensity for metastatic spread. We present a clinical case of a 48-year-old patient who came to the emergency area of General Hospital Babahoyo with symptoms of abdominal pain, transvaginal bleeding, nausea, and dizziness. The suspicion of a molar pregnancy arose after the first ultrasound, which revealed indicative features. Additionally, an elevation in the beta fraction of human chorionic gonadotropin was detected. It was decided to prepare the patient for her first instrumental uterine curettage (LUI). Ten days later, the patient returned, and additional ultrasound and laboratory studies were performed. These results supported the need for a second LUI. During this procedure, the patient experienced persistent bleeding, leading to hemodynamic compromise, triggering an emergency protocol. Measures were taken, including the insertion of an intrauterine balloon and the Zea technique, along with the administration of blood products to stabilize her. Discussions with the family regarding the complications took place, and a panhysterectomy was suggested due to continuous bleeding. The family members comprehended the explanation of the patient's obstetric clinical conditions and proceeded to sign the informed consent form. The intervention was successfully performed in a timely manner, and the patient's life was saved. The samples obtained during the surgery were sent for pathological examination.
2023-01-01T00:00:00Z