Medicina
Permanent URI for this collectionhttp://repositorio.uta.edu.ec/handle/123456789/815
Browse
3 results
Search Results
Item “Histerectomía abdominal total por embarazo ectópico cervical”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Borja Cepeda, Paola Vanessa; Dr. Cazar Gallegos, Luis Fabricio.Cervical pregnancy corresponds to an unusual type of ectopic pregnancy; it represents around 0.1% of all ectopic pregnancies. The incidence is estimated at 1: 2500 to 1: 98,000 pregnancies worldwide. In America this amounted to 4.5 per 1,000 pregnancies, among the causes of this increase, have mentioned the increase in sexually transmitted diseases, pelvic inflammation and assisted reproduction techniques. In Ecuador, although there are no reports on the incidence of its presentation, according to the INEC (National Institute of Statistics and Census), it states that ectopic pregnancies are among the ten leading causes of maternal death in our nation. This pregnancy, characterized by implantation of a fertilized ovule in the endocervical canal, causes late diagnosis to delay the start of treatment; and it is extremely dangerous because the trophoblast can reach the uterine vessels, through the thin cervical wall and cause a severe and incoercible hemorrhage. Due to this antecedent the importance of this investigation is born, on this type of pregnancy, because a massive hemorrhage can occur secondary to bleeding of the cervical vessels. For what is of interest to all, primarily for health personnel, as it is a condition that threatens the patient's life. A clinical case is presented below. Patient of 31 years of age, with no significant personal or family history. He has been presenting for 2 months genital bleeding in a small amount, accompanied by pain of great intensity localized in hypogastrium, so he goes to the Pelileo Hospital, obtains positive qualitative BHCG and is referred to the Ambato Regional Teaching Hospital and admitted to the Obstetric Center. in revision of cervix gestational sac adheres and broken with active bleeding so a total abdominal hysterectomy is performed.Item Placenta Previa Increta como causa de Hemorragia Obstétrica(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Cupueran Limachi, Carolina Estefanía; Remache Cevallos, Héctor Rodrigo Dr. EspecialistaPlacenta previa is defined as the total or partial insertion of the placenta in the lower segment of útero. La incidence is estimated to be 1 in every 200 pregnancies to term and varies throughout the world. It seems to have increased relative to the increasing rate of births cesárea. It is classified as complete, partial and marginal, depending on how the placenta covers the opening endocervical. According to the degree of penetration of abnormal placentation three types are recognized: accreta, increta, percreta. We present the case of female patient of 33 years old that causes pregnancy 22 weeks 5 days with reproductive background of sharp curettage 3 years ago. Go to the emergency room to present in moderate vaginal bleeding, bright red, with clots, accompanied by crampy abdominal pain located in lower abdomen. Enter hemodynamically stable. An ultrasound trace is reported total occlusive placenta previa. It remains hospitalized for about 3 months in the HPDA, at 35.3 weeks outpatient reports crystal clear liquid in small quantities, positive crystallography. Patient with uterine activity sporadic transfer is decided by lack of physical space to IESS in Ambato with a pregnancy of 35.3 weeks LMP + premature rupture of membranes 48 hours of evolution + previa low set + fetal distress, is valued and decide their intervention performing a caesarean surgical segmental abdominal hysterectomy + bilateral + adnexectomy. Post-surgical patient remains in recovery of 35.3 weeks + increta placenta previa, pregnancy patient is discharged in good general condition. Histopathological confirms increta placenta. Early prenatal approach through non-invasive diagnostic imaging provides useful information on the commitment and extension in the evaluation of patients with risk factors for placenta accreta. Ultrasonography is the method of choice, leaving magnetic resonance imaging and the study as a confirmatory histopathology as the gold standard definitive diagnosis and image. The only safe and proper method of delivery for placenta previa is a cesarean delivery. It is essential in all hospitals that treat obstetric patients evaluate and implement strategies to achieve a significant reduction in maternal morbidity and mortality. The ideal is to have a contingency plan on therapeutic conduct to follow, so that each case must be individualized. However, there are specific conditions of these high-risk pregnancies that require rapid decision-making, which should ideally be carried out in highly complex centers with highly trained professionals’ health to optimize final results thus reducing the maternal risks fetal.Item Acretismo Placentario(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-05-01) Buenaño González, Ricardo Andrés; Mera Ramos, Gerardo Vinicio Dr.Placenta accreta is a broad term that encompasses the conditions in which the placenta, in histopathological terms, can be accreta, increta or percreta. Being able to distinguish between these entities in clinical situations, is not easy. It remains a challenge even after diagnosis, except when the uterus is removed and subjected to pathological examination. Percreta placenta is the most serious placentas for their great invasion, and is associated with high maternal morbidity compared with other varieties. The case of a patient of 36 years old with a history of antiphospholipid antibodies and stillbirths syndrome occurs, is in her sixth pregnancy of 28.6 weeks and is diagnosed sonographically total occlusive placenta previa and placenta accreta. It is particularly treated with heparin and low molecular weight ASA. Prior to admission, heavy bleeding genital glittering red so it is transferred to Provincial Teaching Hospital Ambato, where diagnoses are confirmed. She underwent emergency caesarean with pregnancy diagnostics 28.6 weeks + Total occlusive placenta previa bleeding + antiphospholipid antibody síndrome + accretism + anticoagulated patient. As a complication of surgery percreta placenta is seen to vegija invasion, parametrial and cervix, so the total obstetric hysterectomy is performed without adnexectomy; hallo posteriormene is complicating bilateral ureteral ligation developing acute renal failure. Therefore it was necessary bilateral ureteral reimplantation, which yields box renal failure, and patient evolves favorably