“Implicación del desarrollo de patologías metabólicas asociadas a obesidad grado III en una gestante”

Abstract

A 38-year-old female patient with a history of multiparity, super-morbid obesity, 16-year-old intergenésic, ORh-cephalovaginal delivery prior to term. Upon admission, I accused of feeling of loss of vaginal fluid from a single pregnancy of 34 SDG, with ultrasound control that reports a decreased ILA and a single fetus, with an 8/10 biophysical profile, with weight over 99 percentile. Its initial management by APP and vaginosis is performed by antibiotic therapy and DMG is diagnosed. Re-enter the 38.2 SDG for contraction-type pain, when performing fetal monitoring, resuscitation-resistant fetal tachycardia is found, so termination of pregnancy is performed due to fetal well-being commitment. During his hospital stay he is assessed by intensive therapy due to tachycardia and desaturations, which are subsequently filmed to wound infection, cataloging as soft tissue sepsis performing several surgical cleanings achieving improvement of the picture. The patient is sometimes several procedures for wound dehiscence. The final endocrinological treatment is done with insulin at low doses without requiring an increase in new hospitalizations. In subsequent controls, it does not maintain adequate glycemic values despite the introduction of pharmacological and dietary measures to correct it.