Eclampsia: a Five-Years Analysis

Background: eclampsia remains an important cause of maternal mortality and morbidity, mostly in developing countries. Objective: to determine the incidence and to characterize patients that were admitted with an eclampsia diagnosis in the "Enrique Cabrera" Teaching Hospital. Method: a descriptive and observational study was conducted in the "Enrique Cabrera" Teaching Hospital including all patients diagnosed with eclampsia who were admitted in the intensive care unit from January 2006 to December 2010. Data were obtained from medical records. Statistics SPSS 11,5 Windows system was used as well as frequency and percentage distributions for qualitative variables. Results: incidence of eclampsia was 9, 8 per 10000 births. 62, 1 % of patients were white skinned and 58, 6 % were adolescents. The average gestational age was 37, 6 ± 3, 3 and 89, 6 % of these patients required to be performed a cesarean (c-section). 55, 2 % of eclampsia cases appeared postpartum, most of them (81, 2 %) were early eclampsia. The constantly present symptom was headache (100 %) and 20, 7 % of patients presented complications. Conclusion: even when eclampsia incidence was not high in our setting, the prevalence of postpartum eclampsia forces us to reflect on the need to improve diagnosis and control of patients at risks

Subcapsular hepatic hematoma. Serious complication during pregnancy

Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe pre-eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes and diminished platelets). Maternal and perinatal mortality in these cases is high, hence the importance of early diagnosis and timely and multidisciplinary treatment. This paper is a review on the subject, held in Ebsco, Hinari and Sci databases

Perinatal Outcomes of Pregnant Women with Cardiac Disease at the “Ramón Gonzalez Coro” Gynecologic & Obstetric Teaching Hospital.

Introduction: pregnancy in women with heart disease is commonly associated with increased perinatal morbidity. Objective: to describe perinatal outcomes in pregnant women with heart disease who were treated according to a new working protocol. Method: a descriptive study with some analytic aspects was conducted in the Heart Disease and Pregnancy service of the “Ramón Gonzalez Coro’’ Gynecologic and Obstetric Teaching Hospital from 2000-2009. The universe consisted on the 472 pregnant women with heart disease that received follow up during that period. They were treated according to the protocol applied since 2000. Data were obtained through a questionnaire and were processed using the SPSS 11,5 system for Windows, through determination of absolute and relative frequencies. They included: obstetric complications, mode of delivery, cesarean indication, gestational age at delivery and neonatal complications. Results: 51 (10, 8 %) patients presented obstetric complications. Vaginal delivery was the most common mode of pregnancy termination. It took place in 242 (51, 3 %) patients. Cesarean sections were performed in 146 (30, 9 %) of cases, being previous cesarean sections the first cause, 42 (28, 8 %). 17 (3, 6 %) patients presented neonatal complications. Conclusion: the new protocol applied to pregnant women with heart disease at ‘’Ramón Gonzalez Coro’’ Gynecologic and Obstetric Teaching Hospital, contributed to improve perinatal outcomes

Embarazo en adolescentes del Policlínico “Rafael Valdés” en el año 2009

Fundamento: la situación del embarazo en la adolescencia es hoy una problemática de salud a nivel internacional, asociada a un incremento de la morbilidad materna. Objetivo: estimar la tasa de embarazo en adolescentes y caracterizar la morbilidad materna asociada. Método: estudio descriptivo y prospectivo, realizado en el Área de Salud del Policlínico “Rafael Valdés del Municipio Cotorro, durante el año 2009. La muestra estuvo constituida por 79 adolescentes gestantes, a las cuales se les solicitó el consentimiento informado para participar en la investigación. Las variables estudiadas fueron: afecciones durante el embarazo y complicaciones relacionadas, que se tomaron del carnet obstétrico y se procesaron mediante el sistema estadístico SPSS-11,5, utilizando frecuencias y porcentajes como técnicas de estadística descriptiva. Resultados: la tasa de embarazo en adolescentes en el año 2009, fue de 226 x 1000 y muestra una tendencia al aumento. La infección vaginal (98,7 %), la anemia (58,2 %) y la bacteriuria asintomática (38 %), fueron las morbilidades más frecuentes. Conclusión: el embarazo en la adolescencia es un problema de salud que hoy está en aumento y que continúa siendo necesario investigar

Psoas abscess secondary to atypical appendicitis in pregnancy. A case report

The psoas abscess is a rare infectious disease that is difficult to diagnose, characterized by a purulent collection at the level of this muscle, which causes a systemic inflammatory response syndrome. The infection can be primary by hematogenous dissemination, or secondary, from a nearby infectious focus. Its presentation during pregnancy is rare, and the primary form predominates, which is why it was decided to write this article. The case of a pregnant woman with a gestational age of 28.4 weeks who was admitted due to inguinal pain with subsequent irradiation to the right hip, flank, and lumbar region; flexed posture of the right hip and analgesic gait, as well as the appearance, nine days after the onset of symptoms, of a painful mass between the right iliac fossa and flank it is presented. The findings of the abdominal ultrasound and MRI allowed the diagnosis of an appendiceal plastron with a retrocecal appendix, as well as a right psoas abscess, which were treated with antibiotic therapy and percutaneous drainage of the abscess, with satisfactory results. Secondary psoas abscess may constitute the debut of atypical retrocecal appendicitis, and its diagnosis requires a high level of suspicion due to its non-specific symptoms

Hemorragia uterina disfuncional en la adolescencia

La hemorragia uterina disfuncional es uno de los problemas ginecológicos más comunes en la adolescencia, constituye el principal motivo de consulta en estas edades, tiene una alta incidencia y se puede presentar en el 80 % de las pacientes después del primer año de vida ginecológica, influyendo de forma negativa en el desarrollo físico e intelectual de estas niñas así como en la salud reproductiva futura de la adolescente, de ahí la importancia del diagnostico precoz, tratamiento oportuno y multidisciplinario

Incidencia y caracterización de los trastornos hipertensivos del embarazo

Fundamento: la incidencia de los trastornos hipertensivos en el embarazo varía en los diferentes estudios, pero en general, se asocian a una elevada morbilidad materna, sobre todo en la preeclampsia/eclampsia. Objetivo: determinar la incidencia de los trastornos hipertensivos del embarazo y caracterizar a las pacientes desde el punto de vista demográfico y obstétrico. Método: estudio observacional-analítico de corte transversal, realizado del 1/enero al 31/diciembre/2010, en el Hospital General Docente “Enrique Cabrera”, con las pacientes diagnosticadas con algún trastorno hipertensivo que tuvieron su parto en dicho hospital, para una muestra de 108 pacientes. Los datos se procesaron con el sistema estadístico SPSS-11,5 con determinación de frecuencias, porcentajes, comparación de medias y valoración de Chi cuadrado. Resultados: la incidencia de los trastornos hipertensivos del embarazo, en el Hospital “Enrique Cabrera” durante el año 2010 fue de 4,2 %, la hipertensión crónica (16,2 x 1000), fue el trastorno más frecuente. Predominó la primiparidad en las pacientes con eclampsia (100 %), preeclampsia (75 %) e hipertensión transitoria (74,6 %), el parto por cesárea y el hematoma retroplacentario en las pacientes con preeclampsia/eclampsia y el ingreso en cuidados intensivos en aquellas con eclampsia (75 %). Conclusión: aunque la incidencia de trastornos hipertensivos gravídicos fue baja, es elevado el parto operatorio y las complicaciones en las pacientes con preeclampsia/eclampsia

Incidence and Characterization of the Hypertensive Disorders during Pregnancy

Background: the incidence of hypertensive disorders during pregnancy varies from study to study. Nevertheless, it is generally associated with high maternal morbidity, mostly in cases of pre-eclampsia/eclampsia. Objective: to determine the incidence of hypertensive disorders during pregnancy and to characterize patients from a demographic and obstetric point of view. Method: a cross sectional, analytic and observational study was conducted from January 1st to December 31st, 2010, at the “Enrique Cabrera” General Teaching Hospital, including all patients diagnosed with some hypertensive disorder that gave birth at this hospital. The sample consisted on 108 patients. Data were processed using SPSS-11, 5 statistics program with determination of frequencies, percents, averages comparison and Chi square assessment. Results: the incidence of hypertensive disorders during pregnancy at the “Enrique Cabrera” Hospital during the year 2010 was of 4, 2 %, being chronic hypertension (16, 2 x 1000) the most common disorder. Predominating conditions were primiparity in patients with eclampsia (100 %), pre-eclampsia (75 %) and transitory hypertension (74, 6 %); cesarean and abruptio placentae in patients with pre-eclampsia/eclampsia and the admission at the intensive care of patients with eclampsia (75 %). Conclusion: although the incidence of serious hypertensive disorders during pregnancy was low, complications and surgical delivery in patients with pre-eclampsia /eclampsia were high

Characterization of High Grade Intraepithelial Cervical Lesion among Adolescents and Young Women

<strong>Introduction:</strong> considering the relationship between human papilomavirus and cervical cancer, the current increase in sexually transmitted diseases constitutes the biggest threaten to adolescents’ health. <strong><br />Objective:</strong> to characterize high-degree intraepithelial cervical lesion in adolescents and young women. <br /><strong>Method: </strong>a descriptive and observational study was conducted. It included 52 patients, all of them younger than 24 years old, who had been diagnosed with high-degree cervical pathology and were treated in the cervix pathology consultation of the "Ramón González Coro" Teaching Gynecologic and Obstetric Hospital from January 2007 to December 2008. Risk factors and diagnosis variables were studied and processed using the SPSS 11.5 system for Windows, through the determination of absolute and relative frequencies. <br /><strong>Results:</strong> 78,8 % of patients had from 20 to 24 years old, 65,3 % of them began having sexual relationships between 15 and 17 years old, 62,2 % had had 3 or more sexual partners and 67,3 % used no contraceptive method. Cyto- histological correlation was of 100 % for intraepithelial cervical lesion II and III. <strong><br />Conclusion:</strong> the results of the present study compromise us to highlight the need of extended sexual education among young people

ACALASIA Y EMBARAZO: PRESENTACION DE UN CASO Achalasia and pregnancy: Case presentation

La acalasia es un trastorno primario infrecuente de la motilidad esofágica, caracterizado por la ausencia de peristaltismo en el cuerpo esofágico y la disfunción del esfínter esofágico inferior (EEI) que se muestra incapaz de relajarse tras la deglución y cuyos síntomas principales son disfagia, dolor torácico y regurgitación de alimentos ingeridos previamente. Los datos disponibles sobre el efecto de la acalasia en el embarazo y la influencia de éste sobre el curso de la enfermedad son insuficientes. Nos propusimos revisar la literatura internacional sobre el tema a propósito del manejo de una gestante con este trastorno. Reportamos una gestante de 34 años con diagnóstico pregestacional de acalasia que culminó su embarazo con resultados maternos y perinatales favorables. Se concluye que el manejo multidisciplinario de las gestantes complicadas con esta afección, contribuye de manera decisiva a disminuir las complicaciones.The achalasia is an infrequent primary disorder characterized by abnormal motility of the esophageal body and non relaxation of the lower esophageal sphincter with swallowing, resulting in dysphagia, chest pain and regurgitation as main symptoms. Information on the effects of achalasia on pregnancy outcome and the influence of pregnancy on the natural course of achalasia is limited. We reviewed the available international literature on the topic in connection with the management of a case complicated with this disorder. A 34 year old pregnant woman with the prenatal diagnosis of Achalasia and successful maternal and perinatal outcomes is reported. The multidisciplinary management of pregnant women complicated with this affection, contributes significantly to decrease complications