Revista colombiana de obstetricia y ginecologia最新文献

Objectives: To understand the breastfeeding experience from the perspective of a group of women who breastfeed for the first time.

Materials and methods: Qualitative study from an ethnographic perspective, focusing on a group of women from the eastern region of the Department of Antioquia (Colombia). Intentional sampling until data saturation was used. The group included 16 first-time breastfeeding mothers aged 18 or older, with children under 24 months of age and who were breastfeeding or had breastfed exclusively for at least three months. Semi-structured interviews and participant observations were carried out. Data were analyzed by triangulation and open and axial coding. The results are presented in the form of category descriptions.

Results: Four categories were identified in relation to the breastfeeding experience: exhaustion and pain dispelled by love, breastfeeding and the new order of things, emotions of a woman embodied in a mother, and breastfeeding as a social act.

Conclusions: Protection of breastfeeding requires special attention to the woman as a subject beyond the act of breastfeeding, giving priority to her physical and emotional health as essential elements that must be kept in mind by healthcare professionals. Studies to assess the effects of creating support groups that foster the exchange of insights to help the breastfeeding woman are required.

Objectives: To report the case of a patient with a uterine collision tumor and to conduct a review of the literature.

Material and methods: A 76-year-old patient who presented to the national cancer referral center in Bogota (Colombia), where she was diagnosed with a uterine collision tumor consisting of a seroustype endometrial adenocarcinoma and a cervical adenosarcoma. The patient underwent surgical treatment followed by chemotherapy and supplemental radiotherapy, and died 16 months later. A search was conducted in the Medline via PubMed and Embase databases, including reports and case series of women with a diagnosis of uterine collision tumor, with retrieval of information regarding diagnosis, treatment and prognosis. A narrative summary of the findings was made.

Results: The search identified 36 titles, of which 14 studies with 17 patients were included. The most frequent histopathological diagnosis was endometrial adenocarcinoma and high and low grade endometrial sarcoma (47 %). Primary treatment was surgery and adjuvant treatment with chemotherapy and radiotherapy (15 %) was performed in close to 50 % of cases. One-year survival was 75 %.

Conclusions: No cases of uterine collision tumors with the histopathology or in the location of the reported case were found in the literature. If this reported case is taken into account, 2-year mortality is 28 %. Further studies to describe the immunohistochemistry, treatment and prognosis of this condition are needed.

Objectives: To describe the prevalence of the risk of under or overnutrition and the food intake pattern vis à vis the recommendations of the Ministry of Health and Social Protection and the Colombian Family Welfare Institute.

Material and methods: Descriptive cross-sectional study carried out in healthy women receiving care in two hospitals of eastern Antioquia, with food and nutrition security in accordance with the Latin American and Caribbean Food Security Scale (ELCSA), in the first trimester of breastfeeding, assessed between 2021 and 2022. The clinical record was used as the source of information. The sociodemographic, clinical, anthropometric characteristics, as well as dietary and micronutrient intake, were measured. Descriptive statistics were used. The prevalence of deficient or excessive energy intake and the food consumption score (FCS) are presented. The EVINDI v5, PC-SIDE v1.0, Stata 16.1 and Jasp 0.16.4 software packages were used.

Results: Overall, 30 breastfeeding women were included. The prevalence of the risk of deficient energy intake was 43 %, while the risk of excessive intake was 16 % and the risk of protein deficiency was 98 %. Intake exceeding the reference value for saturated fats was 86 %, and 72 % for simple carbohydrates. The consumption pattern was characterized by exceeding the recommendations for sugars (FCS = 1.29), milk and dairy products (FCS = 1.09), grains, roots, plantains and tubers (FCS = 1.04). Recommendations for the intake of fats (FCS = 0.70), meats, eggs, legumes, nuts, seeds (FCS = 0.49), fruits and vegetables (FCS = 0.41 were not met.

Conclusions: The food intake pattern identified is far from meeting the national guidelines, limiting macro and micronutrient intake and contributing to the intergenerational malnutrition cycle. Additional research in the country is essential in order to identify other intake patterns and drive political action.

Objectives: To report a case of prenatal diagnosis of ectopic intrathoracic kidney with diaphragmatic hernia managed surgically after birth, and to conduct a review of the literature on prenatal diagnosis of ectopic intrathoracic kidney and perinatal prognosis.

Material and methods: We report the case of a 28-week fetus in which, on ultrasound imaging, a mass was observed displacing the heart and lung in the right hemithorax, which was was confirmed by magnetic resonance (MR) to be an ectopic intrathoracic kidney (ITEK). After birth, the neonate was approached by laparoscopy to place a mesh in continuity with the diaphragm, leaving the kidney in the abdomen, with good evolution. A search was conducted in the PubMed, Embase and Cochrane databases for cohorts, case reports and case series of prenatal diagnosis of intrathoracic kidney in the fetus. Information was retrieved regarding design, population, imaging diagnosis, treatment and prognosis.

Results: The search identified 8 studies that met the inclusion criteria, reporting a total of 8 cases. Ultrasound diagnosis showed ectopic intrathoracic kidney associated with diaphragmatic hernia in all the subjects. Fetal magnetic resonance imaging (MRI) was also used in 5 cases.

Conclusions: Ectopic intrathoracic kidney is a congenital abnormality amenable to prenatal diagnosis. Survival after corrective surgery performed in the neonatal period is common. There is a paucity of publications, limited to case reports, regarding the prenatal diagnosis of this condition.

Objectives: As part of sexual and reproductive health, abortion is a woman’s right in Colombia. However, not all the members of Colombian society recognize this right. The aim of this work is to understand the transformation of meanings after having to cope with voluntary termination of late pregnancy in women living in Colombia, as well as their interaction with family and friends and the health system.

Material and methods: Hermeneutic research undertaken within a constructivist paradigm and analyzed from a feminist perspective using grounded theory techniques: coding, categorization and constant comparison. Nineteen semi-structured interviews were conducted among 18 women living in Colombia who underwent voluntary termination of late pregnancy defined as more than 20 weeks of gestation, accompanied by feticide and labor induction, in two Colombian cities between 2016 and 2020. Besides, two focus groups were conducted, one with some of the interviewees and another with feminist experts in order to cross-reference the information derived from the research process and delve deeper into the findings.

Results: Women attached a negative and opposite meaning to voluntary termination of pregnancy, but once they found themselves in a situation that forced them to put an end to gestation, they transgressed their own meanings and those of society to find justifications to help them uphold their decision. This confrontation brought them to a place of profound and intimate reflection and led them to transform their lives.

Conclusions: Meanings regarding abortion in women who undergo late pregnancy termination are usually contrary to this right in sexual and reproductive health. After the event, these meanings become transformed through a process of conscious reflection as women come face-to-face with their own meanings and those of society.