Revista colombiana de obstetricia y ginecologia最新文献

Objectives: Hospitalization in critical care areas has compromised the well-being of the mother-child bond during childbirth and the postpartum period. Therefore, it is necessary to describe the experiences of pregnant women with hypertensive disorders admitted to the intensive care unit.

Material and methods: A qualitative research study with a phenomenological design, involving a sample of ten participants with a history of hypertensive disorders during pregnancy, admitted to critical care. Using snowball sampling and data saturation, information was gathered through semi-structured interviews following informed consent. Data were analyzed with open coding a posteriori using Colaizzi's method and complemented by MAXQDA 2022 software.

Results: Six categories emerged: 1) consequences of hypertensive disorders in pregnant women in intensive care units; 2) positive aspects during perinatal care; 3) emotions and suffering due to the loss of the newborn; 4) impact of critical conditions on the mother-newborn relationship; 5) lack of resources for timely therapeutic interventions in perinatal care, and 6) lack of assertive communication by healthcare personnel.

Conclusions: Maternal morbidity and mortality caused by hypertensive disorders require high complexity care in specialized institutions to reduce life-threatening risks, leading to disrupted early bonding and separation of the mother-child dyad, as well as negative feelings in the mothers. This situation results in a painful experience for the family. Therefore, healthcare professionals must develop strategies to ensure the preservation of the emotional bond, which can be compromised in critical care areas.

Magnesium sulfate marks 100 years in the medical management of eclampsia. Lazard, starting in May 1924 at the Los Angeles General Hospital, collected clinical evidence of its benefits on the mortality associated with pregnancy convulsions. Doses, regimens, and dilutions were analyzed, revealing therapeutic safety for both mother and fetus. By the end of the 20th century, randomized clinical trials demonstrated the clinical utility of magnesium for the following indications: treatment of eclampsia, prevention of eclampsia, and neurological protection of the brain in preterm infants less than 32 weeks of gestation, among others. This journey has been controversial among many authorities; however, the National University of Colombia and its Department of Obstetrics and Gynecology have defended the Zuspan regimen as the ideal approach for managing these patients since 1982. Through this review, we aim to present all the evidence that has established magnesium as an essential drug for reducing maternal mortality worldwide, especially in developing countries.

Information and data are accelerating the implementation of competency-based medical education. The adoption of precision education can contribute to this purpose. This article discusses the extent to which precision surgical education can be used in assessing the minimum reliability standards of future surgeons - given the advent of Entrustable Professional Activities - and as an option to strengthen the career trajectory of residents.

Editorial.

Editorial.

Objectives: Preeclampsia (PE) is a pregnancyrelated hypertensive disorder that can lead to severe complications and adverse maternal and fetal outcomes. This study aimed to estimate the economic impact of integrating the sFlt-1/PlGF ratio into Uruguay's healthcare system as part of routine clinical practice for diagnosing.

Material and methods: A decision tree model was used to estimate the annual economic impact on the Uruguayan healthcare system for a hypothetical cohort of women with suspected PE. This included relevant costs associated with diagnosis, monitoring, and treatment from the initial presentation of suspected PE until childbirth. The study analyzed the annual costs under two scenarios: the standard of care and a scenario incorporating the sFlt-1/PlGF ratio for PE, using 2022 as the reference year. Various deterministic and probabilistic sensitivity analyses were performed.

Results: The economic model estimated that the implementation of the sFlt-1/PlGF ratio could save the Uruguayan healthcare system $95,432,678 Uruguayan pesos (2,320,269 United States Dollars [USD]) annually, representing a 5 % reduction in costs compared with the standard of care. These savings were primarily due to a reduction in hospitalizations of women with suspected PE. The estimated economic impact equated to an annual net saving of approximately $10,602 Uruguayan pesos (258 USD) per patient.

Conclusions: The introduction of the sFlt-1/PlGF ratio into the Uruguayan healthcare system is likely to generate savings due to the optimization of the management of hospitalizations for women with suspected preeclampsia (PE). However, the potential for savings will primarily depend on the current hospitalization rate of these women (the efficiency of managing high-risk PE pregnancies) and the length of stay for hospitalized women.

Reply to the letter to the Editor

Objectives: To describe the prevalence and characterize gestational anemia in women attending prenatal care in the department of Quindío, Colombia, and to identify associated risk factors.

Material and methods: An analytical crosssectional study was conducted. Out of 1,003 pregnant women, 307 were selected. The study included pregnant women aged 18 years or older who attended a prenatal care program at three high-complexity private institutions in Armenia (Quindío, Colombia) from 2018 to 2023, providing a five-year observation window. Pregnant women with a diagnosis of fetal malformations and hemolytic disease, those who changed healthcare centers, or moved out of Quindío were excluded.

Results: The mean age of the participants was 28.14 ± 5.27 years. The prevalence of gestational anemia was identified as 26.38 %, with an average hemoglobin level of 9.82 ± 1.74 g/dL. Of these, 12.37 % had hemoglobin levels of 10.1-10.9 g/dL (mild anemia), 8.46 % had levels of 7.1-10.0 g/dL (moderate anemia), and 5.53 % had levels below 7.0 g/dL (severe anemia). In the third trimester, the prevalence of anemia increased to 41.97 % (n = 34/81), with 91.35 % (n = 74/81) of cases being iron-deficiency anemia. A BMI of < 18.5 (OR: 15.46; 95 % CI: 7.13-28.59), multiple pregnancy (OR: 9.73; 95 % CI: 1.49-26.83), and a history of pregestational anemia (OR: 7.43; 95 % CI: 4.52-9.13) were associated with gestational anemia.

Conclusions: The prevalence of gestational anemia is over 25 % and increases in the third trimester. It is important to identify risk factors during preconception evaluation and prenatal care.