Carlos Manuel Espinosa-García, C. Ramírez-Isarraraz, Es Rodríguez-Colorado, Viridiana Gorbea-Chávez, Verónica Granados-Martínez
de arterias uterinas; cesárea; histerectomía. Abstract BACKGROUND: Obstetric genitourinary fistulas can cause as a complication of uter- ine artery embolization due to necrosis of the uterus and/or bladder. Vaginal surgical treatment is a less invasive option with success rates of up to 84.12%. CLINICAL CASE : A 40-year-old woman who came with a pregnancy of 35 5/7 weeks and placenta accreta, which was managed with uterine arteries embolization and obstetric hysterectomy after caesarean section. At 3 weeks she had vaginal urine loss; by physical examination and with support of dye test, cystoscopy and retrograde cys-tography, obstetric vesicovaginal fistula was diagnosed. After the improvement of the inflammatory process, vaginal fistulectomy was performed with modification of the Latzko technique. Its postoperative evolution was satisfactory and without recurrence of the fistula during the follow-up in the outpatient clinic. CONCLUSION: This is the fifth case of post-embolization bladder necrosis reported in the literature. The favorable resolution of this case allows us to conclude that vaginal fistulectomy is a viable and safe alternative in the surgical treatment of this type of obstetric fistulas.
{"title":"Fistulectomía vaginal exitosa en un caso de fístula vesicovaginal obstétrica por embolización de arterias uterinas","authors":"Carlos Manuel Espinosa-García, C. Ramírez-Isarraraz, Es Rodríguez-Colorado, Viridiana Gorbea-Chávez, Verónica Granados-Martínez","doi":"10.24245/gom.v88i3.3662","DOIUrl":"https://doi.org/10.24245/gom.v88i3.3662","url":null,"abstract":"de arterias uterinas; cesárea; histerectomía. Abstract BACKGROUND: Obstetric genitourinary fistulas can cause as a complication of uter- ine artery embolization due to necrosis of the uterus and/or bladder. Vaginal surgical treatment is a less invasive option with success rates of up to 84.12%. CLINICAL CASE : A 40-year-old woman who came with a pregnancy of 35 5/7 weeks and placenta accreta, which was managed with uterine arteries embolization and obstetric hysterectomy after caesarean section. At 3 weeks she had vaginal urine loss; by physical examination and with support of dye test, cystoscopy and retrograde cys-tography, obstetric vesicovaginal fistula was diagnosed. After the improvement of the inflammatory process, vaginal fistulectomy was performed with modification of the Latzko technique. Its postoperative evolution was satisfactory and without recurrence of the fistula during the follow-up in the outpatient clinic. CONCLUSION: This is the fifth case of post-embolization bladder necrosis reported in the literature. The favorable resolution of this case allows us to conclude that vaginal fistulectomy is a viable and safe alternative in the surgical treatment of this type of obstetric fistulas.","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48881112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johana Santa María-Ortiz, E. Álvarez-Silvares, M. Alves-Pérez, Sandra García-Lavandeira
{"title":"Maternal and neonatal outcomes in advanced maternal age","authors":"Johana Santa María-Ortiz, E. Álvarez-Silvares, M. Alves-Pérez, Sandra García-Lavandeira","doi":"10.24245/gom.v88i2.3215","DOIUrl":"https://doi.org/10.24245/gom.v88i2.3215","url":null,"abstract":"","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43208169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillermo Federico Ortíz-Luna, Arturo Arellano-Eguiluz, Alicia Sánchez-Ceballos, Cinthya Salazar-Jiménez, L. E. D. Barco, A. Zavala-García
OBJECTIVE: Categorize the demographic, biochemical and symptomatic profile of the Mexican population served at the Instituto Nacional de Perinatología to describe their behavior in the stages of reproductive aging. MATERIALS AND METHODS: The following is an observational, descriptive, cross sectional study women from the Peri- and Postmenopause clinic at the National Insti-tute of Perinatology in Mexico that enrolled 741 women over 41 years of age with a diagnosis of menopause according to the STRAW+10 criteria and classified in three categories: Category 1 (-2 to -1), Category 2 (+1A to +1C), and Category 3 (+2). The statistical analysis was performed by measure of central tendency, c 2 and ANOVA for the inferential analysis. RESULTS: In our population of 741 women, the average age at menopause was 50.08 years, while the population’s age average was 57.11 years. Average body mass index was 27.92 kg/m2, with 56.2% of the population within obesity range. The most prevalent comorbidity was arterial hypertension and the most frequent symptom was hot flushes. Hot flushes were most prevalent during the transition to menopause.
{"title":"Descripción demográfica, bioquímica y sintomática según los estadios reproductivos STRAW+10 en mujeres mexicanas en la peri y posmenopausia","authors":"Guillermo Federico Ortíz-Luna, Arturo Arellano-Eguiluz, Alicia Sánchez-Ceballos, Cinthya Salazar-Jiménez, L. E. D. Barco, A. Zavala-García","doi":"10.24245/gom.v88i1.3282","DOIUrl":"https://doi.org/10.24245/gom.v88i1.3282","url":null,"abstract":"OBJECTIVE: Categorize the demographic, biochemical and symptomatic profile of the Mexican population served at the Instituto Nacional de Perinatología to describe their behavior in the stages of reproductive aging. MATERIALS AND METHODS: The following is an observational, descriptive, cross sectional study women from the Peri- and Postmenopause clinic at the National Insti-tute of Perinatology in Mexico that enrolled 741 women over 41 years of age with a diagnosis of menopause according to the STRAW+10 criteria and classified in three categories: Category 1 (-2 to -1), Category 2 (+1A to +1C), and Category 3 (+2). The statistical analysis was performed by measure of central tendency, c 2 and ANOVA for the inferential analysis. RESULTS: In our population of 741 women, the average age at menopause was 50.08 years, while the population’s age average was 57.11 years. Average body mass index was 27.92 kg/m2, with 56.2% of the population within obesity range. The most prevalent comorbidity was arterial hypertension and the most frequent symptom was hot flushes. Hot flushes were most prevalent during the transition to menopause.","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45555121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karla Judith Delgado-Arévalo, R. González-Habib, Israel Castro-Torres, Gordon Bennett-Vidales, C. Cruz
{"title":"Tamizaje del estreptococo del grupo B durante el embarazo: conducta actual en un centro de tercer nivel","authors":"Karla Judith Delgado-Arévalo, R. González-Habib, Israel Castro-Torres, Gordon Bennett-Vidales, C. Cruz","doi":"10.24245/gom.v88i2.3716","DOIUrl":"https://doi.org/10.24245/gom.v88i2.3716","url":null,"abstract":"","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47524341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janine Rosario Gutiérrez-Estrella, Francisco Mejía-Romo, Julio César Cárdenas-Valdez
BACKGROUND: Klippel-Trenaunay syndrome is a neurocutaneous syndrome with vascular repercussion whose characteristic triad is a cutaneous vascular nevus, varicose veins and asymmetric soft tissue and bone hypertrophy, which affect one or more limbs, during pregnancy these malformations increase, with pelvic and intra-abdominal repercussion. In the world literature, fewer than 100 cases of complicated pregnancies with this syndrome have been reported. OBJECTIVE: The second case of complicated pregnancy with Klippel-Trenaunay syndrome treated in our institution is reported, given its high morbidity, due to the high risk of severe complications such as venous thromboembolism or excessive bleeding in the intrapartum period. CLINICAL CASE: A 16-year-old, with a Klippel-Trenaunay syndrome diagnosed at fifteen, sent to our unit, with a third-trimester pregnancy, for resolution of pregnancy. Preoperative studies were performed blood count, coagulation tests, reported without alterations; as well as Doppler ultrasound of the uterine segment, without an increase in vasculature. It is scheduled for caesarean section, which is performed without intraoperative complications, with total bleeding of 600 cc, with an increase in vascularity at the colon level. She remains in immediate postoperative surveillance for 48 hours in an intensive care unit, without presenting haemorrhagic or ischemic complications. She is discharged at 72 hours, with thromboprophylaxis, analgesic and antibiotic. Janine Rosario Gutiérrez-Estrella,1 Francisco Mejía-Romo,2 Julio César Cárdenas-Valdez3
背景：Klippel-Trenaunay综合征是一种具有血管反应的神经皮肤综合征，其特征三联征是皮肤血管痣、静脉曲张、不对称软组织和骨骼肥大，影响一个或多个肢体，妊娠期间这些畸形增加，伴有盆腔和腹内反应。在世界文献中，只有不到100例患有这种综合征的复杂妊娠病例被报道。目的：报告在我院治疗的第二例Klippel-Trenaunay综合征并发妊娠的病例，因为其发病率很高，产时发生静脉血栓栓塞或过度出血等严重并发症的风险很高。临床病例：一名16岁的女孩，15岁时被诊断为Klippel Trenaunay综合征，因妊娠晚期被送往我们的病房，以解决妊娠问题。术前研究进行了血液计数、凝血测试，报告没有改变；以及子宫段的多普勒超声而不增加脉管系统。计划进行剖腹产手术，没有术中并发症，总出血量为600毫升，结肠血管增加。她在重症监护室接受了48小时的术后即时监测，没有出现出血或缺血性并发症。她在72小时出院，服用了血栓预防、镇痛药和抗生素。Janine Rosario Gutiérrez Estrella，1 Francisco Mejía-Romo，2 Julio César Cárdenas-Valdez3
{"title":"Síndrome Klippel-Trenaunay en el embarazo. Reporte de un caso","authors":"Janine Rosario Gutiérrez-Estrella, Francisco Mejía-Romo, Julio César Cárdenas-Valdez","doi":"10.24245/gom.v88i3.3225","DOIUrl":"https://doi.org/10.24245/gom.v88i3.3225","url":null,"abstract":"BACKGROUND: Klippel-Trenaunay syndrome is a neurocutaneous syndrome with vascular repercussion whose characteristic triad is a cutaneous vascular nevus, varicose veins and asymmetric soft tissue and bone hypertrophy, which affect one or more limbs, during pregnancy these malformations increase, with pelvic and intra-abdominal repercussion. In the world literature, fewer than 100 cases of complicated pregnancies with this syndrome have been reported. OBJECTIVE: The second case of complicated pregnancy with Klippel-Trenaunay syndrome treated in our institution is reported, given its high morbidity, due to the high risk of severe complications such as venous thromboembolism or excessive bleeding in the intrapartum period. CLINICAL CASE: A 16-year-old, with a Klippel-Trenaunay syndrome diagnosed at fifteen, sent to our unit, with a third-trimester pregnancy, for resolution of pregnancy. Preoperative studies were performed blood count, coagulation tests, reported without alterations; as well as Doppler ultrasound of the uterine segment, without an increase in vasculature. It is scheduled for caesarean section, which is performed without intraoperative complications, with total bleeding of 600 cc, with an increase in vascularity at the colon level. She remains in immediate postoperative surveillance for 48 hours in an intensive care unit, without presenting haemorrhagic or ischemic complications. She is discharged at 72 hours, with thromboprophylaxis, analgesic and antibiotic. Janine Rosario Gutiérrez-Estrella,1 Francisco Mejía-Romo,2 Julio César Cárdenas-Valdez3","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48830282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid América Cazarez-Ávalos, Demnsi García-Benavente, Cinthia Nallely Toledo-Lorenzo, J. Valle-Leal, Diego Misael López-Valenzuela
OBJECTIVE: To determine the diagnostic performance of the FullPIERS model as a predictor of perinatal complications in patients with preeclampsia from a public hospital in Northwest Mexico. MATERIALS AND METHODS: Retrospective study, for the evaluation of a proper diagnosis, performed in patients with diagnosis of preeclampsia attended at a secondlevel public hospital between October 2018 and February 2019. Inclusion criteria: sufficient data to introduce them into the FullPIERS calculator (saturation of oxygen, platelet retreat, creatinine, aspartate, transaminases and the existence of dysnea). Exclusion criteria: patients with previous diagnosis of acute, pulmonary or renal liver diseases. It is compared to the percentage of the ingrowth risk of each patient versus the number of patients with complications. Calculated: sensitivity, specificity and predictive values of the model. RESULTS: If 100 patients were studied with preeclampsia: 11 with positive results according to the Full PIERS calculator (over 5% risk), and 7 out of 11 were true. For Ingrid América Cazarez-Ávalos, Demnsi García-Benavente, Cinthia Nallely Toledo-Lorenzo, Jaime Guadalupe Valle-Leal, Diego Misael López-Valenzuela Recibido: junio 2019 Aceptado: noviembre 2019 1 Departamento de Ginecología y Obstetricia. 2 Departamento de Educación e Investigación en Salud. Hospital General Regional 1, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora, México. Correspondencia Jaime Guadalupe Valle Leal Valle_jaime1@hotmail.com Este artículo debe citarse como Cazarez-Ávalos IA, García-Benavente D, Toledo-Lorenzo CN, Valle-Leal JG, López-Valenzuela DM. Desempeño diagnóstico del modelo FullPIERS como predictor de complicaciones perinatales en pacientes con preeclampsia. Ginecol Obstet Mex. 2020 enero;88(1):1-7. https://doi .org /10.24245/gom. v88i1.3253 Diagnostic performance of FullPIERS model as predictor of perinatal complications in patients with preeclampsia. Ginecología y Obstetricia de México
目的：确定FullPIERS模型作为墨西哥西北部一家公立医院先兆子痫患者围产期并发症的预测指标的诊断性能。材料和方法：回顾性研究，用于评估2018年10月至2019年2月期间在二级公立医院就诊的先兆子痫患者的正确诊断。纳入标准：足够的数据将其引入FullPIERS计算器（血氧饱和度、血小板消退、肌酸酐、天冬氨酸、转氨酶和呼吸困难的存在）。排除标准：既往诊断为急性、肺或肾性肝病的患者。将其与每位患者向内生长风险的百分比与并发症患者的数量进行比较。计算：模型的敏感性、特异性和预测值。结果：如果对100名先兆子痫患者进行研究：根据Full-PIERS计算器，11名患者的结果为阳性（风险超过5%），11名中有7名为真。对于Ingrid América Cazarez-Ávalos、Demnsi García-Benavente、Cinthia Nallely Toledo Lorenzo、Jaime Guadalupe Valle Leal、Diego Misael López Valenzuela Recibido：2019年6月Aceptado：2019年11月1日Ginecoloía和产科部。2 Salud教育和投资部。墨西哥索诺拉州奥夫雷贡市墨西哥社会研究所1区综合医院。通讯员Jaime Guadalupe Valle LealValle_jaime1@hotmail.comEste artículo debe citarse como Cazarez-Ávalos IA、García-Benavente D、Toledo Lorenzo CN、Valle Leal JG、López Valenzuela DM。FullPIERS模型的诊断是先兆子痫患者围产期并发症的预测指标。Ginecol Obstet Mex.2020 enero；88（1）：1-7。https://doi.org/10.24245/gom.v88i1.3253 FullPIERS模型作为先兆子痫患者围产期并发症预测指标的诊断性能。墨西哥妇科
{"title":"Desempeño diagnóstico del modelo FullPIERS como predictor de complicaciones perinatales en pacientes con preeclampsia","authors":"Ingrid América Cazarez-Ávalos, Demnsi García-Benavente, Cinthia Nallely Toledo-Lorenzo, J. Valle-Leal, Diego Misael López-Valenzuela","doi":"10.24245/gom.v88i1.3253","DOIUrl":"https://doi.org/10.24245/gom.v88i1.3253","url":null,"abstract":"OBJECTIVE: To determine the diagnostic performance of the FullPIERS model as a predictor of perinatal complications in patients with preeclampsia from a public hospital in Northwest Mexico. MATERIALS AND METHODS: Retrospective study, for the evaluation of a proper diagnosis, performed in patients with diagnosis of preeclampsia attended at a secondlevel public hospital between October 2018 and February 2019. Inclusion criteria: sufficient data to introduce them into the FullPIERS calculator (saturation of oxygen, platelet retreat, creatinine, aspartate, transaminases and the existence of dysnea). Exclusion criteria: patients with previous diagnosis of acute, pulmonary or renal liver diseases. It is compared to the percentage of the ingrowth risk of each patient versus the number of patients with complications. Calculated: sensitivity, specificity and predictive values of the model. RESULTS: If 100 patients were studied with preeclampsia: 11 with positive results according to the Full PIERS calculator (over 5% risk), and 7 out of 11 were true. For Ingrid América Cazarez-Ávalos, Demnsi García-Benavente, Cinthia Nallely Toledo-Lorenzo, Jaime Guadalupe Valle-Leal, Diego Misael López-Valenzuela Recibido: junio 2019 Aceptado: noviembre 2019 1 Departamento de Ginecología y Obstetricia. 2 Departamento de Educación e Investigación en Salud. Hospital General Regional 1, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora, México. Correspondencia Jaime Guadalupe Valle Leal Valle_jaime1@hotmail.com Este artículo debe citarse como Cazarez-Ávalos IA, García-Benavente D, Toledo-Lorenzo CN, Valle-Leal JG, López-Valenzuela DM. Desempeño diagnóstico del modelo FullPIERS como predictor de complicaciones perinatales en pacientes con preeclampsia. Ginecol Obstet Mex. 2020 enero;88(1):1-7. https://doi .org /10.24245/gom. v88i1.3253 Diagnostic performance of FullPIERS model as predictor of perinatal complications in patients with preeclampsia. Ginecología y Obstetricia de México","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48334798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVE: To compare maternal and neonatal morbidity and mortality between trial of labor and planned caesarean section in twin pregnancies. MATERIALS AND METHODS : A retrospective cohort study in Donostia University Hospital during 2016 and 2017 including monochorial-biamniotic and bichorial biamniotic twin pregnancies >24+0 weeks of gestation. Gestations with antenatal death of one or both fetuses were excluded. Patients were classified into trial of labor group and planned cesarean section group. Primary outcomes were maternal and neonatal morbidity and mortality. Statistical analysis included χ 2 , Fisher´s exact test, Student´s T-test, Mann-Whitney U test and binary logistic regression models. RESULTS: Of 248 twin births, 173 (69.8%) were included in the attempted delivery group and 75 (30.2%) in the scheduled cesarean section group. No difference was found in maternal morbidity and mortality (OR 0.92; 95% CI 0.36-2.36). The attempted group had lower rates of admission to neonatal intensive care (first twin OR 0.27; 95% of the delivery vs CONCLUSIONS: Although second twins’ umbilical artery pH is lower in trial of labor group, neonatal morbidity is decreased. Therefore, trial of labor in selected cases is an adequate option that does not increase maternal and neonatal morbidity and mortality.
目的:比较试验分娩和计划剖宫产在双胎妊娠中的孕产妇和新生儿发病率和死亡率。材料与方法:2016年至2017年在多诺斯蒂亚大学医院进行回顾性队列研究，包括妊娠24+0周的单绒毛膜双羊膜和双绒毛膜双羊膜双胎。排除一个或两个胎儿产前死亡的妊娠。将患者分为待产组和计划剖宫产组。主要结局是孕产妇和新生儿的发病率和死亡率。统计分析包括χ 2、Fisher精确检验、Student t检验、Mann-Whitney U检验和二元logistic回归模型。结果:248例双胞胎中，尝试分娩组173例(69.8%)，计划剖宫产组75例(30.2%)。产妇发病率和死亡率无差异(OR 0.92;95% ci 0.36-2.36)。尝试组入院新生儿重症监护率较低(首胎OR 0.27;结论:虽然产程组二胎脐带动脉pH值较低，但新生儿发病率降低。因此，在选定的情况下，试产是一个适当的选择，不会增加产妇和新生儿的发病率和死亡率。
{"title":"Desenlaces maternofetales según la comparación entre intento de parto o cesárea programada en embarazos gemelares","authors":"Oihane Vázquez-Maiz, Leire Maitane Ginto-Zabaleta, Maitane Zubikarai-Iturralde, Olaia Aristegui-Guridi, José Ángel Navarrina-Martínez, Arantxa Lekuona-Artola","doi":"10.24245/gom.v88i11.4379","DOIUrl":"https://doi.org/10.24245/gom.v88i11.4379","url":null,"abstract":"OBJECTIVE: To compare maternal and neonatal morbidity and mortality between trial of labor and planned caesarean section in twin pregnancies. MATERIALS AND METHODS : A retrospective cohort study in Donostia University Hospital during 2016 and 2017 including monochorial-biamniotic and bichorial biamniotic twin pregnancies >24+0 weeks of gestation. Gestations with antenatal death of one or both fetuses were excluded. Patients were classified into trial of labor group and planned cesarean section group. Primary outcomes were maternal and neonatal morbidity and mortality. Statistical analysis included χ 2 , Fisher´s exact test, Student´s T-test, Mann-Whitney U test and binary logistic regression models. RESULTS: Of 248 twin births, 173 (69.8%) were included in the attempted delivery group and 75 (30.2%) in the scheduled cesarean section group. No difference was found in maternal morbidity and mortality (OR 0.92; 95% CI 0.36-2.36). The attempted group had lower rates of admission to neonatal intensive care (first twin OR 0.27; 95% of the delivery vs CONCLUSIONS: Although second twins’ umbilical artery pH is lower in trial of labor group, neonatal morbidity is decreased. Therefore, trial of labor in selected cases is an adequate option that does not increase maternal and neonatal morbidity and mortality.","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48460735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-15DOI: 10.24245/gom.v88i11.4177
Alonso de Jesús Ortegón-López, Sandra Acevedo-Gallegos, J. M. Gallardo-Gaona, Berenice Velázquez-Torres, J. A. Ramírez-Calvo, Dulce Maria Camarena-Cabrera, Yazmín Copado-Mendoza, M. Aguinaga-Ríos
OBJECTIVE: Determine the prevalence of omphalocele, describe its characteristics, its relationship to other fetal defects and congenital syndromes in a third level of care referral center. MATERIALS AND METHODS: Retrospective, retrolective, case series study, carried out by reviewing the records of patients attended in the defects clinic of the Maternal-Fetal Medicine Department of the Instituto Nacional de Perinatología between 2007 and 2019. Inclusion criteria: patients with prenatal diagnosis of omphalocele, with prenatal care and termination of pregnancy at the Institute. Prevalence was calculated, char- acteristics of the defect, perinatal outcomes, other related defects and coexistence of genetic diseases were described. Descriptive statistics were used to analyze the results. RESULTS: Sixty-two files were reviewed and it was found that the prevalence of the defect was 1 case per-1000 newborns in the period studied. The average age of the mothers was 26.7 (15 to 41) years and the weeks of pregnancy at birth 35.6 (25 to 41.1). Giant omphalocele was found in 39 patients. Thirty-seven cases of omphalocele related to other structural defects were identified; 21 of the 62 neonates died. CONCLUSION: The omphalocele is a heterogeneous and multifactorial defect; having the knowledge of its behavior, describing the characteristics of the defect, its association with other congenital and genetic defects allows us its prenatal and post-birth approach in an optimal way, Prenatal ultrasound is a useful tool for its diagnosis and surveillance.
{"title":"Diagnóstico y seguimiento prenatal de pacientes con onfalocele","authors":"Alonso de Jesús Ortegón-López, Sandra Acevedo-Gallegos, J. M. Gallardo-Gaona, Berenice Velázquez-Torres, J. A. Ramírez-Calvo, Dulce Maria Camarena-Cabrera, Yazmín Copado-Mendoza, M. Aguinaga-Ríos","doi":"10.24245/gom.v88i11.4177","DOIUrl":"https://doi.org/10.24245/gom.v88i11.4177","url":null,"abstract":"OBJECTIVE: Determine the prevalence of omphalocele, describe its characteristics, its relationship to other fetal defects and congenital syndromes in a third level of care referral center. MATERIALS AND METHODS: Retrospective, retrolective, case series study, carried out by reviewing the records of patients attended in the defects clinic of the Maternal-Fetal Medicine Department of the Instituto Nacional de Perinatología between 2007 and 2019. Inclusion criteria: patients with prenatal diagnosis of omphalocele, with prenatal care and termination of pregnancy at the Institute. Prevalence was calculated, char- acteristics of the defect, perinatal outcomes, other related defects and coexistence of genetic diseases were described. Descriptive statistics were used to analyze the results. RESULTS: Sixty-two files were reviewed and it was found that the prevalence of the defect was 1 case per-1000 newborns in the period studied. The average age of the mothers was 26.7 (15 to 41) years and the weeks of pregnancy at birth 35.6 (25 to 41.1). Giant omphalocele was found in 39 patients. Thirty-seven cases of omphalocele related to other structural defects were identified; 21 of the 62 neonates died. CONCLUSION: The omphalocele is a heterogeneous and multifactorial defect; having the knowledge of its behavior, describing the characteristics of the defect, its association with other congenital and genetic defects allows us its prenatal and post-birth approach in an optimal way, Prenatal ultrasound is a useful tool for its diagnosis and surveillance.","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45613226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janer Sepúlveda-Agudelo, Andrea Juliana Sepúlveda-Sanguino
{"title":"Sangrado uterino anormal y PALM COEIN","authors":"Janer Sepúlveda-Agudelo, Andrea Juliana Sepúlveda-Sanguino","doi":"10.24245/gom.v88i1.3467","DOIUrl":"https://doi.org/10.24245/gom.v88i1.3467","url":null,"abstract":"","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48878273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Reyna-Castelán, Sandra Nayeli Robledo-Márquez, Dafne Andrea López-Salazar
BACKGROUND: Hodgkin lymphoma during pregnancy accounts for 4 th place in the neoplasms. Pregnancy has no impact on the natural history of the disease; however, it hinders treatment, which is individualized from a clinical evaluation and based on staging. CLASSIC CASE: Patient 18 years of age, with pregnancy of 35 weeks gestation, who is referred to the external consultation of Oncology Gynecology by increased volume in right axillary region with deep palpation pain. During its examination presence of 3 x 3.5 cm mobile node, on the right side of the axillary region, and left inguinal adenopa-thy >1 cm. The ultrasound reported right breast with solid mass, homogeneous, sharp edges, 38 x 35 mm and volume of 20.84 cc, doppler color with increased vascularity, is staged as BIRADS 3. Cesarean section was performed, with male birth, weight; 2900 g Apgar 8/9 without incident report. In the periareolar excisional biopsy, eight axillary lymph nodes were removed. Immunohistochemistry confirmed a classic LH-compatible lymphoproliferative process with CD30+, KI67 50% mixed cellularity. The hematology service decides management based on chemotherapy with ABVD protocol in 6 blocks, without radiotherapy. Currently it is evolving smoothly after six months of surgery, there was no corroborate of palpable nodes, and so far treatment, without reports of relapses or reaction to medications.
背景：妊娠期霍奇金淋巴瘤在肿瘤中占第4位。妊娠对疾病的自然史没有影响；然而，它阻碍了根据临床评估和分期进行个性化治疗。典型病例：患者18岁，妊娠35周，因右腋窝体积增加伴深部触诊疼痛而转诊至妇科肿瘤科外部会诊。在检查过程中，腋窝右侧有3 x 3.5 cm的活动淋巴结，左侧腹股沟腺癌厚度>1 cm。超声报告右侧乳房肿块实性，均匀，边缘锋利，38 x 35 mm，体积20.84 cc，多普勒彩色，血管增加，分期为BIRADS 3。剖宫产，产男，体重；2900g Apgar 8/9，无事故报告。在乳晕周围切除活组织检查中，切除了8个腋窝淋巴结。免疫组织化学证实了典型的LH相容性淋巴增生过程，CD30+，KI67 50%混合细胞。血液学服务部门决定在6个区块采用ABVD方案进行化疗的基础上进行管理，不进行放射治疗。目前，经过六个月的手术，它进展顺利，没有可触及的淋巴结的证实，到目前为止，也没有治疗，也没有复发或药物反应的报告。
{"title":"Linfoma de Hodgkin durante el embarazo: reporte de un caso","authors":"Carlos Reyna-Castelán, Sandra Nayeli Robledo-Márquez, Dafne Andrea López-Salazar","doi":"10.24245/gom.v88i1.1972","DOIUrl":"https://doi.org/10.24245/gom.v88i1.1972","url":null,"abstract":"BACKGROUND: Hodgkin lymphoma during pregnancy accounts for 4 th place in the neoplasms. Pregnancy has no impact on the natural history of the disease; however, it hinders treatment, which is individualized from a clinical evaluation and based on staging. CLASSIC CASE: Patient 18 years of age, with pregnancy of 35 weeks gestation, who is referred to the external consultation of Oncology Gynecology by increased volume in right axillary region with deep palpation pain. During its examination presence of 3 x 3.5 cm mobile node, on the right side of the axillary region, and left inguinal adenopa-thy >1 cm. The ultrasound reported right breast with solid mass, homogeneous, sharp edges, 38 x 35 mm and volume of 20.84 cc, doppler color with increased vascularity, is staged as BIRADS 3. Cesarean section was performed, with male birth, weight; 2900 g Apgar 8/9 without incident report. In the periareolar excisional biopsy, eight axillary lymph nodes were removed. Immunohistochemistry confirmed a classic LH-compatible lymphoproliferative process with CD30+, KI67 50% mixed cellularity. The hematology service decides management based on chemotherapy with ABVD protocol in 6 blocks, without radiotherapy. Currently it is evolving smoothly after six months of surgery, there was no corroborate of palpable nodes, and so far treatment, without reports of relapses or reaction to medications.","PeriodicalId":12654,"journal":{"name":"Ginecologia y obstetricia de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49246903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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