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Hallazgos ecocardiográficos en el embarazo y posparto tardío en mujeres mexicanas sanas 健康墨西哥妇女怀孕和产后晚期的超声心动图发现
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i5.3385
Carmen Armida Íñigo-Riesgo, Juan Rafael Gómez-Vargas, Pedro Gutiérrez-Fajardo, Luis Guillermo Torres-Gómez
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引用次数: 0
Desenlaces obstétricos en mujeres embarazadas con enfermedad renal crónica y factores asociados 慢性肾脏疾病孕妇的产科结局及其相关因素
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i4.3325
Martha Cecilia Guzmán-Solís, Olivia Sánchez-Rodríguez, Abisaí Montaño-Martínez, Dulce Elvia Peredo-Villa, R. Paniagua-Sierra, Miguel Trejo-Villeda, Juan-Carlos-H Hernández-Rivera
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引用次数: 1
Mola invasiva en adolescente de 13 años. Aspectos fundamentales del diagnóstico y tratamiento 13岁青少年的侵入性翻车鱼。诊断和治疗的基本方面
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i4.3676
Z. Frías-Sánchez, Lidia María Melero-Cortés, María Inés Merchán-Felipe, M. B. V. Pérez-Quintela, Ana María Calderón-Cabrera, C. González-Cejudo, M. A. Martínez-Maestre
Resumen ANTECEDENTES: La neoplasia gestacional trofoblástica es un tumor raro, derivado de la gestación que procede de un desarrollo anormal del tejido trofoblástico. Incluye cuatro variedades, entre las que se encuentra la mola invasiva y el coriocarcinoma. Puede tener diferentes grados de proliferación; el diagnóstico diferencial es decisivo porque influye directamente en el tratamiento. Las molas premalignas suelen tratarse con legrado uterino, las malignas requieren tratamiento sistémico con mono o poliquimioterapia. Paciente de 13 años, hospitalizada debido a un cuadro de vómitos y dolor abdominal. Durante el internamiento se le practicaron estudios complemen-tarios: determinación de la fracción β de la gonadotropina coriónica humana ( β -hCG) y tomografía axial computada para plantear el diagnóstico diferencial. El diagnóstico definitivo lo aportó la biopsia obtenida mediante legrado. El tratamiento se basó en la poliquimioterapia. En la actualidad está en remisión completa de la enfermedad. CONCLUSIONES: Resulta imprescindible detectar lo más temprano posible la gestación anómala, entender perfectamente su evolución e importancia de la anticoncepción mientras se trata y la enfermedad desaparece y minimizar la cantidad de pacientes que deben recibir quimioterapia. Abstract BACKGROUND: Gestational trophoblastic neoplasia is a rare tumor that originates from pregnancy and it develop from anormal proliferation of trophoblastic tissue. It includes four varieties, including invasive mole and choriocarcinoma. They can present different degrees of proliferation, being essential differential diagnosis since it directly influences the treatment. Premalignant moles are usually treated by suction curettage while malignant forms require systemic therapy with mono or polychemotherapy. OBJECTIVE: Report the case, paying special attention to the differential diagnosis and treatment used, analyzing the reasons why polychemotherapy is established and de-scribing the different possible options, based on current scientific evidence. CLINICAL CASE: We present the case of an invasive mola in a 13-year-old patient hospitalized by vomiting and abdominal pain. During this period, complementary techniques such as the determination of the β fraction of the human chorionic gonado- tropin ( β -hCG) or computed tomography (CT) are required to establish the differential diagnosis. Finally, the definitive diagnosis is provided by the biopsy obtained by curet- tage. Treatment is instituted with the pattern of polychemotherapy being, currently, with complete remission of the disease. CONCLUSIONS: Thus, it is essential to detect anomalous gestation early, to understand perfectly the evolution of this entity, the importance of contraception during its resolu-tion, and to minimize patients susceptible to chemotherapy.
我们的研究结果表明,在20世纪90年代末和21世纪初,在美国和欧洲的一些国家,有一种普遍的趋势,即在某些情况下,在某些情况下,在某些情况下,在某些情况下,在某些情况下,在某些情况下,在某些情况下,在某些情况下。它包括四种类型,包括浸润性痣和绒毛膜癌。可能有不同程度的增殖;鉴别诊断是决定性的,因为它直接影响治疗。子宫内膜异位症(子宫内膜异位症)是指子宫内膜异位症(子宫内膜异位症)或子宫内膜异位症(子宫内膜异位症)。患者13岁,因呕吐和腹痛住院。在住院期间进行了额外的研究:测定人绒毛膜促性腺激素β组分(β -hCG)和计算机轴向断层扫描以提高鉴别诊断。确诊后,我们进行了活检,以确定肿瘤的位置。治疗以多药治疗为基础。他目前病情完全缓解。结论:有必要尽早发现异常妊娠,充分了解其演变和避孕的重要性,同时治疗和疾病消失,并尽量减少需要接受化疗的患者数量。摘要背景:妊娠滋养细胞肿瘤是一种罕见的肿瘤,起源于妊娠期,由滋养细胞组织异常增殖发展而来。它包括四稻米,包括肺炎软and choriocarcinoma。They can目前不同的应付,being”的俄罗斯直接诊断influences the待遇。预对齐痣通常采用吸力刮刀治疗,而恶性痣则需要单化疗或多化疗系统治疗。目的:报告病例,特别注意所使用的不同诊断和治疗方法,分析建立多化疗的原因,并根据目前的科学证据解释不同的可能选择。临床病例:我们报告了一名13岁患者因呕吐和腹痛住院的侵袭性翻车病例。在此期间,需要采用诸如测定人绒毛膜促性腺激素β部分(β - hcg)或计算机断层扫描(CT)等辅助技术来建立鉴别诊断。最后,the definitive is提供切片诊断获得by curet - tage。= =地理= =根据美国人口普查,这个县的总面积为,其中土地和(2.641平方公里)水。结论:因此,必须及早发现妊娠异常,充分了解妊娠异常的演变,在解决妊娠异常时避孕的重要性,并尽量减少接受化疗的患者。
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引用次数: 1
Mitos y realidades de la anticoncepción hormonal combinada. 联合激素避孕的神话和现实。
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88isupl1.3854
I. García, J. Neyro-Bilbao, Marina Carrascoso
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引用次数: 0
Cáncer de ovario endometrioide asociado con útero didelfo: reporte de un caso 子宫内膜样卵巢癌伴子宫didelfo:一例报告
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i11.4289
V. E. Valdespino-Castillo, Juan Landa-Mejía, G. Maytorena-Córdova, Yazmín Ballesteros-Montenegro, Giselle Zavala-Ramírez, Víctor Manuel Valdespino-Gómez
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引用次数: 0
Teratoma quístico maduro con transformación maligna: serie de casos 成熟囊性畸胎瘤伴恶性转化:一系列病例
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i3.3561
V. E. Valdespino-Castillo, G. Maytorena-Córdova, Israel López-Matamoros, Juan Landa-Mejía, Perla Esther Zaragoza-Vargas, Víctor Manuel Valdespino-Gómez
OBJECTIVE: Describe the clinical and histopathological characteristics of cases of mature teratoma with malignant transformation, its treatment and survival. MATERIALS AND METHODS: Retrospective, cross-sectional and observational study conducted between January 2014 and December 2018 in a gynecological oncology service. Study parameters: pathological stage of the tumor, concentra- tions of Ca 125, survival and treatment. The sample size did not allow statistical tests to be applied. RESULTS: 147 patients with a diagnosis of mature teratoma were studied of these 4 underwent malignant transformation to squamous cell carcinoma and 18 were ruled out due to incomplete information. The transoperative histopathological study identi- fied 3 of the 4 ovarian tumors as malignant. Fertility conservative surgeries were not performed because in none of the cases was it necessary. In 3 of the 4 mature teratomas with malignant transformation, adjuvant chemotherapy scheme was indicated. All patients remain alive and have no relapse so far. CONCLUSIONS: The histopathological transoperatory study is absolutely necessary for an ovarian tumor, even in cystic ovarian tumors. Carefully management of ovarian tumors is very important, we should prevent a rupture of the malignant tumor because this changes the surgical stage and the prognosis. The surgical and medical treatment
目的:探讨成熟畸胎瘤伴恶性转化的临床和组织病理学特点、治疗方法及生存期。材料与方法:2014年1月至2018年12月在妇科肿瘤科开展回顾性、横断面和观察性研究。研究参数:肿瘤病理分期、Ca - 125浓度、生存率及治疗情况。样本量不允许进行统计检验。结果:147例诊断为成熟畸胎瘤的患者中,4例恶性转化为鳞状细胞癌,18例因信息不全而排除。经手术组织病理学检查,4例卵巢肿瘤中3例为恶性肿瘤。没有进行生育保守手术,因为没有一个病例是必要的。4例成熟畸胎瘤伴恶性转化3例均行辅助化疗。到目前为止,所有患者均存活且无复发。结论:对于卵巢肿瘤,甚至是囊性卵巢肿瘤,经手术组织病理学检查是绝对必要的。卵巢肿瘤的精心处理是非常重要的,我们应该防止恶性肿瘤破裂,因为这改变了手术分期和预后。手术和药物治疗
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引用次数: 1
Rotura vesicouterina posparto eutócico en ausencia de cirugía uterina previa. Caso clínico y revisión bibliográfica 在没有子宫手术的情况下,分娩后出现共济失调性膀胱子宫破裂。临床病例与文献回顾
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i12.4270
B. Díaz-Rabasa, Andrea Espiau-Romera, Mariano Laguna-Olmos, Cristina Fernández-García, A. C. Ruiz-Peña, Paula Cebolla-Gil
BACKGROUND: Uterine rupture is an unpredictable and infrequent obstetric emer- gency which is associated to a high maternal and perinatal morbi-mortality. The most important risk factor is prior uterine surgery. OBJECTIVE: To report a complete vesicouterine rupture case occurred after a vaginal delivery without prior uterine surgery. It is intended to review the risk factors, the suspicious signs and symptoms, as well as the optimal management and maternal and perinatal prognosis of uterine rupture in unscarred uterus. CLINICAL CASE: A 35-year-old woman, para 2 with neither uterine surgical pro- cedures nor other medical records, had a normoevolutive pregnancy and required induction of labour with a dinoprostone vaginal slow-release system (10 mg) due to late-term pregnancy at 41 +5 weeks. The labor progressed normally, ending in a vaginal delivery. After 1h postpartum, the patient started with a progressive abdominal pain and haematuria. The computerized tomography scan showed a severe hemoperito-neum and suggested the presence of a vesical continuity solution with disfiguration of the of a subtotal Diagnostic suspicion, even in the absence of risk factors, and early diagnosis and management are crucial to decrease it.
背景:子宫破裂是一种不可预测且罕见的产科紧急事件,与高孕产妇和围产期并发症死亡率有关。最重要的风险因素是先前的子宫手术。目的:报告一例未经子宫手术的阴道分娩后发生的膀胱外泌尿道完全破裂病例。旨在综述未捕获子宫中子宫破裂的危险因素、可疑体征和症状,以及最佳处理方法和孕产妇及围产期预后。临床病例:一名35岁的妇女,第2段,既没有子宫外科手术,也没有其他医疗记录,妊娠期正常,由于在41+5周时妊娠晚期,需要使用地诺前列酮阴道缓释系统(10 mg)引产。分娩进展正常,以阴道分娩结束。产后1小时后,患者开始出现进行性腹痛和血尿。计算机断层扫描显示严重的腹腔积血,并提示存在膀胱连续性溶液和次全部畸形。即使在没有危险因素的情况下,也有诊断怀疑,早期诊断和管理对减少这种情况至关重要。
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引用次数: 0
Láser fraccionado de CO2 para el tratamiento de pacientes con síndrome genitourinario de la menopausia CO2分馏激光治疗更年期泌尿生殖系统综合征患者
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i5.4097
S. M. Pizarro
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引用次数: 0
Útero didelfo como causa de ruptura uterina espontánea. Reporte de un caso didelfo子宫是子宫自发破裂的原因。报告个案
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v88i6.3705
Yazmin del Socorro Conde-Gutierrez, Noemí Cruz-López, L. C. Jiménez-Ibáñez
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引用次数: 0
Eficacia y seguridad de la sonda Foley transcervical y oxitocina vs oxitocina sola en la inducción del trabajo de parto en pacientes con cesárea previa 经颈Foley探针和催产素与催产素单独在剖腹产患者引产中的有效性和安全性
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.24245/gom.v87i1.2501
Noemí Raquel Guerrero-Patiño, Sandra Magdalena Aguilera-Cervantes, Pablo Mariano González-Aldeco, Cecilio Rodríguez-Ayala
OBJETIVO: Evaluar si la combinacion de la sonda Foley transcervical con oxitocina intravenosa, como metodo para induccion del parto en pacientes con cesarea previa, es mas efectiva que la oxitocina sola para alcanzar una fase activa del trabajo de parto y, por consiguiente, incrementar la frecuencia de partos. MATERIALES Y METODOS: Estudio de casos y controles efectuado en el Centro Hospitalario Nuevo Sanatorio Durango del 1 de marzo de 2017 al 31 de marzo de 2018. Criterios de inclusion: edad gestacional mayor o igual a 37 semanas, cesarea previa con incision transversal baja (Kerr), embarazo unico, feto en presentacion cefalica. Se crearon dos grupos: A: induccion del parto con oxitocina intravenosa y B: induccion con sonda Foley transcervical y oxitocina. Las variables categoricas se describieron con frecuencias y porcentajes, y las numericas con media (±), desviacion estandar o mediana. Se utilizo la prueba de Kolmogorov-Smirnov y t de Student y se considero estadisticamente significativo un valor de p 0.05; IC95%: 0.16-0.4). El tiempo del trabajo de parto fue: grupo A con una media de 17.11 horas y en el grupo B de 12.44 (p < 0.05; IC95%: 2.4-6.2 y 2.4-6.3, respectivamente). CONCLUSIONES: Por lo menos en la muestra estudiada la combinacion de sonda Foley transcervical con oxitocina demostro ser sumamente eficaz y segura para la induccion del trabajo de parto en pacientes con cesarea previa; se consiguio disminuir significativamente el tiempo de trabajo de parto y aumentar la frecuencia de pacientes que logran llegar a una fase activa del trabajo de parto
目的:评估Foley经颈导管与静脉催产素联合作为一种在既往剖腹产患者中诱导分娩的方法是否比单用催产素更有效地实现分娩的活跃阶段,从而增加分娩频率。材料和方法:2017年3月1日至2018年3月31日在杜兰戈新疗养院医院中心进行的病例对照研究。纳入标准:胎龄大于或等于37周,剖宫产前低横切面(Kerr),单胎,有头畸形的胎儿。创建了两组:A:静脉催产素引产和B:经颈福利管和催产素引产。类别变量用频率和百分比描述,数字用平均(±)、标准差或中位数描述。使用Kolmogorov-Smirnov和Student T检验,p值为0.05,具有统计学意义;95%可信区间:0.16-0.4)。分娩时间为:A组平均17.11小时,B组12.44小时(P<0.05;95%可信区间:分别为2.4-6.2和2.4-6.3)。结论:至少在所研究的样本中,经宫颈Foley探针与催产素的联合应用证明对先前剖腹产患者的引产是非常有效和安全的;大大减少了分娩时间,增加了成功进入活跃分娩阶段的患者的频率
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引用次数: 0
期刊
Ginecologia y obstetricia de Mexico
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