scholarly journals Miomectomía en embarazo temprano

2022 ◽  
pp. 1
Author(s):  
Edgar Rodolfo Herrerarte Méndez ◽  
María Dolores Molina Rodríguez
Keyword(s):  
Placenta Previa

Los miomas o leiomiomas son tumores benignos monoclonales que histológicamente surgen de la proliferación del músculo liso y tejido conectivo del útero. Son de crecimiento lento y la degeneración maligna es menor a 1% y tan bajo como 0.2%. La prevalencia mundial varia de 5-21%, aumenta con la edad; 1.8% en mujeres de 20-29 años y 14.1% en mayores de 40 años. Se reporta reducción del embarazo clínico en pacientes con miomatosis uterina mayor de 4 cms (29 vs 52%, p=0.025), comparadas en mujeres sin miomatosis uterina. Si se logra el embarazo como tal, los miomas durante el embarazo pueden causar: incremento en la tasa de abortos espontáneos (por distorsión de la cavidad uterina), contracciones prematuras, ruptura prematura de membranas, placenta previa, desprendimiento prematuro de placenta, presentación fetal anormal, o hemorragia post parto y aumento en el índice de cesáreas. Describimos el caso clínico de paciente femenina de 36 años, primigesta, con historia de infertilidad primaria y diagnóstico de miomatosis uterina de grandes elementos con embarazo de 11 semanas, en quien se decide miomectomía durante embarazo por presentar varios cuadros clínicos de amenaza de aborto y dolor pélvico constantemente, así como dificultad respiratoria por volumen uterino, que evoluciona satisfactoriamente y en quien se resuelve embarazo por medio de una cesárea programada mas histerectomía, obteniéndose recién nacida femenina a término.

A Case of Emergency Cesarean Section on Client with Pseudopregnancy

2020 ◽  
pp. 1-6
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Medical Service ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Urban Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

PENGARUH MOBILISASI DINI TERHADAP PENYEMBUHAN LUKA POST SECTIO CAESAREA

2017 ◽  
Vol 11 (1) ◽  
pp. 109
Author(s):  
Reni Heryani ◽  
Ardenny Denny
Keyword(s):  
Wound Healing ◽  
Placenta Previa ◽  
Healing Process ◽  
Early Mobilization ◽  
Sectio Caesarea ◽  
Uterine Action ◽  
Wound Healing Process ◽  
P Value ◽  
Post Test ◽  
Development Goals

<p align="center"><strong>A</strong><strong>BSTRAK</strong><strong></strong></p><p align="center"> </p><p>Salah satu tujuan pembangunan era <em>Millenium Development goals (MDG’s)</em> 2015 adalah perbaikan kesehatan maternal. Salah satu cara di dalam persalinan atau mengeluarkan bayi secara patologis yaitu dengan sectio caesarea. Menurut  statistik 3.509 kasus sectio caesarea, indikasi terbanyak adalah disproporsi cephalo pelvik (21%), sedangkan indikasi lain adalah gawat janin (14%), plasenta previa (11%), pernah sectio caesarea (11%), incoordinate uterine action (9%), preeklamsi dan hipertensi (7%). Penelitian ini menggunakan desain penelitian <em>Quasy Experiment</em> dengan <em>post test only with control.</em> Hasil penelitian menunjukkan bahwa umumnya responden memiliki umur tidak berisiko terhadap tindakan operasi yati sebanyak 15 orang (75%), sebagian responden pertama kali dilakukan operasi caesarea yaitu sebanyak 10 orang (50,0%), sebagian responden mengalami penyembuhan luka yang normal yaitu sebanyak 13 orang (65,0%), dan sebagian responden responden melakukan mobilisasi dini yaitu sebanyak 14  orang (70,0%). Secara statistik terdapat pengaruh mobilisasi dini terhadap penyembuhan luka post sectio caesarea di RSUD Arifin Achmad Pekanbaru (p value = 0.007). Disarankan bagi respnden dapat meningkatkan kesadarannya dalam meningkatkan derajat kesehatan melalui latihan mobilisasi dini untuk mempercepat proses penyembuhan luka akibat operasi.</p><p><em> </em></p><p><em>Kata Kunci      : </em><em>sectio </em><em>caesarea, mobilisasi, penyembuhan luka</em></p><p><em> </em></p><p align="center"><strong><em>ABSTRACT</em></strong></p><p><em> </em></p><p><em>One of the goals of development era of Millennium Development Goals (MDG's) in 2015 is the improvement of maternal health.</em><em> </em><em>One way in the delivery or the baby out with the pathological ie sectio caesarea. According to 3509 statistics compiled case sectio caesarea, an indication of cephalo pelvic disproportion is the highest (21%), while the other is an indication of fetal distress (14%), placenta previa (11%), never sectio caesarea (11%), incoordinate uterine action (9%), preeclampsia and hypertension (7%).</em><em> </em><em>This study research design quasy Experiment with post test only with control. The results showed that respondents generally have a lifespan of no risk for surgery yati many as 15 people (75%), the majority of respondents were first performed caesarea operation as many as 10 people (50.0%), the majority of respondents experienced a normal wound healing as many as 13 people (65.0%), and the majority of respondents respondents did early mobilization as many as 14 people (70.0%). There is a statistically significant relationship between early mobilization on wound healing post sectio caesarea (p value = 0.007). Suggested for respnden can increase awareness in improving health status through early mobilization exercises to accelerate the wound healing process as a result of the operation.</em></p><p><em> </em></p><em>Keywords: sectio caesarea, mobilization, wound healing</em>

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

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