Medicina
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Item “Parto pretermino en embarazo gemelar con incidencia de bajo peso al nacer y prevalencia de hipertensión inducida por el embarazo”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-09-01) Sánchez Jaya, Lucio David; Frías Raza, Edison Tarcisio Dr. Esp.The case corresponds to a pregnant patient of 34 years of age, who is referred from the Totoras health center on 06/06/2017 at 04.55 pm to the emergency service of the general teaching hospital Ambato, presenting abdominal pain type contraction of great intensity, pulsatile holocranial headache accompanied by lower limb edema. At the physical examination, conscious, oriented, afebrile, hydrated, oral, wet oral mucosa, Glasgow 15/15, blood pressure (BP): 140/90 mmHg, heart rate (HR): 85 beats per minute (bpm), respiratory rate ( FR): 20 breaths per minute (rpm), temperature (T) 36 ° C, oxygen saturation (SatO2) 95%, normoelastic and normothermic skin, slightly depressed abdomen painful to palpation at epigastric level pregnant uterus according to gestational age twin pregnancy, 2 live fetuses, twin: 1 fetal heart rate (FHR): 148 beats per minute (bpm), rhythmic, cephalic, twin 2 poralic 143 beats per minute (bpm), bottom uterine height (AFU): 39 centimeters (cm), uterine height (AU): 3 contractions in 10 minutes of 35 seconds duration, negative percussion fist, negative ureteral points, vaginal touch inguinogenital region, posterior cervix 4 cm dilatation effacement of 40% flat membranes without evidence of bleeding transvagin l. She is diagnosed with Pregnancy of 36.5 weeks by date of last menstruation + Preterm labor + twins plus gestational hypertension, constant controls and monitoring is performed after which hydration, analgesia, Tocolytics are administered and complementary tests are requested. : Leukocytes 9600, hemoglobin (Hb): 14 g / dl, hematocrit (Hct): 45.8%, Platelets: 251000, Glucose: 65.8 mg / dl, Urea: 19.7 mg / dl, Proteinuria: 100, Obstetric ultrasound: twin 1 cephalic live 34.1 weeks adequate amniotic fluid biophysical profile 10/10 male twin sex 2 poral 31.4 weeks amniotic fluid suitable biophysical profile 10/10 female. They decided to enter the Obstetric Center on 06/06/2017 at 7:00 p.m., in fetal assessment and monitoring, on June 8 an emergency caesarean section was performed due to fetal wellbeing commitment, presenting type 2 fetal monitoring and premature rupture of the membranes of 2 hours evolution with heavy meconium amniotic fluid, obtaining RN 1 cephalic alive with male 1940 gr, live pelvic RN 2 with weight of 1400 g female newborns enter neonatology for premature and low birth weight.Item “Parto pretermino en embarazo gemelar con incidencia de bajo peso al nacer y prevalencia de hipertensión inducida por el embarazo”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-09-01) Sánchez Jaya, Lucio David; Frías Raza, Edison Tarcisio Dr. Esp.The case corresponds to a pregnant patient of 34 years of age, who is referred from the Totoras health center on 06/06/2017 at 04.55 pm to the emergency service of the general teaching hospital Ambato, presenting abdominal pain type contraction of great intensity, pulsatile holocranial headache accompanied by lower limb edema. At the physical examination, conscious, oriented, afebrile, hydrated, oral, wet oral mucosa, Glasgow 15/15, blood pressure (BP): 140/90 mmHg, heart rate (HR): 85 beats per minute (bpm), respiratory rate ( FR): 20 breaths per minute (rpm), temperature (T) 36 ° C, oxygen saturation (SatO2) 95%, normoelastic and normothermic skin, slightly depressed abdomen painful to palpation at epigastric level pregnant uterus according to gestational age twin pregnancy, 2 live fetuses, twin: 1 fetal heart rate (FHR): 148 beats per minute (bpm), rhythmic, cephalic, twin 2 poralic 143 beats per minute (bpm), bottom uterine height (AFU): 39 centimeters (cm), uterine height (AU): 3 contractions in 10 minutes of 35 seconds duration, negative percussion fist, negative ureteral points, vaginal touch inguinogenital region, posterior cervix 4 cm dilatation effacement of 40% flat membranes without evidence of bleeding transvagin l. She is diagnosed with Pregnancy of 36.5 weeks by date of last menstruation + Preterm labor + twins plus gestational hypertension, constant controls and monitoring is performed after which hydration, analgesia, Tocolytics are administered and complementary tests are requested. : Leukocytes 9600, hemoglobin (Hb): 14 g / dl, hematocrit (Hct): 45.8%, Platelets: 251000, Glucose: 65.8 mg / dl, Urea: 19.7 mg / dl, Proteinuria: 100, Obstetric ultrasound: twin 1 cephalic live 34.1 weeks adequate amniotic fluid biophysical profile 10/10 male twin sex 2 poral 31.4 weeks amniotic fluid suitable biophysical profile 10/10 female. They decided to enter the Obstetric Center on 06/06/2017 at 7:00 p.m., in fetal assessment and monitoring, on June 8 an emergency caesarean section was performed due to fetal wellbeing commitment, presenting type 2 fetal monitoring and premature rupture of the membranes of 2 hours evolution with heavy meconium amniotic fluid, obtaining RN 1 cephalic alive with male 1940 gr, live pelvic RN 2 with weight of 1400 g female newborns enter neonatology for premature and low birth weight.