Ciencias de la Salud
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Item Placenta previa oclusiva total con signos de acretismo secundaria a cirugía uterina anterior(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2020-10-01) Salazar Urrutia, Pamela de los Angeles; Belalcazar Sánchez, Yajaira MonserrathDra.The placenta previa is defined as the total or partial insertion of the placenta in the lower segment of the uterus. It is considered responsible for 20% of bleeding in the 3rd trimester, the 3rd cause of blood transfusion in the last stage of gestation and the 2nd cause of radical hysterectomy. It is more frequently associated with older women, a previous caesarean section, induced or spontaneous abortions. The case of a 43-year-old female patient with a surgical history of a previous caesarean section is described. She is in her third 35.1-week pregnancy due to chronological FUM, diagnosed with total occlusive placenta previa and placental accretion confirmed by MRI and obstetric ultrasound. Prior to admission, she presented with contraction-type abdominal pain that radiated to the lumbar region accompanied by small amount of dark bleeding, which is why admission to the Ambato Provincial Teaching Hospital was assessed and the pregnancy was planned to end at 36 weeks. Cesarean section is scheduled at 36 weeks due to the diagnosis of total occlusive Placenta previa with signs of placental accreta. As a complication of the surgical act, a uterine uterine atony is observed, so a total abdominal hysterectomyItem “Hipertiroidismo en embarazo complicado por placenta previa”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Vinueza Sánchez, Diego Ismael; Guarnizo Briceño, José Abdón Dr. Esp.Thyroid pathology is common in pregnancy and is associated with the risk of miscarriage, preterm delivery, neonatal morbidity, and obstetric complications such as eclampsia, preeclampsia, and premature delivery. Timely diagnosis and adequate treatment of thyroid disease in pregnancy are very important to avoid maternal-fetal complications. The causes of hyperthyroidism are diverse, of which Graves' disease has the highest incidence, others such as toxic multinodular goiter, toxic solitary adenoma, subacute thyroiditis (de Quervain), are exceptional. There are a variety of symptoms in this clinical entity that stand out are: tachycardia, heat intolerance, tremor, anxiety, nervousness and diaphoresis, orbitopathy, pretibial myxedema and have found the loss or inadequate gain of weight. The documented maternal complications of hyperthyroidism without treatment are hypertension, preeclampsia, placental abruption, congestive heart failure and even abortions. To reach the diagnosis of gestational hyperthyroidism, there must be low TSH levels (less than 0.1 mUI / l) or undetectable (less than 0.01 mIU / l) and high levels of free T4. If free T4 is normal, hyperthyroidism is subclinical. On the other hand placenta previa is a condition in which the placenta is implanted in the lower uterine segment, very close to the internal cervical os (OCI) or covering it either totally or partially. The classification used for placenta previa is based on 2 variants: placenta previa proper mind (OCI is covered by placental tissue totally or partially) and marginal placenta previa (the placental edge is less than 2cm from the OCI but does not cover it). Placenta previa occurs with painless active bleeding without uterine activity in the 2nd trimester or during the 3rd trimester. For the diagnosis, transvaginal ultrasound allows the measurement of the placental edge to the OCI. The distance between the placental border and the OCI determined by the transvaginal ultrasound after the week. Normally, a distance of 2cm or less from the OIC is indicative of cesarean section to prevent obstetric hemorrhage.