RESUMEN
INTRODUCTION: Herlyn-Werner-Wunderlich syndrome , a rare Müllerian ducts congenital disease, is characterized by a diphtheritic uterus, blind hemivagina, and ipsilateral renal agenesis. Diagnosis is at young age by ultrasound and magnetic resonance imaging, and the prognosis is good. Usually, complications evolve endometriosis and secondary pelvic inflammation. CASE REPORT: A 40-year-old female patient, Brazilian, white, primigravida, diagnosed at 30 years with a didelphic uterus on ultrasound, and 4 years later, with a left ovarian endometrioma, multiple ovarian cysts, and left renal agenesis on magnetic resonance imaging. Subsequently, due to dyspareunia and a feeling of swelling, the patient underwent transvaginal ultrasound with bowel preparation, and a hematocolpos was found and Herlyn-Werner-Wunderlich syndrome was suspected; 10 years after the diagnosis she had a planned pregnancy. She presented frequent contractions following the 15th week of pregnancy and fortunately there were no complications or premature labor. Labor was inducted at 40 weeks and 6 days without progress and a cesarean section was indicated and performed without complications. Herlyn-Werner-Wunderlich syndrome often goes unnoticed, leading to inadequate treatment. Individuals with Herlyn-Werner-Wunderlich syndrome commonly face fertility issues, such as high miscarriage rate (21-33%), and obstetric complications, such as spontaneous abortions (40% risk), intrauterine growth restriction, postpartum hemorrhage, increased fetal mortality, preterm delivery (21-29%), and elevated rates of cesarean sections. In addition, there is higher susceptibility of developing endometriosis, especially with hemivaginal obstruction, and pelvic adhesions. CONCLUSION: Early diagnosis enables timely treatment and, consequently, fewer complications. Still, when these factors are absent, vaginal birth may still be possible. The true prevalence and incidence of complications related to Herlyn-Werner-Wunderlich syndrome are still unknown.
Asunto(s)
Endometriosis , Humanos , Femenino , Adulto , Endometriosis/complicaciones , Embarazo , Útero/anomalías , Útero/diagnóstico por imagen , Cesárea , Riñón/anomalías , Conductos Paramesonéfricos/anomalías , Anomalías Múltiples , Anomalías Congénitas/diagnóstico , Anomalías Congénitas/diagnóstico por imagen , Vagina/anomalías , Complicaciones del Embarazo , Enfermedades Renales/congénito , Enfermedades Renales/diagnósticoRESUMEN
Objectives: Hepatitis C virus elimination is complex. The objective was to analyze measures to eliminate virus transmission in a hemodialysis unit. Methods: Case study composed of multiple units of analysis. The scenario is the hemodialysis unit of a Brazilian public hospital. Population composed of health service records. Descriptive analyzes were performed and the beginning of the event was considered as the moment of increased incidence of HCV. The intentional and purposeful collection of information for understanding the event and implementing interventions. Results: The subunits of analysis were related to: clinical-epidemiological profile, active search, transmission routes, management protocol and results achieved. In August 2019, out of 45 patients, six were reactive for anti-HCV. All received treatment. Patients had exposure to contaminated medical equipment, objects or hands of professionals. Preventive measures were adopted and routine techniques were corrected. Situational Analysis Committee guided the management of the event. No new cases were detected. Conclusions: Strategies for the microelimination of the C virus in a dialysis environment are demonstrated and it shows the multidisciplinary efforts in conducting the event.