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1.
Ginecol. obstet. Méx ; Ginecol. obstet. Méx;85(3): 212-215, mar. 2017.
Artigo em Espanhol | LILACS | ID: biblio-892525

RESUMO

Resumen ANTECEDENTES: La ruptura hepática es una complicación inusual, pero potencialmente mortal, que sucede en 1 de cada 100,000 a 250,000 embarazos. La mortalidad materna se ha reportado en 86% de los casos. En las pacientes con síndrome de HELLP debe considerarse que la manifestación de un hematoma hepático puede culminar en ruptura hepática y muerte. CASO CLINICO: Paciente de 46 años de edad, con antecedente de embarazo gemelar doble, bicorial, biamniótico de 36.5 semanas y preeclampsia severa, posterior a ruptura hepática por síndrome de HELLP y muerte de ambos fetos. El último embarazo evolucionó sin problemas y finalizó en cesárea en la semana 37, sin complicaciones materno-fetales, por lo que fue dada de alta del hospital al tercer día y posteriormente evolucionó sin incidentes. CONCLUSIONES: La atención médica multidisciplinaria y la infraestructura hospitalaria permitieron que la paciente no perdiera la vida debido a la ruptura hepática y hemorragia grave. La hipertensión durante el embarazo es una de las principales causas de muerte materna en todo el mundo; por tanto, es importante concientizar a las pacientes para que acudan a control prenatal regularmente y orientarlas acerca de la hipertensión y sus complicaciones. Los ginecoobstetras deben considerar que la ruptura hepática es una complicación muy grave, con consecuencias fatales para la madre y el feto.


Abstract BACKGROUND: Hepatic rupture is a potentially fatal rare complication, which is diagnosed in 1 of each 100,000 to 250 000 pregnancies. Maternal mortality has been reported in up to 86% of the patients. In cases where there has been a diagnosis of HELLP syndrome, the presence of a hepatic hematoma has to be suspected since it could lead to a hepatic rupture and eventually death. CLINICAL CASE: 46 year old female in late stage of pregnancy, following a hepatic rupture caused by HELLP syndrome and fetal demise of both fetuses in previous twin pregnancy. Her last pregnancy being of normal evolution, having been submitted to cesarean section without complications on her 37th week of gestation, and discharged on her third post-operative day showing a good evolution. CONCLUSION: The multidisciplinary medical attention given to the patient, as well as the hospital infrastructure, allowed the patient to be kept in good health despite the hepatic rupture and hemorrhage presented. It is important to remember that one of the leading causes of maternal death around the world is hypertension during pregnancy. Therefore, patients have to be made conscious of the significance and importance of attending prenatal care on a regular basis and be given information on hypertension and its complications. Additionally, it is important that obstetricians keep in mind that although this is a rare complication, it can lead to a fatal outcome when presented.

2.
Ginecol Obstet Mex ; 84(3): 136-42, 2016 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-27424439

RESUMO

BACKGROUND: Screening programs for breast cancer include self and clinical examination and Imaging studies to obtain the BIRADS (Breast Imaging Reporting and Data System) grade has been described as an important tool. In México, breast cancer is the leading death cause from malignancy in women and thus an early detection and prompt treatment is an important public health concern OBJECTIVE: To compare the BIRADS classification with histopathological findings and cases of malignancy. METHODS: This is a retrospective, observational and descriptive study about of the correlation between histopathological reports and BIRADS classification. RESULTS: Records of 1551 patients were reviewed, of which only 176 met the inclusion criteria. There was a predominance of fibrocystic condition. 44 patients had cancer, with varying degrees of detection according to each category of the classification where BIRADS 5 corresponded to 100% of the malignant cases. CONCLUSION: Consistent with the results reported by other authors, highlighting some situations like BIRADS 4C (where there was a slight difference compared to literature) and the BIRADS 5 in which a detection of 100% of cases of cancer was achieved.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia , Ultrassonografia Mamária , Adulto , Idoso , Neoplasias da Mama/classificação , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
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