Examinando por Materia "Óbito fetal"

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Acceso abierto
Importance of cardiotocography and its interpretation in gestational diabetes"
(Universidad Privada Norbert Wiener, 2019-06-28) Villanueva Arequipeño, Liz Soledad; Fernández Ledesma, Scarlett Estela
To present the clinical case of a 39-year-old pregnant woman, multigravida at 37.3 weeks according to second-trimester ultrasound, with no prior history of diabetes or family history of diabetes. However, her obstetric history included fetal death, spontaneous abortion, and hospitalization one month earlier for uncontrolled gestational diabetes. The patient presented to the emergency department of a healthcare institution on August 26, 2017, at 10:24 a.m. due to decreased fetal movements for two days. Two fetal well-being tests were performed: a non-stress test (NST) with a non-reassuring pattern and a biophysical profile (BPP) indicating 37 weeks of gestation with a score of 6/8, nuchal cord, and an estimated fetal weight of 3329 grams. Blood glucose was 63 mg/dL. An endocrinology consultation recommended continuous glucose monitoring, dietary adjustments, and insulin treatment. With these clinical findings, the patient was transferred to the delivery room, where a stress test (CST) yielded unsatisfactory results. At 10:44 p.m., due to the absence of an indication for delivery and a glucose level of 62 mg/dL, the on-duty physician recommended hospitalization. Fetal heart rates were monitored every three hours during the night and found to be normal. However, at 8:00 a.m., fetal heart sounds were absent, confirmed by ultrasound, leading to an abdominal delivery. Operative findings: fetal death, female fetus, APGAR 0/0, Capurro: 37 weeks, weight: 3280 grams, placenta: 500 grams with complete cotyledons, intact membranes, thick meconium-stained amniotic fluid in small quantities, and a slightly tightened single nuchal cord. Conclusion: Proper recording and interpretation of cardiotocographic parameters in electronic fetal monitoring in diabetic pregnant women are crucial to identifying fetal risks, ensuring timely management, and preventing maternal and perinatal complications.
Acceso abierto
INFORME DEL TRABAJO ACADÉMICO: COLESTASIS INTRAHEPATICA GESTACIONAL Y OBITO FETAL
(Universidad Privada Norbert Wiener, 2017-10-27) Torres Jara, Doris Charito; Ayala Peralta, Felix Dasio
Objetivo: Describir el manejo de un trabajo académico sobre colestasis intrahepática gestacional ocurrida durante la atención de salud materna en el Hospital de Chancay. Material y métodos: Es un estudio de tipo observacional, descriptivo, retrospectivo de revisión sistemática de la historia clínica perinatal de colestasis intrahepática gestacional manejada en el Hospital de Chancay ocurrida en mes de marzo 2014. Se incluyeron antecedentes personales, familiares y patológicos, examen general y específico, diagnóstico, exámenes auxiliares, manejo obstétrico, evolución hasta el alta. Resultados: Se presenta, una primigesta de 21 años de edad, con 36 semanas de edad gestacional con diagnóstico de colestasis intrahepática gestacional + óbito fetal. Síntoma predominante fue el prurito generalizado desde la semana 32. Hallazgos de pruebas hepáticas son patológicos, incremento de bilirrubina total y dosaje de ácido biliar de 44 micromol/L. La culminación del embarazo fue parto vaginal, obteniendo un natimuerto impregnado de meconio, sexo femenino, con peso de 3000g. Manejada en el puerperio con ácido ursodexocicólico; con evolución materna favorable, con alta al 2° día post parto. Conclusión: La colestasis intrahepática gestacional, patología de la segunda mitad del embarazo caracterizada por prurito y elevación sérica de los ácidos biliares que ocasiona muerte fetal intraútero
Acceso abierto
Subclinical choriamnionitis and stillbirth in a hospital in Lima Level II-2
(Universidad Privada Norbert Wiener, 2019-09-10) Robles Sánchez, Gleiky Janet; Sanchez Aranda, Katerin Fiorela; Sanz Ramirez, Ana María
The clinical case of a 25-year-old patient at 26 weeks of gestation diagnosed with fetal death is evaluated. The patient previously underwent four prenatal checkups, all seemingly normal, and was under syndromic treatment for a vaginal infection. After vaginal delivery, the placenta and fetal membranes were evaluated in the pathology department, leading to a diagnosis of subclinical chorioamnionitis caused by E. coli. It is concluded that predisposing factors, nonspecific management for certain infections, and the limited scientific evidence on this pathology highlight the importance of prenatal care, reducing risk factors, and timely treatment of conditions that may arise during pregnancy.