Examinando por Materia "Cesarean section"

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(Universidad Privada Norbert Wiener, 2018-12-06) Torres Santisteban, Karla Isabel; Cárdenas Hernández, Rosario Alicia; Rodriguez Chávez, Carlos Leonidas
Objective: To describe the management of a clinical case of placental accreta in a woman with a previous cesarean section and a diagnosis of placenta previa at the National Maternal and Perinatal Institute. Materials and Methods: This is a case study chosen at the National Maternal and Perinatal Institute in Lima, May 2017. Personal, pathological, obstetric history, clinical examination, diagnoses, auxiliary tests, specialty management, and the evolution from admission through emergency to medical discharge were analyzed, considering relevant references about the clinical case. Results: A clinical case of a 42-year-old multigravida, multiparous woman at 38 weeks of gestation is presented. She was diagnosed with placental accreta with risk factors including a previous cesarean section, advanced maternal age, placenta previa, and multiparity. The patient underwent a cesarean section and suffered a massive hemorrhage of over 1500 cc due to total placenta previa adhered to the uterine segment, which required immediate total abdominal hysterectomy. A live newborn was delivered with a normal Apgar score and appropriate weight for gestational age. The patient progressed favorably postoperatively and was discharged on the fifth day of hospitalization. Conclusion: The relevant risk factors for the clinical suspicion of placental accreta that must be considered during prenatal care are mainly obstetric history, such as a previous cesarean section and a diagnosis of placenta previa.
Acceso abierto

(Universidad Privada Norbert Wiener, 2017-12-07) Cruzado Valeriano, Delly Hermelinda; Cuba Navarrete, Luduvina Editta; Ayala Peralta, Félix Dasio
Uterine rupture is a clinical situation that may occur during labor or, more rarely, during pregnancy, with severe consequences for both maternal and fetal life. The possibility of uterine rupture in an intact uterus is rare, but prevalent risk factors such as multiparity, dystocia, fetal macrosomia, use of oxytocin, breech deliveries, obstetric trauma, internal and external fetal versions, uterine abnormalities, misuse of prostaglandins, and instrumental deliveries are described. This clinical case involves a 44-year-old multiparous patient at 38 weeks of gestation with uterine hypokinesia and a third-degree facial presentation. Fetal bradycardia was noted, and an immediate cesarean section revealed uterine rupture with posterior uterine segment rupture, followed by a cesarean hysterectomy and unilateral right salpingo-oophorectomy. The patient recovered well and was discharged with her newborn on the 7th postoperative day.
Acceso abierto
Usefulness of fetal cardiotocography in the diagnosis of funicular dystocia in a pregnant woman treated at the level II-2 hospital in Tarapoto.
(Universidad Privada Norbert Wiener, 2021-08-05) Cortez Ramirez, Henry; Ayala Peralta, Félix Dasio
Materials and Methods: This is an observational, descriptive, retrospective study and case review on the management of a primigravida at 37 weeks presenting a cardiotocographic trace compatible with umbilical cord prolapse. Case Description: A 19-year-old primigravida presenting with elevated hypertension at 37 weeks gestation, not in labor, and was hospitalized to rule out preeclampsia. The initial Non-Stress Test (NST) revealed a baseline of 145 bpm, variability of 8, presence of variable decelerations, with the result of an active, reactive fetus showing clear signs of cord compression. The Stress Test (ST) revealed a baseline of 160 bpm, variability of 5, absence of accelerations and fetal movements, with 60% presence of variable decelerations, and a non-reactive, positive result for the stress test. She underwent an emergency cesarean section, delivering a newborn with an APGAR score of 7 at one minute and 9 at five minutes, weighing 2620 g, with clear amniotic fluid and a double-loop umbilical cord around the fetal neck. Conclusion: The findings of variable decelerations on fetal cardiotocography helped in diagnosing umbilical cord prolapse, allowing timely cesarean section and a newborn in good condition.