Hepatic ruptura associated with severe preeclampsia and hellp syndrome attended at the regional hospital of Cajamarca 2017

Abstract

This is an observational, descriptive, retrospective study involving a systematic review of the clinical history of a case of hepatic rupture associated with severe preeclampsia managed at the Regional Hospital of Cajamarca, occurring on June 30, 2017. The study included personal, family, and pathological history, general and specific examination, diagnosis, auxiliary exams, obstetric management, complications including hepatic rupture, referral to the National Maternal Perinatal Institute, clinical evolution, and discharge. A review of the literature was also conducted on the case. Results: The clinical case presented involves a 32-year-old multigravida at 39 weeks of gestation who underwent a home vaginal delivery. During the immediate postpartum period, she developed postpartum hemorrhage and epigastric pain, leading to referral from the José Sabogal Health Center to the Regional Hospital of Cajamarca with a diagnosis of a 11-hour postpartum woman in hypovolemic shock. Laboratory results showed: hemoglobin 8.6 g%, platelets 184,000/mm³, TGO 564 UI/L, TGP 299 UI/L, coagulation time 8 seconds, bleeding time 4 minutes, and prothrombin time 21.3 seconds. Abdominal ultrasound revealed approximately 1500 cc of free peri-hepatic fluid. She underwent exploratory laparotomy and hepatic packing due to severe preeclampsia, HELLP syndrome, hepatic rupture, and massive hemoperitoneum. The intraoperative finding was a subcapsular hematoma involving nearly the entire right lobe and a rupture at segment VI of the liver. The patient received 7 units of packed red blood cells and 6 units of fresh frozen plasma after informed consent. On the second postoperative day, she experienced unfavorable progression and was referred to the National Maternal Perinatal Institute for continued high-complexity management in the ICU. The clinical evolution was favorable, and she was subsequently referred back to her original hospital for further care.

Esta indagación se ejecutó con el propósito identificar la relación entre conocimiento y prácticas sobre prevención de cáncer de mama en mujeres de edad fértil en la asociación JIREH, Lima 2023, por lo que estuvo encaminada bajo una metodología básica, cuantitativa, descriptivo-correlacional, diseño no experimental y corte transversal; donde se administraron dos instrumentos a 100 mujeres en edad fértil. Los hallazgos reflejaron que el 56% de mujeres tenían entre 25 y 45 años, el 98% tenían proveniencia rural, el 38% eran solteras, el 51% tenían secundaria completa y el 36% eran trabajadoras independientes; además, el 55% presentaron un grado medio de conocimiento y el 67% tuvieron prácticas preventivas de cáncer de mama regulares. También, se estableció que prevalece un vínculo entre conocimiento y las dimensiones de prácticas preventivas de cáncer de mama (p<0.05). En conclusión, existe relación positiva y alta entre conocimiento y prácticas sobre prevención de cáncer de mama en mujeres de edad fértil, con un valor p=0.000; Rho=0,819.