Revista colombiana de obstetricia y ginecologia最新文献

{"title":"Reflexiones desde la experiencia del Sistema General de Seguridad Social en Salud de Colombia: 1993-2026","authors":"Hernando Gaitán Duarte, Ximena Briceño, Carlos Fernando Grillo Ardila, Jorge Andres Rubio Romero","doi":"10.18597/rcog.4746","DOIUrl":"10.18597/rcog.4746","url":null,"abstract":"","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 2","pages":"e4746"},"PeriodicalIF":0.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myomatous erythrocytosis syndrome: Case report and literature review","authors":"Giovanni Enrique Riaño Castellanos, Bernarda Jinneth Acosta Forero, Laura Lorena Leuro Mosquera, Daniela Valentina Afanador Jaimes","doi":"10.18597/rcog.4653","DOIUrl":"10.18597/rcog.4653","url":null,"abstract":"<p><strong>Objective: </strong>To present a clinical case of Myomatous Erythrocytosis Syndrome (MES) and to review the literature regarding its diagnosis and treatment.</p><p><strong>Materials and methods: </strong>We describe the case of a 45-year-old woman who presented to a medium- complexity hospital with abnormal uterine bleeding. She was diagnosed with myomatosis and polycythemia. She underwent hysterectomy with resolution of erythrocytosis 42 days after surgery. A literature review was conducted through searches in the Medline, EMBASE, and LILACS databases using related MeSH and DeCS terms. Case reports and case series of women with MES were included, and information regarding diagnosis and treatment was collected from publications in English and Spanish from the last 20 years.</p><p><strong>Results: </strong>Twenty-nine titles were identified, of which 17 met the inclusion criteria, corresponding to 15 case reports and two case series that together described 20 patients with MES. The most frequent symptoms were progressive enlargement of the abdominal mass (85 %), pelvic pain (65 %), and abnormal uterine bleeding (35 %). Ultrasound was the most commonly used imaging technique, while molecular biology and hormone studies were infrequently performed. Hysterectomy was the most common treatment, with complete resolution of erythrocytosis in all cases with available follow-up. Few reports described complications associated with this condition.</p><p><strong>Conclusions: </strong>MES should be considered in the differential diagnosis of women with unexplained polycythemia and uterine leiomyomatosis. Hysterectomy constitutes the definitive treatment, leading to normalization of hematologic parameters. Further studies are needed to better understand its pathophysiology asses new therapeutic strategies and its complications.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 2","pages":"e4653"},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Hepatitis B, Hepatitis C, and HTLV-1 Using an Expanded Testing Panel Among Pregnant Women in Two Cities in Colombia, 2024-2025","authors":"Juan Pablo Rojas-Hernández, Mónica Alexandra Gil-Artunduaga, Nathalia Cortés, Herney Andrés García Perdomo, Ludy Vargas Torres","doi":"10.18597/rcog.4645","DOIUrl":"10.18597/rcog.4645","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human T-cell lymphotropic virus type 1 (HTLV-1) infection using an expanded panel among pregnant women in two Colombian cities, 2024-2025.</p><p><strong>Material and methods: </strong>A descriptive crosssectional study was conducted among pregnant women attending three primary care institutions in Cali and Buenaventura. Participants were selected through consecutive sampling. A total of 320 women were assessed for eligibility; 305 provided informed consent, completed a structured questionnaire, had complete samples, and were included in the final analysis. The panel included hepatitis B surface antigen, antibodies against hepatitis B surface antigen and total core antigen, antibodies against HCV with confirmation by viral RNA, and antibodies against HTLV-1 with confirmation by Western blot. A descriptive analysis was performed, and period prevalence estimates were calculated.</p><p><strong>Results: </strong>The median age was 26 years, and the median gestational age was 22 weeks. Five cases of HTLV-1 infection (1.6 %) and two cases of active HCV infection (0.7 %) were confirmed. For HBV, 214 women were susceptible (70.2 %), 84 had vaccine-induced immunity (27.5 %), 4 had resolved infection (1.3 %), 2 had reactivated chronic infection (0.7 %), and 1 had acute infection (0.3 %).</p><p><strong>Conclusion: </strong>The expanded panel allowed estimation of the prevalence of HBV, HCV, and HTLV-1. The high susceptibility to HBV highlights the need to strengthen vaccination status assessment and hepatitis B vaccination during prenatal care.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 2","pages":"e4645"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of self-medication among pregnant women attending a public hospital in Cartagena, Colombia, 2023–2024","authors":"Ana María Bello Trujillo, Nestor Lora Villamil, Melissa Iriarte Camargo, Gabriela Jinete Cervantes, Carlos Avellaneda Martinez, Diego Cabarcas Castilla, Rogelio Méndez Rodríguez","doi":"10.18597/rcog.4405","DOIUrl":"10.18597/rcog.4405","url":null,"abstract":"<p><strong>Objective: </strong>To describe the practice of selfmedication during the pregnancy among pregnant women attending Clínica Maternidad Rafael Calvo between June 2023 and February 2024.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted at Clínica Maternidad Rafael Calvo, Cartagena, Colombia. Pregnant women over 14 years of age who attended the clinic between June 2023 and February 2024 were included. A questionnaire was designed based on the Medication-Related Outcome Expectancies Scale for Self-Medicating and the survey developed by Mizan-Tepi University. Sociodemographic variables and the practice of self-medication during pregnancy were assessed, collecting information on the types of medications used, as well as knowledge and attitudes regarding medication use and selfmedication among pregnant women. A descriptive analysis was performed.</p><p><strong>Results: </strong>Of 356 women included, 258 (72.5%) reported practicing self-medication with modern medicines during the current pregnancy. The main reason given was prior experience with the drug (28.7%). The most frequent symptom leading to self-medication was headache, reported by 164 (63.3%) women, with acetaminophen being the most commonly used drug for its management (64.3%). 23.8% of the participants reported self-medicating with herbal remedies.</p><p><strong>Conclusions: </strong>It is necessary to identify selfmedication practices during prenatal care and inform patients about their associated risks. Population-based studies are needed to provide a more accurate estimate of the frequency of this practice in the country.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 2","pages":"e4405"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of Including p16/Ki-67 Dual Staining in the Detection of Cervical Lesions in Colombia, 2024","authors":"Andrés Álvarez, Simón Díaz, Rafael Alberto Niño, Yudely Asmith Medina, Andrea Chacón, Andrea Franco","doi":"10.18597/rcog.4510","DOIUrl":"10.18597/rcog.4510","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the cost-effectiveness of incorporating p16/Ki-67 dual-stain cytology into cervical cancer screening protocols compared to the standard diagnostic pathway in Colombia.</p><p><strong>Material and methods: </strong>A decision-tree model was developed from the healthcare provider perspective, using real-world data and scientific evidence. The primary outcome was the number of invasive procedures avoided. Deterministic and probabilistic sensitivity analyses were performed to address uncertainty.</p><p><strong>Results: </strong>Incorporating p16/Ki-67 dual-stain cytology proved to be a dominant strategy, significantly reducing unnecessary colposcopies and biopsies and generating cost savings (–COP $80 million for women aged 25 to 29 and –COP $54 million for women aged 30 to 65). Sensitivity analyses confirmed model robustness.</p><p><strong>Conclusions: </strong>The cost-effectiveness analysis suggests the advisability of incorporating the p16/Ki-67 dualstaining test into cervical cancer screening protocols, as it reduces unnecessary examinations and improves resource allocation. Studies are needed that evaluate the performance of screening tests in the local context and that incorporate morbidity and mortality outcomes to assess hard outcomes over a longer time horizon.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdisciplinary Approach to Endometriosis-Related Chronic Pelvic Pain in Colombia: A Consensus Statement for Patient-Centered Care","authors":"Juan Diego Villegas-Echeverri, Lilian Rubiano Paiva, Luis Fernando García Rodríguez, Jorge Darío López-Isanoa, José Fernando De Los Ríos Posada, Jerutsa Orjuela Monsalve, Carolina Meza Paul, Claudia Bastidas Guarín, Álvaro José Escobar Flórez, Angélica Cuello Salcedo, Hebert Quintero, Daniel Sanabria, Juan Carlos Ramírez Mejía, Lina Grajales Marulanda, María Alejandra Santacruz Mosquera, Jimmy Castañeda Castañeda","doi":"10.18597/rcog.4671","DOIUrl":"10.18597/rcog.4671","url":null,"abstract":"<p><strong>Objective: </strong>This consensus statement seeks to transform endometriosis care in Colombia by standardizing clinical management through the establishment of transdisciplinary teams and the use of quality indicators; strengthening education and awareness for both professionals and the community to reduce diagnostic delay; and promoting research and investment in public policies that guarantee equitable access and comprehensively improve the quality of life of patients.</p><p><strong>Methods: </strong>A transdisciplinary panel of experts in chronic pelvic pain and endometriosis was formed in Colombia. Participants included obstetrician-gynecologists, a physical therapist, and a nutritionist. The consensus was developed through a structured participatory process, sharing experiences, available scientific evidence, and international guidelines from the perspective of the Colombian context. The statements are presented according to the proposed objectives to achieve equitable and high-quality care for pelvic pain associated with endometriosis and to support women suffering from this condition.</p><p><strong>Results: </strong>The consensus consolidated seven strategic statements and principles for the care of this condition in Colombia:\u0000\u00001. Construction of transdisciplinary work teams.\u00002. Challenges to overcome in the creation of transdisciplinary teams for CPP associated with endometriosis.\u00003. Strategies to improve care for CPP associated with endometriosis.\u00004. Strategies for equitable access to management of CPP associated with endometriosis.\u00005. Strategies to reduce the stigma of menstrual pain and CPP associated with endometriosis.\u00006. Key guidelines for a National Guideline on CPP associated with endometriosis.\u00007. Monitoring and impact measurement strategies.</p><p><strong>Conclusions: </strong>Seven key areas are proposed, and initial proposals are developed for the comprehensive care of women with CPP associated with endometriosis. We invite all stakeholders in the healthcare system, from frontline professionals to national leaders, to join this effort so that these actions—promoting continuing education and research in Colombia on this condition and its consequences—are implemented.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of war on the health of women and girls","authors":"Ximena Briceño-Morales, Clara Briceño-Morales, Hernando Guillermo Gaitán Duarte","doi":"10.18597/rcog.4678","DOIUrl":"10.18597/rcog.4678","url":null,"abstract":"<p><p>Editorial.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to requests for birth plans in a sample of Colombian institutions between 2020 and 2023: A case series","authors":"Salomé Hinojosa Millán, Édgar Augusto Páez-Castellanos, Sonia Paola Barrios Galvis, Alejandra Fonseca Alzate","doi":"10.18597/rcog.4430","DOIUrl":"10.18597/rcog.4430","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the responses issued by a sample of Colombian healthcare institutions to birth plans submitted by pregnant women between 2020 and 2023, as well as the reasons provided for denying specific requests.</p><p><strong>Material and methods: </strong>A case series study was conducted. Pregnant women who had submitted a birth plan to the healthcare institution assigned by their insurer between June 1, 2020, and October 11, 2023, within Colombian territory, and who received a positive response from the receiving institution were included. Consecutive sampling was used. The characteristics of institutions that issued positive responses were assessed, along with the proportion of accepted requests within birth plans, according to local regulations.</p><p><strong>Results: </strong>Only 10% of the responses were personalized. Between 41% and 52% of the requests received no response, except for the request for companionship, which was denied in 9% of vaginal births and 31% of cesarean sections. Other procedures frequently denied included the availability of a Pilates ball and freedom of position during childbirth, which were refused in 31% and 36% of cases, respectively. Epidural analgesia was accepted in 41% of private institutions and 7% of public institutions. The reasons given for denying these requests included lack of infrastructure, risk of infection, and lack of trained personnel.</p><p><strong>Conclusions: </strong>Health regulatory and oversight bodies are required to monitor institutional compliance with pregnant women’s requests as expressed in birth plans during prenatal care. In addition, further quantitative and qualitative studies using appropriate study designs are needed to confirm these findings and to better assess the true magnitude of the problem, its underlying causes, determinants, and potential points of intervention.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating acid–base status and perfusion: arterial and venous blood gases during pregnancy","authors":"Daniel Molano Franco, Antonio Viruez-Soto, Yuliana Luna","doi":"10.18597/rcog.4357","DOIUrl":"10.18597/rcog.4357","url":null,"abstract":"<p><strong>Objective: </strong>Developing a conceptual framework that enables the interpretation of arterial and venous blood gases and perfusion parameters in pregnant women, integrating the physiological adaptations of pregnancy to support clinical decision-making.</p><p><strong>Materials and methods: </strong>Based on a hypothetical case that practically illustrates the topic, an explanatory document was developed and used to analyze the main physiological changes of pregnancy that affect the interpretation of arterial and venous blood gases, such as progesterone-induced hyperventilation, which causes compensated respiratory alkalosis. Furthermore, the study addressed maternal hemodynamic and perfusion adaptations, fetal oxygenation, and their clinical implications.</p><p><strong>Results: </strong>During pregnancy, a series of physiological changes occur that impact maternal and fetal homeostasis, leading to subsequent modifications in arterial and venous blood gases and perfusion parameters. Respiratory changes, such as increased oxygen consumption, minute ventilation and tidal volume, are responsible for the decrease in PaCO₂ levels, resulting in a compensated respiratory alkalosis and, secondarily, an increase in arterial pH. At the hemodynamic level, a progressive increase in cardiac output and a decrease in peripheral vascular resistance are observed, resulting in a highvolume, low-resistance circulation, characteristic of a hyperdynamic state. These aspects are key when providing care to critically ill obstetric patients.</p><p><strong>Conclusions: </strong>There are limitations in current knowledge regarding the interpretation of arterial blood gases as indicators of respiratory function and tissue perfusion in pregnant women, as well as regarding the interaction between maternal and fetal oxygenation and placental perfusion, particularly under conditions of critical stress or at high altitudes. At present, interpretation parameters derived from nonpregnant women should guide the management of pregnant women with serious complications. Further studies are required to better characterize the changes observed in critically ill pregnant women, in light of the physiological changes that accompany pregnancy, in order to allow a more accurate interpretation of arterial and venous blood gases as indicators of ventilation and tissue perfusion in the mother, the fetus, and the placenta.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway management in the obstetric patient: management strategy","authors":"Carlos Eduardo Laverde-Sabogal, Miguel Ángel Aguilar Schotborgh","doi":"10.18597/rcog.4361","DOIUrl":"10.18597/rcog.4361","url":null,"abstract":"<p><strong>Objective: </strong>To integrate the available evidence into a conceptual framework that supports decision-making on airway management in pregnant patients.</p><p><strong>Materials and methods: </strong>Using a hypothetical case to illustrate the problem, we developed an explanatory document based on a structured narrative review. It describes key aspects and a step-by-step approach to achieving airway control, culminating with three challenging theoretical scenarios.</p><p><strong>Results: </strong>Pregnancy induces anatomical and physiological changes that complicate airway management, including edema, laryngeal distortion, and increased bleeding risk. Diaphragmatic elevation, together with reduced functional residual capacity, favors atelectasis, rapid hypoxemia during apnea, and an increased risk of aspiration particularly after 30 weeks’ gestation.\u0000We propose a practical framework for evaluation, preparation, planning, and execution of obstetric airway management, integrating these principles across three theoretical scenarios.</p><p><strong>Conclusions: </strong>Airway management in obstetrics is challenging due to pregnancy-related changes that increase difficulty and complications, especially hypoxemia. Continuous training and a comprehensive, protocol-driven approach are essential to optimize maternal and neonatal outcomes.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"76 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}