Revista colombiana de obstetricia y ginecologia最新文献

{"title":"How to best address the challenges of mental health in medical education?","authors":"Jorge Andrés Rubio-Romero, Hernando Gaitán-Duarte","doi":"10.18597/rcog.4332","DOIUrl":"10.18597/rcog.4332","url":null,"abstract":"<p><p>Editorial.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524022","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":"Letter to the Editor regarding \"Recurrent voluntary termination of pregnancy. Prevalence study and exploration of associated factors. Antioquia, Colombia, 2015 – 2021\"","authors":"Ariana Uceda Molina, Andrea Pari Roque","doi":"10.18597/rcog.4274","DOIUrl":"10.18597/rcog.4274","url":null,"abstract":"","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635587","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":"Colombian consensus for the diagnosis, prevention, and management of Rhesus disease","authors":"Jesús Andrés Benavides-Serralde, Marcela Buitrago-Leal, Saulo Molina Giraldo, Juan Pablo Benavides Calvache, Isabella Rivera Tobar, Melva Juliana López Rodríguez, Jezid Miranda, Catalina Valencia","doi":"10.18597/rcog.4142","DOIUrl":"10.18597/rcog.4142","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To train healthcare professionals involved in the care of Rh-D negative pregnant women, with the aim of standardizing the management of Rh isoimmunization prevention, timely antenatal diagnosis of Rh disease, fetal assessment, and treatment of fetuses with Rh disease, in order to prevent adverse perinatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A group of 23 expert panelists participated in the development of the consensus through three rounds, answering a questionnaire consisting of 8 domains and 22 questions. A modified Delphi method was used until the consensus threshold among participants was reached, defined as 80% or greater agreement in responses. In the third round of the expert panel, a twenty-third question emerged, which was answered by one of the thematic leaders. The eight domains of antenatal management for Rh-D negative pregnant women were: 1) Rh-D determination, 2) initial prenatal care for Rh-D negative patients, 3) titration and periodicity of the indirect Coombs test, 4) sensitizing events, 5) administration of anti-D immunoglobulin (IgG), 6) Doppler velocimetry of the middle cerebral artery (MCA), 7) antenatal management of isoimmunized patients and anemic fetuses, and 8) timing for pregnancy termination based on different clinical scenarios. Based on these responses, and a review of international clinical practice guidelines, consensus statements were formulated, including recommendations, their justification, and adaptation to the local context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The following recommendations were issued:\u0000\u0000It is suggested that Rh-D negative women of childbearing age attend a preconception consultation.\u0000It is recommended to determine maternal Rh-D status at the first contact with health services, either during the preconception consultation or at the first prenatal check-up.\u0000For Rh-D negative patients, it is recommended to determine the Rh-D status of the child's father during prenatal care as early as possible, preferably before the 28th week of gestation.\u0000For Rh-D negative primigravidas, where the father is Rh-D positive, it is suggested to: a) determine and quantify Rh-D antibodies (indirect Coombs test) during the first consultation and then quarterly, b) expand the obstetric history, with an emphasis on identifying sensitizing events, and c) provide parental counseling regarding potential risks, the need for additional tests, and the possibility of immunization during pregnancy.\u0000During prenatal care for Rh-D negative multiparous patients with previous Rh-D positive offspring, the initial approach should include: a) determining and titrating Rh-D antibodies (indirect Coombs test); b) expanding the obstetric history, focusing on sensitizing events; and c) providing parental counseling about potential risks and additional tests.\u0000After a sensitizing event, it is recommended to administer anti-D IgG within the first 72 hours at a dose of 1500 IU (300 μg). If not fea","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635582","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":"Economic analysis of the use of the Flt-1/PlGF preeclampsia ratio compared to the standard of care in Uruguay","authors":"Gonzalo Guiñazú, Giselle Tomasso, Gerardo Vitureira, Grazzia Rey, Verónica Fiol, Leonardo Sosa, Osvaldo Ulises Garay","doi":"10.18597/rcog.4148","DOIUrl":"10.18597/rcog.4148","url":null,"abstract":"<p><strong>Objectives: </strong>Preeclampsia (PE) is a pregnancyrelated hypertensive disorder that can lead to severe complications and adverse maternal and fetal outcomes. This study aimed to estimate the economic impact of integrating the sFlt-1/PlGF ratio into Uruguay's healthcare system as part of routine clinical practice for diagnosing.</p><p><strong>Material and methods: </strong>A decision tree model was used to estimate the annual economic impact on the Uruguayan healthcare system for a hypothetical cohort of women with suspected PE. This included relevant costs associated with diagnosis, monitoring, and treatment from the initial presentation of suspected PE until childbirth. The study analyzed the annual costs under two scenarios: the standard of care and a scenario incorporating the sFlt-1/PlGF ratio for PE, using 2022 as the reference year. Various deterministic and probabilistic sensitivity analyses were performed.</p><p><strong>Results: </strong>The economic model estimated that the implementation of the sFlt-1/PlGF ratio could save the Uruguayan healthcare system $95,432,678 Uruguayan pesos (2,320,269 United States Dollars [USD]) annually, representing a 5 % reduction in costs compared with the standard of care. These savings were primarily due to a reduction in hospitalizations of women with suspected PE. The estimated economic impact equated to an annual net saving of approximately $10,602 Uruguayan pesos (258 USD) per patient.</p><p><strong>Conclusions: </strong>The introduction of the sFlt-1/PlGF ratio into the Uruguayan healthcare system is likely to generate savings due to the optimization of the management of hospitalizations for women with suspected preeclampsia (PE). However, the potential for savings will primarily depend on the current hospitalization rate of these women (the efficiency of managing high-risk PE pregnancies) and the length of stay for hospitalized women.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635584","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":"Reply to the letter to the Editor about \"Recurrent voluntary termination of pregnancy. Prevalence study and exploration of associated factors. Antioquia, Colombia, 2015-2021\"","authors":"Freddy Andrés Barrios-Arroyave, Laura Andrea González-Pérez","doi":"10.18597/rcog.4314","DOIUrl":"https://doi.org/10.18597/rcog.4314","url":null,"abstract":"<p><p>Reply to the letter to the Editor</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, characterization, and risk factors of gestational anemia in Quindío, Colombia, 2018-2023","authors":"Franklin José Espitia De La Hoz, Lilian Orozco Santiago","doi":"10.18597/rcog.4202","DOIUrl":"10.18597/rcog.4202","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the prevalence and characterize gestational anemia in women attending prenatal care in the department of Quindío, Colombia, and to identify associated risk factors.</p><p><strong>Material and methods: </strong>An analytical crosssectional study was conducted. Out of 1,003 pregnant women, 307 were selected. The study included pregnant women aged 18 years or older who attended a prenatal care program at three high-complexity private institutions in Armenia (Quindío, Colombia) from 2018 to 2023, providing a five-year observation window. Pregnant women with a diagnosis of fetal malformations and hemolytic disease, those who changed healthcare centers, or moved out of Quindío were excluded.</p><p><strong>Results: </strong>The mean age of the participants was 28.14 ± 5.27 years. The prevalence of gestational anemia was identified as 26.38 %, with an average hemoglobin level of 9.82 ± 1.74 g/dL. Of these, 12.37 % had hemoglobin levels of 10.1-10.9 g/dL (mild anemia), 8.46 % had levels of 7.1-10.0 g/dL (moderate anemia), and 5.53 % had levels below 7.0 g/dL (severe anemia). In the third trimester, the prevalence of anemia increased to 41.97 % (n = 34/81), with 91.35 % (n = 74/81) of cases being iron-deficiency anemia. A BMI of < 18.5 (OR: 15.46; 95 % CI: 7.13-28.59), multiple pregnancy (OR: 9.73; 95 % CI: 1.49-26.83), and a history of pregestational anemia (OR: 7.43; 95 % CI: 4.52-9.13) were associated with gestational anemia.</p><p><strong>Conclusions: </strong>The prevalence of gestational anemia is over 25 % and increases in the third trimester. It is important to identify risk factors during preconception evaluation and prenatal care.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635593","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":"Meaning of the experience of breast cancer patients in a university clinic in Bogotá, Colombia: A qualitative study","authors":"Jhonatan Daniel Olivero Luna, María Claudia Ramírez Flórez, Nicolás Rozo Agudelo, Juliana Vanessa Rincón López, John Alexander Castro Muñoz, María Fernanda Luna","doi":"10.18597/rcog.4167","DOIUrl":"10.18597/rcog.4167","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the meaning of the experiences of breast cancer patients undergoing diagnostic and treatment processes.</p><p><strong>Material and methods: </strong>A descriptive qualitative study based on the hermeneutic-interpretative scientific paradigm and grounded in a phenomenological epistemological framework. The study included women aged 18 years or older diagnosed with breast cancer and treated at a university clinic in Bogotá, who were given a semi-structured interview. Procedure: Semi-structured interviews were conducted based on pre-established categories. Aspects evaluated: Knowledge about current breast cancer screening and detection patterns, current utilization patterns of healthcare services, and perceived healthcare needs.</p><p><strong>Results: </strong>Regarding Current knowledge patterns on breast cancer screening and detection, patients demonstrated limited awareness. Concerning Current utilization patterns of healthcare services, there were noted dissatisfactions with the administrative process. Regarding Perceived healthcare needs, a feeling of abandonment was identified, stemming from a lack of continuity in the care process. Additionally, two emergent categories were identified: trust in the healthcare system and predisposition to feelings of guilt due to a lack of knowledge about the disease.</p><p><strong>Conclusions: </strong>A comprehensive care process is needed that addresses the real medical needs of patients, beyond administrative concerns, and is focused on the quality of the doctor-patient relationship across the entire multidisciplinary team.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524029","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 unexpected malignant disease in the histopathology of hysterectomy indicated for benign condition","authors":"Isabela Sanchez Mayorca, Angela María Gómez Forero, Roberto Gallo Roa, Camilo Alberto Garzón Sarmiento","doi":"10.18597/rcog.4174","DOIUrl":"10.18597/rcog.4174","url":null,"abstract":"<p><strong>Objective: </strong>To describe the prevalence of incidental malignant pathology following a hysterectomy performed for benign reasons.</p><p><strong>Method: </strong>A descriptive cross-sectional study based on hospital records. Women who underwent hysterectomy for benign reasons at a general referral hospital between 2013 and 2021 were included. Women with obstetric hysterectomy were excluded. Measured variables: age, route of hysterectomy, type of hysterectomy, histopathological diagnosis of premalignant lesion or invasive cancer, type of cancer. Analysis: Descriptive, the prevalence of preneoplastic and neoplastic conditions was estimated for the overall period.</p><p><strong>Results: </strong>Of 816 clinical records, 674 cases (87 %) met the inclusion criteria and were analyzed. The premenopausal population predominated. Twentysix cases of unexpected malignant disease were identified, yielding a prevalence of 3.8 %, and 13 cases of premalignant pathology (1.9 %). The most common origin was the cervix (40 %), followed by the ovary (33 %).</p><p><strong>Conclusions: </strong>Patients undergoing hysterectomy for benign conditions should be informed about the risk of unexpected injury. The importance of performing, in our context an adequate preoperative approach to rule out cervix uteri and ovarian cancer is emphasized. Follow-up studies of patients with unanticipated cancer are required to determine their treatment and prognosis in the region.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524026","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":"Gastric signet ring cell adenocarcinoma metastatic to the breast. Systematic review of the literature, regarding a case","authors":"José Ismael Guío-Ávila, Adriana Yulieth Soler-Perilla, Ximena Briceño-Morales, Clara Briceño-Morales","doi":"10.18597/rcog.4187","DOIUrl":"10.18597/rcog.4187","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the general state of scientific evidence published in the last 20 years on gastric signet ring cell (SRC) adenocarcinoma metastatic to the breast, and present a case.</p><p><strong>Material and methods: </strong>The case of a patient who attended a high-complexity reference institution in Bogotá for a breast metastasis from a gastric SRC adenocarcinoma is reported. A Systematic Review of the literature was carried out, including cohort studies, reports and case series of patients with gastric SRC adenocarcinoma metastatic to the breast, which will present information on the epidemiology, clinical, radiological and histopathological characteristics, and the treatment and prognostic of this disease.</p><p><strong>Results: </strong>There were identified 363 references, twenty-six of which met the eligibility criteria. Gastric SRC adenocarcinoma metastatic to the breast predominated in the Asian continent (75.9%). The mean age at presentation was 42.5 years. In 62% (n=18) of cases this condition manifested clinically as a breast mass. From a radiological point of view, the majority of breast lesions presented as one or several nodules with suspicious characteristics (55.2%; n=16). In the biopsy of breast lesions, positivity for cytokeratin 7 and cytokeratin 20 occurred in 41.4% (n=12) and 37.9% (n=11) of cases, respectively. Only nine patients (31%) underwent any type of breast surgery. There is a lack of information on the treatment and prognosis of gastric SRC adenocarcinoma metastatic to the breast.</p><p><strong>Conclusions: </strong>The frequency of cases of gastric SRC adenocarcinoma metastatic to the breast published in the last 20 years is low. The general practitioner and the gynecologist could be the first medical professionals to face this rare condition, so knowing it and suspecting it is essential, especially if we take into account that the median overall survival of these patients is low.</p>","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524023","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":"Treatment of ectopic pregnancy implanted in cesarean scar: other therapeutic approaches","authors":"Jorge Andrés Castrillón-Lozano, Mariean Kamila Caraballo-Martínez","doi":"10.18597/rcog.4186","DOIUrl":"10.18597/rcog.4186","url":null,"abstract":"","PeriodicalId":101422,"journal":{"name":"Revista colombiana de obstetricia y ginecologia","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524030","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}