Revista Colombiana de Obstetricia y Ginecologia最新文献

{"title":"Perinatal transmission of SARS-CoV-2: Need of study by possible congenital infection","authors":"Oscar Limay-Ríos, Carmen Dávila-Aliaga, Ricardo Álvarez-Carrasco, Marcos Espinola-Sánchez","doi":"10.18597/rcog.3545","DOIUrl":"10.18597/rcog.3545","url":null,"abstract":"","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195464","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":"[Safety and acceptability of the 52 mg levonorgestrel-releasing intrauterine system in women with abnormal uterine bleeding in an ambulatory care center in Bogotá, Colombia, 2012-2016].","authors":"Patricia Sandoval-Vivas","doi":"10.18597/rcog.3547","DOIUrl":"https://doi.org/10.18597/rcog.3547","url":null,"abstract":"<p><strong>Objective: </strong>To describe safety and acceptability with the use of the 52-mg levonorgestrel-releasing intrauterine system in women with abnormal uterine bleeding.</p><p><strong>Methods: </strong>Retrospective cohort of women 18 years of age and older diagnosed with abnormal uterine bleeding, ultrasound-reported uterine length between 6 and 10 cm and uniform endometrial cavity in its entire length, regardless of structural abnormality, who received treatment with 52-mg levonorgestrel-releasing intrauterine system between 2012 and 2016. Non-probabilistic convenience sampling was carried out. Sociodemographic and clinical baseline variables were measured, as well as patient perception of bleeding and the frequency of failure, amenorrhea, need for hysterectomy and adverse events, over a 12-month follow-up period. Descriptive statistics were applied.</p><p><strong>Results: </strong>Overall, 200 patients were assessed. A subjective perception of improvement in terms of bleeding volume and frequency of leave of absence or visits to the emergency department was found; 90 % of the patients had amenorrhea, and 6 % experienced adverse events.</p><p><strong>Conclusions: </strong>The 52-mg levonorgestrel-releasing intrauterine system is a safe option for the management of abnormal uterine bleeding in women with normal uterine size and no submucosal endometrial abnormalities. Local randomized studies are required to assess effectiveness and efficiency in comparison with other management options.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38309890","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":"Tribulaciones de la investigación en los tiempos de covid-19","authors":"Hernando Gaitán Duarte","doi":"10.18597/rcog.3621","DOIUrl":"https://doi.org/10.18597/rcog.3621","url":null,"abstract":"","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226316","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":"[Genital abnormalities: Contextualization of a neglected area in prenatal diagnosis].","authors":"Álvaro López Soto","doi":"10.18597/rcog.3446","DOIUrl":"https://doi.org/10.18597/rcog.3446","url":null,"abstract":"<p><strong>Objective: </strong>To reflect on how the area of genital abnormalities has fallen behind in prenatal diagnosis.</p><p><strong>Methods: </strong>Based on the thesis that prenatal diagnosis of genital abnormalities has scarcely developed, a comparison with other areas of prenatal diagnosis and with its postnatal counterpart is presented; different explanations for this situation are examined; and a reflection is presented on ways to expand this field of knowledge.</p><p><strong>Conclusions: </strong>Compared to other disciplines, prenatal diagnosis of genital abnormalities finds itself lagging behind in terms of diagnostic tools, management protocols and scientific literature. Potential causes include a perception of low prevalence and limited importance, or exploration challenges. Integration of current knowledge, together with the acquisition of the appropriate tools and translation to clinical medicine, would be a way to make this discipline stronger.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38653371","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":"Partial molar pregnancy with live fetus complicated by intrauterine growth restriction and severe preeclampsia. Case report and review of the literature","authors":"Andrés Mauricio Camacho-Montaño, Reinaldo Niño-Alba","doi":"10.18597/rcog.3461","DOIUrl":"10.18597/rcog.3461","url":null,"abstract":"<p><strong>Objective: </strong>To report the case of a partial molar pregnancy with live fetus and conduct a review of the literature regarding maternal and fetal complications associated to this condition.</p><p><strong>Methods: </strong>Case report of a partial mole with a 33 weeks live fetus complicated by intrauterine growth restriction, oligohydramnios and severe preeclampsia. We report satisfactory maternal and neonatal outcomes and 1-year follow-up. A search was conducted in the Medline via Pubmed, Lilacs, Ovid, Uptodate and Google Scholar databases using the following MESH terms: hiditadiform mole, partial mole, live fetus, coexisting live fetus. Case series and case reports of pregnant women with coexisting partial mole and live fetus at the time of diagnosis were selected and information regarding maternal and fetal prognosis was extracted.</p><p><strong>Results: </strong>Initially, 129 related titles were identified. Of these, 29 met the inclusion criteria, and 4 articles were excluded due to failed access to the full text. Overall, 31 reported cases were included; 9 ended in miscarriage, 8 in fetal demise or perinatal death, and 14 (45 %) resulted in a live neonate. The most frequent maternal complication was preeclampsia in 6 (19.35 %) cases.</p><p><strong>Conclusions: </strong>The coexistence of a partial mole with a live fetus poses a high risk of adverse perinatal outcomes and preeclampsia. The volume of information regarding this rare condition must be increased in order to better determine potential interventions in cases of euploid fetuses and to provide adequate counseling in clinical practice. Therefore, reporting these cases is important to build sufficient evidence about the natural course of this condition.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207035","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":"[Diagnostic accuracy of a hysteroscopic score for the detection of endometrial cancer in patients with postmenopausal bleeding and endometrial thickening].","authors":"César Augusto Rendón-Becerra,&nbsp;Alex Gómez-Bravo,&nbsp;Andrés Felipe Erazo-Narváez,&nbsp;Roberth Alirio Ortiz-Martínez","doi":"10.18597/rcog.3445","DOIUrl":"https://doi.org/10.18597/rcog.3445","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic accuracy of hysteroscopic scores in endometrial cancer.</p><p><strong>Methods: </strong>Diagnostic accuracy study assembled within a cross-sectional study that included patients with postmenopausal bleeding and endometrial thickening greater than 5 mm in whom hysteroscopy was performed and then compared with endometrial biopsy as the diagnostic gold standard, in two high complexity hospitals. Clinical, sociodemographic variables, as well as hysteroscopic scores and the results of endometrial tissue histopathology were measured. Sensitivity and specificity, likelihood ratios and area under the curve with their respective confidence intervals were estimated in the analysis.</p><p><strong>Results: </strong>With a 9 % prevalence of endometrial cancer, the hysteroscopic assessment system was shown to have 75 % sensitivity (95 % CI; 30.1- 95.43), 95,1 % specificity (95 % CI; 83.9-98.7), a positive likelihood ratio of 15.38 (95 %; CI 3.55- 66.56), a negative likelihood ratio of 0.26 and area under the curve of 85 %.</p><p><strong>Conclusions: </strong>The standardized hysteroscopic assessment system was found to have an acceptable sensitivity for screening in patients with postmenopausal bleeding and endometrial thickening (≥ 5 mm). Further studies with larger sample sizes are required in order to arrive at a more precise estimation of the operational characteristics of the hysteroscopic assessment system for the detection of endometrial cancer.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38309889","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":"[Safety of total laparoscopic hysterectomy in a high complexity Hospital in Pereira, Colombia, between 2007 and 2017. Cohort study].","authors":"Claudia Bastidas-Guarín,&nbsp;Claudia Patricia Zambrano-Moncayo,&nbsp;Jorge Darío López-Isanoa,&nbsp;José Duván López-Jaramillo,&nbsp;Ana Lucía Herrera-Betancourt,&nbsp;Angélica Cuello-Salcedo,&nbsp;Eliana Gutiérrez-Calderón,&nbsp;Danny Leandro Piedrahíta-Gutiérrez,&nbsp;Juan Diego Villegas-Echeverri","doi":"10.18597/rcog.3530","DOIUrl":"https://doi.org/10.18597/rcog.3530","url":null,"abstract":"<p><strong>Objective: </strong>To describe intra and postoperative complications of total laparoscopic hysterectomy (TLH) for benign uterine pathology and to compare with other hospitals with large volumes of laparoscopic hysterectomies.</p><p><strong>Methods: </strong>Retrospective cohort study of women who underwent TLH for benign gynecological pathology between 2007 and 2017 in a private high complexity institution that serves populations covered by contributive and state-subsidized insurance in Pereira, Colombia. The procedures were performed by the group of surgeons of the ALGIA training center. Consecutive sampling was used. Sociodemographic and baseline clinical characteristics, intra-operative findings and intra- and post-operative complications are described. Descriptive statistics were used.</p><p><strong>Results: </strong>A total of 1.350 patients were included during the study period. Surgical time was 95 minutes (SD ± 31), blood loss 88 cc (SD ± 66), and average uterine weight was 236 g (SD ± 133); 96.5% of the patients were assessed within the next 30 to 45 days; 3.48% had minor complications and 2.5% had major complications; 3 patients were converted to laparotomy. There were no deaths in the study sample.</p><p><strong>Conclusions: </strong>TLH is a safe procedure and the rate of complications is similar to the best international standards. Further prospective studies using objective criteria are important in order to compare the performance of different groups and institutions offering surgical procedures and training.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38309891","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 of lymph node involvement in patients with endometrial cancer, Colombia 2009-2016: Exploratory analysis of associated factors].","authors":"Robinson Segundo Fernández-Mercado,&nbsp;Mauricio Arturo Miranda-Mejía,&nbsp;Angélica Viviana Fletcher-Prieto,&nbsp;Jorge Alexander Rodríguez-Gallego,&nbsp;Edmundo Mora-Padilla,&nbsp;Simón Orostegui-Correa,&nbsp;Álvaro González-Rubio de la Hoz,&nbsp;Carlos Alberto Vallejo-Bertel,&nbsp;James Sáenz-Salazar,&nbsp;María Alejandra Fernández-Cásseres,&nbsp;Karen Cecilia Flórez-Lozano,&nbsp;Édgar Navarro-Lechuga","doi":"10.18597/rcog.3450","DOIUrl":"https://doi.org/10.18597/rcog.3450","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of lymph node involvement in patients with endometrial cancer and to explore factors associated with lymph node invasion.</p><p><strong>Methods: </strong>Prevalence study with exploratory analysis. The study included patients with endometrial cancer who underwent total abdominal hysterectomy plus bilateral salpyingooophorectomy and pelvic lymphadenectomy with or without para-aortic lymphadenectomy in seven oncology centers in Colombia between 2009 and 2016. Patients who had received prior radiotherapy or chemotherapy, with a histological diagnosis of neuroendocrine tumors, carcinosarcomas or synchronous or metachronous lesions were excluded. Non-probabilistic sampling. Sample size n=290. Measured variables: sociodemographic, clinical and histopathological, and pelvic or para-aortic lymph node involvement. The prevalence for the period is presented. The exploratory analysis was conducted using crude odds ratio (OR) and adjusted OR by means of a multivariate model (unconditional logistic regression).</p><p><strong>Results: </strong>Overall, 467 cases were retrieved. Of them, 163 were excluded because of non-availability of all the variables. In total, 304 patients were studied. The prevalence of lymph node involvement was 15.8 % (48/304). In the crude and adjusted analysis, factors associated with lymph node involvement were lymphovascular invasion (adjusted OR: 9.32; 95 % CI 4.27-21.15) and myometrial invasion (adjusted OR: 3.95; 95 % CI 1.29-14.98).</p><p><strong>Conclusions: </strong>Of the patients undergoing lymphadenectomy, 15 % have lymph node involvement. Less invasive diagnostic options than radical surgery to ascertain lymph node invasion should be assessed.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245005","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":"[Social considerations affecting acceptance of HPV vaccination in Colombia. A systematic review].","authors":"Francisco Palencia-Sánchez,&nbsp;Sandra Johanna Echeverry-Coral","doi":"10.18597/rcog.3448","DOIUrl":"https://doi.org/10.18597/rcog.3448","url":null,"abstract":"<p><strong>Objective: </strong>To identify social factors influencing the acceptance of human papilloma virus (HPV) vaccination in the Colombian population before and after the unexpected and poorly defined event of unknown etiology which occurred in 2014.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted in the following databases: Scopus, Web of Science, Medline via PubMed, Embase, Online Health Library (Biblioteca Virtual en Salud) and Ovid, and also in Google Scholar, academic repositories and in Colombian health institutions, using the terms \"recombinant tetravalent vaccine against Human Papilloma Virus types 6, 11, 16, 18\", \"Colombia\", \"Papilloma\" in order to primarily identify systematic reviews, quantitative and qualitative studies, narrative reviews, focusing on social aspects such as education, access, relationship with healthcare staff and role of the media which may have acted as barriers or facilitators for the acceptance of HPV vaccination in Colombia between 2006-2018. A narrative synthesis of the data was made.</p><p><strong>Results: </strong>Twenty-four documents were included. The importance attached by parents, adolescents, providers and the media to having greater knowledge about HPV and its association with cervical cancer was identified. The relevance of good communication among healthcare professions and the community to enable adequate sharing of information regarding the risks and benefits of the vaccines was recognized. The inclusion of the vaccine in health insurance plans made access easier. The media must be involved as facilitators in vaccination programs.</p><p><strong>Conclusions: </strong>Education regarding HPV, patient-centered healthcare and adequate media coverage influence the acceptance of HPV vaccination in the Colombian population. Close follow-up of any vaccine-related adverse events is required.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245007","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":"FROM EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES TO CLINICAL PROTOCOLS AND EVIDENCE SUMMARIES.","authors":"Hernando Gaitán-Duarte","doi":"10.18597/rcog.3579","DOIUrl":"https://doi.org/10.18597/rcog.3579","url":null,"abstract":"One of the most common problems in hospital care is variability in clinical practice, which has been defined as “inequality in the use of health resources between different geographic areas or healthcare levels, in circumstances in which adaptation of the knowledge and resources of the system should primarily be aimed at meeting individual patient needs” (1). Obstetrics and gynecology as a field of practice has not been immune to this issue. In 2015, for example, removal of ovaries at the time of hysterectomy for benign uterine disease ranged between 50% in the United States, 30% in Australia and 12% in Germany (2). As for cesarean section, Latin America has one of the highest frequencies, with 40% of all deliveries, followed by North America with 30%, Europe with 25%, Asia with 19% and Africa with 7% (3). It is not self-evident that this wide variation in the frequency with which this surgery is performed is due to varying patient needs, but rather to different styles in the practice of medicine. The problem occurs when this variability is associated with poor health outcomes for the population in the form of an increase in adverse events, and unwarranted higher costs, or when it is the result of health inequalities among populations (1). One example of poor results is the association which has been described between elective cesarean delivery and the increase in neonatal respiratory distress syndrome in gestations under 38 weeks and 6 days (4). Therefore, variability in obstetric practice is reflected in higher costs for healthcare services due to increased delivery costs and management of neonatal respiratory distress. As pertains to prophylactic FROM EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES TO CLINICAL PROTOCOLS AND EVIDENCE SUMMARIES","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245006","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}