RESUMO
Chile has one of the highest cesarean rates in the World. Many factors contribute to increase its incidence. Medical literature shows us that even though there are differences in neonatal and maternal outcomes among patients that undergo cesarean or vaginal delivery; evidence, besides the contrast in costs, is not concluding. Disparities between the private sector and the National System of Health Services (SNSS) are unquestionable. The application of regulatory rules and the individualized registry of actions, as well as a system of medical auditory could help lower significantly the numbers of cesareans. The actual state of cesarean in the public sector and some private health institutions is shown. The elevated rate of cesareans does not assure good quality obstetric care. Private sector interventions could be causing unsuitable handling of this situation, which is why they should give detailed information of the factors implied in their obstetric care and perinatal outcomes obtained in order to evaluate the impact of their interventions.
Assuntos
Humanos , Feminino , Cesárea/efeitos adversos , Cesárea/estatística & dados numéricos , Cesárea/métodos , Chile/epidemiologia , Parto Obstétrico/estatística & dados numéricos , Procedimentos Cirúrgicos Obstétricos/estatística & dados numéricosRESUMO
El número de pacientes sometidos a cirugía bariátrica ha aumentado rápidamente en el mundo. Esta revisión pretende describir la literatura publicada relativa a las deficiencias nutricionales posteriores a la cirugía bariátrica y su importancia en el embarazo.
Assuntos
Feminino , Gravidez , Adulto , Humanos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/reabilitação , Estado Nutricional , Apoio Nutricional , Obesidade Mórbida/cirurgia , Obesidade Mórbida/complicações , Complicações Pós-Operatórias/dietoterapia , Cuidados Pós-Operatórios/métodos , Derivação Gástrica/métodos , Resultado da GravidezRESUMO
Se comentan los aspectos clínicos del tratamiento anticoagulante en la paciente embarazada.
Assuntos
Feminino , Gravidez , Adulto , Humanos , Anticoagulantes/administração & dosagem , Complicações Hematológicas na Gravidez/prevenção & controle , Anticoagulantes/uso terapêutico , Complicações Cardiovasculares na Gravidez/prevenção & controle , Heparina/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Trombofilia/prevenção & controle , Trombose/prevenção & controle , Varfarina/uso terapêuticoRESUMO
Antecedentes: La histerectomía es una intervención quirúrgica frecuente y de alto costo. Después de la operación cesárea, es el segundo procedimiento quirúrgico más frecuente en ginecología. Objetivos: Evaluar la relación costo/efectividad de la histerectomía vaginal versus la histerectomía abdominal. Método: Estudio retrospectivo observacional, en 2.338 pacientes sometidas a histerectomía por patología benigna en el Servicio de Ginecología del Hospital Clínico de la Universidad de Chile, en el período comprendido entre enero de 1997 a diciembre de 2005. Se analizaron variables clínicas y de costo entre las dos vías de abordaje. Resultados: La edad de las pacientes fluctuó entre 27 y 86 años. De las 2.338 histerectomías, la vía vaginal correspondió al 36,9 por ciento y la abdominal en el 63,1 por ciento; con una tasa de complicaciones de 29,8/100 mujeres operadas vaginalmente y de 42,8/100 mujeres operadas abdominalmente. Conclusión: Este estudio sugiere que el abordaje vaginal se asoció a tiempos operatorios más cortos, menor número de complicaciones y a costos más bajos que la vía abdominal.
Background: After cesarean delivery, hysterectomy it is the second most frequently performed major surgical procedure. Objective: To study de relation cost/effectivity between vaginal and abdominal hysterectomy. Method: Retrospective and observational study in 2338 hysterectomy, performed between January 1997 and December 2005. Clinical and cost variables were analysed between both surgical routes. Results: The study included 2338 patients aged 27 to 86 years in whom hysterectomy was performed for benign gynaecologic disorders. Of 2338 hysterectomies, 36.9 percent were performed vaginally and an abdominal approach was required in 63.1 percent. The overall complication rate was 29.8 per 100 women for vaginal hysterectomy and 42.8 per 100 women for abdominal hysterectomy. Conclusion: This study suggests that vaginal route presents some advantages in comparison to abdominal hysterectomy that include less expensive, fewer complications, shorter operating times and shorter stays.
Assuntos
Humanos , Feminino , Adulto , Histerectomia/economia , Histerectomia/métodos , Análise de Variância , Chile , Análise Custo-Benefício , Histerectomia Vaginal/economia , Histerectomia Vaginal/métodos , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de TempoRESUMO
Se reportan dos casos de quistes vaginales: se analiza el cuadro clínico y su dificultad diagnóstica.
We report two cases of vaginal cysts: clinical presentation and diagnostic difficulties are analysed.