ABSTRACT
OBJECTIVE: To analyze the clinical situations that leads us to carry out curettage after cesarean section, the ultrasound prior surgery, intraoperative, and pathological findings. METHODS: A retrospective study of all cases of postpartum curettage after cesarean section in a level 3 maternity unit. RESULTS: There were 42 curettages to women with cesarean sections (1.6% of all cesarean sections). The indications for curettage were: fever: 21, methrorraghia: 11, and residual trophoblastic tissue: 10. In the previous ultrasound, all indicated curettages for retained trophoblastic tissue showed it, and in a lower proportion those indicated for fever (66.6%) or methrorraghia (22.2%). A total of fourteen curettages (35%) were performed without suspect image of retained tissue, and in all cases the surgeon described to obtain small amount of tissue. From material submitted to pathologic evaluation trophoblastic tissue was found in 64.7%, and there were no differences as curettage indication. CONCLUSIONS: When the previous ultrasound do not showed retained tissue, the surgeon did not remove retained material. When extracted there were always in small amounts. Therefore, it could be concluded that after cesarean section the curettage should be indicated only in the presence of evident ultrasound image of retained products.
Subject(s)
Cesarean Section/methods , Curettage/methods , Puerperal Disorders/surgery , Cesarean Section/adverse effects , Endometritis/etiology , Endometritis/surgery , Female , Humans , Placenta, Retained/diagnosis , Placenta, Retained/etiology , Placenta, Retained/surgery , Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/surgery , Postpartum Period , Pregnancy , Puerperal Disorders/etiology , Retrospective StudiesABSTRACT
El caso que se presenta es el de una mujer joven, cuyo diagnóstico de diabetes monogénica por mutación del gen de la glucocinasa, en el tercer embarazo, planteó un cambio en la actitud terapéutica respecto a susgestaciones previas. Se hace, asimismo, un breve repaso de la literatura sobre las implicaciones obstétricas de las pacientes gestantes condiabetes mellitus MODY 2 (AU)
We report the case of a young woman who was diagnosed with monogenic diabetes caused by a glucokinase gene mutation during the third trimester of pregnancy,r equiring a change in treatment plan in comparison with her previous pregnancies. We also discuss the implications for obstetric management in patients with maturity onset diabetes of the young, type2 (MODY-2) (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Diabetes, Gestational/metabolism , Diabetes Mellitus, Type 2/genetics , Polymerase Chain Reaction , MutationABSTRACT
We report the case of a young woman who was diagnosed with monogenic diabetes caused by a glucokinase gene mutation during the third trimester of pregnancy, requiring a change in treatment plan in comparison with her previous pregnancies. We also discuss the implications for obstetric management in patients with maturity onset diabetes of the young, type 2 (MODY-2).
