Journal of the Central American Federation of Obstetrics and Gynecology
Journal of the Federation of Societies of Gynecology and Obstetrics - eISSN 2710-7604, Print 0428-0911 The FECASOG journal publishes original articles related to any area of knowledge relevant to gynecology and/or obstetrics. Publications may include unpublished research of interest, revisions of topics and descriptions of cases/series of cases that, at the discretion of the editorial committee and after undergoing a rigorous peer review, deserve to be known by the Central American and world scientific community. The journal accepts articles that have not been published in any other journal or digital media available online and written in Spanish, as it is the predominant language among the member countries of the federation. From this point we take the first steps required to opt to be cited in the future in one of the main quality indexes (Scimago, Scopus, among others).
Derechos autoriales y de reproducibilidad. La Revista RevCog es un ente académico, sin fines de lucro, que forma parte de la Sociedad Centroamericana de Ginecología y Obstetricia. Sus publicaciones son de tipo ACCESO GRATUITO y PERMANENTE de su contenido para uso individual y académico, sin restricción. Los derechos autoriales de cada artículo son retenidos por sus autores. Al Publicar en la Revista, el autor otorga Licencia permanente, exclusiva, e irrevocable a la Sociedad para la edición del manuscrito, y otorga a la empresa editorial, Infomedic International Licencia de uso de distribución, indexación y comercial exclusiva, permanente e irrevocable de su contenido y para la generación de productos y servicios derivados del mismo.
During the busy Radiological Society of North America (RSNA) conference in 1999, Dr. Peter L. Choyke noticed a peculiar detail. While examining a poster about a new magnetic resonance imaging technique for renal tumors, he noticed a bright, consistent “spot” on the patients' kidneys that was neither a blood vessel nor a tumor, and which the presenter of the study considered irrelevant.
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Traditional uses and scientific evidence of Cinnamomum verum in gynecology and obstetrics: a literature review
Introduction: Cinnamomum verum (cinnamon) has traditionally been used in the management of gynecological and obstetric conditions, although the scientific evidence supporting its use requires systematization. This review integrates ethnopharmacological knowledge and clinical findings to evaluate its efficacy and safety. Methods: A systematic search (2000-2023) was conducted in PubMed, SciELO, and LILACS using DeCS/MeSH terms. Thirty-two studies (9 RCTs, 15 preclinical, 8 ethnographic) were included, and methodological quality was evaluated using PRISMA and GRADE tools. Results: The evidence suggests benefits in dysmenorrhea 3 RCTs demonstrated pain reduction (RR: 0.68 95% CI: 0.52-0.89) Postpartum healing: Significant improvement in perineal pain (RCT, p <0.05) Pregnancy: Tocolytic effect in murine models (↓ uterine contractions by 42%), but no RCTs in humans. Traditional uses (labor induction, lactation) lack robust support. Safety is confirmed at doses <4 g/day, except for C. cassia (anticoagulant risk). Conclusion: C. verum shows validated therapeutic potential for dysmenorrhea and postpartum recovery, but its use in obstetrics requires further research. A safe dosage framework and prioritization of RCTs for clinical applications are proposed.
Influence of metabolic dysregulation on the progression of diabetic retinopathy during pregnancy
BACKGROUND. It is estimated that more than 530,000,000 people suffer from diabetes globally. In Mexico, it represents the second cause of death, with a prevalence close to 17%, representing approximately 14,600,000 people. The lack of control of diabetes in pregnancy has consequences at different organic and functional levels, causing alterations at the level of the micro and macrovasculature, at the ocular level could cause uveitis, glaucoma and diabetic retinopathy, with a strong association with the development of macular edema and cataracts. MATERIALS AND METHODS. Search the Medline database via PubMed using terms: "diabetic retinopathy", "mellitus diabetes", and "ophthalmological diseases". The search was limited to: "Case Reports", "Review", "Systematic Reviews", and "Books and Documents", "Spanish and English", editorials, reviews, duplicate articles were excluded, and 33 studies were selected that included pregnant diabetic women with the development of diabetic retinopathy, and other different ophthalmological complications. CONCLUSIONS. The hyperglycemic state is the major determinant for a more severe and rapid progression of DR. Although pregnancy itself is a state that causes alterations at the ophthalmological level, these are not severe, and generally return to normal in the puerperium, however, pregestational diabetes is one of the main causes of progression of diabetic retinopathy. Predisposing an important cause of presbyopia and blindness in early adulthood, hence the importance of achieving an optimal state of preconceptional health, or failing that, achieving an acceptable metabolic state during pregnancy.
Ectopic pregnancy in a previous cesarean section scar
A 24-year-old female patient G4P2C1 presents with a history of transvaginal bleeding and amenorrhea for 5 weeks. Physical examination showed no findings of interest. Vaginal ultrasound was performed, showing 5 weeks gestation, with embryo with heart rate present, located in the anterior uterine wall, in relation to previous cesarean scar. Based on the COS (Crossover sign) classification it is determined to be a COS-1. In addition, with intramural myoma of 9 cm in the anterior uterine wall and adjacent to the ectopic pregnancy. Patient with satisfied parity and unplanned pregnancy. Risks were explained and it was decided to perform a total abdominal hysterectomy. Image corresponding to the transoperative finding that confirms the established diagnosis.
Prenatal diagnosis of congenital autoimmune heart block: a case report
Complete fetal heart block is a rare type of arrhythmia characterized by a decrease in the fetal heart rate outside the accepted range of 110 to 160 beats per minute; It can usually lead to fetal hemodynamic decompensation, hydrops and death. The case of a fetus with a prenatal diagnosis of autoimmune fetal heart block is presented, which allowed planning the neonatal birth with a comprehensive multidisciplinary team. Due to the rarity of prenatal diagnosis of this entity, the most representative case and clinical findings are described.
Obstetric Complications During the Peripartum Period by Age Groups. A Case-Control Study
Background: Pregnancies at the extremes of reproductive age increase the risk of maternal and perinatal morbidity and mortality. Objective: To determine peripartum obstetric complications according to age groups in the Hospital Materno Infantil (January 2019-2024). Materials and methods: Case-control study with patients <19 and >35 years (cases) and 25-29 years (controls). Proportions, odds ratio (OR) and 95% confidence interval (95%CI) were estimated. Results: 208 cases and 208 controls were evaluated. Mean age: 16.0 (<19 years), 39.0 (>35 years) and 27.0 (controls). The main complications were Urinary tract infection in 26.4% in cases vs. 17.8% in controls (P=0.033), low birth weight in 38.9% in cases vs. 29.8% in controls (P=0.049), perineal tears 26.0% in cases vs. 15.4% in controls (P=0.007), postpartum hemorrhage in 13 .0% in cases vs. 7.2% in controls (P=0.037). Conclusions: Complications associated with reproductive age included perineal tears, urinary tract infection, low birth weight, and postpartum hemorrhage.
Usefulness of fetal liver length measurement for the prediction of gestational age
Objective: To evaluate the usefulness of fetal liver length measurement for the prediction of gestational age. Methodology: Longitudinal and prospective study between January 2016 and July 2024 in women with low-risk singleton pregnancies, between 14 and 40 weeks of gestation, who attended prenatal consultation at the Central Hospital “Dr. Urquinaona,” Maracaibo. Biparietal diameter, abdominal circumference, femur length, and fetal liver length were measured. Results: Data from 215 healthy pregnant women were selected for the final analysis. When analyzing the correlation between fetal liver length and gestational age by date of last menstrual period and the rest of the ultrasound variables used, strong, positive, and significant correlations were found (p < 0.0001). The value of the coefficient of determination of the gestational age model predicted by the measurement was 0.892. When combining the four ultrasound parameters studied, the resulting value of the coefficient of determination was 0.944. Conclusion: The measurement of fetal liver length constitutes a valuable and complementary tool in the prediction of gestational age. Moreover, its use in combination with other ultrasound parameters has a high coefficient of determination for the prediction of gestational age.
Knowledge, attitudes, and practices regarding humanized childbirth and delivery in two national hospitals of Honduras. Cross-sectional, descriptive study
Background: Humanized childbirth prioritizes the physical and emotional needs of the mother, with minimal medical interventions. FIGO and WHO seek to adapt obstetric practices respecting female autonomy but unnecessary interventions that negatively affect the birthing experience. Objectiv: To identify the level of knowledge, attitudes and practices on humanized childbirth in order to sensitize the labor and delivery room staff of two national hospitals. Methods: Cross-sectional, descriptive study with a sample of 160 physicians. Measures of central tendency, dispersion, frequencies and percentages were used to analyze the results. Results: Age ranged from 25.2 to 42 years. Women predominated in all groups. Knowledge of humanized childbirth was high, with 100% of specialists and 94.3% of general practitioners familiar with its benefits. Most valued privacy and respect for maternal decisions, although almost half of the interns and general practitioners were aware of specific protocols. Positive attitudes towards recommended practices were widespread, especially among general practitioners. Conclusions/recommendations: The study revealed a high level of knowledge about humanized childbirth among health professionals, especially among specialists, with positive attitudes toward recommended practices.
One of the pillars of the scientific method, the recognized methodology for obtaining new knowledge from observation, experimentation and analysis of the information gathered, is replicability. If a study reaches a conclusion, the scientific community has the obligation to verify the data, since making decisions, particularly those that could affect people's health, cannot be based on the data from a single trial. The statistical significance of scientific studies depends on probabilities and, as such, the first study conducted on a topic can reach the wrong conclusion by chance, no matter how well designed. This is without taking into account other issues, which fall more into the realm of research fraud and which I prefer not to consider at this time. Since 2010, a worrying trend began to be noticed, which received the name of "replication crisis" and which applies to a methodological problem where the results of many scientific studies fail to be replicated. This only generates suspicion in scientific knowledge and forces to retake old studies, considered reliable, and to repeat them, either to determine if the original conclusions survive the test of time and, if not, the reason behind the failure. It is not the only problem that researchers must face, but it is one of the most pressing, as it lies at the heart of evidence-based medicine. If the evidence starts to be called into question and the evidence increases the weight of uncertainty, the heart of scientific knowledge will start to crack and that would be catastrophic, more so in a world where lying and deceiving, with today's technological advances, is extremely easy. What to do? Fight doubt with the certainty of a well-done research. Make sure to write a solid methodology, to follow all the guidelines of the ethics committees involved in the approval of the study, to collect the data under the umbrella of the strictest ethical criteria, always prioritizing patient safety, reporting the data as objectively as possible and analyzing the results, not chasing a "p" for statistical significance, but whatever the numbers report. And, above all, do not be discouraged because the results are negative or because someone else did the same study. This should not be a reason for abandonment, but rather a reinforcement of interest in research. Replicability is crucial to give certainty to what we investigate. Not prestige or academic value. The truth.
Benefits of hormonal replacement therapy – Tibolone in postmenopausic healthy women
Tibolone is effective in postmenopausal women for relieving vasomotor symptoms, improving mood, and preventing bone loss. Safe use requires personalized strategies, including vascular risk stratification and standardized gynecological monitoring (endometrial and mammographic). These measures enhance safety, adherence, and a personalized medicine approach, optimizing tibolone’s therapeutic benefits.
Challenges and Opportunities in the Eradication of HPV: Education, Immunization, and Early Diagnosis
Human papillomavirus (HPV) remains a major global public health challenge, especially because of its association with cervical cancer. Although HPV vaccination has been shown to be highly effective in reducing the incidence of persistent infections and precursor cancerous lesions, eradication of the virus continues to face significant obstacles. The combination of educational strategies, increased vaccination coverage and early diagnosis is essential to reverse this scenario. These obstacles, such as limited educational level, low knowledge of the human papillomavirus and difficulties associated with work schedules, increased the likelihood of not attending to receive the test report. The likelihood that a patient will come for her Pap test report increases significantly when she is knowledgeable about cervical cancer and has heard about its causative agent, human papillomavirus (HPV).
Anaplastic astrocytoma during pregnancy: A case report
This case report describes the diagnosis and management of a 29-year-old woman who at 21 weeks pregnant presented to the emergency department with a headache, vertigo and dysarthria. A suspected low-grade astrocytoma vs oligodendroglioma was diagnosed with the initial MRI. The patient was able to continue pregnancy until term with expectant management without worsening of the neurological symptoms. A healthy female baby was delivered via c-section. During puerperium, the patient presented with seizures which ultimately led to institutional neuronavigation-guided resection of the lesion with a histological diagnosis of an anaplastic astrocytoma. To this date, the patient continues oncological treatment no additional surgical interventions were required. Due to low incidence of primary brain tumors in association to pregnancy, there are no generalized or unified guidelines for the diagnosis, management and treatment of such disease. A multidisciplinary approach may aid physicians achieve a targeted and effective treatment during pregnancy to improve obstetric and fetal outcomes.
Results with the Tension-Free Vaginal Tape (TVT) technique and other pelvic floor surgical procedures in the treatment of stress urinary incontinence
BACKGROUND: Stress urinary incontinence is defined as the involuntary loss of urine after exertion, coughing, or during exercise. It is currently estimated that urinary incontinence affects 40% of adult women, 50% of whom experience stress incontinence. Around the year 2000, the physiological anatomical support of the pelvis began to be replaced with the implementation of mid-urethral slings. However, since then and to date, the appropriate tension has not been standardized during the surgical procedure, which has led to major complications. MATERIALS AND METHODS: Retrospective, observational case series study and literature review, which included 100 adult women with stress incontinence, treated with TVT surgery, reconstructive vaginal hysterectomy, anterior and/or posterior colpoperineoplasty alone, or colposacropexy. Search of electronic databases with MeSH terms: “urinary incontinence,” “female stress urinary incontinence,” and “tension-free vaginal tape.” The search was limited to the following filters: “Case Reports,” “Review,” and “Systematic Reviews,” “Spanish and English” from 1961 to 2018. A total of 261 studies were found, from which editorials, reviews, and duplicate articles were excluded. Twelve studies were selected. RESULTS: Patients with a mean age of 64 years, 36 underwent TVT + HVR, 25 underwent TVT + sacrospinous fixation, 20 underwent TVT only, and 19 underwent TVT + anterior colpoperineoplasty. After 12 months of follow-up, 76 patients had a favorable and satisfactory response to the different treatments. Regarding unfavorable results, 8 patients continued to experience urinary urgency, 8 had urinary incontinence, 3 developed urinary retention, and the remaining 5 patients shared data such as recurrent UTIs, mild dysuria, and dyspareunia. CONCLUSIONS: The use of different surgical techniques together with TVT continues to be the best option for patients diagnosed with stress urinary incontinence. however, the appropriate tension is not standardized during the surgical procedure, which is the source of the main complications reported by this and other studies, such as persistent urinary incontinence and urinary retention, as well as data on a low irritative syndrome. Therefore, it is essential to continue studying these types of cases in the future until a standard procedure is established that offers the fewest adverse results.
Impact of breastfeeding on jaw development
INTRODUCTION. Breastfeeding during the early stages of life is the optimal way to feed infants. OBJECTIVES. To identify the benefits of breastfeeding, the influence on oral habits and the difference between breastfeeding and bottle feeding through a review of scientific studies. MATERIALS AND METHODS. A literature review of 20-year-old articles was conducted in online databases searching for research literature in biomedical and biological sciences. RESULTS. Direct breastfeeding of the mother avoids retrognathism and a better relationship between the jaws is obtained, and malocclusions are reduced. CONCLUSIONS. Functional alterations or bottle-feeding can negatively affect oral and dental development.
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Wernicke's Encephalopathy secondary to Hyperemesis Gravidarum in a 21-year-old patient
INTRODUCTION: Wernicke's encephalopathy (WE), caused by thiamine deficiency, is a potentially fatal but reversible neurological emergency. It can develop in patients with hyperemesis gravidarum, as uncontrollable vomiting leads to decreased food intake, malnutrition and malabsorption. CASE: A 21-year-old patient, primigravida, 13 1/7 weeks pregnant, presented with a 2-month history of nausea and vomiting (> 10 vomiting per day) associated with an episode of lipothymia. The patient was diagnosed with a pregnancy of 13 6/7 weeks, hyperemesis gravidarum and Wernicke's Encephalopathy. It is managed with doses of oral thiamine and transferred to the Obstetrics Intensive Care Unit (ICU). CONCLUSION: Wernicke's encephalopathy is a medical emergency that requires immediate medical treatment. The treatment of choice is the administration of thiamine.
Maternal and neonatal serum soluble e-selectin in preeclamptic patients and normotensive pregnant women
OBJECTIVE: To compare maternal and neonatal serum concentrations of soluble E-selectin in preeclamptic and normotensive pregnant. METHODOLOGY: A case-control study was conducted in 180 pregnant women (group A, 90 preeclamptic and group B, 90 normotensive pregnant women) who attended the Central Hospital "Dr. Urquinaona", Venezuela. The general characteristics, laboratory parameters and maternal-neonatal serum concentrations of soluble E-selectin were evaluated. RESULTS: Compared with patients in group B, patients in group A had higher soluble selectin E concentrations (p <0.0001). However, neonates in this group showed significantly lower concentrations (p <0.0001). When comparing maternal and neonatal concentrations in each of the groups, no significant differences were found between neonatal maternal concentrations in group A (p = 0.6849) but significant differences were found in group B values (p <0.0001). CONCLUSION: Preeclamptic patients have higher soluble E-selectin concentrations compared to healthy normotensive pregnant women. However, their neonates show significantly lower concentrations compared with neonates of normotensive pregnant women.
Adverse effects and acceptability of contraceptive subdermal implantation in panamanian adolescents and young adults 2017 – 2020
OBJECTIVE: To describe the adverse effects and acceptability of Implanon in patients under 24 years of age. METHODOLOGY: Prospective descriptive study of 98 women consecutively recruited. The Epi Info version 7 program was used. Those under 18 years of age were attended by assent. Patients with contraindications were excluded. RESULTS: The mean age was 19.6 years, 47.4% adolescents and 52.5% young adults. 85.7% had the onset of sexual life between 15 and 19 years of age. The alterations more frequent were changes in bleeding patterns. There was a significant difference between those who were postpartum and those who had not had recent births. In addition, a patient with a medical history of schizophrenia had periods of increased aggression during the first six months of implant use. Weight gain occurred in 26% of patients. Nine patients had the implant removed. There were no pregnancies. CONCLUSIONS: There was a great acceptance of women who used Implanon. This was due to the strict follow-up and control during the study and at the same time, bleeding was reduced in quantity and time, achieving a low percentage of withdrawal before three years.
Risk factors and complications associated with pregnancy in adolescents treated at the Dr. Luis "Chicho" Fábrega Hospital from January to December 2022
INTRODUCTION: Teen pregnancy is a public health problem. Latin America is the region with the highest adolescent fertility in the world after Sub-Saharan Africa. In Panama about 15 to 20% of pregnancies occur in adolescents despite strategies, hence the interest in conducting this study which aimed to know the risk factors and complications associated with pregnancy in adolescents aged 10 to 19 years who completed their pregnancy at the Hospital Dr. Luis “Chicho” Fábrega between January and December 2022. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted where the records of said patients were reviewed. The Epi Info 7 program was used to calculate the sample, tabulate and analyze the information. RESULTS: It was possible to know that out of 3353 deliveries attended 16% were adolescents. Determinants were described as place of residence in Comarcas (35.7%), start of sexual life between 10 and 13 years (12.1%), multiparity (17%), vaginal (62.1%) and cesarean (37.9%), loss of fetal well-being (36.5%). The most frequent complications were birth canal tear (17.4%), anemia (16.1%) and premature rupture of membranes (15.6%). CONCLUSIONS: These results support the need to improve strategies to prevent modifiable risk factors and prevent adolescent pregnancy and its complications.
For years the U.S. Health System reported an alarming trend. A persistent rise in maternal mortality. According to the National Vital Statistics System, the maternal mortality rate in the US rose from 9.65 x 100 thousand live births (1996 - 2002) to 23.6 x 100 thousand live births (2018 to 2021). This behavior, with the technological advances of modern times, was unheard of and a clear sign that something bad was happening. And yes, something was wrong, but not at the primary care level. The problem was the data tabulation system. Specifically a box on death certificates, which specified whether the death was pregnancy-related or not. Unfortunately, by mistake, this box was often checked on patients who were not even pregnant. It took a researcher, concerned about the rise in maternal mortality, to go to the primary source of information and discover the problem. If non-pregnancy related deaths were eliminated (as they should be) the mortality rate was reduced to 10.2 (1996-2002) and 10.4 (2018 to 2021). In short, almost no change. What lesson can we learn from this monumental mistake? On the one hand, the importance of information. As researchers, the data collected is vital to reach valid conclusions that allow us to generate changes. If it is not collected correctly or if mistakes are made, no matter how small they may seem to be (such as checking a box), the consequences can be unpredictable. On the other hand, if a finding seems to be unexplained or out of the expected, do not trust. Research is the search for truth and that should be the north of those of us who dedicate ourselves to this laudable work. This does not mean that we are obliged to discover something new, but to think critically. If our knowledge tells us that something does not make sense, if an article describes something that changes known behaviors, do not accept it out of hand. A single voice should not be reason enough and the replicability of studies is one of the pillars of the scientific method. Remember that, from time to time, the truth is within reach of an inquiring mind. From someone who wondered why?
Series of cases of cutaneous endometriosis in a tertiary care hospital
This article describes four cases of women diagnosed with cutaneous endometriosis at the Rio Hortega Hospital in Valladolid (Spain) between January 1, 2021, and December 31, 2023. Our objective is to evaluate the clinical presentation of the cases, diagnostic methods, and treatment, along with the subsequent follow-up of the patients.
HUGO RAS robotic system, components and coupling steps in gynecological surgery
Video of the section “Imaging in gynecology and obstetrics” showing the components and the 7 steps for gynecological surgery using robotas sisted laparoscopic surgery (HUGO RAS).
Psychosocial risk factors that influence adolescent pregnancy in prenatal control women in Panama.
Objectives: To know psychosocial factors that affect the pregnancy of a group of adolescents who attended prenatal care in 3 Health Regions of the province of Panama. Methodology: the sample, originally of 350 adolescents, had to be reduced to 230 young people, due to the COVID-19 pandemic; Even so, only 121 young people were recruited (53.0%). The information was collected through a semi-structured questionnaire, with open and closed questions. Results: the average age is 17 years; 67.0% have incomplete secondary schooling and 43.8% are in union. 60.3% and 41.3% define the relationship with their mother and father as good, respectively, while 44.5% of these young women say they have positive communication with their mother and only 27.3% consider the dialogue with their father in the same way. 72.7% had a history of early pregnancy; 51.2% of their peers were mothers or pregnant. 90.0% had heard about contraceptive methods, but more than a third of the sample (36.4%) had never used contraceptive methods. The desire for pregnancy occurred in 30.6% of cases. Conclusion: Incomplete schooling, family history of early pregnancies, motherhood among their peer group, non-use of contraceptive methods and desire for pregnancy can contribute to adolescents becoming mothers early.
In 2011 a professor from the Department of Gynecology and Obstetrics at the University of Melbourne (Australia) came across a removal notice from a scientific article. This kind of news always catches the attention of researchers and he started reading. The notice clarified that the data presented in the withdrawn article were identical to those presented in a previous publication, but from Spain. The difference was that the original article studied polyps and the retracted article, myomas. Same data, different pathologies. The decision of the journal editors was the right one, since, although nothing is impossible, it is unlikely that this degree of similarity was the result of chance. Just to put them in context, the probability of two twenty-word sentences being written identically in two different journals (by different authors) is in the range of 1 x 10-80. In the realm of statistics, this is equivalent to "almost impossible". If we add numerical data to this, you can imagine that the number of 0's will be much higher and the chance much lower. The professor, who was at that time editor of a prestigious journal in the field, took it upon himself to be more cautious with the manuscripts received. Shortly thereafter, he received a manuscript with, in his opinion, manipulated data and rejected it, only to discover that the same article, with the data made up, had been published in another journal a year later. What does all this lead us to? To remember that the articles we read have passed through the hands of many people, who are still human. If on one end we have someone with a desire to lie, there is a chance that the lies will go unnoticed until they are printed on paper and even then it may be a long time before someone discovers the deception. How can we avoid this? First, on the investigator's side. Remember why you are investigating and that lies can have consequences in the lives of many patients. If, despite this, your prestige, academic position or money are more important, then you are in the wrong profession. Let your conscience be your jury and executioner. On the receiving end, detection will depend on factors such as the level of plagiarism (the more extensive, the more likely); the experience of the reviewer and, if possible, the use of artificial intelligence tools. Although they tend to be stigmatized, they can be very useful in this process. With their ability to review millions of pages of data, published articles and websites in seconds, the possibility of lying and successfully escaping is reduced. It is currently estimated that 60 to 90% of plagiarism will be detected before publication. Almost 100, but it is not an absolute victory. It only remains for us from this platform to advocate their scientific side, support ethics in research and remind them of the consequences of fraud. After all, today's lies may be tomorrow's rules.
The relationship between COVID-19 vaccination and menstrual irregularity: what has been described in the literature?
In March 2020, the World Health Organization decreed the COVID-19 pandemic and to avoid cases of Severe Acute Respiratory Syndrome and other complications, one of the measures adopted was vaccination for COVID-19. The SARS-CoV-2 virus, responsible for COVID-19, enters host cells through angiotensin II converting enzyme receptors that are expressed in various organs such as the uterus and ovaries. Until the last quarter of 2021, around the world, about twelve vaccines were approved, in six different categories, for COVID-19 and among the adverse effects there was the report of menstrual irregularities. In several studies, changes in the menstrual cycle are mentioned, such as changes in the duration of the cycle, increased menstrual flow, dysmenorrhea and amenorrhea from 7 to 30 days after the administration of the last dose for COVID-19. It was also observed in these studies that women who did not have irregularities after the first dose of the vaccine started to have them after the second dose. In general, changes in the menstrual cycle cease within 3 months after the last dose of the vaccine and there is no definitive impact on the woman's fertility.
Extraction of myomas by posterior colpotomy in robot-assisted laparoscopic myomectomy (HUGO RAS).
Video from the section "Images in gynecology and obstetrics" showing the removal of myomas by posterior colpotomy in robot-assisted laparoscopic myomectomy (HUGO RAS).
The podocyte is a highly differentiated cell located in the basement membrane of the glomerulus. Among its multiple functions is to guarantee the integrity and functionality of the main filtration unit of the kidney, but it lacks the capacity to divide under normal conditions and in stressful situations it presents the risk of separating from the basement membrane, leading to the possibility of developing proteinuria as the first step of renal damage that may become permanent. One of these stressful situations is pregnancy and, in particular, gestational hypertensive disorders, which places the podocyte in the peculiar position of being able to be used as a diagnostic test or as a marker of long-term renal prognosis. In this review we will look at the role of the podocyte in these scenarios.
If you look up the origins of "intermittent fasting," a form of calorie restriction where food is only eaten for short periods of time (usually 8 hours), you will discover something interesting. Despite the popularity of the concept and the fact that in modern times many food gurus, including physicians, support and promote it, its roots date back to 1915. These early trials culminated in a chapter published in the book Obesity: its pathogenesis and management. The chapter mentioned fasts of one to fourteen days, suggesting spectacular results. This information, which required a rigorous replication process to prove its efficacy, jumped into the cultural magazines without being confirmed by other experts. Once something moves from the scientific to the popular arena, it becomes public knowledge and its use grows exponentially. This led, as early as the 1970s, physicians and researchers to warn of the risk of these therapies that sought quick fixes to a much deeper problem.
Uterine torsion in a non-gravid patient with giant myomatosis: case report
Uterine torsion is a rare condition and is considered a gynecological emergency. It consists of the rotation of the uterus on its long axis of more than 45 degrees at the level of the isthmus. It can occur at any stage of a woman's life, premenarche to postmenopause, as a consequence of alteration in uterine support mechanisms associated with predisposing factors of the uterus or adnexa. Uterine torsion in non-pregnant premenopausal women is extremely rare and the most common cause is large leiomyomas. It presents with nonspecific abdominal pain, which makes preoperative diagnosis difficult. There are indirect signs in radiological studies, however they are not precise. The treatment is surgical and will depend on the intraoperative findings, in most cases total abdominal hysterectomy with possible complications such as pulmonary thromboembolism, shock and even death if a timely diagnosis is not made. We report the case of uterine torsion due to pedunculated myoma in a 38-year-old nulliparous patient with persistent abdominal pain in whom conservative surgery was performed.
Motivations and reasons for teenage pregnancy in a group of young mothers attended at the Santo Tomás Maternity Hospital in Panama City
Introduction: In Panama, adolescent pregnancy is an important public health problem, more than because of its numbers, because of its biopsychosocial repercussions. Objective: To determine the motivations and reasons that lead an adolescent to become a mother. Methods: Descriptive study. The sample consisted of 204 adolescents. A structured interview-type questionnaire was used. Results: The mean age was 17.6 years. The 72.1% had a mother/sister with a history of adolescent pregnancy. The 57.4% attributed their pregnancy to lack of impulse control. 30.4% disclose that their pregnancy was wanted. 38.2% of these pregnancies correspond to feelings of invulnerability to pregnancy; 15.7% to low self-esteem. The reasons for pregnancy linked to contraceptives are as follows: 33.4% fear of using it; 25% lack of knowledge; 22.5% lack of money; 11.3% feelings of embarrassment when requesting it. Conclusions: Copying an intergenerational reproductive pattern was constituted as the main reason for pregnancy. The desire for motherhood to give meaning to life was one of the most frequently mentioned. Among unwanted pregnancies, more than half pointed to lack of impulse control. Family reasons, such as escaping from problems at home, were the least reported.
Case report: pregnancy in the cervical isthmus following in vitro fertilization.
Low implantation ectopic pregnancy includes cervical pregnancy, located between the isthmus and the cesarean scar. It is characterized by implantation of the blastocyst outside the uterine cavity. This condition occurs in 1% to 2% of all pregnancies and is the leading cause of maternal death in the first trimester of gestation. It has a low incidence compared to other locations, and a high risk of maternal morbidity due to the probability of bleeding during the intervention. We present a case of a cervical isthmic ectopic pregnancy following in vitro fertilization in a 37 year old woman with a history of cesarean section, last 17 years ago, and surgical sterilization at the Hospital Militar Central de Bogotá. The objective is to document the process and the interventions, since the management of this pathology depends on the clinical conditions and the woman's desire to reproduce.