Tesis Especializaciones (Ciencias Médicas)

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Prevalencia de Amenaza de Parto Pretérmino y Factores Asociados, Hospital Vicente Corral Moscoso, 2018
(2019) Vásquez Rodríguez, Marcela Catalina; Cárdenas Mateus, Julio César; Vintimilla Maldonado, Jaime Rosendo
Background: Prematurity is a serious public health problem due to the morbidity and mortality that it presents, as well as the high economic and social costs that this generates with its care. General objective: To determine the prevalence of threatened preterm delivery and related factors in patients treated in the Emergency Area of Gynecology and Obstetrics at the Hospital Vicente Corral Moscoso, during the year 2018. Methodology: A cross-sectional study was conducted in 257 pregnant women from 22,0 to 36,6 weeks of pregnancy. The sample size was calculated with prevalence of 16,7 %, confidence level of 95 %, inference error of 5 % and infinite population. The data were obtained by direct interview and from the clinical histories were analyzed through the SPSS program, v 15; for the qualitative variables, frequencies and percentages were applied; to determine the association, chi-square was applied, prevalence ratio, 95 % confidence interval and value p. Result: The predominant maternal age is 20-34 years old, 67,3 %, urban residence, 72 %, prevalent instruction between 6 and 12 years old, 80,2 %, overweight and obesity 75,1 %. The prevalence of threat of preterm delivery was 21,4 % ( 95 % IC: 16.4-26.4), the predominant age was under 20 years old, which represents 24,1 %, and finally, 30,1 %, was concentrated in the 34,0-36,6 week of pregnancy. Of the group with threatened preterm delivery, 40% had urinary tract infection (RP: 2.02, 95% CI: 1.11-5.66, p: 0.035). The premature rupture of membranes was manifested in 70 %, (RP: 3.6, 95% CI: 2.23-5.81, p:0.000). Preeclampsia was evidenced in 45,5 % (RP: 2.24, 95% CI: 1.12-4.47, p 0.047). Conclusions: The prevalence of threat of preterm delivery was higher than the literature consulted and statistical relationship was found with urinary tract infection, rupture of membranes and preeclampsia.
Prevalencia de anemia y factores asociados durante el tercer trimestre del embarazo, en el departamento de ginecología y obstetricia del Hospital Vicente Corral Moscoso, 2018
(Universidad de Cuenca, 2020-03-13) Ochoa Hurtado, María Cecilia; Cárdenas Mateus, Julio César
Background information: At present, anemia is considered a health problem worldwide, predominating at its most part in developing countries, and causing an increase in maternal-fetal morbimortality. Objective: To determine the prevalence of the anemia and associated factors during the third trimester of pregnancy in the Gineco-Obstetrics Department, in Vicente Corral Moscoso Hospital in 2018. Materials and methods: Observational, analytical, and transversal studies were conducted in this research, where 354 patients contributed and complied with the criteria for their inclusion in this study. The information was extracted from clinical files by means of a form. For the statistical analysis, version 15 of the program SPSS was utilized, making use of descriptive statistics; for the association of risk factors, the Chi-square test was applied, reporting predominance with a level of reliability of 95%, and the value of (<0.05). Results: The prevalence of anemia was 25,7% (IC 95%: 21.01%-30.4%) being predominantly higher in female young adults with 40.7%; rural areas inhabitants with 51.6%, secondary education with 62.6%, those with an occupation of housewife with a 46.2%, and civil status single and married respectively, with a 40%. In addition, it was common in pregnant women with >5 prenatal control with 74.7%; multiple gestations in a 62.6%, and pregnancy end periods with 86.8%. It was found a statistically significant relation (p< 0.05) between young adults and newly pregnants; overweighting and obesity were protective factors RP 0.6; IC 95% (0.4-0.9), p=0.04. Conclusions: The prevalence of anemia was high, and it was linked to non-alterable factors such as age, and the fact of being newly pregnant.
Prevalencia de Hipotiroidismo Clínico, Subclínico y Factores Asociados en Maternas Atendidas en el Hospital José Carrasco Arteaga, Cuenca, 2017
(2019) Zhinin Morales, Verónica Leonor; Cárdenas Mateus, Julio César
Background: the undetected and untreated thyroid disorders in pregnancy are associated with complications in the mother and child binomial. Objective: To determine the prevalence of clinical hypothyroidism, subclinical and factors associated with those attended at the Hospital José Carrasco Arteaga, Cuenca 2017. Method and materials: Observational, analytical, cross-sectional study, participation 231 users who met the inclusion criteria. A data collection form was applied with the study variables. The information was analyzed in the SPSS 15 MB program, the results are presented in tables. Chi square was applied for associated factors, reporting prevalence ratio with 95% confidence interval and p value, accepting hypotheses in this age less than 0.05. All the bioethical processes of rigor were applied. Results: 71.4% of participants aged 20 to 24 years, 59.3% married, 50.2% higher education and 93.1% lived in urban areas. 45.9% had 3 or more births, 43.7% were overweight. No patients were found with clinical hypothyroidism, the prevalence of subclinical was 29.4% (95% CI 23.15 - 34.85). No statistically significant relationship was found with age (PR: 1.30, 95% CI: 0.85 to 1.97 p value> 0.05) and overweight or obesity (PR 0.91, 95% CI 0.61 to 1.37, p> 0.05). Conclusions: the prevalence of hypothyroidism is higher in the universal bibliography. There is no relationship with the risk factors proposed for thyroid disease
Prevalencia y factores asociados a preeclampsia, Hospital José Carrasco Arteaga, 2019
(Universidad de Cuenca, 2021-01-27) Torres Yanza, Paola Andrea; Cárdenas Mateus, Julio César; Salazar Torres, Zoila Katherine
Background: hypertensive disorders are one of the main causes of maternal death, high rates of morbidity and mortality are influenced by their variation in definitions, classifications, poor adherence to health services and late referral to specialized centers, hence the importance of recognizing the main associated factors that allow us to act in a timely manner. Objective: to determine the prevalence and factors associated with pre-eclampsia in pregnant women between 20 and 40 years of age treated in the Department of Gynecology and Obstetrics of the José Carrasco Arteaga Hospital, 2019. Methodology: a cross-sectional analytical study was carried out, in a sample of 272 patients, the data were obtained from the review of medical records prior to a simple random sampling. Data processing was carried out using the SPSS program, considering the p value <0.05 and the factors associated with the Odds Ratio and their respective 95% CI statistically significant. Results: in the 272 patients, the mean age was 30.6 years, married (64.71%), urban residence (65.44%), secondary, multiparous (73.16%), of which 6.62% had preeclampsia Finding as associated risk factors without significant relevance age ≥35 years (OR = 1.2), nulliparous / primiparous (OR = 1.3), overweight or obesity (OR= 1.37) and maternal history of arterial hypertension chronic (OR= 1.33). Conclusions: the prevalence of preeclampsia was 6.62%, the associated factors without statistical significance were: with age ≥35 years, nulliparity, primiparity, overweight or obesity and maternal history of arterial hypertension chronic.
Ventajas trans y post operatoria inmediata del no cierre del peritoneo en pacientes con cesárea en el Hospital José Carrasco Arteaga del IESS - Cuenca, 2010
(2011) Cárdenas Mateus, Julio César; Molina Novillo, Javier Alonso; Mejía Chicaiza, Jorge Victoriano
Objective. To determine the intraoperative and postoperative immediate benefits of non-closure of peritoneum versus closure of peritoneum at caesarean section patients. Methodology. With a randomized controlled trial design included two groups of 80 pregnant women each to be performed cesarean section: group 1 (G1) is not sutured parietal or visceral peritoneum and group 2 (G2) closure of the two peritoneum. Surgical time was measured in minutes, pain intensity, the requirements for supplementary doses of analgesics and the number of them and finally the restoration of bowel function postoperatively. Results. The groups were comparable in demographic variables. The average age was 28.3 ± 4.9 years in group 1 (Gl) and 30.5 ± 5.9 years in group 2 (G2) (p = 0.016 NS). In group 1, 43.8% were primiparous and 31.3% in group 2 (p = 0.8 NS). Statistically significant differences were found between the two groups: Group 1 (G1) showed reduction of surgical time (G1: 43.5 ± 6.9 minutes vs. Gl: 55.9 ± 5.27 minutes, p <0.001), decreased intensity of pain in Group I, only 13 patients (16.3%) experienced severe pain compared with 37 patients (46.3%) in group 2 who showed that magnitude of pain, p <0.001), therefore requiring less doses of analgesics used for pain control in G2 48.8% (39 patients) required 44 additional doses of analgesics and in group 1 in 32.8% (18 patients) had to be supplemented with analgesics p value <0.0001. There were no differences with respect to average hours of restoration of intestinal function by auscultation of bowel sounds the same as were between 12 and 24 hours postoperatively. It is suggested further study to track patients and identify long-term complications and their impact on morbidity and obstetric future. Discussion. The current trend in caesarean section does not close favors parietal and visceral peritoneum in relation to the reduction of surgical time, decreased intraoperative bleeding and postoperative pain

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