Embarazo con miomatosis uterina complicado con isquemia intestinal: reporte de un caso / Pregnancy with uterine myomatosis complicated by intestinal ischemia: case report

Resumen Los miomas uterinos, también conocidos como fibromas o leiomiomas, son los tumores uterinos benignos más prevalentes. Afectan a las mujeres principalmente durante sus años reproductivos y se diagnostican hasta en un 70% de las mujeres blancas y en más del 80% de las mujeres de ascendencia africana durante su vida, con una prevalencia durante el embarazo del 2% al 10%. Pueden ser asintomáticos hasta en un 70% de las pacientes, y se estima que pueden ocurrir complicaciones en aproximadamente una de cada 10 mujeres embarazadas. Se han asociado a complicaciones y resultados adversos del embarazo, según su tamaño y ubicación en el útero, y pueden manifestarse de diferentes formas. Presentamos el caso de una mujer de 30 años, con embarazo en el tercer trimestre, quien consultó por dolor abdominal, con ecografías obstétricas durante su control prenatal que reportaban miomatosis uterina, quien presentó isquemia intestinal por un vólvulo de intestino delgado versus compresión extrínseca.

Abstract Uterine fibroids, also known as fibroids or leiomyomas, are the most prevalent benign uterine tumors, affecting women mainly during their reproductive years and are diagnosed in up to 70% of white women and more than 80% of women of African descent during their lifetime, with a prevalence during pregnancy of 2% to 10%; they may be asymptomatic in up to 70% of patients, and it is estimated that complications may occur in approximately one in 10 pregnant women. They have been associated with complications and adverse pregnancy outcomes, depending on their size and location in the uterus, they can manifest in different ways. We present the case of a 30-year-old woman, pregnant in the third trimester, who consulted for abdominal pain, with obstetric ultrasound scans during her prenatal check-up reporting uterine myomatosis, who presented intestinal ischemia due to small bowel volvulus versus extrinsic compression.

Blood pressure in adolescent patients with pre-eclampsia and eclampsia.

OBJECTIVE: To compare variables among adolescent and adult patients diagnosed with severe pre-eclampsia or eclampsia. METHODS: The present cross-sectional study enrolled patients with severe pre-eclampsia or eclampsia treated at an intensive care unit in Neiva, Colombia, between January 1 and November 30, 2014. Patients were stratified using age (younger than 20 years [adolescents] and aged at least 20 years [adults]) and patient variables were compared between groups. Maternal age, pregnancy duration at delivery, eclampsia, blood pressure, severe hypertension, maternal organ damage, HELLP syndrome, obstetric hemorrhage, laboratory findings, need for blood transfusion and fetal data were analyzed by group. RESULTS: There were 171 patients enrolled; 154 (90.1%) with severe pre-eclampsia and 17 (9.9%) with eclampsia. There were 46 (26.9%) adolescent patients and 125 (73.1%) adults, and 13 (28.3%) and 4 (3.2%) patients had eclampsia in the adolescent and adult groups, respectively (P=0.001). The systolic (P=0.081), diastolic (P=0.174), and mean (P=0.102) blood pressure did not differ significantly between the groups but were higher in the adult group. The incidence of severe hypertension was significantly higher among adult patients (P=0.037). CONCLUSION: The blood pressure used in defining pre-eclampsia and eclampsia should differ for adolescent patients in comparison with the rest of the population.