RESUMEN
Objetivo: Demostrar que la revisión de la cavidad uterina instrumental gentil previene mayormente, la hemorragia posparto en comparación con la revisión manual de la cavidad uterina. Métodos: Estudio observacional, transversal, descriptivo y asociativo. Se llevó a cabo en las pacientes que ingresaron a las unidades toco-quirúrgicas de 2 hospitales públicos en el Estado de México. Muestreo por conveniencia (aquellas pacientes a quienes se les realizó revisión de cavidad uterina, durante la atención del parto). Muestra integrada por 236 pacientes. Resultados: Hubo 76 casos de hemorragia posparto, que se analizaron por grupos de edad, distinguiendo entre adolescentes, en edad reproductiva óptima y en edad materna avanzada, encontrándose mayor incidencia en el primer y tercer grupo, con el 34.4% y 48.3% de los casos, respectivamente. La relación entre hemorragia posparto y tipo de técnica de revisión de cavidad uterina, mostró mayor incidencia en la revisión manual. Los casos analizados según la instrucción del personal que brindó la atención, mostraron mayor número de casos de hemorragias, en quienes fueron atendidos por personal en formación. Los especialistas de Enfermería Perinatal, llevaron a cabo 97 procedimientos de atención de parto, 25 presentaron hemorragia posparto, frente a 72 que no presentaron la patología. Conclusiones: La revisión manual de cavidad uterina se asocia estrechamente con la aparición de hemorragia posparto, en contraste con la revisión instrumentada gentil, en la que se registró menor incidencia de esta complicación. La revisión de cavidad uterina debe practicarse bajo indicaciones precisas, hecho que contribuye a la disminución de complicaciones en el posparto.
Objective: to demonstrate that the gentle instrumental uterine cavity assessment largely prevents postpartum hemorrhage in comparison to the manual assessment. Methods: cross-sectional, observational, descriptive, and associative study on patients admitted to the labor-surgical units of two public hospitals in the State of México, using a convenience sample (patients to whom a uterine cavity assessment was performed during their labor process) of 236. Results: There were 76 total cases of post-partum hemorrhage. Patients were classified in three age groups: adolescents, optimal reproductive age, and advanced maternal age. Post-partum hemorrhage cases were prevalent in the first and third groups with 34.4% and 48.3% respectively. The manual uterine cavity assessment technique resulted in a higher prevalence of post-partum hemorrhage. More post-partum hemorrhage cases were also found in those patients attended by inexpert staff. Perinatal Nursing Specialists, conducted 97 childbirth care procedures, 25 had Postpartum Hemorrhage, compared to 72 who did not have the pathology. Conclusions: The manual uterine cavity assessment technique, is closely associated with the onset of Postpartum Hemorrhage, Gentle instrumented uterine cavity assessment resulted in a lower incidence of post-partum hemorrhage. In order to decrease post-partum complications, the uterine cavity assessment must be performed through precise procedures.
Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , AdultoRESUMEN
Identifying the evolution of displasycs and Carcinoma cervicouterine, it was carried out a retrospective study, in which they were revised the 100% of the records from the service of cytology exfoliative with diagnosis of Displasyc and Cancer cervicouterine in the period understood between 1990-1994. The frequency was analyzed, the percentage of presentation of the different varieties, the type of lesion, as well as the prevalence, and the control process. The studies of 455 women were analyzed, 80.2% they presented displasyc, 19.8% carcinoma, with rates of prevalence respectively of 41.65 10.27/100,000. It was cervical slight, displasyc in the 50.8%; moderate in the 10.1%; carcinoma epidermoid intraepithelial in the 11% and diverse lesions in the 9.7%. There was not medical control in the 28%. Considering that exists fail to program inside in several of the steps, it propuse a reorganization of the activities through a epiciclic system in order to archive operatives the essential actions of the program.
