CALOSTRO ( ORO LIQUIDO)

Es la primera secreción que toma el recién nacido , que dura entre 2 a 3 días , antes que aparezca la leche definitiva .El calostro  tiene un aspecto más denso  y amarillo que la leche  madura :El calostro  tiene 87% de agua ;2.9gr/100ml de grasa ; 5,5gr/100ml de lactosa  y 2.3g/100ml.de proteinas  proporcionando 58 Kcal/ml .Destacando  en el calostro  la concentración  de Ig A  y lactoferrina que junto a la grasa cantidad de  de linfocitos y macrofagos  , también es rico en minerales  como el magnesio  que ayuda al desarrollo del corazón  y de los huesos ;  cobre  y zinc  que ayuda al desarrollo del sistema inmunitario  y del cerebro  dándole  protección al recién nacido.

COLOSTRUM (LIQUID GOLD)

It is the first secretion that the newborn takes, which lasts between 2 to 3 days, before the final milk appears. Colostrum has a denser and yellower appearance than mature milk: Colostrum has 87% water; 2.9gr/ 100ml of fat; 5.5gr/100ml of lactose and 2.3g/100ml of protein providing 58 Kcal/ml. Highlighting in the colostrum the concentration of Ig A and lactoferrin which, together with the fat quantity of lymphocytes and macrophages, is also rich in minerals such as magnesium that helps the development of the heart and bones; copper and zinc that help the development of the immune system and the brain giving protection to the newborn.

 

GRIETAS DEL PEZON/NIPPLE CRACKS

They are wounds that occur on the nipple, during breastfeeding, which causes a lot of pain to the postpartum woman when breastfeeding her baby (the baby does not latch on well to the breast)

1. Bad posture of the baby is related to the mother's inappropriate way of breastfeeding

2.-Mechanical suction problems

3.-Anatomical difficulties in the chest (flat, short nipples)

 SINDROME DE OVARIO POLIQUISTICO (SOP) / POLYCYSTIC OVARY SYNDROME                     

PCOS is the most common endocrinopathy in women in the reproductive stage

EL SOP  es la endocrinopatia  más frecuente  de la mujer en la etapa reproductiva

 LAS MANIOBRAS DE LEOPOLD/LEOPOLD'S MANEUVERS

 CASO CLINICO N° 8 

LIE(LESION INTRAEPITELIAL ) DE ALTO GRADO /CLINICAL CASE N° 8 FOR INTERNALS -HIGH GRADE LEL

 

4.-SINDROME DE HELLP.-/4.-HELLP SYNDROME.-

Es una complicación del embarazo ,usualmente de gestantes con preeclampsia , se presenta en el 20% de preeclampsia severa ,cursa con alta mortalidad materna y fetal ,su acrónimo en ingles 
H.-hemolisis, 
EL.-enzimas hepáticas elevadas
LP.-plaquetas  bajas
su incidencia es mayor con abruptio placentae, preeclampsia severa, incluye CID

TAC:HEMATOMA SUBCAPSULAR POR SINDROME DE HELLP(HEMOLISIS, AUMENTO DE ENZIMAS HEPÁTICAS, CUENTA PLAQUETARIA BAJA.

1-La mortalidad  perinatal es tan alta  como 60%

2.-Se asocia prematurez y RCIU

 3.-No hay síntomas específicos (se asocia con preeclampsia )

4.-La cuenta plaquetaria es el indicador más confiable  de este sindrome

5.-.El tratamiento  es profilaxis de convulsiones, control de presión arterial , corrección de alteraciones hematológicos como plaquetopenia,transfusion de plaquetas y terminar la gestación de emergencia

6.-se usan  dosis altas de dexametasona , betametasona en dos dosis de 12mg con 12 horas de diferencia

7.-la morbilidad y mortalidad materna es de 25%

8.-Ato(se asocia con preeclampsia severa nia uterina y CID (Coagulacion Intravascular Diseminada) hematuriaIt is a complication of pregnancy, usually of pregnant women with preeclampsia, it occurs in 20% of severe preeclampsia, it presents with high maternal and fetal mortality, its acronym in English

H.-hemolysis,

EL.-elevated liver enzymes

LP.-low platelets

its incidence is higher with abruptio placentae, severe preeclampsia, includes DIC

CT: SUBCAPSULAR HEMATOMA DUE TO HELLP SYNDROME (HEMOLISIS, INCREASED LIVER ENZYMES, LOW PLATELET COUNT.

1-Perinatal mortality is as high as 60%

2.-Prematurity and IUGR are associated

 3.-No specific symptoms (associated with preeclampsia)

4.-The platelet count is the most reliable indicator of this syndrome

5.-.The treatment is seizure prophylaxis, blood pressure control, correction of hematological alterations such as thrombocytopenia, platelet transfusion and emergency termination of pregnancy.

6.-high doses of dexamethasone are used, betamethasone in two doses of 12mg 12 hours apart

7.-maternal morbidity and mortality is 25%

8.-Ato (associated with severe uterine preeclampsia and DIC (Disseminated Intravascular Coagulation) hematuria

 

ACRETISMO PLACENTARIO / PLACENTAL ACRETISM

1.-PLACENTA ACRETA.-El término placenta acreta se usa para describir cualquier implantación  en la cual hay adherencias  anormalmente firme a la pared del utero,como consecuencia la falta parcial o total de la decidua basal  y el desarrollo imperfecto de la capa de nitabuch o fibrinoide , las vellosidades coriales están fijas  al miometrio en la placenta acreta.
2.-PLACENTA INCRETA.-las vellosidades  invaden el miometrio .
3.-PLACENTA PERCRETA.-las vellosidades penetran através del miometrio ,pueden llegar a región vesical.

El principal factor de riesgo  para la placenta accreta , es cirugia uterina previa ,más comunmente ocurre  en pacientes que han tenido placenta previa y partos por cesárea .La incidencia de placenta acreta  ha ido en aumento 3/1000 en la decada del 2000 sigue en un valor cercano de 2/1000 .incluso algunos paises tienen unidades (multidisciplinarios ,cirujano ,anestesiologo,urologo, intensivista , ginecologo obstetra , neonatologo ,banco de sangre)  exclusivas dedicadas al tratamiento de placenta acreta ,donde son transferidos los pacientes con este diagnóstico -

1.-PLACENTA ACRETA.-The term placenta accreta is used to describe any implantation in which there are abnormally firm adhesions to the wall of the uterus, as a consequence of the partial or total lack of the decidua basalis and the imperfect development of the nitabuch layer. or fibrinoid, the chorionic villi are attached to the myometrium in the placenta accreta.

2.-PLACENTA INCRETA.-the villi invade the myometrium.

3.-PLACENTA PERCRETA.-the villi penetrate through the myometrium, they can reach the bladder region.

The main risk factor for placenta accreta is prior uterine surgery, most commonly occurring in patients who have had placenta previa and cesarean deliveries. The incidence of placenta accreta has been increasing 3/1000 in the 2000s and continues value close to 2/1000. Some countries even have units (multidisciplinary, surgeon, anesthesiologist, urologist, intensivist, obstetrician gynecologist, neonatologist, blood bank) exclusively dedicated to the treatment of placenta accreta, where patients with this diagnosis are transferred -