Browsing by Author "Delgado, E"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- Casuística da Consulta de Diabetes da Maternidade Dr. Alfredo da Costa no Ano de 1997Publication . Baleiras, C; Nabais, H; Gonçalves, G; Neves, V; Rocha, T; Aleixo, F; Delgado, EA Diabetes Mellitus é uma doença crónica que frequentemente complica a gravidez. Por outro lado, as perturbações do metabolismo glucídico podem ser exageradas pela gravidez, com as suas alterações endócrino-metabólicas. A vigilância da grávida diabética é complexa e deve envolver uma equipa multidisciplinar. Com o objectivo de avaliar as repercussões da diabetes no prognóstico da gravidez e vice-versa, os autores efectuaram a casuística da Consulta de Diabetes da Maternidade Dr. Alfredo da Costa durante o ano de 1997. Das 138 doentes que recorreram à consulta, 108 apresentavam Diabetes Gestacional/Intolerância à glicose oral (DG/IGO) e 30 Diabetes prévia à gravidez. Apenas 2 destas últimas tiveram uma consulta pré-concepcional. Cerca de 44% das mulheres com DG/IGO necessitaram de insulina em algum momento da gestação. A doença hipertensiva constituiu a complicação obstétrica mais frequente. A taxa de cesarianas (49%) situou-se acima da mencionada por outros estudos. Não se registaram mortes fetais in útero e a morbi/mortalidade neonatal foi semelhante à referida por outros autores. O dado mais importante que interessa salientar deste estudo reside no trabalho desta equipa multidisciplinar, sem o qual não se teria conseguido uma diminuição da morbilidade materna e peri-natal.
- Contracepção de Emergência: o que há de Novo?Publication . Soares Albergaria, F; Machado, AI; Palma, F; Sobral, D; Aleixo, F; Delgado, E; Moniz, LA Contracepção de Emergência é um método simples, seguro e não-abortivo de evitar gravidezes não desejadas. O desconhecimento dos métodos disponíveis compromete a difusão do seu uso e reduz as suas potencialidades na melhoria da Saúde Reprodutiva. Em Portugal estão disponíveis métodos hormonais (método de Yuzpe e pílula de Levonorgestrel) e o DIU de cobre. A pílula de Levonorgestrel impõe-se sobre o método de Yuzpe por ser mais eficaz (até 98,9%), apresentar consideravelmente menores efeitos secundários (redução superior a 50% da ocorrência de náuseas e vómitos) e por ser cómodo (administrável em toma única). Estudos recentes demonstraram que ambos os métodos hormonais podem ser usados até 120 horas após relações sexuais (RS) não protegidas com eficácia, embora esta pareça ser maior quanto maior a precocidade da toma, o DIU de cobre é o método de eleição para a CE que se inicia 72 horas após RS não protegidas.
- Essure®: Effectiveness, Complications and Satisfaction in 13 Years of ExperiencePublication . Félix, N; Carvalho, C; Isidro Amaral, P; Sousa, F; Delgado, E; Machado, AI; Mira, ROverview and aims: Female sterilization is the most used contraceptive method in the world. The hysteroscopic route is especially attractive for women at high surgical and anesthetic risk. Publications worldwide reported several possible adverse events, doubting the safety of the method. The objectives of this study are to evaluate the technical difficulties and complications, the adverse events in the short and long term, the effectiveness of the method and satisfaction. Study design: Retrospective cohort study. Population: A total of 105 women undergoing hysteroscopic sterilization with Essure® between 2005 and 2017 (13 years of study). Methods: The epidemiological and procedural data were accessed by consulting the clinical processes the family planning appointments. Long term follow-up was evaluated by telephone contact of all the women, with success in 68 cases. Results: The mean age was 38 years (SD 4,7). The procedure was successful in the first attempt in 99% (n=67) cases, the main technical difficulty identified was the permeabilization of the internal cervical os (8.6%; n=6) and the only intercurrence documented was vasovagal reaction (4.8%; n=3). The mean immediate pain post procedure was 4 (numeric pains cale, SD 2). Long term complications identified were: 1.5% (n=1) migration, 1.5% (n=1) partial unilateral expulsion, 4.4% (n=3) gynecological reoperation, 9% (n=7) headache, 11.8% (n=8) weight gain, 22.1% (n=15) chronic pelvic pain and 24.6% (n=17) abnormal uterine hemorrhage. There were no cases of pregnancy or allergic reaction. Most women were very or completely satisfied and would advise Essure® as a contraceptive method, 94% (n=64) and 97.1% (n=66) respectively. Conclusions: Hysteroscopic sterilization was highly effective and associated with low and mild difficulties and acute complications. Most women were satisfied with the method and long term adverse effects identified are difficult to promptly associate with Essure® since their high frequency in the peri-menopause, forcing more studies.
- Esterilização Feminina: Estudo Comparativo entre Esterilização Histeroscópica e LaparoscópicaPublication . Correia, L; Queirós, A; Machado, AI; Delgado, E; Farelo, AOverview and Aims: Female sterilization is increasingly requested as a contraceptive method. Hysteroscopic sterilization by transcervical placing of Essure® micro-inserts in the initial portion of the tubes is a recent alternative to laparoscopic sterilization. The objective of this study is to evaluate the safety and effectiveness of hysteroscopic versus laparoscopic sterilization. Study Design: Retrospective cohort study. Population: A total of 98 women undergoing sterilization in an outpatient clinic between July 2005 and July 2009. Methods: Patients’ age, associated diseases, anesthesic risk, procedure time, discomfort, adverse events and success rate were evaluated. Results: Mean age at surgery was 37.8 years (19-49), and there were no statistically significant differences between the groups regarding this parameter. Women in the hysteroscopic group had a significant number of associated diseases (98% versus 47%), obesity (31% versus 6%), and anesthesic risk (ASA III- 31% versus 0%). The mean duration of the procedure was the same for both techniques (laparoscopy 28 minutes and hysteroscopy 26 minutes). All laparoscopic sterilizations were successfully completed. In the hysteroscopic group 4% failed to complete the technique. There were no cases of severe pain. Women in the hysteroscopy group reported pain less frequently (40% versus 57%, χ2 p<0.05). Long term success rate was similar in both groups (96% for hysteroscopy and 98% for laparoscopy). Conclusions: In spite of a higher incidence of associated diseases, obesity and anesthetic risks in the hysteroscopy group, there were no significant differences in the duration of the procedure, adverse events and success rate. The hysteroscopic approach can therefore be considered an alternative to laparoscopy, eliminating the need for incisional surgery and for general anaesthesia. If women with high surgical risk and several associated diseases can safely undergo this procedure, it could well become the preferred method for women who want a permanent and irreversible contraceptive method.
- Fibromioma Extra-Peritoneal do Ligamento Redondo. Caso ClínicoPublication . Carocha, A; Ribeiro, V; Cunha, V; Delgado, E; Marques, CFibromyoma of the round ligament should be considered as a possible etiology for a large preperitoneal tumor. We report a case of a 44-year-old female who was found to have a fibroleiomyoma that measured 14 cm, weighed 3599 gr and had grown in the abdominal wall between the muscle and the peritoneum, taking as its starting point the right round ligament.
- Septic Shock Following Hysteroscopy. A Case ReportPublication . Meneses, T; Faria, J; Martins, AT; Delgado, E; Silva, MCIntroduction: Minimally invasive gynecological surgery such as hysteroscopy has a small risk of complications. These include uterine perforation (with or without adjacent pelvic organ lesion), bleeding and infection, and are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease (PID) and endometriosis. Case presentation: A patient submitted to a diagnostic hysteroscopy with no immediate complications was admitted five days later to the emergency department in septic shock. The diagnosis of ruptured tubal abscess was made, requiring emergency laparotomy with sub-total hysterectomy and bilateral adnexectomy. Despite multiple organ failure requiring admission to the intensive care unit, the patient made a full recovery. Conclusion: Ascending infection can be a life-threatening complication of hysteroscopy, even in the absence of previously known risk factors.