Vaginosis bacteriana como factor de riesgo preconcepcional y del embarazo, propuesta para el manejo médico integral Centro de Salud 24 horas Pichincha-Manabi
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2011-10
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La vaginosis bacteriana es la causa más común de aumento del flujo genital en las mujeres en edad reproductiva; producida por un trastorno de la flora bacteriana normal que ocasiona la pérdida de lactobacilos y proliferación de bacterias anaerobias. Se asocia con riesgo,incrementado de Enfermedad Pélvica Inflamatoria que puede poner en peligro la fertilidad (riesgo pre-concepcional) y durante el embarazo con Rotura Prematura de Membranas, parto
pretérmino, corioamnionitis y endometritis subsecuente a cesárea. Se realizó un estudio descriptivo longitudinal no experimental en base a revisión de historias clínicas con el
objetivo de estudiar la prevalencia de Vaginsosis Bacteriana en el Centro de Salud Pichincha así como otras características de la afección a fin de plantear una propuesta para mejorar la calidad del diagnóstico y tratamiento de la misma. La prevalencia fue del 7%. Se confirmó que la Vaginosis Bacteriana no suele afectar a las mujeres después de la menopausia. El bajo nivel de instrucción, la procedencia rural, los antecedentes de abortos, Infección Transmisión Sexual, Enfermedad Pélvica Inflamatoria fueron características de las mujeres con Vaginosis Bacteriana, al igual que refiere la literatura consultada. La mayoría de usuarias no presentó condiciones predisponentes; solo un 24% indicó realizarse duchas vaginales y tener nueva
pareja sexual. No se presentaron complicaciones durante el tiempo que duró el estudio pero si hubo recidivas. Se evaluó que el tratamiento utilizado siguió los esquemas internacionales solo en un 45%; esto es, el uso de la vía oral o la vía vaginal con metronidazol, pero no las dos vías a la vez. Se implementó la propuesta consistente en aplicar la “prueba de olor” y
tirilla reactivas para Ph vaginal, así como mejorar el tratamiento a las embarazadas. También se realizaron charlas educativas sobre el tema. Esta propuesta fue acogida por la Dirección del Centro de Salud, así como por las usuarias.
Bacterial vaginosis is the most common cause of increased genital discharge in women of reproductive age, caused by a disorder of the normal bacterial flora that causes the loss of lactobacilli and anaerobic bacterial growth. It is associated with risk of pelvic inflammatory disease increase that may compromise fertility (pre-conception risk) and during pregnancy with Premature Rupture of Membranes, childbirth preterm chorioamnionitis and subsequent cesarean delivery endometritis. We conducted a non-experimental longitudinal study based on review of medical records with In order to study the prevalence of bacterial Vaginsosis Health Center Pichincha and other features of the condition in order to make a proposal to improve the quality of diagnosis and treatment of it. The prevalence was 7%. It was confirmed that bacterial vaginosis does not usually affect women after menopause. The low level of education, rural origin, history of abortions, sexually transmitted infection, pelvic inflammatory disease were characteristic of women with bacterial vaginosis, as referred to in the literature. Most users showed no predisposing conditions, only 24% reported douching and have made new sexual partner. No complications occurred during the period of the study but were no recurrences. The treatment was evaluated international schemes used alone followed by 45%, ie, the use of oral or vaginal metronidazole, but not the two tracks at a time. We implemented the proposal to apply the "smell test" and reagent strip for vaginal pH and improving treatment for pregnant women. Also conducted educational talks on the subject. This proposal was welcomed by the Director of the Center for Health, and for the users.
Bacterial vaginosis is the most common cause of increased genital discharge in women of reproductive age, caused by a disorder of the normal bacterial flora that causes the loss of lactobacilli and anaerobic bacterial growth. It is associated with risk of pelvic inflammatory disease increase that may compromise fertility (pre-conception risk) and during pregnancy with Premature Rupture of Membranes, childbirth preterm chorioamnionitis and subsequent cesarean delivery endometritis. We conducted a non-experimental longitudinal study based on review of medical records with In order to study the prevalence of bacterial Vaginsosis Health Center Pichincha and other features of the condition in order to make a proposal to improve the quality of diagnosis and treatment of it. The prevalence was 7%. It was confirmed that bacterial vaginosis does not usually affect women after menopause. The low level of education, rural origin, history of abortions, sexually transmitted infection, pelvic inflammatory disease were characteristic of women with bacterial vaginosis, as referred to in the literature. Most users showed no predisposing conditions, only 24% reported douching and have made new sexual partner. No complications occurred during the period of the study but were no recurrences. The treatment was evaluated international schemes used alone followed by 45%, ie, the use of oral or vaginal metronidazole, but not the two tracks at a time. We implemented the proposal to apply the "smell test" and reagent strip for vaginal pH and improving treatment for pregnant women. Also conducted educational talks on the subject. This proposal was welcomed by the Director of the Center for Health, and for the users.
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Vaginosis bacteriana, Infección, Factores de riesgo, Embarazo, Centro de Salud Pichincha, Cantón Pichincha, Ecuador