medica, estudios de pregrado realizados en universidad católica de Santiago de Guayaquil, destacada académicamente, ubicada en primer quintil correspondiente a los mejores promedios de la promoción 45. Especialista en Ginecologia y Obstetricia, estudios de postgrado Universidad de Guayaquil. Investigadora Científica
Cervical cancer during pregnancy is the most commonly detected malignant tumor. It has become a public health problem, 99% related to human papillomavirus (HPV) infection, making it the only gynecological malignant tumor of clear etiology in the world. It is diagnosed at any stage of pregnancy. Its initial presentation is observed as transvaginal bleeding in all three trimesters associated with HPV infection. If the metastasis is negative in the lymph nodes, it improves. At an early stage the prognosis is favorable, management consists of preserving pregnancy, neoadjuvant chemotherapy can be used to treat cervical cancer in pregnancy, in cases of viable pregnancies between 27- and 31-weeks’ gestation chemotherapy may be performed depending on the staging, caesarean section at 35 weeks, radical surgery and systemic chemotherapy may achieve good results depending on the stage of the tumor.
Part of the book: Women's Health Updates
Invasive candidiasis secondary to
Part of the book: Candida albicans
Fetal growth is a process that is not easy to assess and is regulated by multiple mechanisms that depend on many fetal, placental, and maternal factors. The birth weight percentile compared to the estimated gestational age reveals lower gestational ages for women and higher gestational ages for men in certain geographic areas such as Africa, with differences in comparison with the world population. The alteration in fetal growth is related to several perinatal complications such as intrauterine death, increased cesarean section, maternal-neonatal injuries, and shoulder dystocia. Among the main manifestations of fetal growth disturbance is intrauterine fetal growth restriction, which affects approximately 3–7% of all pregnancies and is defined as a condition in which the fetus fails to achieve the growth determined by its genetic makeup. Its diagnosis requires an estimated fetal weight by ultrasound lower than the 10th percentile for gestational age. The most outstanding maternal risk factor for fetal growth disturbance is maternal body mass index, where obesity predominates. Asymmetric or type II intrauterine growth restriction is more frequent in the second trimester of pregnancy.
Part of the book: Reproductive and Gynecologic Health Annual Volume 2025
The risk of endometritis and puerperal fever can be decreased by reducing the upward infection of the vaginal bacterial load, even in patients with ruptured membranes. The use of prophylactic antibiotic treatment for puerperal sepsis remains under investigation. Sepsis during pregnancy and the postpartum period accounts for 11% of maternal deaths and ranks third globally. Its global incidence has been increasing, in countries with a maternal mortality rate of 8%, and is caused by multisystem dysregulation resulting from an infection, which can develop during pregnancy, abortion, childbirth, or in the postpartum period and is considered an obstetric emergency. Sepsis is a state of multisystem dysfunction, which is caused by a dysregulated host response to infection. Several factors influence the severity, clinical manifestations, and progression of sepsis, such as immunological heterogeneity, cell signaling pathways, and dynamic regulation of cell signaling pathways.
Part of the book: Postpartum Period for Mother and Newborn
Neonatal sepsis is one of the main causes of mortality in premature newborns worldwide; the infection can be acquired during pregnancy, childbirth, or during hospital admission to the neonatal intensive care unit. Mortality from sepsis increases considerably with the appearance of antibiotic-resistant germs. Neonatal sepsis is one of the main causes of morbidity and mortality in preterm infants worldwide. Special care should be taken in prenatal control with genitourinary tract infections to avoid premature rupture of membranes with bacterial ascent complicated by chorioamnionitis, also considering that the administration of intrapartum antibiotics has not been shown to reduce mortality from neonatal sepsis. The use of penicillin plus gentamicin is one of the best schemes, with less effects on bacterial resistance and translocation. The most common germs in neonatal-onset sepsis include group B
Part of the book: Neonatal Care
It is often a therapeutic challenge to manage polycystic ovary/ovarian syndrome (PCOS), as it is a pathology that affects both the metabolic and endocrine systems, generating problems associated with insulin resistance, obesity, and biopsychosocial problems mainly in adolescents and women in the reproductive stage. It affects between 5% and 18% of women of childbearing age. Its etiology is heterogeneous, and its definitive cause is still unknown. Therefore, treatment will depend on each patient’s symptoms and individual preferences. It is a common cause of anovulatory infertility in 75% of cases. The objective of this research was to determine the therapeutic challenges of PCOS, for which we reviewed high-level scientific medical articles published in databases such as PubMed, Cochrane, Latindex, Elsevier, Google Scholar, and Embase, concluding that symbiotic supplementation improves several clinical and laboratory aspects of PCOS, including an improvement in hyperandrogenism and lipid profile. In patients with PCOS resistant to treatment with clomiphene citrate (CC), the addition of human chorionic gonadotropin (HCG) at low doses would be an effective method to improve ovulation and, therefore, fertility. The combination of letrozole and clomiphene is superior to either drug separately for ovulation induction in PCOS. Surgical treatment is an option for patients resistant to medical treatment and is performed by laparoscopic or transvaginal ovarian drilling.
Part of the book: Women’s Sexual Health and Dysfunction