Identification of anemia in the pregnant woman is an essential aspect of prenatal control. The potential consequences of anemia are known. If the condition is managed from an integral perspective from the beginning, potential perinatal complications may be recognized early. Perinatal adversities in maternal anemia include premature rupture of membranes, preterm labor and preeclampsia; and in the newborn, low birth weight, perinatal asphyxia and hyaline membrane syndrome. Neurodevelopmental alterations occur in early childhood, and the mother is susceptible to chronic diseases.

We present the clinical case of a patient with a diagnosis of primary non-gestational ovarian choriocarcinoma corresponding to a germline malignant neoplasm. Likewise, the updated literature on the subject is reviewed, emphasizing molecular biology, diagnosis, and initial cancer management. It was developed at the Dos de Mayo National Hospital (HNDM) in the Oncology Gynecology Service, Lima, Peru. The present case is recorded due to its limited casuistry in our setting and due to the important value of oncological criteria in the management of adnexal ovarian masses.

We present the clinical case of a patient with a diagnosis of primary non-gestational ovarian choriocarcinoma corresponding to a germline malignant neoplasm. Likewise, the updated literature on the subject is reviewed, emphasizing molecular biology, diagnosis, and initial cancer management. It was developed at the Dos de Mayo National Hospital (HNDM) in the Oncology Gynecology Service, Lima, Peru. The present case is recorded due to its limited casuistry in our setting and due to the important value of oncological criteria in the management of adnexal ovarian masses.

Preeclampsia is a disease that appears only during human pregnancy and is associated toimportant maternal and perinatal morbidity and mortality. There is no integral model to predictpreeclampsia. A review on preeclampsia most predictive markers is performed includingDoppler velocimetry of the uterine arteries, biochemical markers and some associated clinicalfactors. A new preeclampsia prediction index proposal is reviewed.Keywords: Preeclampsia, pregnancy, prediction.

Preeclampsia is a disease that appears only during human pregnancy and is associated toimportant maternal and perinatal morbidity and mortality. There is no integral model to predictpreeclampsia. A review on preeclampsia most predictive markers is performed includingDoppler velocimetry of the uterine arteries, biochemical markers and some associated clinicalfactors. A new preeclampsia prediction index proposal is reviewed.Keywords: Preeclampsia, pregnancy, prediction.

Background: In Peru, intestinal infections rank third as cause of morbidity registered in outpatient settings. On the other hand access to water and sewage was respectively 74.7% and 62.8%. Objectives: To determine correlation of drinking water and sewage access and consultations for intestinal infectious diseases. Design: Ecological study of time series. Setting: Faculty of Medicine San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru. Material: Records from the Ministry of Health and Statistics and data from the Statistics and Informatics National Institute, Lima, Peru. Methods: A time series study was conducted based on records of the Ministry of Health on causes of morbidity in outpatients and data from the Statistics and Informatics National Institute records during the period 2002-2009. Results were analyzed using Spearman’s rho coefficient. Main outcome measures: C...

Objective. Determine the study of the diagnostic test of the prediction nomogram for the risk of preeclampsia. Material and method. A nested case-control analytical observational study and validation of the proposed prediction index was performed with the design of a nomogram. It was performed at the Guillermo Almenara Irigoyen-EsSalud Hospital, Lima-Peru, and Fetal Medicine Unit. Participated asymptomatic pregnant patients of the Almenara-EsSalud Healthcare Network between the first or second trimester of pregnancy that developed or not at the end of the follow-up severe preeclampsia. The clinical, laboratory and Doppler predictors of the uterine arteries were evaluated. The data obtained were analyzed under a multivariate binary logistic regression model to construct the prediction equation and the prediction nomogram. In addition, the ROC curve analysis was performed. Results. Th...

La preeclampsia constituye un problema de salud pública en medicina materno perinatal y el reconocimiento de los factores de riesgo es de vital importancia para su manejo inicial. Asimismo, el vertiginoso avance de la ciencia y la investigación, nos compromete a revisar desde el enfoque actual de la medicina basada en evidencias (MBE) los nuevos hallazgos que sustentan el reconocimiento de los potenciales factores riesgo de nuestras pacientes en la práctica clínica diaria. Por ello el objetivo de la presente revisión es documentar desde el enfoque de la MBE las últimas publicaciones en relación al estudio de los factores de riesgo de preeclampsia.

Objective. Determine the study of the diagnostic test of the prediction nomogram for the risk of preeclampsia. Material and method. A nested case-control analytical observational study and validation of the proposed prediction index was performed with the design of a nomogram. It was performed at the Guillermo Almenara Irigoyen-EsSalud Hospital, Lima-Peru, and Fetal Medicine Unit. Participated asymptomatic pregnant patients of the Almenara-EsSalud Healthcare Network between the first or second trimester of pregnancy that developed or not at the end of the follow-up severe preeclampsia. The clinical, laboratory and Doppler predictors of the uterine arteries were evaluated. The data obtained were analyzed under a multivariate binary logistic regression model to construct the prediction equation and the prediction nomogram. In addition, the ROC curve analysis was performed. Results. Th...

La preeclampsia constituye un problema de salud pública en medicina materno perinatal y el reconocimiento de los factores de riesgo es de vital importancia para su manejo inicial. Asimismo, el vertiginoso avance de la ciencia y la investigación, nos compromete a revisar desde el enfoque actual de la medicina basada en evidencias (MBE) los nuevos hallazgos que sustentan el reconocimiento de los potenciales factores riesgo de nuestras pacientes en la práctica clínica diaria. Por ello el objetivo de la presente revisión es documentar desde el enfoque de la MBE las últimas publicaciones en relación al estudio de los factores de riesgo de preeclampsia.

Objective: To determine the relationship between quality of care and satisfaction of users treated via gynecologic oncology telemedicine from August to October 2021. Materials and methods: An observational, cross-sectional and prospective study conducted with 302 users. Instruments: modified SERVPERF questionnaire to evaluate the quality of care, MINSA’s checklist to evaluate the structure, and telemedicine time record sheet to evaluate the process. Data was analyzed using IBM SPSS Statistics V27 and Fisher's F test with p < 0.05. Results: Compliance with the structure was 66.67 % according to MINSA. Regarding the process, patient waiting time to get a telemedicine appointment was 1 to 7 days in 53.31 %, patient waiting time to begin a telemedicine consultation was < 10 minutes in 64.22 %, and telemedicine length was 11 to 15 minutes in 41.39 %. Quality of care dimensions such as...

Anemia, the most common hematological abnormality in the world, is a reduction in concentration of erythrocytes or hemoglobin in blood. The most frequent cause of anemia in pregnancy is nutritional-derived iron deficiency, and in the puerperium, acute blood loss. Iron requirements increase during pregnancy, and failure to maintain iron levels may lead to serious and adverse consequences for both the mother and the developing fetus and newborn. From a global perspective, anemia during pregnancy is more frequent and severe in countries with poor social and economic development. Consensus recommendations define anemia as hemoglobin level (Hb) <10.5 g / dL during pregnancy and <10 g / dL during the postpartum period, cut-off values to initiate therapy with oral iron, intravenous iron or red blood cell transfusion. This paper attempts to compile recommendations for a safe and effective treatm...

Objective. To determine the relationship between maternal hemoglobin of pregnant adolescents and the weight of newborns in the National Maternal Perinatal Institute (INMP). Material and methods. 914 pregnant women were analyzed cross-sectionally by inclusion and exclusion criteria of 2729 deliveries of adolescents attended in the INMP corresponding to the year 2017. The data were collected from the birth registry and clinical histories, the variables of interest were hemoglobin maternal and the weight of the newborn. Results. Of the 914 births, 299 mothers (32%) presented anemia and 615 (68%) did not present anemia, the predominant age group were adolescents in the late stage 73% (with anemia) and 71% (without anemia). In the prenatal control, there was a predominance of insufficient or uncontrolled 74% (with anemia) and 73% (without anemia). Single women were the majority group, 91% (wi...

Objetivo: Evaluar la situación y determinantes sociales de la anemia en gestantes de centros poblados y comunidades rurales del Perú durante el año 2017. Materiales y Métodos: Estudio Transversal utilizando la base de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) 2017. Se analizaron los registros de 8 533 mujeres gestantes pertenecientes a centros poblados y comunidades rurales incluyendo gestantes que residen en la capital y capitales departamentales. Se analizó la estadística descriptiva y regresión logística. Resultados: El 28% de las pacientes presentaron anemia en la gestación. Aquellas pacientes que pertenecen a centros poblados y comunidades rurales del Perú tienen un OR 2,0 IC95% (1,4-2,9) p <0,001 en comparación con las gestantes que residen en las capitales departamentales y la capital nacional. Conclusiones: Existe asociación entre el lugar de re...

Objective. To determine the relationship between maternal hemoglobin of pregnant adolescents and the weight of newborns in the National Maternal Perinatal Institute (INMP). Material and methods. 914 pregnant women were analyzed cross-sectionally by inclusion and exclusion criteria of 2729 deliveries of adolescents attended in the INMP corresponding to the year 2017. The data were collected from the birth registry and clinical histories, the variables of interest were hemoglobin maternal and the weight of the newborn. Results. Of the 914 births, 299 mothers (32%) presented anemia and 615 (68%) did not present anemia, the predominant age group were adolescents in the late stage 73% (with anemia) and 71% (without anemia). In the prenatal control, there was a predominance of insufficient or uncontrolled 74% (with anemia) and 73% (without anemia). Single women were the majority group, 91% (wi...

Objetivo: Evaluar la situación y determinantes sociales de la anemia en gestantes de centros poblados y comunidades rurales del Perú durante el año 2017. Materiales y Métodos: Estudio Transversal utilizando la base de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) 2017. Se analizaron los registros de 8 533 mujeres gestantes pertenecientes a centros poblados y comunidades rurales incluyendo gestantes que residen en la capital y capitales departamentales. Se analizó la estadística descriptiva y regresión logística. Resultados: El 28% de las pacientes presentaron anemia en la gestación. Aquellas pacientes que pertenecen a centros poblados y comunidades rurales del Perú tienen un OR 2,0 IC95% (1,4-2,9) p <0,001 en comparación con las gestantes que residen en las capitales departamentales y la capital nacional. Conclusiones: Existe asociación entre el lugar de re...

Introduction: The National Medical Examination is a tool that measures knowledge and clinical reasoning as an approach to assess educational quality. Objective: To determine factors associated with qualification of the National Medical Examination (ENAM) 2012 at Universidad Nacional Mayor de San Marcos (UNMSM). Design: Cross-sectional study. Setting: Faculty of Human Medicine, UNMSM, Lima, Peru. Participants: Medical Interns 2012. Interventions: Analysis of secondary sources using the binary logistic regression method. Pearson and Spearman correlation coefficients and Student t test were applied. Main outcome measures: ENAM’s average scores, belonging to the 2006 class, internship hospital, and merit rank according to weighted university average (PPU). Results: Belonging to the 2006 incoming class, doing internship at EsSalud, and be placed in the academic upper and middle third were f...

Objective. Determine the knowledge, attitudes and practices in Evidence Based Medicine (EBM) in attending physicians of a public hospital. Materials and methods. Analytical observational cross-sectional design, a validated instrument with a Kuder and Richarson index (KR 20) of 0,79 was used. Results. The knowledge of MBE is low intermediate in 60% of the participants. In addition, there is a statistical association between the number of hours dedicated to the search for information and the level of knowledge of MBE. Conclusions. It is necessary to generate methodological strategies of medical education to improve the knowledge of the MBE to optimize the attitudes and practices of this medical activity.

Objective. Determine the knowledge, attitudes and practices in Evidence Based Medicine (EBM) in attending physicians of a public hospital. Materials and methods. Analytical observational cross-sectional design, a validated instrument with a Kuder and Richarson index (KR 20) of 0,79 was used. Results. The knowledge of MBE is low intermediate in 60% of the participants. In addition, there is a statistical association between the number of hours dedicated to the search for information and the level of knowledge of MBE. Conclusions. It is necessary to generate methodological strategies of medical education to improve the knowledge of the MBE to optimize the attitudes and practices of this medical activity.

Objective. Estimate the prevalence and determine the factors associated with access to modern family planning methods (MPFM) in women of childbearing age Venezuelan immigrants in Peru. Materials and methods. Observational, cross-sectional and analytical study of the Survey Directed to the Venezuelan Population Residing in the Country (ENPOVE) 2018. The proportion of women of fertile age Venezuelan immigrants with access to MPFM was calculated. Crude and adjusted prevalence ratios (RP) of MPFM access were estimated, using generalized linear models. Results. 3,378 Venezuelan immigrant women of childbearing age were included. 78.45% did not have access to MMPF. Being in the young stage of life (RPa: 1.07; IC: 1.05-1.14), being married (RPa: 1.09; IC: 1.03-1.14), living together (RPc: 1.11; IC: 1.06-1.16), residing in the city de Trujillo (RPa: 1.21; CI: 1.13-1.29) were associated with a hig...