Objetivo: Relatar o caso de uma paciente gestante que evoluiu com abdome agudo perfurativo secundário a leiomiomas uterino com degeneração hialina, revisando cientificamente sobre o diagnóstico e suas interrelações. Detalhamento do caso: Paciente gestante, 35 anos, primigesta, sem acompanhamento de pré natal, procura atendimento médico com queixa de dor lombar e abdominal difusa, náuseas, vômitos e constipação intestinal. Exames laboratoriais evidenciando leucocitose, exame de urocultura com infecção, radiografia de abdome indicativo de abdome agudo perfurativo. Foi iniciado antibioticoterapia e abordagem cirúrgica com laparotomia exploratória, evidenciado mioma subseroso degenerado com aderências em intestino delgado e com perfuração de alça intestinal. Foi realizado miomectomia, enterectomia e ileostomia, acompanhamento de pós operatório em UTI e após alta hospitalar em pré natal de alto risco. Considerações finais: A miomatose uterina é a neoplasia benigna mais frequente do trato reprodutivo feminino, podendo ser classificado em intramural, submucoso, subseroso. Os subserosos podem crescer para dentro da cavidade peritoneal, podendo provocar compressão de órgãos como intestino ou bexiga, podendo haver torção, isquemia e necrose.
Infection with the new coronavirus SARS-Cov-2, responsible for causing the disease Covid-19, has become a devastating threat to the health of the world's population and has been declared a global pandemic by the World Health Organization (WHO) on March 11, 2019March 11, . 2020. Given this context, it is necessary to understand the real impact of Covid-19 on pregnancy, childbirth and the puerperium and to know whether the pregnancy-puerperal state modifies the natural history of the disease. In view of this, concern for the care of pregnant and puerperal women is essential, mainly because this population has difficulties in accessing quality prenatal care, which has worsened even more during this pandemic period. In this sense, the present work proposes to carry out a survey of maternal deaths due to the Coronavirus in the municipality of Franca in the period from 2020 to 2021, in order to analyze the magnitude and causes of such deaths. It is also intended to contribute to the collection of statistical data in the municipality, in addition to promoting municipal statistics and contributing to local health management, through the proposal of measures to prevent new cases of maternal deaths. In this research, it is possible to highlight some difficulties during the analysis of the medical records, since there was not much information about the symptoms, their onset, as well as their duration and severity. Another point to be highlighted is the difficulty of collecting data, especially for private services. The work data were only from the public service, and only from patients who need hospitalization, either in a ward or intensive care unit bed. When analyzing the death certificates, we noticed that some patients, in particular, those who died, were not residents of the city of Franca, therefore, they were not included in the maternal mortality indicators. Finally, some items deserve to be highlighted and serve as ways of protocoling the care and care for the pregnant woman from the prenatal consultation, as well as her follow-up. Therefore, health professionals must be aware of the early diagnosis of Covid-19, considering them as a risk group for the development of serious or fatal forms, especially from the 3rd trimester of pregnancy and in the presence of pre-existing diseases.
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