Cor pulmonale is defined as alteration in structure and function of the right ventricle of the heart caused by a primary disorder of the lungs. Presented are two cases of gravidocardiac patients from cor pulmonale secondary to multi-drug resistant tuberculosis. The first case is a case of a 37-year-old gravida 4 para 3 (3-0-0-3) and the second case is that of a 24-year-old pimigravid, both of which were on their third trimester with no known cardiac disease, both initially presenting with dyspnea and heart failure symptoms. The first patient was not in labor, managed conservatively and was discharged clinically improved; the latter was delivered abdominally who later succumbed to fatal arrhythmia. Presented are the strategies in management and challenges encountered in managing a pregnant cardiac patient from cor pulmonale, specifically from pulmonary tuberculosis.
Pulmonary Heart Disease ; Hypertension, Pulmonary ; Pulmonary Artery ; Heart Diseases ; Tuberculosis ; Tuberculosis, Pulmonary ; Pregnancy Complications

Background: There has been an increasing trend in reported sexual abuse patients in the Philippines in the past 20 years. Patient evaluation is critical from health care providers and it is imperative to have an acute care protocol that heath care providers can use in managing these patients. Objective: To assess the adherence to the acute care protocol as applied to adult female sexual abuse patients who consulted at the Philippine General Hospital OB Admitting Section from March to August 2019 Methods: The study design used was an observational, cross-sectional study via descriptive analysis using a designed questionnaire. Relevant data regarding compliance to the acute care protocol was assessed from patient experience via the questionnaire after undergoing the standard services of the hospital. Data was then documented, tabulated and processed via Microsoft Excel data sheets. Results: In terms of patient perspective, 96.2 % of all cases (n=27) were provided service by OBGYNs and psychiatrists and 100% were assessed by social workers. Although stated in the protocol, legal and/or police assistance was not provided by the hospital during patient consult. Conclusion The institution was able to adhere to the acute care protocol services of patients in terms of obstetric and gynecologic, psychiatric and social worker services but not legal and/or police assistance.
Humans ; Sex Offenses ; Patient Compliance

There has been a dramatic increase in very young adolescent pregnancies in recent years, with pregnancies documented in children as young as 10 years old, likely from sexual abuse. This article presents a 10-year-old female who initially consulted at the emergency room in her 27th week of pregnancy as a result of recurrent sexual abuse. Prompt assessment, diagnosis, and appropriate referrals to Obstetrics, Pediatric Adolescent Clinic, Psychiatry, and Child Protection Unit rendered optimal management for the patient. Dilemmas encountered in managing the case included preterm labor, large-for-gestational-age baby, immature pelvis, and approach to the appropriate mode of delivery compounded with management of trauma from sexual abuse. A multidisciplinary approach in managing these dilemmas achieved optimal outcomes with the patient delivering a live baby boy, appropriate for gestational age via cesarean section at term.
Child abuse ; pregnancy in adolescence ; preteen pregnancy ; teenage pregnancy ; sexual