Alertas ginecológicas: cuándo ir a la guardia en tiempos de coronavirus

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saludtotalmedia
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Entre las recomendaciones que circulan desde la llegada del COVID-19 al país una de las principales, además de cumplir el aislamiento preventivo, es no exponerse a ir a un centro de salud si no es estrictamente necesario. Cómo diferenciar una dolencia que requiere consulta médica de una que no para minimizar riesgos17 de junio de 2020

La sugerencia es no exponerse al virus ni ocupar un lugar en el sistema de salud si no es necesario (Shutterstock)
La sugerencia es no exponerse al virus ni ocupar un lugar en el sistema de salud si no es necesario (Shutterstock)

No ocupar lugar en un centro de salud que no sea estrictamente necesario, priorizar el cumplimiento del aislamiento social preventivo y obligatorio, y no exponerse a ir a un centro de salud donde hay más posibilidades de cruzarse con alguien enfermo de coronavirus. Tal las principales recomendaciones que circulan en relación a los sistemas de salud desde que la pandemia de COVID-19 se instaló en el país.

Así, muchos médicos cancelaron consultas y algunos lugares atienden sólo por guardias. En este contexto, muchas inquietudes que en otro momento hubieran sido resueltas acercándose a un centro médico, quedan sin respuesta.

El problema es cuando se exagera la decisión de no salir del hogar a riesgo de no consultar a tiempo cuando se tiene alguna patología que sí lo amerita.

“Los médicos sabemos muy bien lo problemático que puede ser un diagnóstico no dado a tiempo. Se trata de encontrar un equilibrio entre ir o no a una guardia, porque las patologías urgentes siguen ocurriendo”. La médica ginecóloga María Elisa Moltoni (MN 114737), precisó algunas consideraciones que deben ser tenidas en cuenta antes de actuar:

– Maximizar el contacto no presencial. Intentar localizar al médico personal para evacuar dudas. Si no se puede acceder a él, conseguir datos de algún profesional o, en el mejor de los casos, averiguar por las consultas virtuales en el lugar donde suele atenderse.

Aunque no sea lo ideal, muchas consultas podrán ser resueltas por la vía virtual (Shutterstock)
Aunque no sea lo ideal, muchas consultas podrán ser resueltas por la vía virtual (Shutterstock)

“Muchas prepagas, dada la situación, están autorizando este tipo de consultas. El contacto también puede ser a través de un mail o teléfono. El profesional va a ser capaz de hacer preguntas dirigidas y específicas para evaluar si lo que nos está pasando amerita una consulta presencial, funcionando como tamizaje previo a acercarnos a algún lugar -aclaró la especialista de Halitus Instituto Médico-. Si bien la consulta virtual no permitirá que nos revisen, si aparece alguna pauta de alarma el profesional nos pedirá que vayamos a la guardia a hacernos algún estudio o a que nos examinen”.

Para ella, “la realidad es que muchas consultas como picazón, ardor al orinar, anticoncepción de emergencia podrán ser resueltas por la vía virtual (aunque tal vez no sea lo ideal) y podrán darse recetas o indicaciones. Además, los sistemas médicos están aceptando fotos de recetas o recetas digitales”.

– Abusar de los test de embarazos. Gran parte de las urgencias ginecológicas llevan en la guardia a tener que descartar embarazo, sobre todo las asociadas a dolor abdominal agudo, sangrados raros, atrasos menstruales, hemorragias o sangrado entre las menstruaciones. “Incluso quienes están con métodos anticonceptivos, un test negativo descarta alguna falla del método. Entonces, saber si hay o no embarazo de antemano puede ahorrar tiempo valioso -precisó Moltoni-. Porque si el test da negativo, hay patologías que podemos descartar (como por ejemplo el embarazo ectópico, que es un embarazo fuera del útero que se puede asociar a dolor y puede ser grave, así como abortos en curso, frente a hemorragia vaginal y dolor)”.

– Escuchar el cuerpo y confiar en la intuición. “Si alguien se siente muy mal, si nunca se sintió así, o tiene algún síntoma que nunca había tenido no hay que subestimarlo”, aseguró la especialista, quien recomendó “confiar en que el organismo es sabio y puede dar el aviso de que hay que ir a la guardia”.

Con esto en mente, la especialista enumeró qué cosas ameritan ir a una guardia:

El problema es cuando se exagera la decisión de no salir del hogar a riesgo de no consultar a tiempo por alguna patología que sí lo amerita (Shutterstock)
El problema es cuando se exagera la decisión de no salir del hogar a riesgo de no consultar a tiempo por alguna patología que sí lo amerita (Shutterstock)

– Hemorragia muy importante, mayor de lo que suele tenerse, con abundantes coágulos. Si además, la mujer se siente muy decaída o se desmaya, o se marea al movilizarse. Si esa hemorragia fuera de lugar se asocia con un fuerte dolor que nunca antes había experimentado.

– Si se tiene un dolor abdominal intenso, progresivo, y en la parte baja, sobre todo si está asociado a fiebre, puede indicar una infección de origen ginecológico. A veces se debe descartar apendicitis, ya que el apéndice está cerca de la trompa y del ovario derecho. En ese caso es mejor ir a una guardia para que hagan una palpación y probablemente análisis. Puede ser una infección en el útero o en las trompas, esto se llama enfermedad pelviana inflamatoria (EPI), y puede asociarse a flujo vaginal abundante.

– Si se tiene dolor abdominal, progresivo, que no cede con analgésicos comunes. Si ese dolor es tan fuerte que despierta a la noche.

– Si se tenía conocimiento de tener un quiste de ovario que estaban controlando y surge, asociado al dolor, un cuadro de mareos, náuseas o vómitos intensos.

– Si se tiene un test de embarazo positivo, la mujer no se hizo hasta el momento ninguna ecografía y comienza con hemorragia o dolor mayor al menstrual.

“No es necesario acercarse a la guardia para solicitar la anticoncepción de emergencia. Si la mujer tuvo un accidente con su método anticonceptivo o no lo utilizó, debe recordar que puede comprar directamente la pastilla de emergencia, y tomarla lo antes posible -sostuvo Moltoni-. No existen contraindicaciones para tomarla. Recordemos que muchas infecciones, así como el embarazo, se previenen con el uso de preservativo. Es importante usarlo siempre, con o sin pandemia”.

La sugerencia es no exponerse al virus ni ocupar un lugar en el sistema de salud si no es necesario. “Pero, al mismo tiempo, escuchar a nuestro cuerpo y acercarse a la guardia si creemos que nuestra patología puede ser grave. Ir a un centro de salud con todos los recaudos: manos limpias, barbijo y manteniendo en las filas de espera una distancia adecuada con los otros pacientes”, aconsejó la especialista, quien recordó que estas recomendaciones que de ningún modo reemplazan el contacto con un profesional.

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