Recently, a multidisciplinary team from the Dr. Ernesto Guevara General Teaching Hospital managed to save the lives of two teenage pregnant women who had spent several days with very unfavorable prognoses. 26 approaches the event.

A strange fluttering in her ears told her that she was on the edge. She instinctively kept her eyes open for fear of not being able to wake up again. All around her, the doctors tried to attach her to the mechanical ventilator, but all she could think of was the baby inside her womb. She heard them muttering "She's only 18 years old..."

Earlier that week she had woken up with a fickle burning in her throat. She didn't think anything of it. Her belly was getting bigger and bigger. Hours later she was diagnosed with a respiratory infection that triggered severe bronchopneumonia and in the blink of an eye she ended up in the Intensive Care Unit of the Ernesto Guevara Hospital. For seven days the prognosis was extremely critical.

Dr. Aliosky Montero Cala, a first-degree specialist in Intensive Care Medicine and head of the Emergency Centre of the "Guevara", recalls the tension that mobilized a whole team to save the life of this girl. "The patient, as a serious complication, developed respiratory distress that caused significant respiratory, neurological, and cardiovascular dysfunction. We tackled her treatment together with intensivists, gynecologists, cardiologists, and imaging specialists, who provided a lot of information to keep the adolescent as optimized as possible."

"Afterwards, the challenge was to achieve her gradual recovery and finally disconnect her from artificial ventilation. The infection that led to her seriousness was viral, one of the opportunistic germs in pregnant women that can cause very severe complications. We mobilized very efficiently because of what was at stake. It was a fight for life. Up to twice a day we did monitoring by gynecology, cardiology, and all kinds of tests. The necessary drugs were used and we called on many resources so that no parameter was neglected."

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"Something very sad, on her second day in therapy, we met and reached a consensus, collectively and because of her health condition, that it was necessary to terminate the girl's pregnancy, imagine, at more than 24 weeks. Of course, we did it with the prior informed consent of her relatives. It was a complex and very hard time for all of us, but fortunately, the outcome was favorable for the patient. In a short time, we attended to another 16-year-old pregnant woman, also in an extremely severe condition, and we were also able to save her life, but we are very concerned about the increase in complications in these cases and the risks they pose to future mothers."

LESSONS FOR THE FUTURE

The 26 microphones respected the grief of both teenagers, but one of them said she would not want any girl to go through the moments of panic and uncertainty she experienced in the green rooms, clinging to the world with the only hope of being able to guarantee the health of her child, a possibility that is too remote.

"From here, with our hands on our chests, we call on the population, on parents, to internalize that teenage pregnancy entails a real danger for pregnant women because their bodies are simply not yet ready to take on another life," says the Master's degree in Emergency Medicine.

"And we speak with complete certainty because it is in these areas that we really know the complications that arise at this stage and unfortunately cause a lot of pain and fear in the best of cases."

"These two stories are not isolated events. In the service, we are seeing many complications associated with the phenomenon in question. And it has to do with the preparedness of the pregnant women's bodies. If they were suffering from anemia, malnutrition, immunosuppression, or urinary tract infection before they became pregnant, they arrive with risk factors and can have more serious complications."

ALARMS FROM THE INSTITUTIONS

Dr. Eloísa Corría Salgado, head of the Perinatology service, emphasizes that the institution is increasingly confronted with teenage pregnant women, who at the same time are the most complicated in the process because physiologically they are not prepared and have risk factors to trigger pathologies, such as pre-eclampsia, which generally lead them to intensive care.

"I can confirm, beyond the figures, that the largest number of pregnant women who reach intensive care today are adolescents. The maternal death in Las Tunas this year is an adolescent. We are concerned about the high level of urinary tract infections associated with pregnancy that we are seeing, and the population underestimates them. This not only has repercussions on the mother's complications but also the ICUGR (fetus with intrauterine growth retardation) and means that she has to spend a long period in neonatology."

The gynecology specialist shares her concern about the figures that place the province in the most disadvantaged position in the country, but her alarm goes beyond that and seeks to raise awareness within the family.

"I am alarmed by the phenomenon of teenage pregnancy; let me tell you that we are not just talking about 18-year-old girls, here we are receiving patients at a very young age."

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"A few days ago, in the medical ward, I performed a termination of pregnancy, with tablets, on an 11-year-old girl. When I questioned her mother, she told me she was in fifth grade, and the truth is she worries because she is too precocious. Right now we have another 14-year-old girl in hospital with a fetus with retarded growth."

The doctor emphasizes that a fetus with CIUR has a high chance of being born pre-term and life-threatening and that even in its later development it can develop heart disease, diabetes, and neurological disorders, and its psychomotor development is not optimal.

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One maternal death and 30 more teenage pregnancies than at the previous stage reinforce the prominence of this as the main health problem facing Las Tunas today. Today, 18 percent of every 100 pregnant women belong to this age group and continue to fill beds in the Intensive Care Unit, with favorable results to date thanks to many efforts.

In addition to better management within the home, there is still a lack of a multi-sectoral approach, which is beyond the scope of public health, as well as the timely involvement of all local authorities and the collective will to fight for life.