RESUMEN
El síndrome de Marfan es un trastorno hereditario del tejido conectivo. La principal causa de mortalidad en estas pacientes es debida a complicaciones cardiovasculares relacionadas con dilatación aneurismática de la raíz aórtica y disección de la misma, situación que aumenta su riesgo con los cambios fisiológicos que ocurren durante el embarazo, el parto y el puerperio. Presentamos el caso de una paciente embarazada que presentaba síndrome de Marfan y dilatación de la raíz aórtica de 42mm, e intentamos arrojar luz sobre temas como son la vía de parto (parto vaginal vs. cesárea) en función del diámetro aórtico o la elección del tipo de anestesia (general vs. neuroaxial) en estos casos
Marfan syndrome is a hereditary connective tissue disorder. The main cause of mortality in these patients is due to cardiovascular complications related to dilation of an aneurysm and dissection of the aortic root, a situation that increases their risk due to the physiological changes that occur during pregnancy, childbirth and puerperium. The case is presented of a pregnant woman with Marfan syndrome and aortic root dilatation of 42mm. The issues are discussed, such as the mode of delivery (vaginal delivery vs. caesarean section) depending on the aortic root diameter or the choice of type of anaesthesia (general vs. neuraxial) in these cases
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Síndrome de Marfan/diagnóstico , Insuficiencia de la Válvula Aórtica/complicaciones , Cesárea , Anestesia Obstétrica/métodos , Síndrome de Marfan/complicaciones , Complicaciones del Embarazo/diagnóstico , Embarazo de Alto RiesgoRESUMEN
Marfan syndrome is a hereditary connective tissue disorder. The main cause of mortality in these patients is due to cardiovascular complications related to dilation of an aneurysm and dissection of the aortic root, a situation that increases their risk due to the physiological changes that occur during pregnancy, childbirth and puerperium. The case is presented of a pregnant woman with Marfan syndrome and aortic root dilatation of 42mm. The issues are discussed, such as the mode of delivery (vaginal delivery vs. caesarean section) depending on the aortic root diameter or the choice of type of anaesthesia (general vs. neuraxial) in these cases.
Asunto(s)
Anestesia Obstétrica , Enfermedades de la Aorta/etiología , Parto Obstétrico , Síndrome de Marfan/complicaciones , Complicaciones Cardiovasculares del Embarazo/etiología , Adulto , Enfermedades de la Aorta/patología , Dilatación Patológica/etiología , Femenino , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/patologíaAsunto(s)
Cuidados Críticos/estadística & datos numéricos , Cuerpo Médico de Hospitales/estadística & datos numéricos , Carga de Trabajo/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Francia , Humanos , Unidades de Cuidados Intensivos , Estudios Prospectivos , Factores de TiempoRESUMEN
The authors describe a collective histamine related food-poisoning epidemic that occurred in the Navy due to the consumption of imported smoked swordfish (Xyphias gladius). Twenty cases were detected. The relative risk among consumers of swordfish is at 7.44 (C.I. of 95%: 2.57-21.59) and the doses of histamine were from 2.030 to 4.750 ppm in 9 samples of tested fish (N < 200 ppm). The interest in using a high-resolution chromatographic liquid to ensure a diagnosis, and in using the community norms in force are shown. A recent review of the literature serves to show the variety of fish responsible for this type of accident, to insist on the mildness, elusiveness, variability, and lack of specificity of clinical signs and therefore risks error in diagnoses, treatment and under-reporting of this type of collective food-poisoning.