RESUMEN
In order to compare the maternal-fetal outcome in pregnant women of advanced age (bigger than 35 years old) with those smaller than 30 years. 268 pregnant women were studied that went for their control and attention of the childbirth, corresponding 134 patients of more than 35 years and 134 patients between 20-29 years (control group). Cases were excluded if presented confounding variables (smoking, obesity, multiparity and maternal illnesses associated to the pregnancy). Data of maternal-fetal morbimortality were written down both groups and they were analyzed by means of X2 test or Fisher exact test for assessing differences between the groups, P < 0.05 was considered statistically significant, with a power of 80%, with a delta of 12%. The only two variables that had statistical significant were the number of cesarean sections 66 (49.2%) in the group of older women against 43 (32%) in the control group (P < 0.01) and normal vaginal deliveries (45 cases in the study group and 80 cases in the control group (P < 0.001). The rest of the analyzed variables none had difference statistically significant between both groups and they are described next: Forceps delivery was documented in 6 patients of the older group and 4 of the control group; 7 abortions were observed in a group and 17 in the other group of patients; there were not maternal deaths in both groups. The premature rupture of membranes was presented in 22 cases of the study group and in 24 cases of the control group; 8 congenital anomalies were presented in women's of advanced age children and 2 in mother's of the group control children; admission to the unit of therapy intensive neonatal happened in 17 products of the study group and in 9 cases of the control group; there were 3 stillbirths in the women of advanced age and 1 stillbirth in the control group; 3 perinatal deaths were presented in the patients of advanced age and 2 cases in the control group, all these variables had a value of P greater than 0.05 (not significant). When controlling confounding variables that can influence in the increase of the maternal-fetal morbimortality, it was observed that the only two significant variables were smaller normal vaginal deliveries (P < 0.001) and higher number of cesarean sections (P < 0.01) in patients with advanced age, owing to most of them are subjected to cesarean section without evaluating the possibility to obtain the product by means of a childbirth, for what the indication of cesarean section should be revalued in advanced age multiparous pregnant and in case of not having factors of associated risk to attempt the birth for childbirth, reducing by this way the incidence of cesarean sections as well as the morbidity that this procedure may imply.
Asunto(s)
Muerte Fetal , Edad Materna , Mortalidad Materna , Complicaciones del Embarazo/epidemiología , Adulto , Cesárea , Femenino , Rotura Prematura de Membranas Fetales , Edad Gestacional , Humanos , Paridad , Embarazo , Complicaciones del Embarazo/etiología , Factores de RiesgoRESUMEN
This is a prospective study in order to evaluate the association between placenta grade III changes and the neonatal outcome. A total of 370 patients divided into two groups were included: the case group included 182 patients with placenta grade III changes (placental senescence) and the control group included 188 cases with grade 0, I or II placenta. The patients with grade III placenta had more cases of oligohydramnios (37 vs 24%), cardiotocographic non reactive tests (35 vs 17 cases) and an elevated frequency of cesarean sections (83%), (P < 0.05). The newborns in both groups had not difference in birth weight and Apgar scores, but the senescence placental group had a higher incidence of meconium stained fluid (13 vs 8%, P < 0.05) and an increased admissions to special care nursery (17 vs 5 cases, P < 0.05). We concluded that our findings support that the placental senescence had a close association with the perinatal morbidity and we suggested a closer surveillance in these patients to improve the perinatal outcome.
Asunto(s)
Placenta/diagnóstico por imagen , Resultado del Embarazo , Ultrasonografía Prenatal , Adolescente , Adulto , Envejecimiento/fisiología , Peso al Nacer , Cesárea/estadística & datos numéricos , Femenino , Humanos , Presentación en Trabajo de Parto , Placenta/fisiología , Embarazo , Estudios ProspectivosRESUMEN
PURPOSE: To identify current concepts and practices to treat a folk illness "empacho" in Leon, Guanajuato and a critical appraisal of risk involved. DESIGN: Prospective cross sectional survey. FRAMEWORK: General population. PATIENTS: A random sample of 519 families. MEASUREMENTS: Socioeconomic stratum, the point of view on empacho, the type and kind of treatment undertook and the clinical course observed were recorded. RESULTS: The 45.9% of the families considered empacho as a serious condition, though the prevalence of the concept was less in the high socioeconomic group. The most frequent (44.1%) concept on empacho was "something stuck in the gut" and it use to be deal with abdominal massage and herb infusions. Cooking oil was used in 34.7%, bismuth powder in 36.5%, and an unknown powder in a further 7.9% of cases. The remedy was "prescribed" by the mother herself in 48.3% of patients, whilst in the remaining someone else did it. Simultaneous medical treatment was received by 44.2% of children and 95% of them improved. CONCLUSIONS: There is a high prevalence of the concept of empacho in the general population, mainly in the low and medium socioeconomic strata. In its treatment, dangerous practices are used, which can results in lipidic pneumonia or poisoning and according to their intensity can produce lose of life or deterioration in the respiratory or neurologic functions or both.