Asunto(s)
Etanol/uso terapéutico , Hemangioma/terapia , Enfermedades Placentarias/terapia , Complicaciones Neoplásicas del Embarazo/terapia , Neoplasias Vasculares/terapia , Etanol/administración & dosificación , Femenino , Edad Gestacional , Hemangioma/irrigación sanguínea , Humanos , Inyecciones Intralesiones , Enfermedades Placentarias/patología , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Neoplasias Vasculares/irrigación sanguíneaRESUMEN
Serial decompressive amniocenteses were performed at 18-23 weeks of gestation in 23 pregnancies referred due to echographic signs typical of twin-twin transfusion syndrome. The procedures were repeated until delivery or permanent normalization of the amniotic fluid volume both in the donor and the recipient twin sac. The overall survival rate was 57%, but in only 39% of the pregnancies did both twins survive without handicaps. The absence of end diastolic flow in the umbilical artery of the donor twin was associated with poor chances of survival for both fetuses; in contrast, the presence of hydrops or ascites in the recipient twin did not worsen the prognosis. A policy of aggressive amniotic fluid decompression may achieve permanent resolution of the fluid in over 50% of the pregnancies complicated by twin-twin transfusion syndrome.
Asunto(s)
Amniocentesis , Transfusión Feto-Fetal/cirugía , Líquido Amniótico , Diástole , Femenino , Transfusión Feto-Fetal/diagnóstico por imagen , Transfusión Feto-Fetal/fisiopatología , Edad Gestacional , Humanos , Embarazo , Pronóstico , Flujo Sanguíneo Regional , Resultado del Tratamiento , Ultrasonografía Prenatal , Arterias Umbilicales/fisiopatologíaRESUMEN
OBJECTIVE: To evaluate changes in cervical dimensions by transvaginal ultrasound in non-randomly selected pregnant women. METHODS: This longitudinal study included 154 pregnant women undergoing transvaginal ultrasound assessment of the cervix at a mean gestational age of 12, 16, 20, 25, and 31 weeks. On each occasion, the longitudinal and anteroposterior diameters of the cervix were measured. The rate of prematurity in the series was 1.9%, and the mean gestational age at delivery was 38.7 weeks. RESULTS: Overall, cervical length (mean 4.3 cm; 95% confidence interval 4.1-4.3) did not change significantly (P = .06), whereas the anteroposterior diameter of the cervix at its midportion shortened throughout the investigated period of gestation. Multiparous women had longer and thicker cervices than primigravidas or women with previous cesareans or first-trimester abortions. Gestational age at delivery did not correlate with cervical dimensions at any stage of pregnancy. CONCLUSIONS: The cervix undergoes a change in shape from cylindrical to conic, more marked in primigravidas than in parous women. Women who had previous cesarean deliveries had cervical characteristics similar to primigravidas; therefore, it appears that mechanical, rather than hormonal, factors have a greater effect in determining changes of cervical dimensions throughout pregnancy.
Asunto(s)
Cuello del Útero/diagnóstico por imagen , Embarazo , Adulto , Cuello del Útero/anatomía & histología , Cesárea , Femenino , Humanos , Estudios Longitudinales , Trabajo de Parto Prematuro/diagnóstico por imagen , Paridad , UltrasonografíaRESUMEN
The fetal humerus, radius/ulna, femur, tibia/fibula and foot were measured in 296 pregnant women at 64-108 days' menstrual age, using vaginal sonography. All limb measurements correlated significantly with gestational age and biparietal diameter independently. Ratios of limb segment lengths did not change with gestation. Reference ranges (mean and 95% data intervals) were constructed for each limb segment. These data may prove useful in prenatal diagnosis of skeletal dysplasias and in the antenatal assessment of patients at risk of chromosomal abnormalities.
RESUMEN
Twenty women with Chlamydia trachomatis genitourinary infection were treated with oral enoxacin 800 mg/day in two divided doses for 12 days starting on day 1 of the menstrual cycle. A physical examination was performed before the start and 28-30 days after the end of the treatment. At the final examination cultures of urethral and endocervical swabs and endometrial samples were negative in all cases, demonstrating that Chlamydia trachomatis infection had been eradicated. No significant results were obtained at serologic evaluation with the indirect immunofluorescence method to show specific IgM, IgG and IgA antibodies. In the four women with subjective symptomatology this was improved by the treatment with enoxacin. Only two patients presented mild side effects (headache, tachycardia, nausea). Enoxacin seems therefore a very effective and well tolerated drug in the treatment of Chlamydia trachomatis genitourinary infection.