RESUMEN

Our objective was to compare the latency periods after preterm premature rupture of membranes (PPROM) and determine its subsequent impact on maternal and fetal outcomes for singleton and twin gestations > 24 weeks' and ≤ 34 weeks' gestation. Delivery in the first 72 h after the rupture of membranes was observed to be more frequent in the twin group (RR 1.98, 95% CI 1.06-3.73, p = 0.03); whereas the overall median latency periods were comparable (p = 0.06). Singleton pregnancies had shorter latency periods after 28 gestational weeks by comparison to the latency periods before 28 weeks. Gestational age of rupture of membranes and delivery and latency periods were comparable between spontaneous twin pregnancies and twin pregnancies after assisted reproductive technologies (ART). As a conclusion, singleton and twin pregnancies had similar outcomes after PPROM. The first 72 h is especially important for the outcome of twin pregnancies at when the delivery risk is high.

Asunto(s)

Parto Obstétrico/estadística & datos numéricos , Rotura Prematura de Membranas Fetales/epidemiología , Embarazo Gemelar/estadística & datos numéricos , Adulto , Femenino , Edad Gestacional , Humanos , Embarazo , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Turquía/epidemiología

RESUMEN

The objective of this study was to assess the impact of body mass index (BMI) on transobturator tape (TOT) success rates, patient acceptability and complications 1 year following surgery. The medical records of stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) patients who underwent the TOT operation were retrospectively reviewed. The patients were divided into non-obese (BMI < 25) and obese (BMI ≥ 30) groups. Baseline and 1 year post-surgical outcomes were assessed by including multichannel urodynamics, Urogenital Distress Inventory (UDI-6) scores, Incontinence Impact Questionnaire (IIQ-7) scores and cure, failure and success rates. There were no significant differences between groups in terms of urodynamic parameters, objective cure rate and subjective success, quality of life scores, or postoperative complications. Both obese and non-obese patients had cure and/or improvement of their symptoms and had better quality-of-life in the postoperative period. As a conclusion, BMI does not affect the clinical effectiveness of TOT operation in the treatment of female SUI or MUI.

Asunto(s)

Obesidad/complicaciones , Cabestrillo Suburetral , Incontinencia Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento , Incontinencia Urinaria/fisiopatología , Urodinámica

RESUMEN

Diabetes is a metabolic disorder that complicates pregnancy. Early detection of patients at risk of developing complications is particularly important. Failure of normal cardiovascular adaptation that takes place in pregnancy has been associated with poor perinatal outcome in preeclamptic patients. The aim of this study was to investigate if complications were higher in diabetic patients with cardiac maladaptation. Fetal, uteroplacental Doppler and echocardiographic examinations were performed once in the second and third trimesters in diabetic and healthy pregnant patients. Physiological cardiac hypertrophy was apparent in healthy patients. This, although within normal limits, was less prominent in patients with diabetes. The majority of patients were found to have normal Doppler waveforms. The abnormal uteroplacental flow group consisted almost entirely of patients with pregestational diabetes, especially type I diabetes. Neonatal complications were most common in this group. No relationship was found between echocardiographic findings, Doppler waveforms and poor perinatal outcome.

Asunto(s)

Adaptación Fisiológica , Diabetes Gestacional/fisiopatología , Corazón/fisiopatología , Placenta/irrigación sanguínea , Embarazo en Diabéticas/fisiopatología , Útero/irrigación sanguínea , Adulto , Presión Sanguínea/fisiología , Estudios de Casos y Controles , Cesárea/estadística & datos numéricos , Diástole/fisiología , Ecocardiografía Doppler , Femenino , Retardo del Crecimiento Fetal/epidemiología , Humanos , Hiperbilirrubinemia Neonatal/epidemiología , Placenta/diagnóstico por imagen , Embarazo , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Primer Trimestre del Embarazo , Tercer Trimestre del Embarazo , Nacimiento Prematuro/epidemiología , Estudios Prospectivos , Pulso Arterial , Flujo Sanguíneo Regional/fisiología , Volumen Sistólico/fisiología , Sístole/fisiología , Ultrasonografía Doppler , Ultrasonografía Prenatal , Útero/diagnóstico por imagen , Resistencia Vascular/fisiología , Función Ventricular Izquierda/fisiología

Asunto(s)

Anemia/diagnóstico , Edema/diagnóstico , Complicaciones Hematológicas del Embarazo/diagnóstico , Enfermedades de la Vulva/diagnóstico , Adulto , Anemia/patología , Diagnóstico Diferencial , Edema/patología , Femenino , Humanos , Recién Nacido , Paridad , Embarazo , Complicaciones Hematológicas del Embarazo/patología , Tercer Trimestre del Embarazo , Enfermedades de la Vulva/patología

RESUMEN

Acute fatty liver is a rare but fatal complication of pregnancy. Here we describe a patient presenting with stupor and jaundice after aspirin intake at 35 weeks of gestation. Supportive management and delivery resulted in uneventful discharge of the patient and the newborn. Differential diagnosis and management of this condition are discussed.

Asunto(s)

Antiinflamatorios no Esteroideos/efectos adversos , Aspirina/efectos adversos , Hígado Graso/inducido químicamente , Complicaciones del Embarazo/inducido químicamente , Adulto , Aspirina/administración & dosificación , Transfusión de Componentes Sanguíneos , Diagnóstico Diferencial , Hígado Graso/mortalidad , Hígado Graso/terapia , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/terapia , Tercer Trimestre del Embarazo

RESUMEN

OBJECTIVE: To examine the effect of antenatal steroids on the biophysical profile and the Doppler parameters of umbilical and middle cerebral arteries of healthy fetuses. STUDY DESIGN: Thiry-five singleton pregnancies between the gestational ages of 28 and 34 weeks, who received two consecutive doses of betamethasone 24h apart to accelerate pulmonary maturation were prospectively studied. Fetal biophysical profile and Doppler assessment were performed at 0 (pre-steroid), 24, 48, 72, 96 and 120 h after the administration of first dose. We compared the percentage of the fetuses with biophysical parameters present for each of the five components of the biophysical profile and the Doppler indices, using Cochran's Q-test, Friedman's test and one way analysis of variance of repeated measures where appropriate. The statistical significance was defined as P<0.05. RESULTS: The mean delivery time was 36.9(+/-1.8) weeks. There was a statistically significant difference in the frequency of the following findings in the pre- compared to post-steroid measurements: absence of body movements (48 h, P<0.05), non-reassuring fetal heart rate tracings (24, 48 and 72 h, P<0.05) and absence of breathing movements (24, 48 and 72 h, p<0.05). Initially none of the biophysical profile score was

Asunto(s)

Betametasona/uso terapéutico , Arterias Cerebrales/embriología , Glucocorticoides/uso terapéutico , Venas Umbilicales/diagnóstico por imagen , Adulto , Fenómenos Biofísicos , Biofisica , Arterias Cerebrales/diagnóstico por imagen , Arterias Cerebrales/efectos de los fármacos , Femenino , Edad Gestacional , Frecuencia Cardíaca Fetal/efectos de los fármacos , Humanos , Embarazo , Ultrasonografía Doppler , Venas Umbilicales/efectos de los fármacos , Venas Umbilicales/embriología

RESUMEN

We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated.

Asunto(s)

Neoplasias Renales/terapia , Linfangioma Quístico/terapia , Nefrostomía Percutánea , Complicaciones Neoplásicas del Embarazo/terapia , Adulto , Diagnóstico Diferencial , Drenaje , Femenino , Humanos , Neoplasias Renales/diagnóstico , Linfangioma Quístico/diagnóstico , Embarazo , Complicaciones Neoplásicas del Embarazo/diagnóstico , Tomografía Computarizada por Rayos X , Ultrasonografía

RESUMEN

OBJECTIVE: To assess the presence of subtle carbohydrate metabolism abnormalities in otherwise healthy mothers who have given macrosomic birth by utilizing postpartum oral glucose tolerance test (PPOGTT). STUDY DESIGN: Prospective controlled study enrolled gestational diabetic women (GDM, n=10), mothers with macrosomic infants (MwMIs, n=62) and controls (n=50). RESULTS: Receiver operating characteristic (ROC) curve analysis revealed that incremental 1-h+2-h PPOGTT value >111 mg/dl had a sensitivity of 80% and specificity of 78% in predicting antecedent diabetes. PPOGTT results were positive in 53.2% of MwMIs and 28% of controls (P<0.01). Maternal low-density lipoprotein and triglyceride levels, 50 gram glucose challenge test (50 g GCT) values and neonatal weight were the significant predictors of PPOGTT results. ROC analyses suggested that threshold of 50 g GCT should be lowered in order to better predict subjects with both macrosomia and positive PPOGTT. CONCLUSION: PPOGTT may identify a subset of women with macrosomic infants who have metabolic alterations of a prediabetic state. The discrepancies between antenatal and postpartum tests may reflect the need for redefinition of currently utilized criteria in screening and diagnosis of GDM.

Asunto(s)

Diabetes Gestacional/diagnóstico , Macrosomía Fetal/etiología , Prueba de Tolerancia a la Glucosa , Periodo Posparto , Adulto , Glucemia/metabolismo , Femenino , Humanos , Lípidos/sangre , Lipoproteínas LDL/sangre , Embarazo , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad , Triglicéridos/sangre

RESUMEN

Four pregnant women with mitral stenosis who did not respond to medical therapy underwent successful percutaneous balloon valvuloplasty with complete resolution of their symptoms. Their clinical features and echocardial and hemodynamic data are presented. The procedures and the remainder of their pregnancy were uncomplicated. Percutaneous balloon valvuloplasty of the mitral valve is a safe and effective alternative to surgical therapy if medical management is unsuccessful.

Asunto(s)

Cateterismo , Estenosis de la Válvula Mitral/terapia , Complicaciones Cardiovasculares del Embarazo/terapia , Adulto , Femenino , Humanos , Embarazo , Resultado del Tratamiento

RESUMEN

Although rheumatic diseases are reported to be almost eradicated in the developed countries, they still continue to contribute significantly to maternal mortality in the developing world. Surgical therapies need to be considered for those patients who do not respond satisfactorily to medication. However, valve replacement or valvulotomy during pregnancy carries significant risks for both the mother and the fetus. Two patients with severe mitral stenosis refractory to medical therapy are presented. Both patients were subjected to percutaneous balloon valvuloplasty during pregnancy without any complications. They were able to discontinue medication and deliver vaginally at term. Balloon valvuloplasty appears to be a safe alternative to conventional surgical approaches in pregnancy.

Asunto(s)

Cateterismo , Países en Desarrollo , Estenosis de la Válvula Mitral/terapia , Complicaciones Cardiovasculares del Embarazo/terapia , Cardiopatía Reumática/terapia , Adulto , Femenino , Monitoreo Fetal , Edad Gestacional , Frecuencia Cardíaca Fetal/fisiología , Hemodinámica/fisiología , Humanos , Recién Nacido , Masculino , Estenosis de la Válvula Mitral/fisiopatología , Embarazo , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Cardiopatía Reumática/fisiopatología , Turquía

Asunto(s)

Antígenos de Superficie de la Hepatitis B/sangre , Vacunas contra Hepatitis B/uso terapéutico , Hepatitis B/transmisión , Inmunización Pasiva , Inmunoglobulinas/uso terapéutico , Complicaciones Infecciosas del Embarazo , Femenino , Estudios de Seguimiento , Hepatitis B/sangre , Hepatitis B/prevención & control , Humanos , Lactante , Recién Nacido , Tamizaje Masivo , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/prevención & control

RESUMEN

An abdominal pregnancy after treatment for female genital tuberculosis is presented. Early treatment after the diagnosis of female genital tuberculosis may restore fertility in the rare patient. Chemotherapy is the cornerstone of therapy. Ectopic pregnancies are common and should be ruled out to avoid catastrophic results.

Asunto(s)

Antituberculosos/uso terapéutico , Embarazo Abdominal , Tuberculosis de los Genitales Femeninos/tratamiento farmacológico , Adulto , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Embarazo , Factores de Tiempo

RESUMEN

An abdominal pregnancy after treatment with human menopausal and chorionic gonadotropins is reported. The role of induction of ovulation with human menopausal and chorionic gonadotropins as a cause of ectopic pregnancy has not been delineated. However, it appears that ultrasonography has become one of the most important aids in the diagnosis of abdominal pregnancy.

Asunto(s)

Gonadotropina Coriónica/efectos adversos , Menotropinas/efectos adversos , Embarazo Abdominal/inducido químicamente , Adulto , Femenino , Humanos , Embarazo , Embarazo Abdominal/diagnóstico , Embarazo Abdominal/cirugía , Ultrasonografía