RESUMEN
Nocardiosis is a rare disease associated with significant morbidity and mortality in immunocompromised patients. We report on a 32-year-old pregnant woman with nocardiosis, which may be the third reported case in which no risk factor for the infection (other than the pregnancy itself) could be found. Pregnancy was complicated by the formation of a tubo-ovarian nocardia abscess, resulting in abortion. Lapartomy with trimethopprim-sulfamethoxazole led to complete cure of the patient at the end of the fifth month. This case emphasizes the difficulty in the diagnosis and treatment of a nocardial infection during pregnancy.
Asunto(s)
Absceso/diagnóstico , Enfermedades de las Trompas Uterinas/diagnóstico , Nocardiosis/diagnóstico , Enfermedades del Ovario/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Diagnóstico Prenatal , Aborto Espontáneo , Absceso/terapia , Adulto , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Enfermedades de las Trompas Uterinas/terapia , Femenino , Humanos , Laparotomía , Nocardiosis/terapia , Nocardia asteroides , Enfermedades del Ovario/terapia , Embarazo , Complicaciones Infecciosas del Embarazo/terapiaRESUMEN
OBJECTIVE: To construct an ultrasonographic nomogram of the fetal gastric size with gestational age in normal singleton pregnancy. PATIENTS AND METHODS: Out of 17 000 outpatient pregnant women who were admitted to our hospital, a total of 250 fetal measurements were randomly collected from routine ultrasonographic examinations performed in women with normal singleton pregnancies between 13 and 39 weeks of gestation without medical or obstetric complications. None of the fetuses had detectable fetal malformations. The ultrasound plane which provided the largest stomach area including the pylorus on a transverse and oblique section was used for definition and measurement of gastric longitudinal dimensions. The transverse section at the center of the gastric corpus was used for transverse and anteroposterior dimensions. Biparietal diameter, abdominal circumference were also measured. RESULTS: The fetal gastric longitudinal, anteroposterior and transverse dimensions were significantly correlated with gestational age (r values 0.74, 0.71, and 0.49, respectively). There was a significant correlation measurements between gastric size and AC. The correlation coefficents for gastric dimensions with gestational age was larger than those with AC (r=0.732, 0.702 and 0.489, respectively). The ratio of fetal gastric anteroposterior dimension to fetal AC was a constant parameter calculated as 1/3. CONCLUSION: Fetal stomach dimensions in normal pregnancy correlate with gestational age and nomogram of fetal gastric development appears to be useful in assessment of normal fetal growth.
Asunto(s)
Desarrollo Fetal , Feto/anatomía & histología , Estómago/embriología , Adolescente , Adulto , Femenino , Edad Gestacional , Humanos , Embarazo , Distribución Aleatoria , Estómago/diagnóstico por imagen , Ultrasonografía PrenatalRESUMEN
In this report, two conjoined twin cases that were diagnosed at the 19th and 25th week of gestational age are reported. In the first case the pregnancy was terminated because of the very poor prognosis. In the second case the decision was made to continue the pregnancy after counseling explaining the possibility of a separation procedure with good prognosis being carried out after birth. The babies were delivered at 38 weeks of gestation and the separation procedure was carried out at ten months of age without any complications. In selected cases, there is no need to abort, because of the possibility of a separation procedure after birth with good prognosis. Color Doppler ultrasound examination in an early stage of pregnancy in cases of conjoined twin can make it possible to decide which cases are candidates for a separation procedure after birth.