RESUMEN

OBJECTIVE: To improve differential diagnosis of choledochal cyst, a rare pathology but whose prenatal diagnosis improves neonatal prognosis. CASE REPORT: Choledochal cysts are a rare congenital abnormality of biliary ducts that present as an anechoic mass in the right upper quadrant of the abdomen. In sonographic examination, a connection between the cyst and the common bile duct must be observed to confirm this diagnosis. It is more frequently diagnosed in females and in Asian countries. We describe a pregnant woman diagnosed of an intra-abdominal fetal cyst at 17-weeks of gestation. Ultrasound assessment showed a cystic mass separated from the stomach, moving other abdominal organs from its normal location and growing progressively. Postnatal study confirmed a choledochal cyst of 8-centimeters in diameter. Surgical treatment was recommended and post-surgical evolution was favourable. CONCLUSIONS: Prenatal diagnosis of choledochal cyst allowed to intensify controls to check the growth. Early surgical treatment improved neonatal prognosis and reduced the risk of sequelae

OBJETIVO: mejorar el diagnóstico diferencial del quiste de colédoco, una patología rara pero cuyo diagnóstico prenatal mejora el pronóstico neonatal. CASO CLÍNICO: los quistes de colédoco son una anormalidad congénita rara de los conductos biliares que se presentan como anecoicos, una masa en el cuadrante superior derecho del abdomen. En el examen ecográfico hay una conexión entre el quiste y se debe observar el conducto biliar común para confirmar este diagnóstico. Se diagnostica con mayor frecuencia en mujeres y en países asiáticos. Describimos a una mujer embarazada diagnosticada de un quiste fetal intrabdominal a las 17 semanas de gestación. La evaluación por ultrasonido mostró una masa quística separada del estómago, moviendo otros órganos abdominales desde su ubicación normal y creciendo progresivamente. El estudio posnatal confirmó un quiste de colédoco de 8 centímetros de diámetro. Se recomendó tratamiento quirúrgico y la evolución posquirúrgica fue favorable. CONCLUSIONES: el diagnóstico prenatal del quiste de colédoco permitió intensificar los controles para supervisar el crecimiento temprano. El tratamiento quirúrgico mejoró el pronóstico neonatal y redujo el riesgo de secuelas

Asunto(s)

RESUMEN

INTRODUCTION: Delayed delivery is sometimes performed in selected multifetal pregnancies when the first twin birth occurs inevitably. The aim of this procedure is to improve the prognosis and decrease the morbidity and mortality of the second twin. We report three cases of delayed-interval delivery of dichorionic-diamniotic twin pregnancies assisted in our center between 2015 and 2017. After the first twin delivery, the second twin was left in utero and the patient received tocolytic therapy and antibiotics. Cervical cerclage was not performed. RESULTS: Our patients were admitted between 21 + 3 and 23 + 6 weeks of gestation. We achieved an average interval delivery of 6.33 d. Four out of six twins did not survive the delayed interval procedure. The average stay of the first and second twins that were admitted to the neonatal intensive care unit (NICU) was of 72 d (28-116) and 39.5 d (12-67), respectively. The first twin birth was vaginal in all cases, while the second twin delivery was performed by cesarean section in two out of our three patients. Our neonatal results are not favorable, probably due to the extreme prematurity. CONCLUSIONS: Delayed delivery of the second twin before 28 weeks of gestation can be an alternative for the obstetrician since it could prolong the pregnancy until a gestational age which confers a better prognosis and a better perinatal outcome for the second twin.

Asunto(s)