RESUMEN
El cerclaje istmicocervical por vía abdominal es una técnica escasamente utilizada, de mayor riesgo que el cerclaje convencional, pero que puede constituir la única opción terapéutica en determinados casos de insuficiencia istmicocervical. En este trabajo presentamos nuestra primera experiencia con esta técnica, realizada en la semana 11 a una paciente con mala historia obstétrica y que permitió una evolución favorable del embarazo (AU)
Asunto(s)
Adulto , Femenino , Humanos , Técnicas de Sutura , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/fisiopatología , Conización/métodos , Diabetes Gestacional/complicaciones , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/tratamiento farmacológico , Incompetencia del Cuello del Útero/cirugía , Incompetencia del Cuello del Útero/diagnóstico , Aborto/etiología , Progesterona/administración & dosificación , Tocólisis/métodosRESUMEN
Objetivo: Revisión de las nuevas líneas de estudio en el aborto de repetición sin causa tras un estudio de abortabilidad. Sujetos y método: Revisión de la literatura más reciente sobre el tema. Resultados: La abortadora sin causa necesita una atención individualizada. Conclusiones: Sólo el diagnóstico etiológico permitirán individualizar a cada paciente y someterla al tratamiento específico necesario en cada caso. Mientras esto no suceda sólo se podrá ofrecer tratamientos empíricos, mejoras de sus hábitos de vida y cuidados especiales de seguimiento que disminuyan el grado de ansiedad de estas pacientes (AU)
Asunto(s)
Adulto , Femenino , Humanos , Aborto/diagnóstico , Aborto/etiología , Hábitos , Ansiedad/diagnóstico , Ansiedad/terapia , Trastornos de la Coagulación Sanguínea/diagnóstico , Trastornos de la Coagulación Sanguínea/etiología , Trombosis/complicaciones , Trombosis/diagnóstico , Trombosis/etiología , Antitrombinas/deficiencia , Proteína C/deficiencia , Proteína S/análisis , Homocisteína/metabolismo , Aborto Habitual/diagnóstico , Aborto Habitual/etiología , Factores Socioeconómicos , Anticuerpos Antifosfolípidos/administración & dosificación , Anticuerpos Antifosfolípidos/análisis , Edad Materna , Autoinmunidad , Estudios Prospectivos , Aborto Habitual/fisiopatología , Aborto Habitual/terapia , Aborto Habitual/psicologíaRESUMEN
OBJECTIVES - To evaluate social class, ethnic origin, and various endocrine variables as potential risk factors in the development of nephritis in patients with systemic lupus erythematosus (SLE). METHODS - A cross-sectional survey was carried out of all outpatients with SLE attending the lupus clinic of St Thomas's Hospital from March to October 1992 using retrospective survival data. The main outcome measure was to duration of SLE before the onset of nephritis. RESULTS - Two hundred and ninety six women and 11 men were studied; the male patients were excluded from the analysis. Univariate analysis showed an increased risk of nephritis in patients with SLE of West Indian origin with 54 v 19 percent with nephritis at five years, in patients of lower social class, in patients who did not drink alcohol and in those with a history of fetal loss after the onset of lupus. No significant effect of the age of onset of SLE, use of oral contraceptives, normal pregnancy, or smoking was seen. Multivariate analysis showed that ethnic origin did not infulence the risk of nephritis independently of social class. CONCLUSIONS - Factors associated with socioeconomic deprivation may increase disease severity in patients with SLE (AU)
Asunto(s)
Humanos , Embarazo , Adulto , Persona de Mediana Edad , Masculino , Femenino , Lupus Eritematoso Sistémico/complicaciones , Nefritis/etiología , Aborto/etiología , Estudios Transversales , Incidencia , Londres/epidemiología , Nefritis/etnología , Estudios Retrospectivos , Factores de Riesgo , Clase Social , Factores Socioeconómicos , Indias Occidentales/etnologíaRESUMEN
Thirteen pregnancies in ten patients with homograft cardiac valves resulted in 11 healthy infants, one spontaneous abortion, one elective termination of pregnancy, and the stillbirth of one member of a twin pregnancy. Two forceps deliveries and three cesarean section were performed and routine antibiotic prophylaxis at the time of delivery was utilized to prevent infective endocarditis in all patients. No hemorrhagic or teratogenic complications were observed, and this was considered directly related to the fact that anticoagulant therapy was rendered unnecessary with the homograft valve - a distinct advantage. A more permissive policy of allowing pregnancy in young women with homograft cardiac valves is suggested by the satisfactory outcome of the pregnancies reported here (AU)
Asunto(s)
Humanos , Recién Nacido , Masculino , Femenino , Prótesis Valvulares Cardíacas , Embarazo , Aborto Inducido , Válvula Aórtica , Parto Obstétrico , Muerte Fetal , Gemelos , Aborto/etiologíaRESUMEN
The foetal outcome of 127 pregnancies in 47 patients with SS disease is analysed. In contrast to other reports, the incidence of abortions is not increased. In the latter half of pregnancy Haemoglobin SS disease appears to have an adverse effect on foetal growth and survival, and the incidence of foetal anoxia, "prematurity" (in the sense of low birth weight) and perinatal mortality is high. Perinatal loss was doubled when obstetric supervision was inadequate. For inadequately supervised pregnancies, foetal deaths were mainly secondary to maternal complication of sickle cell disease such as pulmonary infarction and severe abdominal pain. Severe maternal anaemia was an important contributory cause of foetal dealth. Painful crises involving bones and joints only, do not, in the absence of other complications, appear to have any significant effect on foetal growth and survival (AU)