RESUMO
Background: Neural tube defects are a heterogeneous group of alterations of the central nervous system with multifactorial origin, mainly caused by a failure in the mechanisms of closure of the neural tube which involves skin, paravertebral muscles, connective tissue, bone and spinal cord. Clinical case: 36-year-old woman with a pregnancy of 25.3 weeks, corroborated by second trimester ultrasound. She had a previous pregnancy with anencephaly and a poor prenatal care in the actual pregnancy. An obstetric ultrasound was performed with the diagnosis of craniorachischisis, which is why the delivery was performed by vaginal birth with labor induction with prostaglandins. Conclusions: The craniorachischisis is a rare defect of the neural tube that must be diagnosed early because it is a pathology incompatible with life.
Introducción: los defectos del tubo neural son un grupo heterogéneo de alteraciones del sistema nervioso central, de origen multifactorial, principalmente ocasionados por una falla en los mecanismos de cierre del tubo neural, la cual involucra: piel, músculos paravertebrales, tejido conectivo, hueso y médula espinal. La craneorraquisquisis es la variante más grave y rara de los defectos del tubo neural. Caso clínico: Mujer de 36 años con un embarazo de 25.3 semanas, corroborado por ultrasonido del segundo trimestre, con el antecedente de un embarazo previo con anencefalia y mal control prenatal en el embarazo actual. Se le realizó un ultrasonido que diagnosticó craneorraquisquisis, por lo que se procedió a finalizar el embarazo por inducción de trabajo de aborto con prostaglandinas. Conclusiones: la craneorraquisquisis es un defecto raro del tubo neural que debe diagnosticarse tempranamente por ser una patología incompatible con la vida.
Assuntos
Anencefalia , Defeitos do Tubo Neural , Adulto , Anencefalia/complicações , Sistema Nervoso Central , Feminino , Humanos , Defeitos do Tubo Neural/etiologia , Gravidez , Ultrassonografia Pré-NatalRESUMO
INTRODUCTION: Anencephaly is the most severe neural tube defect in human fetuses. There is an increasing need for tissue replacement in chronic diseases and reconstructive surgeries. Fetal tissues have been used as a substitute for native organs. AIM: The aim of this article was to compare the structure and morphology of the corpora cavernosa (CC) and spongiosum (SP) of penises from anencephalic and normal human fetuses. MAIN OUTCOME MEASURES: The main outcome measures of this study were the proposition of a new model for biological studies and tissue transplantation. METHODS: We studied 11 penises from normal human fetuses, aged 14-23 weeks postconception (WPC), and five penises from anencephalic fetuses, aged 18-22 WPC. The organs were removed and processed by routine histological and immunolabeling techniques. Analysis of connective tissue (Cot), smooth muscle (SMC), and elastic fiber (EF) were performed in sections. Data were expressed as area density (Ad) using digital processing and software. Means were statistically compared using the unpaired t-test and linear regression was performed. Statistical significance was considered if P<0.05. RESULTS: The intracavernosal septum was present in all samples. We did not observe differences in the Ad of Cot and SMC in the penises of anencephalic fetuses when compared with normal ones. The simple linear regression suggested that during human development, there is a gradual increase in Cot (R(2)=+0.45) and a decrease of SMC (R(2)=-0.62) in the CC in both groups studied. Elastin was observed only in fetuses from 20th WPC. CONCLUSIONS: There was no difference in the structure of the CC and corpus SP of anencephalic fetuses compared with normal ones. Elastin was documented from 20th WPC, which suggests the maintenance of erectile function. Histochemistry and immunolabeling suggested that penile shaft development is maintained and unaltered in anencephalic fetuses. Further studies should be performed to analyze anencephalic fetuses as a potential tissue-donating group and a model for biological studies.
Assuntos
Anencefalia/complicações , Doenças Fetais/etiologia , Doenças do Pênis/etiologia , Pênis/anormalidades , Feminino , Humanos , Masculino , Pênis/embriologia , Gravidez , Doadores de TecidosRESUMO
PURPOSE: Anencephaly is the most severe neural tube defect in human fetuses. The objective of this paper is to analyze the structure of the bladder in anencephalic human fetuses. METHODS: We studied 40 bladders of normal human fetuses (20 male and 20 female, aged 14 to 23 WPC) and 12 bladders of anencephalic fetuses (5 male and 7 female, aged 18 to 22 WPC). The bladders were removed and processed by routine histological techniques. Stereological analysis of collagen, elastic system fibers and smooth muscle was performed in sections. Data were expressed as volumetric density (Vv-%). The images were captured with Olympus BX51 microscopy and Olympus DP70 camera. The stereological analysis was done using the software Image Pro and Image J. For biochemical analysis, samples were fixed in acetone, and collagen concentrations were expressed as micrograms of hydroxyproline per mg of dry tissue. Means were statistically compared using the unpaired t-test (p<0.05). RESULTS: We observed a significant increase (p<0.0001) in the Vv of collagen in the bladders of anencephalic fetuses (69.71%) when compared to normal fetuses (52.74%), and a significant decrease (p<0.0001) in the Vv of smooth muscle cells in the bladders of anencephalic fetuses (23.96%) when compared to normal fetuses (38.35%). The biochemical analyses showed a higher concentration of total collagen in the bladders of anencephalic fetuses (37354 µg/mg) when compared to normal fetuses (48117 µg/mg, p<0.02). CONCLUSIONS: The structural alterations of the bladder found in this study may suggest the existence of functional alterations in the bladder of anencephalic human fetuses.
Assuntos
Defeitos do Tubo Neural/complicações , Bexiga Urinária/anormalidades , Anormalidades Múltiplas , Anencefalia/complicações , Colágeno/metabolismo , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Humanos , Imuno-Histoquímica/métodos , Masculino , Músculo Liso/metabolismo , Gravidez , Bexiga Urinária/embriologiaRESUMO
Se realizó el análisis anatomoclínico de cuatro fetos malformados con la asociación anencefalia-mielosquisis-onfalocele, que nacieron en el Hospital Universitario de Los Andes de Mérida entre 1989 y 1991. Además estas anomalías, un caso presentó malformaciones en los miembros, tres de ellos alteración en el número de vasos umbilicales y uno estaba asociado con el síndrome del cordón corto. Se analizaron los posibles factores teratógenos relacionados con la aparición de malformaciones del tubo neural asociaciadas con onfalocele, y se hicieron comentarios sobre el uso de la ultrasonografía y de la determinación de ciertas enzimas como las alfafetoproteínas y la acetilcolinesterasa, para el diagnóstico prenatal de tales anomalias
Assuntos
Humanos , Masculino , Feminino , Anormalidades Congênitas/genética , Ultrassonografia , Feto/anormalidades , Hérnia Umbilical/patologia , Anencefalia/complicaçõesRESUMO
Las cardiopatías congénitas tienen una incidencia de 1 por ciento de la población general, siendo la malformación congénita más frecuente. El síndrome del corazón izquierdo hipoplásico (SCIH), es un cuadro que se caracteriza por el desarrollo incompleto del lado izquierdo del corazón. Comprende varios grados de hipoplasia de la aorta, de la válvula aórtica, de la válvula mitral, de la aurícula izquierda y del ventrículo izquierdo. Su incidencia es 10-15 por ciento del total de las malformaciones cardíacas congénitas. Su etiología es desconocida y el riesgo de recidiva es del 0,5 por ciento. El diagnóstico prenatal se sospecha en el examen de rutina de las 20 a 24 semanas, el diagnóstico definitivo se realiza mediante la ecocardiografía fetal. El pronóstico es grave, falleciendo el 95 por ciento de los fetos aproximadamente en los primeros tres meses de vida. En este trabajo se comunica el diagnóstico, manejo y evolución de los casos de ventrículo izquierdo hipoplásico diagnosticados en nuestro servicio. Se realizó un estudio retrospectivo descriptivo que incluye seis casos con diagnóstico de hipoplasia del ventrículo izquierdo reunidos en nuestro servicio
Assuntos
Humanos , Gravidez , Feminino , Recém-Nascido , Síndrome do Coração Esquerdo Hipoplásico , Ultrassonografia Pré-Natal , Anencefalia/complicações , Cardiopatias Congênitas , Idade Gestacional , Síndrome do Coração Esquerdo Hipoplásico/complicações , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Idade Materna , PrognósticoRESUMO
Se presenta nuestra experiencia clínica con el uso de prostaglandinas E2 en gel intracervicales y en tabletas intravaginales en la inducción del parto o abortos en fetos muertos. Considerados globalmente las 50 pacientes, el éxito fue de 70 por ciento, excluídos los 9 casos de fetos acráneos; esta proporción de éxito asciende a 77,7 por ciento en los casos de aborto retenido y a 78,26 por ciento en los casos de feto muerto in utero