Study of obstetric and perinatal outcome of twin pregnancy

Background: Multifetal pregnancy constitutes a significant portion of high-risk pregnancies. This is due to the increasing obstetric and perinatal morbidity and mortality rates associated with it. Maternal and perinatal outcome of twin pregnancies has been evaluated in this study.Methods: Total 30 patients with twin pregnancy and having gestational age more than 28 weeks were included in this observational study.Results: Incidence of twins in the study was found to be 2%. Twin pregnancies were more common in multiparous women aged between 20 and 30 years. Most common foetal presentation was vertex- vertex presentation. Most common maternal complication was preterm labour seen in 67% women, followed by anaemia seen in 50% women. Most of the women were delivered by caesarean section (63.3%). Most common perinatal complication was birth hypoxia (41.6%). Other perinatal complications were jaundice, septicemia, intrauterine growth restriction. 71% of the neonates had birth weight less than 2.5 kg. Perinatal mortality was found to be 11.6%.Conclusions: Twin pregnancies are high risk pregnancies associated with higher obstetric and perinatal morbidity. Perinatal morbidity was more common for the second coming twin. Regular antenatal visits, planned delivery and better NICU facilities can help combat these complications. A team of skilled obstetricians and pediatricians along with a multidisciplinary approach is essential for the effective management of twin pregnancies.

Trastornos hipertensivos durante el embarazo en gestantes del Policlínico Universitario Santa Clara (2015-2016) / Hypertensive disorders during pregnancy in the University Polyclinic Santa Clara (2015-2016)

Introducción: la preeclampsia es la complicación médica más frecuente del embarazo. En Cuba se ha encontrado una incidencia entre 5 y 10 por ciento, y constituye una de las primeras causas de morbilidad materna y perinatal. Objetivos: describir el comportamiento de los trastornos hipertensivos en las gestantes. Métodos: se realizó una investigación de tipo descriptiva transversal en el Policlínico Santa Clara en el periodo 2015-2016. La población de estudio estuvo constituida por la totalidad (210) las gestantes que pertenecen al policlínico Santa Clara, para la selección de la muestra se empleó un muestreo no probabilístico por criterios, quedando finalmente constituida por 52 pacientes. Resultados: los trastornos hipertensivos del embarazo es una entidad frecuente en el área de salud con repercusión sobre las tasas de morbilidad materna en 20 pacientes (38,5 por ciento), la morbilidad perinatal en 17 pacientes (32,7 por ciento) y la mortalidad en 2 pacientes (3,8 por ciento). Conclusiones: estos trastornos se presentan más en mujeres en las edades extremas de la vida reproductiva y con trastornos nutricionales. Las hipercolesterolemia y la HTA crónica están entre las principales afecciones asociadas. Se presentó mayormente en nulíparas y primíparas con embarazos a término completos y hubo elevado índice de inducciones del parto y cesáreas. La morbilidad puerperal fue elevada con prevalencia de la anemia y también tuvo repercusión sobre el peso y estado de los recién nacidos(AU)

Introduction: Preeclampsia is the most frequent medical complication of pregnancy. In Cuba, an incidence of between 5 and 10 percent has been found and is one of the earliest causes of maternal and perinatal morbidity. Objectives: to describe the behavior of hypertensive disorders in pregnant women. Methods: a cross-sectional descriptive study was carried out in the Santa Clara Polyclinic in the period 2015-2016. The study population consisted of all the (210) pregnant women who belonged to the Santa Clara polyclinic. For the selection of the sample a non-probabilistic sampling was used by criteria, and finally it was constituted by 52 patients. Results: hypertensive disorders of pregnancy are a frequent entity in the health area with repercussions on maternal morbidity rates in 20 patients (38.5 percent), perinatal morbidity in 17 patients (32.7 percent) and mortality in 2 patients (3.8 percent). Conclusions: these disorders present more in women in the extreme ages of reproductive life and with nutritional disorders. Hypercholesterolemia and chronic hypertension are among the main associated conditions. It was present mainly in nulliparous and primiparous women with full term pregnancies and there was a high index of labor induction and cesarean section. Puerperal morbidity was high with prevalence of anemia and also had an impact on the weight and condition of newborns(AU)

Diagnóstico, Evaluación y Manejo de la Enfermedad Renal en el Embarazo / Diagnosis, Evaluation, and Management of renal diseases during Pregnancy

Introducción: La elevada prevalencia de enfermedad renal crónica y otras enfermedades no transmisibles crónicas, unido al incremento en la edad de embarazo ha generado nuevas investigaciones y evidencias de la relación entre la enfermedad renal crónica, el embarazo y los resultados para la madre y el feto. Objetivo: Exponer las mejores prácticas actuales y ofrece una aproximación al diagnóstico, evaluación y tratamiento de la enfermedad renal en el contexto del embarazo y su repercusión en términos de morbilidad y mortalidad para la madre y el feto. Material y Métodos: Se realizó un análisis de la literatura describiendo los mejores resultados clínicos basado en los avances científicos a la fecha actual. Resultados: Se enfatiza la evolución continua entre el daño renal agudo (incipiente) y la falla renal aguda (con necesidad de métodos dialíticos sustitutivos), también de importancia pronóstica con incrementos en la mortalidad materna asociados a pequeños incrementos en la creatinina sérica. Conclusiones: Tanto el desarrollo de un daño renal agudo, la falla renal aguda y la enfermedad renal crónica son causas importantes de morbilidad y mortalidad materno fetal(AU)

Introduction: The high prevalence of chronic kidney disease and others non contagiables diseases, jointly with its increasing frequency in gestational age women have generated new investigations and evidences of the relationship between the chronic renal diseases, the pregnancy and its consequence for the mother and fetus. Objective: This paper summarizes the best practice up to this date and provides a reasonable approach to the diagnosis, evaluation, and treatment of the Renal Disease Disorders of Pregnancy to evaluate the impact of them on maternal and fetal morbidity and mortality. Material and Methods: An analysis of the published literature of the subject was performed, describing the best clinical results based on scientific advances available today. Results: Was emphasized the continuum evolution between acute kidney damage (incipient injury) and acute kidney failure (need to dialysis) also of importance for prognosis, with increasing of the mortality associated with small increases in serum creatinine. Conclusions: The acute kidney diseases/ acute renal failure and chronic renal diseases are important causes of maternal and perinatal morbidity - mortality(AU)

Perfil epidemiológico y perinatal de pacientes con preeclampsia / Epidemiological and perinatal profile of preeclampsia patients

Introducción: la preeclampsia es un problema obstétrico mayor que acarrea importante morbilidad y mortalidad materna y perinatal por los trastornos sistémicos asociados. Objetivo: comparar los resultados maternos y perinatales en gestantes que cursaron con preeclampsia en sus diferentes presentaciones clínicas. Métodos: estudio prospectivo, descriptivo, transversal, realizado en el hospital "Enrique Cabrera", desde el 1ro. de enero de 2010 al 31 diciembre de 2011. De las gestantes con trastornos hipertensivos (n = 293), se eligieron aquellas con preeclampsia (n = 89) y se dividieron en tres grupos: preeclampsia leve (n = 30), preeclampsia grave (n = 48) y preeclampsia sobreañadida (n = 11). Variables epidemiológicas, obstétricas y perinatales se procesaron por el sistema estadístico SPSS-11,5, utilizando estadística descriptiva, comparación de proporciones mediante la prueba de Chicuadrado y estimado de medias de variables cuantitativas con ANOVA-Eta, considerando la diferencia estadísticamente significativa p £ 0,05. Resultados: predominaron las adolescentes en la preeclampsia grave (25 %) y las ³ 35 años en la preeclampsia sobreañadida (p = 0,002), la obesidad también prevaleció en la preeclampsia sobreañadida (54,5 %, p = 0,01). La mayoría del grupo con preeclampsia leve (60 %) y preeclampsia grave (64,6 %) eran nulíparas, p = 0,009. Fue significativo el índice de prematuridad de la preeclampsia grave (43,8 %, p = 0,005) y el parto por cesárea señoreó en todos los grupos, fundamentalmente en la preeclampsia grave (93,8 %, p = 0,000). La media del peso al nacer fue significativamente inferior en la preeclampsia grave (2 451 g, p = 0,01). Conclusiones: no hubo grandes diferencias en cuanto a los resultados perinatales entre las pacientes que cursaron con los distintos grados de severidad de la preeclampsia.

Introduction: preeclampsia is a major obstetric problem that carries significant morbidity and maternal and perinatal mortality due to associated systemic disorders. Objective: to compare maternal and perinatal outcomes in pregnant women who had preeclampsia in their different clinical presentations. Methods: a prospective, descriptive, cross-sectional study was conducted at Enrique Cabrera hospital from January 1st, 2010 to December 31st 2011. Out of the pregnant women with hypertensive disorders (n = 293), those with preeclampsia (n = 89) were chosen; and they were divided into three groups, mild preeclampsia (n = 30), severe preeclampsia (n = 48) and superimposed preeclampsia (n = 11). Epidemiological, obstetric, and perinatal variables were processed by the SPSS-11, 5 statistical systems, using descriptive statistics, comparison of proportions by Chi-square test and the estimated mean of quantitative variables with ANOVA-Eta, considering the statistically significant difference p ? 0.05. Results: the adolescents had more severe preeclampsia (25 %) and ³ 35 year old patients in the superimposed preeclampsia (p = 0.002), obesity also prevailed in the superimposed preeclampsia (54.5 %, p = 0.01). Most of the patients in the mild PE group (60 %) and severe preeclampsia (64.6 %) were nulliparous, p = 0.009. Prematurity index of severe preeclampsia (43.8 %, p = 0.005) was significant; cesarean delivery was high in all groups, mainly in severe preeclampsia (93.8 %, p = 0.000). The mean birth weight was significantly lower in severe preeclampsia (2 451 g, p = 0.01). Conclusions: there were no major differences in perinatal outcomes among patients who were enrolled with various degrees of preeclampsia severity.