Flujo diastólico borrado o en reversa de la arteria umbilical fetal y su relación con la morbi-mortalidad perinatal / Diastolic deleted or reverse flow in the umbilical artery fetal and their relationship with perinatal morbidity and mortality

Introducción: El flujo diastólico borrado flujo diastólico reverso en las arterias umbilicales, se asocia con resultados perinatales adversos. Objetivo: Determinar el resultado perinatal, en fetos de madres con preeclampsia severa con flujo diastólico borrado y flujo diastólico reverso en la Maternidad “Concepción Palacios”, Caracas. Métodos: Estudio retrospectivo, descriptivo y correlacional. Se incluyeron 64 fetos, de embarazos entre 24-37 semanas en pacientes con preeclampsia severa La información se obtuvo mediante la revisión de historias médicas, para el análisis se registró la relación de la presencia de flujo diastólico borrado o flujo diastólico reverso y edad de gestación al diagnóstico, intervalo entre el diagnóstico e interrupción del embarazo, vía de interrupción, la edad de gestación al nacimiento, variables de pronóstico perinatal y de sobrevida neonatal. Resultados: Se identificaron 47 casos con flujo diastólico borrado y 17 con flujo diastólico reverso; hubo 46 nacidos vivos (71,8 %), y 18 óbitos (28,12 %). Los casos con flujo diastólico borrado se interrumpieron a las 32,66 semanas y los de flujo diastólico reverso a las 26,87 semanas; el peso al nacer fue de 1 333,3 vs 670,55 g respectivamente. La frecuencia de cesárea fue de 78,12 %, con 98 % de ingreso a terapia neonatal. De los 45 recién nacidos vivos que requirieron ingreso a la unidad de terapia intensiva neonatal. La mortalidad neonatal fue de 45,65 % y la sobrevida fue de 53,33 %. Conclusión: El flujo diastólico borrado o flujo diastólico reverso indica insuficiencia placentaria grave, y alta asociación con morbi-mortalidad perinatal por prematuridad.

Introduction: The deleted diastolic flow or reverse in the umbilical arteries, is associated with adverse perinatal outcome. Objective: To determine the perinatal outcome in fetuses of mothers with severe preeclampsia with deleted diastolic flow and reverse diastolic flow at the Maternidad “Concepcion Palacios, Caracas. Methods: Retrospective, descriptive and correlational study. We included 64 fetuses, of pregnancies among 24-37 weeks in patients with severe preeclampsia. The information was obtained from the review of medical records, for the analysis is record the relationship of the presence of deleted diastolic flow or reverse diastolic flow and age of gestation to the diagnosis, interval between diagnosis and termination of pregnancy, termination via, the age of gestation at birth, variables of forecast perinatal and neonatal survival. Results: Forty seven cases with deleted diastolic flow and 17 cases with reverse diastolic flow were identified. There were 46 births (71.8 %), and 18 deaths (28.12 %). Deleted diastolic flow cases were discontinued at 32.66 weeks and the reverse diastolic flow to the 26.87 weeks the weight at birth was of 1 333.3 vs 670.55 g respectively. The frequency of caesarean section was 78.12 %, with 98 % of admission to neonatal therapy. Of the 45 living newborn infants requiring entering the neinatal intensive care unit. Neonatal mortality was 45.65 % and survival was 53.33 %. Conclusion: The deleted diastolic flow or reverse diastolic flow indicates severe placental insufficiency, and high association with prematurity perinatal morbidity-mortality.

Perinatal Prognosis in Cystic Hygroma According to the Presence of Septation / 대한산부인과학회잡지

OBJECTIVE: We evaluated the association between perinatal prognosis and the presence of septation in cystic hygroma deteted by antenatal ultrasonography. METHODS: During a 5-year period, 65 cases of cystic hygroma were diagnosed by antenatal ultrasonography. 31 cases were included in this study. Fetal karyotyping, hydrops, and associated anomalies were compared between septated and non-septated groups. Statistical analysis was performed using Fisher exact test. RESULTS: There were 24 cases of septated cystic hygromas, and 7 cases of nonseptated cystic hygromas. Sixty-three percent of the septated cystic hygromas had accompanying hydrops and other anomalies (15/24), versus 28% (2/7) in the nonseptated group (p=0.022). Other anomalies such as cleft lip and palate, omphalocele, and club foot were more frequently seen in the septated group. Nine of 14 cases of septated cystic hygroma that underwent karyotying showed aneuploidy (64%), compared with 0% (0 of 6 cases) aneuploidy rate in the nonseptated cystic hygroma group (p=0.014). CONCLUSION: Abnormal fetal karyotyping, hydrops, and other anomalies are more likely to be associated in fetuses with septated cystic hygroma. So, the presence of septation may be the useful prognostic indicator of cystic hygroma.