Muerte perinatal / Perinatal death

Se revisaron 86 casos de mortalidad perinatal en el HOspital de Gineco Obstetricia de Garza García, N.L. de la Subsecretaría Estatal de Salud de enero de 1992 a diciembre de 1993. Período de 2 años. La tasa de mortalidad perinatal fue de 12.0 por mil nacimientos, menor que otros reportes. La mayor incidencia en pacientes jóvenes de 20 a 29 años con 47.7 por ciento y con paridad de 1 a 3 un 80.2 por ciento, la mayor frecuencia en embarazos a término de 37 a 42 semanas con 39.6 por ciento, 35 por ciento de los productos con peso mayor de 2,500 gramos y 65 por ciento menor. La muerte fetal se presentó con mayor frecuencia en el preparto 55.8 por ciento y menor en el intraparto 19.8 por ciento, las causas más frecuentes de muerte perinatal fueron insuficiencia placentaria 27.9 por ciento e inmadurez fetal con 24.4 por ciento. Se concluye que un control prenatal adecuado y una vigilancia del trabajo de parto traen como consecuencia una disminución de la mortalidad fetal

Function and morphometric evaluation of intrauterine undernutrition on kidney development of the progeny

Renal function and renal morphometry of the progeny of rats submitted to 50% dietary restriction (pairfed with control group) throughout pregnancy (Rtgroup), during the first half of pregnancy (R1 group) or during the second half of pregnancy (R2 group) were studied 3 months after birth. Glomerular filtration rate (GFR) and renal plasma flow (RPF) decrease significantly in all groups when compared to control (C) (GFR, 4.44 ñ 0.12, 4.04 ñ 0.18, and 4.00 ñ 0.16 vs 6.87 ñ 0.17, and RPF, 19.06 ñ0.57, 17.00 ñ 1.14, and 13.31 ñ0.50 vs 22.57 ñ 0.67, respectively). Urinary osmolality tended to be lower in the R2 and Rt groups (887.1 ñ 42.36 and 868.0 ñ 42.36 vs 975.1 ñ 38.31 in C), and the net acid excretion calculated per ml of GFR was either maintained or stimulated (R1 group). A significant decline in the number of glomeruli occurred in R1, R2 and Rt rats (79.84 ñ 2.08, 62.30 ñ 2.07, and 58.16 ñ 2.32 vs 99.77 ñ 2.28 in C repectively). The results show that intrauterine undernutrition actually caused a deleterious effect on the number of functional nephrons

Effects of intrauterine undernutrition on the renal function of the progeny

The progency of rats submitted to 50% food restriction during a) the first 11 days of pregnancy (R1 group) and b) the entire period of pregnancy (RT group) was studied for renal function. After birth, the litter was left with the mother for 28 days and allowed free access to food and water until the experimental time, which occurred 3 months after birth. Glomerular filtration rate (GFR), renal plasma flow (RPF) and urinary flow (V) decreased significantly in both the Rl and RT groups when compared to control rats (C) (GFR = 4.44 + or 0 0.12 and 4.26 + or - 0.17 vs 6.95 + or - 0.25, and RPF = 19.06 + or - 0.57 and 12.59 + or - 0.60 vs 24.64 + or - 1.18). However, net acid excretion calculated per ml GFR was maintained or even stimulated (AB = 12.63 + or - 0.44 and 8.31 + or - 0.29 vs 7.97 + or - 0.85). The results show that a definite impairment of glomerular hemodynamics is demonstrable 3 months after birth in the progeny of mothers submitted to severe food restriction during pregnancy, even when the progeny have been on a normal diet for 2 months after suckling

Síndrome HELLP: a propósito de un caso / HELLP syndrome: apropos of a case

Se presenta un caso clínico de síndrome HELLP y se realiza una revisión de la literatura. El síndrome es una variedad de la peeclampsia consistente en hemólisis microangiopática, trombocitopenia y falla hepatocelular: se debería a un desequilibrio en la sínteses de prostaglandinas, con aumento de tromboxano y disminución de prostaciclina. El pronóstico es malo, con mortalidad perinatal de 8-36% y materna de l,8-3,5%. Como conclusión, el síndrome HELLP es un índice de severidad de la pre-eclampsia, y su manejo debe ser agresivo, con interrupción inmediata del embarazo