Embarazos exitosos en hemodiálisis crónica: experiencia de un único centro / Pregnancy during dialysis: Experience in six patients

Background: The frequency of pregnancies during dialysis is increasing. This condition requires changes in the dialysis schedule and nutritional approach. Aim: To report the experience in six patients with terminal kidney disease who became pregnant. Material and Methods: Retrospective review of medical records of women with terminal kidney disease in dialysis who became pregnant in a period of 27 years. Results: We recorded six successful pregnancies among women in hemodialysis treatment aged 32 ± 4 years. The mean dialysis-time per week was 19.5 ± 2.7 hours and Kt/V was 1.55 ± 0.17. The mean systolic blood pressure was 130 ± 13.3 mmHg. The mean packed cell volume of the group increased from 22.7% during pre-gestational stage to 30.2% during third trimester of pregnancy. All patients received an intensive treatment for anemia. The most common symptom of pregnancy was hyperemesis. The mean gestational age (GA) at diagnosis was 13.4 ± 4.7 weeks. All patients had preterm deliveries at a GA of 33 ± 1.7 weeks, and 66% of offspring were appropriate for gestational age. Conclusions: A multidisciplinary approach allows high rate of successful pregnancies during hemodialysis.

El Doppler en el diagnóstico de malignidad ovárica / Doppler in ovaric pathology diagnosis

Se presentan 4 pacientes portadoras de tumores ováricos, 2 de ellos benignos (teratoma y endometrioma) y 2 malignos (IIc y metastásico). Mediante Doppler pulsado se estudian las curvas de velocidad de los flujos arteriales tumorales, encontrándose que los tumores benignos tienen curvas de alta resistencia y los malignos de baja resistencia

Procesos expansivos intraselares secretores de prolactina y no secretores: experiencia clínica en 80 casos / Secretive and non secretive intrasellar expansive process of prolactin and non-secretive: clinical experience in 80 cases

Se estudian 80 mujeres con proceso expansivo intraselar secretor de prolactina o no secretor. 51,25% de ellas eran muy secretoras de prolactina (más de 75 ng/ml) y las otras eran no secretoras o poco secretoras (menos de 75 ng/ml). Las del primer grupo eran todas amenorreias, en cambio, en las otras existían inclusive eumenorreicas. Se identifican microadenomas (66,25%), macroadenomas o complicados (17,5% y aracnoideoceles (16,25%). El 45,3% de los microadenomas, el 92,9% de los adenomas complicados y el 30,8% de los aracnoideoceles demostraron ser muy secretores de prolactina. 13,6% del total fueron intervenidas por vía transesfenoidal, con indicación quirúrgica precisa. El estudio histológico demostró un adenoma cromófobo en 10 casos. En el 7,5% de las mujeres estudiadas hubo compromiso quiasmático según los campos visuales de Goldman. Se verificó un 52,9% de recidiva post-operatoria. 37 mujeres anovulantes que deseaban embarazo, lográndose gestación en el 86,5% de ellas