Evaluation of RET-He values as an early indicator of iron deficiency anemia in pregnant women

Abstract Introduction During pregnancy, women are at an increased risk of developing iron-deficiency anemia. Objective The objective of this study was to assess the diagnostic performance of the reticulocyte hemoglobin equivalent (RET-He) in the early detection of iron-deficiency anemia in a group of pregnant women and to establish a reference range for this parameter in a group of control individuals. Method: A total of 60 patients and 130 control subjects were included in the study. Blood samples collected from the subjects were submitted to a complete blood count and a serum ferritin test and the data were analyzed by comparing the groups and ROC curves. Results The reference range found for the RET-He was between 29.75pg and 38.24pg, with a median of 35pg. The receiver operating characteristic (ROC) curve analysis for the ferritin parameter showed an area under the curve of 0.732 for the RET-He, 0.586 for hemoglobin, 0.551 for the mean corpuscular hemoglobin concentration and 0.482 for the mean corpuscular volume. Conclusion Early diagnosis of iron deficiency anemia in pregnancy is essential to prevent damage to both maternal and fetal health. The RET-He presents an excellent potential as an auxiliary tool for the diagnosis of iron deficiency in pregnant women.

Diagnóstico y tratamiento de infección de las vías urinarias en embarazadas que acuden a Emergencia y consulta externa del Hospital Bertha Calderón Roque en Managua, Nicaragua / Diagnosis and treatment of urinary tract infection in pregnant women attending emergency and outpatient services at the Hospital Bertha Calderón Roque in Managua, Nicaragua

Introducción: La infección de vías urinarias es una de las más comunes durante el embarazo y su importancia radica en las complicaciones que se han reportado en la mujer embarazada y en el neonato. Material y métodos: Estudio observacional, descriptivo, longitudinal y prolectivo; se incluyeron embarazadas con síntomas urinarios y urocultivo positivo. Resultados: En el periodo 2011-2012 se llevó a cabo un estudio que incluyó a 1,256 mujeres embarazadas con síntomas de infección urinaria y urocultivo positivo, en el cual se evaluó la sensibilidad y resistencia a los antibióticos. El 55.6% de las pacientes tenía menos de 20 semanas de gestación y el 33.5% se encontraba entre las edades de 15 a 25 años. El 84.9% de pacientes presentó infección urinaria con síntomas leves. El agente etiológico más frecuentemente aislado fue Escherichia coli en el 76.6% de los casos; el 7.1% de las infecciones fueron causadas por Proteus y 6.6% por Klebbsiella sp. La sensibilidad general de nitrofurantoína para los patógenos urinarios fue de 94.3%, la de ampicilina de 73% y la de gentamicina 78%; los antibióticos más sensibles fueron ceftazidima e imipenem. Conclusiones: El mayor porcentaje de infección urinaria fue causado por Escherichia coli; la edad más frecuente de aparición entre los 15 y 25 años; los antibióticos con mayor sensibilidad a los patógenos urinarios fueron nitrofurantoína, ceftazidina e imipenem; la ampicilina y la gentamicina tuvieron una sensibilidad baja.

Introduction: The urinary tract infection is one of the most common infections during pregnancy and its importance lies in the complications that have been reported in the pregnant women and the newborn. Material and methods: Observational, descriptive, longitudinal and prospective study. We included pregnant with urinary symptoms and positive urine culture. Results: In the period 2011-2012 was carried out a study involving 1,256 pregnant women with symptoms of urinary infection and positive urine culture. It was determined the sensitivity and resistance to antibiotics to urinary pathogens. The 55.6% of the pregnant women had less than 20 weeks gestation and 33.5% was 15 to 25 years old. The 84.9% of patients only had mild urinary infection symptoms. The most frequent etiological agent isolated was Escherichia coli with 76.6% of cases, 7.1% were caused by Proteus sp and 6.6% by Klebbsiella. The sensitivity of nitrofurantion for urinary pathogens was 94.3%, gentamycin 78% and ampicillin 73%. The antibiotics with high rates of sensitivity were ceftazidime and imipenem. Conclusions: The highest percentage of urinary tract infection was caused by Escherichia coli; the most common age of onset was between 15 to 25 years; antibiotics with highest sensitive were nitrofurantion, ceftazidime and imipenem.

Embarazo heterotópico: diagnóstico ecográfico temprano, manejo con laparoscopia: reporte de un caso y revisión de la literatura / Laparoscopic management of heterotopic pregnancy following ecographic diagnosis: a case report and literature review

Objetivo: realizar una revisión de la literatura acerca de los aspectos más importantes relacionados con el diagnóstico oportuno y el manejo del embarazo heterotópico. Materiales y métodos: se presenta un caso de un embarazo heterotópico diagnosticado por ultrasonografía, a quien se le realizó salpingectomía por laparoscopia y se continuó con la gestación intrauterina normal. Se realizó una revisión en las bases de datos MEDLINE y EMBASE, además de la base latinoamericana SciELO y libros de la especialidad. Conclusión: el diagnóstico del embarazo heterotópico es difícil debido a las diversas manifestaciones clínicas y a la existencia del embarazo intrauterino que continúa la producción de fracción Beta de la gonadotropina coriónica humana. La ecografía es un pilar importante en el diagnóstico e identificación temprana de esta patología. La laparoscopia surge como una alternativa segura en el manejo.

Objective: reviewing the pertinent literature about the most important aspects related to early diagnosis and management of heterotopic pregnancy. Materials and methods: a case of heterotopic pregnancy is presented which was diagnosed by ultrasonography. The patient underwent laparoscopic salpingectomy and she continued normal intrauterine gestation. MEDLINE and EMBASE databases were reviewed, as well as the Latin-American SciELO database and books on the specialization. Conclusion: diagnosis of heterotopic pregnancy is difficult due to its diverse clinical manifestations and intrauterine pregnancy leading to human chorionic gonadotropin Beta fraction production being continued; echography is thus an important pillar in the early diagnosis and identification of this pathology. Laparoscopy emerges as a safe management alternative.

Pregnancy diagnosis, fetal quantification and gender estimation by ultra-sonography in ewes / Diagnóstico de gestação, quantificação e sexagem fetal por ultra-sonografia em ovelhas

The objective of this experiment was to evaluate the accuracy of gestation, fetal sexing and quantification diagnoses in ewes. Pregnancy and fetal quantification were diagnosed in 105 ewes at 35 days of pregnancy. For the fetal gender diagnosis sexing diagnose 55 ewes between 49 and 59 days of pregnancy were used. All exams were recorded on DVD for posterior analysis. After birth, lamb sex was recorded to determine fetal sexing precision. Data were analyzed by chisquare ( 2) or Fisher’s test, with a significance of 0.05. One hundred percent of pregnancy ultrasound diagnoses were correct. As for the fetal quantification diagnoses, there was an error of 12%. It was possible to diagnose the fetal sex in 87% of the 69 examined fetuses, and 90% of these were estimated correctly. The realtime ultrasound diagnoses were not different from the recorded DVD image diagnoses. Therefore, pregnancy diagnosis accuracy may reach 100%, differing from fetal gender estimation and quantification, which are dependent upon other variables such as fetal genderand examiner experience.

O objetivo deste experimento foi avaliar a acurácia do diagnóstico de gestação, quantificação e sexagem fetal em ovelhas. Foram realizados o diagnóstico de gestação e a quantificação fetal em 105 ovelhas aos 35 dias de gestação. Para o diagnóstico da sexagem fetal foram utilizadas 55 ovelhas com período de gestação entre 49 e 59 dias. As imagens de todos os exames foram gravadas em DVD para permitir posterior análise. Após o nascimento dos cordeiros, os respectivos sexos foram observados para determinar a precisão do exame de sexagem fetal. Os dados foram analisados pelo teste Qui- quadrado ( 2) ou Teste de Fisher, com nível de significância de 5%. Observou-se 100% de acerto no diagnóstico de gestação pela ultra-sonografia. Quanto ao diagnóstico de quantificação fetal, houve 12% de erro. Foi possível diagnosticar o sexo fetal em 87% dos fetos e destes, 90% estavam corretos. Os diagnósticos em tempo real não foram significativamente diferentes dos diagnósticos feitos após a observação de imagens gravadas em DVD. Portanto, a acurácia do diagnóstico de gestação pode alcançar 100%, diferente da quantificação e sexagem fetal, que dependem de outras variáveis como tipo de gestação e experiência do operador.

Ultra-sonografia bidimensional convencional, de alta resolução e tridimensional no acompanhamento da gestação em cadela / Two-dimensional conventional, high resolution two-dimensional and three-dimensional ultrasonography in the evaluation of pregnant bitch

Gestational period in a bitch, after natural mating with a normal dog, was evaluated by two-dimensional conventional, high-resolution two-dimensional and three-dimensional ultrasonography. High-resolution two-dimensional ultrasonography show better image and provides early diagnosis of pregnancy (15 days) in comparison to conventional one (20 days). Three-dimensional ultrasonography was use to evaluate fetal morphology during late gestation period, however its application is still limited

An early pregnancy test

A rapid agglutination – inhibition test was realized with hCG-coated sheep erythrocytes and rabbit antibodies to hCG. Determined amount of hCG on the red blood cells and titrated concentration of antibodies allowed the test to be sensitive at 200 UI/l for confirmation of pregnancy at 2-3 weeks (0-5 days following the first missed period). 3.000 tests were implemented in Nha Trang Pasteur Institute and Hanoi Newborn & Mother Protection Hospital showed that confident rate was 99%. The test was then used for diagnosing the urines of women just before their abortion. The results indicated that more than 11% of these women, at less than 15 days following the first their abortion, were not pregnant and should avoid abortion.

Clinical Evaluation of the Urinary ?—HCG ELISA for Diagnosis of Early Pregnancy — An Analysis of 375 Cases / 昆明医科大学学报

0.05).We conclude that the urine ?—HCG ELISA has the same value as RIA in the early pregnancy diagnosis. It may be used as a routine method, because it is without radiactivity, and simpler, cheaper, more rapid and practical than RIA, especially it is easy to be generalized in the country.