El riesgo preconcepcional y su vínculo con la salud materna / The preconception risk and its link with maternal health

Introducción: la prevención de la enfermedad y la muerte durante el proceso de reproducción es uno de los pilares fundamentales para el desarrollo de la salud reproductiva, donde el riesgo preconcepcional tiene importancia medular por su relación con la mortalidad materna e infantil. Objetivo: mostrar los principales hallazgos sobre la relación entre el riego preconcepcional y la mortalidad materna e infantil. Métodos: se realizó una revisión bibliográfica entre los años 2010 - 2015 a publicaciones relacionadas con el tema objeto de estudio en las siguientes bases de datos: Medline, EMBASE, Current Contents, Science Citation Index, todas en español. Conclusiones: un adecuado control y manejo del riesgo preconcepcional permite determinar y evaluar la morbilidad de cada paciente y su estado de salud para asumir un embarazo con resultados satisfactorios. Se evidencia la relación existente entre el riesgo preconcepcional en mujeres en edad fértil y la presencia de complicaciones de diferente tipo en la madre y el niño, muchas de las cuales ocasionan la pérdida de uno de los dos. Se enfatiza en la necesidad de fortalecer todas las acciones de salud de carácter preventivo que ayuden a la mujer a enfrentar la maternidad en mejores condiciones(AU)

Introduction: Prevention of illness and death during reproduction is one of the fundamental pillars for the development of reproductive health, where the preconception risk has central importance due to its relation to maternal and infant mortality. Objective: Show the main findings on the relationship between preconception risk and maternal and infant mortality. Methods: A literature review was conducted between the years 2010 - 2015 to publications related to the topic under study in the following databases: Medline, EMBASE, Current Contents, Science Citation Index, all in Spanish. Conclusions: Proper preconceptional control and risk management allow to determine and evaluate the morbidity of each patient and their health to take a pregnancy with satisfactory results. The relationship between preconception risks in women of childbearing age and the presence of different types of complications in mother and child is evidenced, many of which cause the loss of one of them. The need to strengthen all actions of preventive health to help women cope with motherhood in better condition is emphasized(AU)

Preconceptional care of women at booking visit at De Soysa Maternity Hospital and Castle Street Hospital for Women.

OBJECTIVE: To study the preconceptional preparedness of women attending two antenatal clinics. DESIGN: Cross-sectional descriptive study done in August and September 2001. SUBJECTS AND SETTING: Pregnant women attending the antenatal clinics De Soysa Maternity Hospital and Castle Street Hospital for Women for their booking visit. MATERIAL AND METHODS: Pregnant women were randomly selected. Before collecting data the purpose of the study was explained and those who consented were recruited for the study. Data were collected on the basis of an interviewer administered questionnaire. Ethical approval was obtained from the Ethical Review Committee of the Faculty of Medicine, University of Colombo. RESULTS: 225 pregnant women were recruited. 55% of them were between the ages of 18 and 30 years. 96% had achieved an educational level of above year five. 55% were in their first pregnancy and 2.75 were grand-multipara. 186 (82.7%) were housewives. 81% had a planned pregnancy. Only 21% had received pre-pregnancy counselling, 52% of them from a specialist obstetrician, and 21% and 19% from a general practitioner and public health midwife. Only 15 (6.6%) had taken preconceptional folic acid supplementation, and all of them had a level of education of GCE (A/L) or above. 11 of those who took preconceptional folic acid were primipara. 159 (70.6%) had received rubella vaccination. Of those who did not take the vaccine, 44% knew about it but did not know its importance, and 38% did not know about its availability. 18% did not take it because of various myths that they believed in. Preconceptional health knowledge regarding pregnancy was assessed by asking 10 questions and expressing it as a score out of 10. This score showed a positive correlation to the level of education of the woman. A majority received information from the print (81.7%) and electronic (72.4%) media. 50% received information from a public health midwife, and 36% from doctors. CONCLUSIONS: Preconceptional preparedness among our women is poor. However, rubella vaccination is relatively successful compared to other aspects of preconceptional preparedness.

Embarazo en la paciente trasplantada renal / Pregnancy in the renal transplant patient

El trasplante renal se acompaña de una importante mejoría de la función reproductiva de las pacientes con enfermedad renal terminal. Se analizaron retrospectivamente los datos de 11 embarazos, correspondientes a 9 pacientes trasplantadas renales que presentaron: 8 recién nacidos vivos: 5 de término ò 37 semanas y 3 pretérmino (37 por ciento); 1 huevo muerto y 2 abortos provocados. La edad gestacional media fue de 36,5 semanas y el peso medio fue de 2.225 gr. La edad media al momento del embarazo fue de 26,4 ñ 5,2 años y el lapso medio desde el trasplante al embarazo fue de 38 meses (rango 6-72 meses). Todas continuaron la inmunosupresión durante la gestación. Siete embarazos (63 por ciento) cursaron con complicaciones médicas. No se detectaron malformaciones congénitas en ninguno de los recién nacidos y tampoco ninguna de las pacientes presentó rechazo agudo del riñón transplantado. Concluimos que las pacientes con trasplante renal pueden tener embarazos exitosos pero no exentos de riesgo para la madre y para el feto