ABSTRACT
OBJECTIVE: To investigate the effect of age and parity on obstetric outcome in a Spanish population of pregnants aged 40 years or older delivered above 32 weeks'gestation. METHODS: A retrospective cohort of 16764 singleton pregnancies delivered above 32 weeks'gestation between 2000 and 2007 in a nontertiary community hospital was studied. Obstetric outcomes in women aged 40 years or above (n = 335) were compared to women aged 20-29 years (n = 347) delivered at the same period. RESULTS: During the study period, the prevalence of mothers aged 40 or above increased from 1.6% to 3%. Older pregnants were more likely to be multiparous and to have used assisted reproductive techniques. They were more likely to develop gestational diabetes (OR 7.77, 3.50-17.94) and preeclampsia (OR 2.60, 1.13-6.16) and to have a higher rate of cesarean delivery (OR 2.95, 1.98-4.42). Elective was the most frequent cause of cesarean delivery in this group. Newborns were at higher risk to suffer diabetes-related complications but no differences neither in 5-min Apgar score of <7 nor in the need for admission into special care baby unit were found. No perinatal deaths were registered. CONCLUSION: Our Spanish population of older mothers showed a higher risk for being delivered by cesarean section and for developing either preeclampsia or gestational diabetes. The overall neonatal outcome was unaffected. These data may be helpfull to counsel patients about their pregnancy expectations and possible outcomes.
Subject(s)
Cesarean Section/statistics & numerical data , Diabetes, Gestational/etiology , Maternal Age , Pre-Eclampsia/etiology , Adult , Apgar Score , Cohort Studies , Female , Gestational Age , Humans , Infant, Newborn , Parity , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk , SpainABSTRACT
Se presenta el caso de una paciente afecta de infertilidad secundaria y clínica de sangrado uterino anómalo como consecuencia de una osificación endometrial producida por el antecedente de dos abortos voluntarios de primer trimestre. La paciente fue diagnosticada mediante ecografía transvaginal e histeroscopia, y tratada mediante resectoscopia. Se discute la etiología y el manejo de esta rara entidad (AU)
We report the case of a patient with secondary infertility and abnormal uterine bleeding caused by endometrial ossification secondary to two previous first trimester voluntary terminations. The patient was diagnosed by transvaginal ultrasonography and hysteroscopy and was treated by means of resectoscopy. The etiology and management of this rare entity are discussed (AU)
Subject(s)
Humans , Female , Adult , Ossification, Heterotopic/diagnosis , Endometrium , Infertility, Female/etiology , HysteroscopyABSTRACT
OBJECTIVES: To evaluate associated congenital anomaly risk, need for surgical treatment and long-term outcome in prenatally diagnosed clubfoot. METHODS: A retrospective study of 20 663 pregnant women who underwent routine ultrasound scanning at 18 to 22 weeks of gestation. Clubfoot was considered as complex or isolated if other structural or chromosomal abnormalities were also present or not. RESULTS: Forty-two cases of congenital clubfoot were diagnosed (incidence: 0.2%), 28 of them (66.6%) were isolated and 14 (33.3%) were complex, of which 3 (7.1%) had an abnormal karyotype and 11 (26.2%) had an associated structural anomaly. The false-positive rate was 2.3% (1 out of 32 liveborns). Out of the 41 confirmed affected fetuses, the defect was unilateral in 12 (29.3%) and bilateral in 29 (70.7%) cases. Surgery was necessary in 12 of the newborns (38.7%). The presence of a bilateral clubfoot was unrelated to either the presence of associated anomalies (p = 0.40) or to the necessity of surgery (p = 0.48). CONCLUSIONS: We provide outcome data about fetuses prenatally diagnosed for clubfoot. One-third are complex cases associated with other congenital anomalies. For isolated clubfoot, the risk of requiring surgery is about 40%. The detection of a bilateral defect does not worsen the prognosis.
Subject(s)
Abnormalities, Multiple/diagnosis , Clubfoot/diagnosis , Clubfoot/therapy , Infant Care/methods , Ultrasonography, Prenatal , Abnormalities, Multiple/epidemiology , Clubfoot/epidemiology , Clubfoot/etiology , Counseling , Female , Follow-Up Studies , Humans , Incidence , Infant, Newborn , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
In this report we describe a case of a successful pregnancy in a 19-year-old patient suffering from the familial form of pulmonary alveolar proteinosis, a very rare pulmonary disorder. The pregnancy course was complicated by preterm labour. The outcome and management are discussed.
