ABSTRACT
OBJECTIVE: Estimation of the prevalence of obstetric anal sphincter injury (OASIS) in our environment and study of the associated risk factors. STUDY DESING: A retrospective observational study of cases and controls of assisted deliveries at the Severo Ochoa University Hospital of Leganés during the period from January 1, 2012, to December 31, 2017. A total of 88 OASIS diagnosed in the study period is compared with a randomly selected group of 181 controls of similar characteristics, vaginal births of cephalic of 36 weeks gestation or more, occurring during the same period. RESULTS: During the study period, a total of 8160 deliveries were attended in our hospital, of which 6187 were vaginal and we diagnosed a total of 88 OASIS at the time of delivery. The prevalence of OASIS is 1.07 % for total births and 1.42 % for total vaginal deliveries. In the case-control study, the univariate analysis shows statistical significance for nulliparity (OR 3.84; 95 % CI 2.155-6.834; p < 0.001), instrumental delivery (OR 8.73; 95 % CI 4.706-16.2016; p < 0.001), occipital posterior position (OR 7.23; 95 % CI 2.535-20.633; p < 0.001), long duration of the second stage of labor (OR 1.99; IC95 % 1,159-3,438; p 0.01), episiotomy (OR 3.51; 95 % CI 1,956-6,309; p < 0.001) and OBGYN labor assistant (<0.001). When performing the multivariate analysis, forceps delivery (OR19.68), Thierry spatulas delivery (OR 8.15), vacuum delivery (OR 2.74), nulliparity (OR 2.56) and fetal weight in grams (OR 1.12) remain significant in the final model. CONCLUSION: The main risk factors for the onset of OASIS are instrumental delivery, nulliparity and fetal birth weight.
Subject(s)
Anal Canal , Obstetric Labor Complications , Case-Control Studies , Delivery, Obstetric , Episiotomy/adverse effects , Female , Hospitals , Humans , Obstetric Labor Complications/epidemiology , Obstetric Labor Complications/etiology , Pregnancy , Retrospective Studies , Risk FactorsABSTRACT
La asociación de feocromocitoma y gestación es rara; su diagnóstico es difícil dada su similitud con la preeclampsia. El pronóstico maternofetal es determinado por el diagnóstico precoz y el manejo multidisciplinario. El diagnóstico se establece por la elevación de catecolaminas en orina de 24 h y las técnicas de imagen. La extirpación del tumor, previo bloqueo adrenérgico, se realiza en función de la edad gestacional antes o después del parto.Así, se reduce de forma considerable la mortalidad maternofetal, que es muy alta cuando se desconoce el diagnóstico (AU)
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Subject(s)
Adult , Pregnancy , Female , Humans , Pheochromocytoma/complications , Pheochromocytoma/diagnosis , Pregnancy Complications/diagnosis , Pregnancy Complications, Neoplastic/diagnosis , Pregnancy Trimester, Third , Hypertension/complications , Hypertension/diagnosis , Thoracotomy/methods , Nitroprusside/administration & dosage , Nitroprusside/therapeutic use , Arrhythmias, Cardiac/complications , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/diagnosis , Maternal and Child Health , Pregnancy Complications, Neoplastic/physiopathology , Catecholamines , Catecholamines/urine , Maternal Mortality , Pregnancy Complications, Cardiovascular/diagnosisABSTRACT
BACKGROUND: To evaluate human immunodeficiency virus (HIV) screening usefulness in pregnancy and to know the prevalence of this infection in an urban area of Spain. PATIENTS AND METHOD: Routine prenatal screening for antibodies to HIV was offered to pregnant women from Fuenlabrada-Leganés Health Care Area (Madrid) from 1992 to 1995. Unlinked anonymous screening of HIV was done with the sera from women refusing the assay or if it had not been offered. RESULTS: HIV prevalence was 0.28% (CI: 95%; 0.19 to 0.40) in the 11.021 pregnant women group studied. 87.1% pregnant seropositive women were detected by consented screening. 55.6% of them recognized risk behavior (73.33% by intravenous drug use) and 44.4% did not do it. With a second anamnesis in this group 75% admitted risk conducts and 25% confirmed their ignorance about them. CONCLUSIONS: HIV seropositive screening in pregnant women selected only by risk behavior may be unsuccessful. For that reason, it is more convenient the perform a routine test for detection of HIV antibodies after informed consent in high prevalence areas of HIV infection.
Subject(s)
AIDS Serodiagnosis , HIV Infections/prevention & control , Pregnancy Complications, Infectious/prevention & control , Female , HIV Infections/epidemiology , Humans , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Prevalence , Risk Factors , Spain/epidemiologyABSTRACT
Se estudia la utilidad de la ecografía en el control de 144 gestantes diabéticas desde un triple sentido: Control del crecimiento del feto, diagnóstico prenatal de malformaciones congénitas y diagnóstico del grado de bienestar fetal. En el diagnóstico prenatal de recién nacidos grandes para su edad gestacional los ultrasonidos diagnosticaron correctamente 23 de 30 casos (76.6%), con un índice de falsos negativos del 7%. En los casos de crecimiento intrauterino retardado la ecografía detectó los 4 casos existentes (100%), con un índice de falsos positivos de 33.3%, sin que existieran falsos negativos. Todos los casos de malformaciones congénitas mayores correspondientes a microcefalia, mielomeningocele occipital, nipoplasia de colon izquierdo y síndrome de Meckel-Gruber (disencefalia esplacno-quística), fueron diagnósticados prenatalmente mediante ultrasonidos
