Thrombocytopaenia in pregnancy: the importance of differential diagnosis during the COVID-19 pandemic.

Since the beginning of the COVID-19 pandemic, an optimal management of vulnerable patients, such as pregnant women, has been regarded as a challenge for healthcare professionals. Although thrombocytopaenia is considered a minor criterion for admission within an intensive care unit, a low platelet count has been observed in COVID-19 patients, including a pregnant woman, who developed severe pulmonary complications. Furthermore, thrombocytopaenia has been proposed as a potential biomarker in order to identify cases at high-risk complications. Nevertheless, thrombocytopaenia is a relatively frequent condition observed in pregnancy. In this context, a differential diagnosis is essential for the correct management of COVID-19 pregnant women.

22q11 Deletion Syndrome and Urogenital Manifestations: A Clinicopathological Case Report.

BACKGROUND: Deletion in the chromosomal region 22q11 results from the abnormal development of the third and fourth pharyngeal pouches during embryonic life and presents an expansive phenotype with more than 180 clinical features described that involve every organ and system. HISTORY AND SIGNS: A 23-year-old African woman presented for the first trimester echography, which revealed an isolated anechoic structure suggesting a ureteral dilatation. The suspicion of a malposition of great arteries in the second trimester indicated an amniocentesis leading to a diagnosis of 22q11 deletion. OUTCOME: At 32 weeks, the patient was admitted for premature rupture of membranes and gave birth 2 weeks later to a male newborn who presented a respiratory distress syndrome and probably died secondary to a tracheal stenosis. Necropsy revealed typical clinical features of 22q11 deletion associated with left renal agenesis, hypospadias, and penile hypoplasia. CONCLUSION: We report a case of 22q11 deletion syndrome with typical clinical features associated with urogenital manifestations suspected at the first trimester ultrasound.

Ausencia o retraso en la formación de la membrana amniocoriónica: ¿un marcador ecográfico de trisomía 21? / Absence or delay in the amniochorionic membrane formation: a trisomy 21 marker?

Objetivo. Describir la asociación encontrada entre fetos portadores de trisomía 21 y el hallazgo de lo que consideramos como un marcador ecográfico.Material y método. Estudio descriptivo prospectivo de ocho pacientes a quienes se les realizó determinación del cariotipo fetal y que presentaban ausencia o retraso en la formación de la membrana amniocoriónica al realizar la amniocentesis.Resultados. De las ocho pacientes estudiadas, en seis de ellas (75%) se obtuvo un cariotipo fetal aneuploide. Comentarios. La detección de ausencia o retraso en la formación de la membrana amniocoriónica podría constituir un marcador ecográfico de cromosomopatía.Comentarios. La detección de ausencia o retraso en la formación de la membrana amniocoriónica podría constituir un marcador ecográfico de cromosomopatía

Objective. Descibe the possible association of this sonographic marker and fetus with trisomy 21.Material and method. Descriptive study of eigth patients that were subjected to amniocentesis. At the scan, before the amniocentesis was done, all of these patients did not present or presented delay in the amniochorionic membrane formation.Results. In six cases (75 %) there was a fetal aneuploidy.Commentary. Absence or delay in the amniochorionic membrane formation could be a sonographic marker during the second-trimester of pregnancy