Normal values of the fronto-occipital relationship in fetuses between 18 and 40 weeks at two maternal fetal medicine units: Bogotá, Colombia.

OBJECTIVE: To establish nomograms for linear measurements of the frontal and occipital horns of the lateral ventricle and their relationship, in pregnant patients between 18 and 40 weeks of gestation and having attended 2 units of Maternal Fetal Medicine in Bogotá-Colombia. METHODOLOGY: A descriptive cross-sectional study with an analytical component was carried out on pregnant patients who utilized the ultrasound services at 2 Maternal-Fetal Medicine units in Bogotá, between 18 and 40 weeks of pregnancy who underwent measurement. From the anterior and posterior horns of the lateral ventricles, the fronto-occipital ratio was calculated at each gestational week, and nomograms were created for each of these variables. RESULTS: Nine hundred and seventy-eight patients were included in the study. The distance of the frontal horns ranged between 6.9 and 51.6 mm with a mean of 19.1 ± 5.8 mm; that of the occipital horns had a measurement between 8.7 and 53 mm with a mean of 28, 1 ± 8.9 mm; on the other hand, the fronto-occipital ratio (FOR) yielded a mean of 0.365 ± 0.067 (0.136-0.616) without bearing any relation to gestational age. The trend of normal values for the studied population is displayed, plotted in percentile curves and nomograms for each gestational age. CONCLUSION: The measurement of the frontal and occipital horns, and the calculation of the fronto-occipital relationship is technically possible between 18 and 40 weeks, finding that the anterior and posterior horns have a positive linear relationship with gestational age. Contrarily, the FOR does not correlate with the gestational age, it was possible to establish a table of percentiles that allows determining the normal values for these measurements during pregnancy.

Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America.

OBJECTIVE: To evaluate fetal ultrasound and magnetic resonance imaging findings among a series of pregnant women with confirmed Zika virus infection to evaluate the signs of congenital Zika syndrome with respect to timing of infection. METHODS: We conducted a retrospective case series of pregnant women referred to two perinatal clinics in Barranquilla and Ibagué, Colombia, who had findings consistent with congenital Zika syndrome and Zika virus infection confirmed in maternal, fetal, or neonatal samples. Serial ultrasound measurements, fetal magnetic resonance imaging results, laboratory results, and perinatal outcomes were evaluated. RESULTS: We describe 17 cases of confirmed prenatal maternal Zika virus infection with adverse fetal outcomes. Among the 14 symptomatic women, the median gestational age for maternal Zika virus symptoms was 10 weeks (range 7-14 weeks of gestation). The median time between Zika virus symptom onset and microcephaly (head circumference less than 3 standard deviations below the mean) was 18 weeks (range 15-24 weeks). The earliest fetal head circumference measurement consistent with microcephaly diagnosis was at 24 weeks of gestation. The earliest sign of congenital Zika syndrome was talipes equinovarus, which in two patients was noted first at 19 weeks of gestation. Common findings on fetal magnetic resonance imaging were microcephaly, ventriculomegaly, polymicrogyria, and calcifications. CONCLUSION: Our analysis suggests a period of at least 15 weeks between maternal Zika virus infection in pregnancy and development of microcephaly and highlights the importance of serial and detailed neuroimaging.

Diagnóstico y prevención del parto pretérmino. Una actualización de la literatura / Diagnosis and prevention of preterm birth. A literature update

Antecedentes: El parto pretérmino es uno de los principales problemas de la obstetricia, ya que es el causante del 35 % de las muertes infantiles en el primer año de vida y de morbilidad severa a corto y largo plazo en aquellos que sobreviven a la prematurez. En el 2010, Colombia reportó 8,8 % de parto pretérmino, por esto es de vital importancia identificar factores de riesgo, realizar prevención y hacer un adecuado diagnóstico y manejo de este síndrome. Objetivo: Actualizar los conocimientos en la prevención del parto pretérmino. Metodología: Se revisó la literatura disponible en idiomas inglés y español desde el año 2001 hasta abril de 2016 utilizando las palabras clave: preterm brith, pessary, vaginal progesterone, cerclage, pevention preterm birth, parto pretérmino, tamizaje de parto pretérmino. Se accedió a diferentes bases de datos: Ovid, ClincalKey, Cochrane, Pubmed, Medline, EM-BASE. Resultados: Se hallaron 81 artículos de texto completo de diversas tipologías: guías de manejo actualizadas, investigación científica y tecnológica, revisiones, los cuales abordaban la temática de diagnóstico y prevención. Conclusión: Existen múltiples controversias sobres las diferentes técnicas en la actualidad para identificar pacien-tes de riesgo y lograr una prevención adecuada del parto pretérmino.

Background: Preterm birth is one of obstetrics main problems, causing 35 % of deaths in infants on their first year of life and severe morbidity on short and long term in those cases when the individual survives premature birth. In 2010, Colombia reported 8.8 % of preterm birth, thus making the identification of risk factors, prevention, pre-cise diagnostic and care of this syndrome of so great and vital importance. Objective: To update our knowledge on the prevention of preterm birth. Methods: Using different databases such as: Ovid, Clinical Key, Cochrane, Pubmed, Medline and EMBASE, an in depth analysis was performed on the literature available. Cross references in both Spanish and English were performed on publications from 2001 to 2016, using the following key words: preterm birth, pessary, vaginal progesterone, cerclage, preterm birth prevention, preterm delivery, preterm de-livery screening. Results: 81 complete text articles were found, of different typologies: updated management guides, scientific and technological research, reviews; which addressed the issue of diagnosis and prevention. Conclusion: There are multiple controversies regarding the different techniques used to identify high risk patients and reach an adequate prevention of preterm birth.

Embarazo abdominal: caso clínico y revisión de literatura / Abdominal pregnancy: a clinic case and literature review

En este artículo se informa un caso y se revisa la literatura acerca de embarazo abdominal. Se reporta el caso de una paciente joven de 24 años, multigestante, con embarazo pobremente controlado, quien acude al servicio de urgencias de un hospital de III nivel de complejidad de la ciudad de Barranquilla, Atlántico, Colombia con cuadro clínico de dolor abdominal. Posterior a rastreo ecográfico realizado en el servicio y con evidencia de anhidramnios, es realizada cesárea de urgencia con hallazgo de embarazo abdominal con producto vivo a término. La madre es llevada a unidad de cuidados intensivos con evolución satisfactoria y dada de alta junto al recién nacido. Se pre-senta una revisión de la epidemiología, cuadro clínico y manejo

In this article a case and a review of the literature about abdominal pregnancy are reported. The patient was a young multiparous woman with a poorly controlled pregnancy who arrived to emergency room with abdominal pain, which began three days ago, later was perform an ultrasonographic examination that revealed oligohydram-nios. Was performed an emergency cesarean section with abdominal pregnancy and finding a live and term fetus. Mother was followed in intensive care unit with a satisfactory postoperative evolution. Mother and child were discharged a few days later. We discuss the epidemiology, clinical manifestations and management.