Postnatal development of fetuses with a single umbilical artery: differences between malformed and non-malformed infants.

BACKGROUND: The presence of a single umbilical artery (SUA) is a fetal soft marker of congenital abnormalities. Among the most common related malformations, there are cardiological, nephrourological and digestive anomalies, most of which are considered to have a vascular etiology. There is an association between increased incidence of intrauterine growth retardation and adverse perinatal indicators, but whether this association is due to related anomalies or isolated SUA (iSUA) is controvisal. METHODS: We reviewed 96 cases of iSUA and non-isolated SUA (niSUA), diagnosed in a period of two years in a referral hospital for high-risk pregnancies. Data on prenatal explorations, including fetal ultrasonography and karyotyping, were obtained. niSUA was diagnosed when no malformations were found prenatally or in postnatal evaluation. RESULTS: Sixty-six newborns (68.8%) had no other anomalies and 30 (31.3%) presented with a variety of malformations including heart diseases, urophaties, digestive, nervous and musculoskeletal disorders, genetic abnormalities and complex malformations. Cardiological and nephrourological abnormalities were found to be the most frequent association with a SUA (both in 23.8% of malformed SUA newborns). Intrauterine growth restriction was not higher in iSUA newborns than in a normal population. Ultrasound allowed optimal prenatal diagnosis in most cases. CONCLUSIONS: The prognosis of the fetus with a SUA is determined by the presence of other malformations observed by an expert sonographer. If no other findings are made, only a routine physical examination should be performed in newborns, but no other complementary examinations are required.

Evolución obstétrica de paciente afectada de síndrome de Ehlers-Danlos / Pregnancy outcome in Ehlers-Danlos Syndrome

El síndrome de Ehlers-Danlos (SED) es un grupo de enfermedades del tejido conectivo caracterizado principalmente por fragilidad tisular e hiperlaxitud articular. Es poco frecuente su asociación con el embarazo y algunos tipos cursan con complicaciones severas maternas. Presentamos nuestra experiencia con una paciente de 35 años afectada de SED tipo clásico, que presentó un embarazo sin complicaciones, que alcanzó las 38 semanas y, un aborto espontáneo en el primer trimestre de una gestación gemelar(AU)

Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders characterised by tissue fragility and joint hypermobility. Although it is rarely associated with pregnancy, some types may have severe maternal complications. We report our experience of a 35-year-old patient suffering from a classic EDS, who had a successful pregnancy at 38 weeks, and first trimester spontaneous miscarriage of a twin pregnancy(AU)

Manejo conservador y seguimiento ecográfico de hematoma en el área Retzius y la fosa isquiopubiana tras malla vía transobturadora / Conservative management and ultrasound monitoring of a hematoma in Retzius’ space and isquiopubic area after placement of transobturator vaginal tape

Las complicaciones de las técnicas quirúrgicas antiincontinencia mediante el uso de mallas vía transobturadora son muy infrecuentes, por lo que no existen protocolos establecidos sobre su manejo y seguimiento. Presentamos el caso clínico de aparición de hematoma de gran tamaño tras colocación de TVT-O, en el cual se optó por un manejo conservador con el uso de la ecografía convencional y 3D como seguimiento de esta complicación, con resultados muy satisfactorios (AU)

Complications after surgery to correct incontinence by using transobturator vaginal tape are highly uncommon and consequently there are no established protocols for their management and monitoring. We report a case of a large hematoma after placement of TVT-O, in which we chose conservative management using conventional and 3-dimensional ultrasound to monitor this complication, with highly satisfactory results (AU)