ABSTRACT
COVID-19 is a respiratory disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The effects of this infection on fetal development and whether there is vertical transmission are currently unknown. We present two cases of pregnant women with COVID-19 infection during the first and second trimester of gestation in which a PCR study of SARS-CoV-2 in amniotic fluid extracted by amniocentesis is performed to try to determine if there is vertical transmission. In both cases, the PCR result was negative. This fact could support the absence of vertical transmission when the infection occurs in these quarters. It would be advisable to carry out more extensive studies to be able to make this statement safely.
Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Amniotic Fluid , Female , Humans , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Trimester, Second , Pregnant Women , SARS-CoV-2ABSTRACT
OBJECTIVE: The objective of this article is to systematically review the various published clinical prediction rules used to calculate the risk of Down syndrome (DS) after carrying out an ultrasound in the second trimester of pregnancy. METHOD: A systematic search in the main bibliographic databases was carried out. Three independent observers identified the odds ratios and regression coefficients that allowed for the estimation of the risk of DS after ultrasound screening. Four of the clinical prediction rules were integrated into a computer application (ecodown 2.0(®) ). RESULTS: A total of ten clinical prediction rules were found. Three had been validated, two internally and one externally. We empirically checked the accuracy of the clinical prediction rule estimates obtained from 2216 ultrasound scans performed at our hospital. The application of the clinical prediction rules elaborated by Nicolaides and Zhong to the 2216 ultrasound scans showed a low concordance. CONCLUSIONS: Clinical prediction rules allow for the integration of second-trimester ultrasound findings to calculate the risk of DS. However, results from the different clinical prediction rules are not concordant and may generate situations of overestimation or underestimation of the risk of DS. It is thus necessary to validate these clinical prediction rules externally to decide which is most suitable for clinical use.
Subject(s)
Decision Support Techniques , Down Syndrome/diagnostic imaging , Female , Humans , Pregnancy , Pregnancy Trimester, Second , Risk Assessment , Software , Ultrasonography, PrenatalABSTRACT
Para determinar la población de riesgo de síndrome de Down a la que debe recomendarse realizar una te ́cnica invasiva para obtener un cariotipo fetal existen varias pruebas de cribado. En nuestro centro se realiza con el cribado del primer trimestre (edad materna + - translucencia nucal +b-HCG + PAPP-A). Cuando éste no es posible, se realiza el doble test (AFP+b- HCG) como cribado de segundo trimestre. Los resultados del doble test en nuestro centro son insatisfactorios ya que tenemos una tasa de detección del 0%, con una tasa de falsos positivos del 7,7%. Por ello consideramos que es necesaria la utilización de otros criterios alternativos para la selección de las mujeres de riesgo de síndrome de Down en el segundo trimestre (AU)
Several screening tests are available to identify the population at risk of Down syndrome. This population should then be recommended to undergo an invasive technique to obtain a fetal karyotype. In our hospital, screening is done by the combined test (maternal age + nuchal translucency + b subunit of human chorionic gonadotropin [b-HCG] + pregnancy- associated plasma-A [PAPP-A]) during the first trimester of pregnancy. When this test is not feasible, we request the double test (alpha-fetoprotein [AFP] + b-HCG) as a second trimester screening test. The results of the double test in our hospital were unsatisfactory because the detection rate was 0% with a false positive rate of 7.7%. Therefore, we believe alternative criteria should be used to select women at risk of having a child with Down syndrome in the second trimester (AU)
Subject(s)
Female , Humans , Pregnancy , Clinical Chemistry Tests/methods , Maternal Serum Screening Tests/methods , Maternal Serum Screening Tests , Down Syndrome/genetics , Down Syndrome/pathology , Pregnant Women/psychology , Fetal Nutrition Disorders/genetics , Fetal Therapies/methods , Fetal Therapies/standards , Clinical Chemistry Tests , Maternal Serum Screening Tests/classification , Maternal Serum Screening Tests/standards , Down Syndrome/complications , Down Syndrome/metabolism , Fetal Nutrition Disorders/pathology , Fetal Therapies/instrumentation , Fetal TherapiesABSTRACT
Objetivo. La presencia de preeclampsia, combinación de hipertensión y proteinuria tras la 20 semana de gestación aumenta de una manera notoria el riesgo de mortalidad y morbilidad perinatal y materna. Sujeto y métodos. El objetivo del estudio realizado es conocer los resultados perinatales y la morbimortalidad materna en las mujeres que presentaron una preeclampsia grave en el Complejo Hospitalario de Albacete. Conclusiones. Analizando nuestros resultados, hemos observado que en nuestra muestra la mortalidad, tanto materna como fetal, fue menor que la observada por otros autores y los neonatos de las mujeres que desarrollaron preeclampsia grave que ingresaron en la unidad de cuidados intensivos con eclampsia o síndrome de HELLP tuvieron una mayor morbilidad(AU)
Objective. The presence of preeclampsia, combination of hypertension and proteinuria after 20 weeks of gestation, would noticeably increase the risk of maternal and fetal morbi-mortality. Subject and methods. The objective of the study is to determine the perinatal outcome and maternal morbidity and mortality in women with severe preeclampsia at Albacete hospital. Conclusions. Analyzing our results we observed in our sample both maternal and fetal mortality was lower than that observed by other authors and infants of women who develop severe preeclampsia admitted to the ICU, with eclampsia or HELLP syndrome had a higher morbidity(AU)
Subject(s)
Humans , Male , Female , Pregnancy , Pre-Eclampsia/epidemiology , Intensive Care Units/standards , Intensive Care Units , Intensive Care Units, Neonatal , Intensive Care, Neonatal/methods , Intensive Care, Neonatal , Hypertension/complications , Hypertension/diagnosis , Proteinuria/complications , Proteinuria/epidemiology , Indicators of Morbidity and Mortality , Pre-Eclampsia/mortality , Thrombocytopenia/complications , Thrombocytopenia/diagnosis , HELLP Syndrome/diagnosis , HELLP Syndrome/epidemiologyABSTRACT
Una fístula es una comunicación anormal entre dos superficies epitelizadas. Aunque las fístulas que envuelven el útero no son infrecuentes, la fístula cutáneo-uterina es una entidad rara. La histerectomía abdominal con la escisión del trayecto fistuloso hasta la piel es el tratamiento de elección En este artículo presentamos 2 casos clínicos de esta complicación tan poco frecuente en que se ha realizado tratamiento quirúrgico (AU)
A fistula is an abnormal communication between two epithelial surfaces. Although fistulas that wrap around the uterus are not infrequent, uterocutaneous fistula is rare. The treatment of choice is abdominal hysterectomy with excision of the fistula up to the skin. We report two cases of uterocutaneous fistula requiring surgical treatment (AU)
