[Cervical length in predicting preterm labor]. / Longitud cervical en la predicción de amenaza de parto pretérmino.

BACKGROUND: Preterm birth is the birth occurring between 20-37 weeks gestation. Is responsible for 75% of neonatal mortality in infants without congenital malformations. OBJECTIVE: To determine the prognostic factor of cervical length measurement in threatened preterm labor, in patients treated at a hospital in Veracruz, Mexico. MATERIAL AND METHOD: Observational, prospective, longitudinal and descriptive study performed at the Obstetrics and Perinatology services of the Hospital General de Zona Núm. 71, IMSS, from May to December 2007. INCLUSION CRITERIA: patients admitted to the obstetrics service with a diagnosis of preterm labor of 22 to 36 weeks, single gestation. EXCLUSION CRITERIA: history of premature rupture of membranes, uterine malformation, stillbirth, pregnancies of fetuses with birth defects, carriers of cerclage and a history of cervical cone biopsy. The cervicometry was performed with 7-9 MHz vaginal transducer; increased risk of preterm delivery were considered in patients with cervical length < 25 mm, the existence of funnel was also assessed. We determined the sensitivity, specificity, positive predictive value and negative. RESULTS: We studied 73 pregnant women diagnosed with preterm labor. The average age was 26.5 + 5.2 years. Fourteen (19.2%) patients had a history of income for preterm labor in previous pregnancies. In ten patients (10.7%), measurement of cervical length < 25 mm and the criterion of the number of weeks of preterm delivery (22-36) agreed (true positives); and 58 (79.5%) patients with cervical length > 25 mm and > or = 38 weeks gestation also agreed (true negatives). CONCLUSIONS: The sensitivity to correctly predict preterm delivery was 71%, specificity of 98%, positive predictive value of 91% and negative predictive value of 94%, so the cervicometry is considered a useful tool for treatment and monitoring of preterm delivery.

[Ectopia cordis: multidisciplinary approach with successful result]. / Ectopia cordis: manejo multidisciplinario con resultado exitoso.

Ectopia cordis is a pathology in which the heart is complete or partially outside of the thoracic cavity. It represents a challenge for the diagnosis and handling because of its high perinatal mortality. We present the first case of thoracic ectopia cordis with prenatal diagnostic (27th week), its multidisciplinary handling at Hospital de Ginecopediatria núm. 71 of the Centro Medico Nacional Adolfo Ruiz Cortines, IMSS, in Veracruz, Mexico. We communicate the case of a 24 year-old woman referred by her correspondent medical unit with the diagnosis of 23.6 weeks pregnancy with suspicion of heart malformation by ultrasound. The pregnancy was followed-up until the 38th week, when it was programmed a caesarean section. The newborn had ectopia cordis, which was treated at the moment of birth. In this article, we present pictures of the heart defect as well as its evolution. The up-to-date bibliography is revised about the medical profile and treatment. The handling of the ectopia cordis includes an appropriate prenatal diagnosis through echocardiograph, a multidisciplinary perinatal team, to program the caesarean operation, aseptic handling of the newborn, immediate correction of the wall defect with skin torn piece without trying to correct the costal grill, specific hemodynamic cares, to reprogramme a correction of associated defects.