ABSTRACT
Debido al número creciente de la tasa de cesáreas, el riesgo de rotura uterina probablemente aumentará. La mayoría aparecen intraparto, siendo más raro un diagnóstico durante el postparto. Se presenta el caso de una mujer de 35 años de edad con antecedente de cesárea anterior hace 4 años que acude a urgencias con un cuadro de dolor abdominal y empeoramiento del estado general, tras parto instrumental 2 semanas antes (AU)
Due to increasing rate of cesarean deliveries, the risk of uterine rupture would probably rise. Most of them appear during labour, being less common a postpartum period diagnosis. Our case report describes a 35-year-old woman with previous caesarean section 4 years ago, who goes to emergency services with abdominal pain and poor performance status after having an instrumental delivery 2 weeks before (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Abdominal Pain/complications , Uterine Perforation/complications , Uterine Perforation/pathology , Peritoneal Neoplasms/complications , Pseudomyxoma Peritonei , Postpartum Period , Uterine Perforation , Laparoscopy/methods , Risk Factors , Pathology/methodsABSTRACT
BACKGROUND AND OBJECTIVE: The main strategies to avoid the vertical transmission of human immunodeficiency virus (HIV-1) is antiretroviral treatment during pregnancy, delivery and to the newborn. Nevertheless, there are scant data about safety of antiretroviral drugs and follow-up studies with a large number of pregnant women are needed. The aims of our study are: to assess toxicity associated with antiretroviral treatment, to determine vertical transmission, and to define epidemiological trends within this population. In this paper we present maternal characteristics of the cohort. PATIENTS AND METHOD: Observational, multicentric, collaborative study about an HIV-1 infected pregnant women cohort and their offspring (666 and 686 cases, respectively) who were born during the study period (from January or May 2000 to 31st december 2003). RESULTS: Most pregnant women were infected by heterosexual transmission (54%). 71% women were included in stage A of the Centers for Disease Control classification of HIV infection and 74% women have received high activity antiretroviral treatment during pregnancy. Prevalence of adverse effects treatment-related was 7%, mainly anaemia related to treatment with zidovudine. We found 6 cases of vertical transmission among 686 newborns (0.8%; 95% confidence interval, 0.3-1.8). CONCLUSIONS: Most patients received highly active antiretroviral treatment, with a good tolerance and a low prevalence of adverse effects related to the treatment. Vertical transmission rate is very low, not higher than 1%. Apart from this, is necessary to pay attention to other phenomena like hepatitis C virus coinfection, other potentially serious adverse effects like hepatotoxicity and pregnancy-related pathologies more frequent in this population, like prematurity and gestational diabetes.
