RESUMEN
Fetal bowel obstruction has a prevalence of 1 in 3000 to 5000 live births. Ultrasonographic diagnosis is made by demonstrating distended loops of bowel. Echogenic bowel, defined as small bowel more echogenic than liver or bone, has been associated with congenital infections, cystic fibrosis, chromosomal abnormalities, and bowel obstruction. Fetal ascites, defined as fluid in the peritoneal cavity partly surrounding the liver and bladder, also has been associated with bowel obstruction. We present a case of jejunal atresia whose presenting appearance consists of echogenic bowel, transient ascites, and massive dilatation of intestinal loops.
Asunto(s)
Atresia Intestinal/diagnóstico por imagen , Obstrucción Intestinal/diagnóstico por imagen , Enfermedades del Yeyuno/diagnóstico por imagen , Yeyuno/anomalías , Ultrasonografía Prenatal , Adulto , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Atresia Intestinal/cirugía , Obstrucción Intestinal/congénito , Obstrucción Intestinal/cirugía , Enfermedades del Yeyuno/congénito , Enfermedades del Yeyuno/cirugía , Yeyuno/diagnóstico por imagen , Yeyuno/cirugía , EmbarazoRESUMEN
OBJECTIVE: To evaluate catalase activity as a rapid predictor of microbial invasion of amniotic fluid (AF). METHODS: The study population consisted of 74 patients before 36 weeks' gestation with preterm labor or premature rupture of membranes (PROM). Subjects were excluded if there was evidence of clinical chorioamnionitis or fetal distress at admission. Amniocentesis was done within 24 hours of admission, and the AF was cultured for aerobic and anaerobic bacteria and for Mycoplasma species. All AF samples were Gram stained, and slides were examined by microbiology technologists. Amniotic fluid catalase activity was measured immediately after amniocentesis using a commercially available kit. The sensitivity of the Gram stain and catalase activity were compared using McNemar exact test. RESULTS: Amniotic fluid cultures were positive in 12 of 37 (32%) patients presenting with preterm labor and in 21 of 37 (56%) patients with PROM. Catalase activity was significantly more sensitive than Gram stain in detecting positive AF cultures in cases of PROM (P < .001) and preterm labor (P < .04). CONCLUSION: Catalase activity is a simple, rapid test that is useful in identifying subclinical intra-amniotic infection in patients with preterm labor or PROM.
Asunto(s)
Líquido Amniótico/enzimología , Catalasa/metabolismo , Rotura Prematura de Membranas Fetales/microbiología , Trabajo de Parto Prematuro/microbiología , Líquido Amniótico/microbiología , Femenino , Edad Gestacional , Humanos , Valor Predictivo de las Pruebas , Embarazo , Sensibilidad y Especificidad , Coloración y Etiquetado , Ureaplasma urealyticum/enzimologíaRESUMEN
We evaluated the relationship between the amniotic fluid index and the accuracy of fetal weight estimation using ultrasonography. Six hundred and sixty-four patients, between 20 and 42 weeks' gestational age, who were delivered within 1 week of a sonographic examination were studied. Five formulas for estimating fetal weight also were studied. Systematic and random errors in predicting birth weight were analyzed relative to birth weight and amniotic fluid index. The accuracy of sonographic fetal weight estimation was independent of amniotic fluid index across all gestational ages and birth weights. Each of the five formulas had similar error percentages, and no significant differences were detected. Predicted fetal weight was significantly underestimated with each of the formulas studied, a finding that was also independent of birth weight and amniotic fluid index. We conclude that ultrasonography can be used reliably to estimate fetal weight in patients with altered amniotic fluid volumes.
Asunto(s)
Líquido Amniótico , Peso Corporal , Monitoreo Fetal/métodos , Feto/anatomía & histología , Ultrasonografía Prenatal , Antropometría , Peso al Nacer , Femenino , Edad Gestacional , Humanos , Recién Nacido , Valor Predictivo de las Pruebas , Embarazo , Reproducibilidad de los ResultadosRESUMEN
Operative laparoscopy is rapidly becoming an important technique used by all surgical specialties. More sophisticated and difficult procedures are continually being performed endoscopically. Complications from these procedures are inevitable and are more frequently being managed with the laparoscope. We describe a case of inadvertent cystotomy during a laparoscopic gynecological operation, which was subsequently repaired endoscopically. The technique and patient followup are presented.