Silver-Russell syndrome associated to Mayer-Rokitansky-Kuster-Hauser syndrome, diabetes and hirsutism.

We report an unusual association of two rare conditions, the Silver-Russell syndrome and the Mayer-Rokitansky-Küster-Hauser syndrome, with extra endocrine anomalies. A 15-year old Silver-Russell syndrome girl was referred to our Unit because of primary amenorrhea and hirsutism of adrenal origin. A thorough assessment confirmed previous diagnoses and revealed the presence of diabetes, hyperinsulinism and a complete Mayer-Rokitansky-Küster-Hauser syndrome with an ectopic localization of both ovaries. Although initial medical treatment was not unsatisfactory, future medical, psychological and social implications are expected.

Obstetric significance of anti-Jr(a) antibody.

The first case in the English-language medical literature of anti-Jr(a) antibody during pregnancy in a Spanish woman is described. The few reported cases to date about this issue are reviewed, with advice as to an obstetric guideline to follow for pregnant women with this antibody.

Post-cesarean section morbidity in HIV-positive women.

BACKGROUND: The present work is an audit of post-cesarean section morbidity in HIV-positive women in the tertiary teaching hospital La Fé, Valencia, Spain. STUDY DESIGN: Retrospective case-control study. SUBJECTS: Forty-five HIV-positive pregnant women and 90 appropriately matched controls, delivered by cesarean section in the same hospital and managed using a uniform protocol. MAIN OUTCOME MEASURES: The duration of stay in hospital after cesarean section, the need for postoperative antibiotics and the incidence of major and minor puerperal complications. Baseline characteristics of HIV-positive women were also analyzed in relation to the morbidity after surgery. STATISTICAL ANALYSIS: Chi-square analysis for categorical data and parametric and non-parametric tests for numerical data, where appropriate. RESULTS: Most HIV-positive women (86.7%) had a complicated recovery after surgery. A longer duration of stay in hospital (p<0.0005) and a greater incidence of major (p<0.003) and minor (p<0.00001) postoperative complications were observed in the HIV-positive group compared to the control group. HIV-positive women with > or =500 CD4 lymphocytes/mm3 had less post-cesarean section morbidity CONCLUSIONS: A greater post-cesarean section morbidity was found in HIV-positive women compared to the control women. Immunological status of HIV-positive women may be important in predicting puerperal morbidity after surgery.