Enfermedad trofoblástica gestacional diagnosticada en restos ovulares obtenidos de pacientes con abortos espontáneos

Objetivo: Evaluar las características de la enfermedad trofoblástica gestacional, diagnosticada en restos ovulares obtenidos de pacientes con abortos espontáneos, atendidas en Sala de Partos de la Maternidad “Concepción Palacios” entre enero 2012 y enero 2014. Métodos: Estudio descriptivo, prospectivo, de corte transversal, que incluyó 325 pacientes con diagnóstico de aborto espontáneo. Previo consentimiento informado, se obtuvo información de la historia clínica, hallazgos del ultrasonido y de los resultados histopatológicos. Resultados: La frecuencia de mola parcial fue de 0,3 %. La edad promedio de las pacientes fue 27 años ± 7 años, la edad gestacional promedio fue 9 semanas + 3 días ± 4 semanas. La mediana de gestas obtenida fue 2, con un rango de 1 a 11. Un 89,84 % de las pacientes se encontraban sintomáticas al momento del ingreso, 55,4 % ingresó con cuello cerrado. Desde el punto de vista macroscópico 96,3 % eran de aspecto ovular, 3 % parcialmente hidrópicos, y 0,6 % hidrópicos y desde el punto de vista microscópico, 92,9 % correspondió a restos ovulares, 7 % a abortos con degeneración hidrópica y 0,3 % a mola parcial. No se encontró correlación estadística entre el ultrasonido y la histología para diagnóstico de enfermedad trofoblástica gestacional. Conclusión: La frecuencia de mola parcial fue baja.

Objective: To evaluate the characteristics of gestational trophoblastic disease, diagnosed in POC from patients with spontaneous abortions, attending Birthplace of “Concepcion Palacios Maternity” between January 2012 and January 2014. Method: A descriptive, prospective, cutting cross, which included 325 patients with a diagnosis of spontaneous abortion. Prior informed consent information from the clinical history, ultrasound findings and histopathological results were obtained. Results: The frequency of partial mole was 0.3 %, the average age of the patients was 27 years ± 7 years, mean gestational age was 9 weeks + 3 days ± 4 weeks. Median deeds obtained was 2 with a range of 1 to 11 A 89.84 % of patients were symptomatic at the time of admission, 55.4 % were admitted with high collar. From the macroscopic viewpoint aspect 96.3 % were ovulating, 3 % partially hydropic and hydropic and 0.6 % from the microscopic, 92.9.% are POC, 7% to abortions with hydropic degeneration and 0, 3 % a partial mole. We did not find that there is statistical correlation between ultrasound and histology for the diagnosis of gestational trophoblastic disease. Conclusion: the frequency of partial mole was low.

Síndrome metabólico durante el embarazo: complicaciones materno-fetales / Metabolic syndrome during pregnancy: maternal and fetal complications

Determinar la asociación entre el síndrome metabólico y las complicaciones maternas, fetales y neonatales, en un grupo de embarazadas entre agosto 2008 y septiembre 2009.En el Servicio Prenatal de la Maternidad “Concepción Palacios”. Estudio prospectivo, longitudinal, comparativo, con una muestra de 130 embarazadas, 38 cumplieron los criterios de la Federación Internacional de Diabetes para síndrome metabólico y 92 fueron el grupo control. El promedio de edad de las pacientes con síndrome 29,86 años, significativamente mayor que el del grupo control (24,11 años). Entre las gestantes con síndrome metabólico 34,2 por ciento presentó trastornos hipertensivos del embarazo, 23,7 por ciento tuvieron diabetes, 26,3 por ciento parto pretérmino y 2,6 por ciento infección puerperal. En el grupo control hubo 13,0 por ciento de trastornos hipertensivos del embarazo 6,6 por ciento de parto pretérmino y ningún caso de diabetes o infección puerperal (P< 0,05). La complicación fetal más frecuente fue la macrosomía, 10,5 por ciento de las gestantes con síndrome metabólico y 4,3 por ciento del grupo control (P>0,05). Hubo 23,7 por ciento de casos con bajo peso al nacer, 18,4 por ciento con hipoglicemia y 10,5 por ciento con sepsis en el grupo de recién nacidos de madres con sindrome metabólico. Este estudio mostró una mayor tasa de complicaciones maternas y neonatales en embarazadas con síndrome metabólico, en comparación con el grupo control

To determine the association between metabolic syndrome and maternal complications, fetal and neonatal in a group of pregnant patients between August 2008 and September 2009. Prenatal care service at the “Concepcion Palacios” Maternity. A prospective, longitudinal, comparative study with a sample of 130 pregnant women was done, from which 38 patients met the International Diabetes Federation metabolic syndrome criteria and 92 patients were part of the control group. The mean age of the patients with metabolic syndrome was 29.86 years, and the control group was 24.11 years. Among pregnant women with metabolic syndrome, 34.2 percent showed hypertensive disorders of pregnancy, 23.7 percent had diabetes, 26.3 percent were preterm delivery and 2.6 percent had preterm puerperal infection. In the control group there were 13.0 percent hypertensive disorders of pregnancy, 6.6 percent preterm deliveries and no cases of diabetes or puerperal infection (P <0.05) were reported. The most frequent complication was fetal macrosomia, with 10.5 percent of cases in pregnant women with metabolic syndrome and 4.3 percent in the control group (P> 0.05). There were 23.7 percent of cases with low birth weight, hypoglycemia 18.4 percent and 10.5 percent with sepsis in the group of infants from mothers with metabolic syndrome. This study showed a higher rate of maternal and neonatal complications in pregnant women with metabolic syndrome compared with the control group

Early post-transplant renal allograft function between 1990 and 1998 in Spain.

BACKGROUND: The last decade has witnessed a sustained improvement of renal allograft survival that is partly explained by a better preservation of renal allograft function. This study describes time-dependent modifications of serum creatinine (SCr) during the first year after transplantation in the last decade in Spain and characterizes the predictive value of SCr on death-censored graft survival. METHODS: A total of 3365 adult patients transplanted in 1990 (n = 824), 1994 (n = 1075) and 1998 (n = 1466) with a functioning graft after the first year were included. Renal function deterioration during the first year was expressed as the difference between SCr at 1 year and SCr at 3 months. RESULTS: Despite the projected renal allograft half-life, estimation was significantly higher in 1998 than in 1990 (17.7 vs 15.4 years, P = 0.007), the SCr levels at 3 months were significantly lower in 1990 (1.59+/-0.64) than in 1998 (1.65+/-0.66). While SCr tended to worsen during the first year in 1990 (0.05+/-0.64) it improved in 1998 (-0.003+/-0.48), P = 0.0001. The following variables were significantly associated with SCr at 3 months: donor age and sex, cause of death, recipient sex, time on dialysis, cold ischaemia time, delayed graft function, acute rejection, cytomegalovirus infection and reintervention for any reason. Renal function deterioration during the first year was associated with the presence of acute rejection and hepatitis C virus antibodies in the recipient. CONCLUSIONS: Despite poorer renal function at 3 months in 1998 than in 1990, renal allograft survival has improved in Spain between 1990 and 1998. This result is partly explained by a slower deterioration of renal function during the first year of follow-up.