Reproductive history in mothers of children with neural tube defects.

The reproductive history of 100 women with at least 1 child with a neural tube defect (NTD) has been studied. The data analyzed correspond to the period previous to their first visit to a genetic counseling service. A total of 204 pregnancies resulted in 205 outcomes. Of the 100 sibships, 14 (14%) had more than 1 affected member. The pregnancy was shorter than 28 weeks in 56/205 (27%) of the total outcomes. Of 104 evaluable previous outcomes, 34 corresponded to short pregnancies, positioned before an affected (23/60, 38%), a healthy (2/18, 11%), or an undiagnosed product (9/26, 35%). Short pregnancies subsequent to affected outcomes were also increased. The inter-gestational interval varied according to diagnosis: it was longer in the affected group than in the healthy one (0.1 > p > 0.05) and the subsequent intervals were shorter for the affected group (p < 0.05). An increased number of abortions adjacent to affected offspring and a changing fertility pattern, depending on the product diagnosis, point to an environmental etiological component in this high-risk NTD group of mothers.

Epignathus: diagnóstico ecosonográfico. Informe de un caso y revisión de la literatura / Epignathus: Echosonographic diagnosis. Report of a case and review of literature

Se informa un caso de teratoma fetal orofaríngeo(epignathus) en una paciente primigesta que cursaba un embarazo de 32 semanas habiéndose efectuado el diagnóstico prenatal por ultrasonido y que fue corroborado al nacimiento. El epignathus es una entidad rara cuyo diagnóstico preciso y oportuno es definitivo y tiene el objeto de establecer un plan de manejo adecuado e inmediato al nacimiento y lograr una sobrevida neonatal. Se realizó una revisión amplia de la literatura mundial y de acuerdo con nuestra investigación no se había publicado un caso de apignathus en etapa prenatal en México

[Epignatus: ultrasonic diagnosis. Report of a case and review of the literature]. / Epignathus: diagnóstico ecosonográfico. Informe de un caso y revisión de la literatura.

This report refers to the case of fetal oropharyngeal teratoma (Epignathus) in a woman at 32 weeks of gestation in her first pregnancy. The diagnosis was done in prenatal period by ultrasonography and ratified at delivery. Epignathus is a rare type of teratoma whom accurate prenatal diagnosis is definitive to plan a peripartum management which resulted in an excellent outcome for the neonate. A review of the literature was done and according to our knowledge this case of epignathus describes the first one reported in our country in fetal period.

[Percutaneous mitral valvuloplasty with Inoue balloon and pregnancy]. / Valvuloplastía mitral percutánea con balón de Inoue y embarazo.

Percutaneous mitral valvuloplasty with Inoue balloon was performed in seven pregnant women with severe mitral stenosis in NYHA state III or IV that were unresponsive to conventional management Usual technique was performed with echocardiographic score of 8 or less except one and average gestational age of 28.5 +/- 6.4 weeks. The mean mitral gradient was 19.8 +/- 6.4 mmHg, and decreased to 3.6 +/- 2.9 mmHg (P < 0.01) and valvular area increased from 0.84 +/- 0.01 to 2.2 +/- 0.05 (P < 0.01) in 5 from 7 (P < 0.05) there was minimal mitral incompetence, there were no cases of atrial septal defect. Two patients had moderate to severe pulmonary hypertension which decreased immediately after treatment. All patients showed an improvement (P < 0.001) in the clinical state. Mean fetal exposure to radiation was seven minutes and the patients had two transesophageal echocardiography done during the procedure. One patient had to be taken to open commissurotomy due to perforation of the aorta which caused minimal hematoma. In two patients transient fetal bradycardias were noted during the hypotensive episodes caused by balloon inflation with no serious fetal distress. All but one pregnancies got to term; four patients delivered vaginally and three underwent cesarean section due to obstetric indication. Neonatal weight and Apgar score were satisfactory. We consider that the significative benefits of the procedure, together with zero maternal and fetal mortality make this technique an acceptable one for this pathology.