Maternal cardiac disease and perinatal outcomes in a single tertiary care center.

OBJECTIVE: Maternal mortality in the U.S. has increased, with a substantial contribution from maternal cardiac disease. As a result of improved childhood survival, more women with congenital heart disease are reaching reproductive age leading to a growing high-risk obstetric population. We sought to determine the obstetrical and neonatal outcomes of women with maternal cardiac disease, including acquired cardiovascular disease and congenital heart disease. METHODS: We studied a retrospective cohort study of women that delivered from 2008 to 2013 (N = 9026). Singleton pregnancies without preexisting conditions were established as the unexposed group for this study. Maternal and neonatal outcomes were compared between the unexposed group (N = 7277) and women exposed to maternal (acquired or congenital) cardiac disease (N = 139) as well as only congenital heart disease (N = 85). Statistical comparisons used univariate/multivariable logistic and linear regression analysis controlling for confounders with p < .05 and 95% confidence intervals indicating statistical significance. RESULTS: Pregnancies complicated by maternal cardiac disease were associated with increased odds of preterm birth (<34 weeks, <37 weeks), intrauterine growth restriction (IUGR), need for assisted vaginal delivery, maternal ICU admission, and prolonged maternal hospitalization (>7 d). Neonatal outcomes including small for gestational age and Apgar score <7 at 5 min were increased in the pregnancies complicated by maternal cardiac disease. When pregnancies complicated by congenital heart disease were analyzed as a sub-group of the cohort, the results were similar. There were increased odds of preterm birth (<37 weeks), early-term delivery, need for assisted vaginal delivery, and prolonged hospitalization. Neonatal outcomes were only significant for small for gestational age. CONCLUSION: We observed that in a select cohort of pregnancies complicated by maternal cardiac diseases (acquired or congenital), there were significant increases of adverse perinatal outcomes. Therefore, a multidisciplinary approach including maternal-fetal medicine specialists, cardiologists, obstetric anesthesia, and dedicated ancillary support is imperative for optimal care of this high-risk obstetrics population.

Control químico del dobesilato de calcio empleado en el tratamiento de la retinopatía diabética / Chemical control of calcium dobesilate for the treatment of diabetic retinopathy

Se plantea que el control químico, cualitativo y cuantitativo, es de gran importancia para garantizar la correcta dosificación de los principios activos en los medicamentos. El dobesilato de calcio, empleado recientemente en oftalmología para el tratamiento de la retinopatía diabética no aparece registrado en la literatura oficial consultada; solamente en algunas publicaciones especializadas se informan algunos datos y características del producto. En el presente trabajo de describe un método espectrofotométrico para la determinación cuantitativa de la materia prima y producto elaborado en forma de tableta de uso por vía oral, donde se utiliza como referencia un patrón de trabajo previamente valorado mediante otros métodos analíticos. Debido a los grupos cromóforos del anillo bencénico, sustituidos, la sustancia posee absorbancia en la zona ultravioleta que presentan dos máximos de absorción a las logitudes de onda de 222 y 302 nm, aproximadamente(AU)