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.

Incidence of anti-Toxoplasma antibodies in women with high-risk pregnancy and habitual abortions.

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular parasite. In pregnant women on the worldwide scale, there are seroprevalences from 7% to 51.3% and in women with abnormal pregnancies and abortions the seroprevalences vary from 17.5% to 52.3%. In Mexico, seropositivity has been found to vary from 18.2% to 44.8% in women with abnormal deliveries or abortions. This study's aim was to determine the incidence of IgG and IgM anti-Toxoplasma antibodies in women at the Gineco-Obstetrics Hospital of the Western Medical Center of the Mexican Social Security Institute. Three hundred and fifty women with high-risk pregnancies were studied, and 122 (34.9%) were found to be IgG seropositive and 76 (20.7%) were IgM positive. In one group of women with habitual abortions there were 48 (44.9%) with the presence of IgG antibodies and 33 (33.3%) were IgM seropositive. Seropositivity was analyzed according to age, occupation, socio-economic level, eating raw or poorly cooked meat, and living with cats.

[Triple mechanical heart valve prosthesis and pregnancy]. / Triple prótesis valvular mecánica cardiaca y embarazo.

A very unusual case, of a multiparous, 36 year-old, woman, she had previous mechanical replacement of her mitral, aortic and tricuspid valves, and was with coumarins. Her 6th pregnancy was uneventful, with no cardiovascular decompensation and delivered a healthy baby girl, weighing 1,700 g. without congenital malformations. We discuss here, her medical management during and after pregnancy as well as, the factors influencing an optimal result for both, mother and baby.

Circulating immune complexes in hypertensive disease of pregnancy.

Circulating immune complexes in the blood of patients with hypertensive diseases of pregnancy were investigated. Sixty women with pregnancies between 30 and 40 weeks were studied. Of these patients, 22 were normal, 18 developed preeclampsia, 2 developed eclampsia, 14 had essential hypertension, and four had hypertension of renal origin. Circulating immune complexes were determined by the method of phagocytosis and immunofluorescence. They were found only in patients with preeclampsia or eclampsia, and were constituted of IgG and C3. It is suggested that the detection of circulating immune complexes by this method can be useful in the differential diagnosis of preeclampsia from other hypertensive diseases of pregnancy.

Prediccion del sindrome de insuficiencia respiratoria neonatal por la prueba de hemolisis con peroxido de hidrogeno. / Prediction of respiratory insufficiency syndrome in newborn infant by the peroxide hemolysis test

El proposito de este estudio fue investigar la posibilidad de efectuar una prueba con sangre del cordon umbilical que permitiera procedir cuales neonatos desarrollarian el sindrome de insuficiencia respiratoria neonatal (SIRN). Para ello se estudiaron 45 neonatos, de los que 30 fueron maduros y 15 inmaduros. En ellos se efectuo antenatalmente la prueba de la espuma (PE) en liquido amniotico y la prueba de la hemolisis de los eritrocitos con peroxido de hidrogeno (PH202).Los 30 neonatos maduros dieron la PE positiva y la PH202 de 7.55+/-7.30 por ciento, y ninguno desarrollo el SIRN. Los 15 inmaduros dieron la PE negativa, la PH202 de 41.23+/- 25.50 por ciento, y todos desarrollaron el SIRN. En nueve inmaduros que desarrollaron el SIRN y se recuperaron, la PH202 fue menor de 30 por ciento. En seis inmaduros que fallecieron por el SIRN, la PH202 fue mayor del 30 por ciento, y la PH202 y la PE tuvieron la misma certeza para pronosticar cuales neonatos desarrollarian el SIRN. Ademas, la PH202 permitio pronosticar la gravedad del sindrome

Determinacion del grupo sanguineo fetal en celulas amnioticas. / Determination of fetal blood group in amniotic cells

Se obtuvieron 50 muestras del liquido amniotico por amniotomia en operaciones cesareas de embarazos de 37 a 40 semanas. Se determino el grupo sanguineo de las celulas amnioticas por reacciones de inmunofluorescencia. Al nacimiento de los productos se obtuvieron muestras de sangre del cordon umbilical y en ellas se determino el grupo sanguineo de los eritrocitos fetales. Se encontro que en 48 de los 50 casos estudiados el grupo sanguineo (ABO) determinado en las celulas amnioticas coincidio con el encontrado en la sangre de los productos. La determinacion en ellos del antigeno D del factor Rh fue acertada solo en 9 de 50 casos

Desprendimiento placentario en ratas a las que se inyecto suero de pacientes con hipertension arterial. / Placental detachment in rats injected with serum of patients with arterial hypertension

Se describe un modelo experimental de desprendimiento placentario en ratas gestantes.Para inducir el desprendimiento placentario se produjeron embarazos en ratas de la cepa Sprague-Dawley y, entre los dias 16 y 17 de la gestacion se les inyectaron por via intraperitoneal 2 ml de suero de a) 12 pacientes embarazadas hipertensas (tres de ellas con desprendimiento prematuro de placenta normoinserta), b) seis pacientes masculinos con hipertension arterial esencial, c) diez mujeres con preeclampsia, d) diez mujeres embarazadas normales, e) cuatro varones sanos, f) seis mujeres sanas no embarazadas,o g) inyeccion de NaCl 0.15 M. Las ratas se sacrificaron 24 horas despues. Se encontro que solo las ratas a las que se inyectaron sueros de los 18 pacientes con hipertension arterial (12 embarazadas y 6 varones), presentaron desprendimiento de dos a tres de las ocho a diez placentas de cada gestacion, con hemorragia intrauterina y muerte de los productos in utero. Queda por investigar cual es el factor serico que causo los desprendimientos placentarios en las ratas

Metahemoglobinemia neonatal. / Neonatal methemoglobulinemia

Se determino la concentracion de metahemoglobina (MHb) en la sangre de 46 neonatos inmaduros que presentaron el sindrome de insuficiencia respiratoria neonatal (SIRN). Las determinaciones de la MHb se hicieron en las muestras de sangre seriadas que se obtuvieron para las gasometrias que requerian los pacientes. Se observo que las cifras de MHb se elevaron en esos neonatos. En los 17 que presentaron el SIRN y se recuperaron, la MHb fue de 0.71 +/- 0.60 por ciento. En los 13 que fallecieron por el SIRN, la MHb fue de 3.02 +/- 1.26. En siete neonatos con SIRN infectados (de los que tres fallecieron y cuatro se recuperaron) la MHb fue de 3.59 +/- 1.5 por ciento. En los nueve neonatos con SIRN y macrosomia diabetogena que se recuperaron, la MHb fue de 3.07 +/- 0.84 por ciento. En seis neonatos maduros normales la MHb fue de 0.18 +/- 0.12 por ciento. Estos resultados demostraron que la MHb se eleva en productos inmaduros en relacion con el pronostico de los casos, probablemente por la inmadurez de los mecanismos enzimaticos que deberian conservar a la hemoglobina en estado reducido

Proteolysis and antiproteolysis associated with toxemia of pregnancy.

Ten pregnancy toxemia patients, 10 pregnant patients with essential arterial hypertension and 12 normal pregnant women were studied between the weeks 37 and 40 of gestation. From them blood samples were obtained 24 hours before and 24 hours and three months after the delivery. In these samples proteolytic (P) and antiproteolytic (AP) activities and alpha-1-antitrypsin (A1-AT) concentration were determined. The P and the AP were measured by hydrolysis of BAPNA, and the A1-AT by radial immunodiffusion. The most interesting results were observed 24 hours before the delivery. Toxemic patients presented increase of P and AP, and hypertensive patients diminution of A1-AT when compared with normal controls. These results demonstrated that in toxemia and essential hypertension during pregnancy maladjustments in mechanisms of serum proteolysis and antiproteolysis, perhaps related with the activation of complement, clotting and circulating immune complexes formation systems, exist.