RESUMO
OBJECTIVE: To investigate the frequency of main symptoms of Obstructive Sleep Apnea Syndrom (OSAS) and their relationship with Pregnancy Induced-Hypertension (PIH) as well as Intrauterine Growth Retardation (IGR) as suggested by recent studies. METHODOLOGY: Four hundred (and) thirty-eight enquiry forms completed during post-partum period were analysed, after exclusion of multiple pregnancies. Collected data were demographic characteristics, obstetrical events, sleep disorders during last trimester, screening of snoring and vigilance troubles with an Epworth score. RESULTS: Forty-five percentages of the patients reported to have habitual snoring during pregnancy. Among these, 85% were non-snorers before pregnancy. Daytime somnolence concerned 84,5% of the population with an Epworth score significatively increased (P<0,0001). The prevalence of PIH was found to be 4,5%, with two apparently independent risk factors: the body mass index (OR=1,1) and an association between snoring and increased vigilance trouble (OR=2,6). No statistical difference was found concerning IGR. CONCLUSIONS: SAS symptoms are frequent during pregnancy and snoring appears to be linked with PIH. However, polysomnographic data are not yet sufficient to explain pathophysiological mechanisms and find relevant diagnostic markers during pregnancy.
Assuntos
Retardo do Crescimento Fetal , Hipertensão Induzida pela Gravidez/epidemiologia , Complicações na Gravidez/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Humanos , Modelos Logísticos , Pré-Eclâmpsia/epidemiologia , Gravidez , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Transtornos do Sono-Vigília/epidemiologia , Ronco/epidemiologia , Inquéritos e QuestionáriosRESUMO
The accessory spleen is often a incidental discovery. The accessory post-accidental spleen are unusual. The torsion of a movable spleen is possible and represent about 0.2 to 0.3% of splenectomy. But the torsion of an accessory spleen is exceptional. A case of acute torsion of an accessory spleen is reported. In a 26-year-old women was admitted with acute abdominal pain. The abdominal ultrasound and the abdominal X-Ray are no specific. In the face of the acute pain, a laparoscopy was necessary. At laparoscopy, the patient was found to have torsion and infarction of an accessory spleen in the pelvis. The treatment was a splenectomy and the evolution was favorable.
Assuntos
Dor Abdominal , Esplenopatias/diagnóstico , Adulto , Feminino , Humanos , Infarto/diagnóstico , Infarto/cirurgia , Laparoscopia , Radiografia , Baço/irrigação sanguínea , Esplenectomia , Esplenopatias/cirurgia , Anormalidade Torcional , UltrassonografiaRESUMO
Intravenous nitroglycerin has been reported to be efficient in various emergency obstetric situations. We report here the first case of intravenous nitroglycerin use in a 20-week pregnant woman with abruptio placentae and hypertonia leading to in utero fetal death and difficult delivery.
Assuntos
Nitroglicerina/uso terapêutico , Complicações do Trabalho de Parto/tratamento farmacológico , Obstetrícia/métodos , Contração Uterina/efeitos dos fármacos , Vasodilatadores/uso terapêutico , Descolamento Prematuro da Placenta/complicações , Adulto , Feminino , Morte Fetal/etiologia , Humanos , Injeções Intravenosas , Hipertonia Muscular/complicações , Gravidez , Segundo Trimestre da Gravidez , Doenças Uterinas/complicaçõesAssuntos
Anestesia Obstétrica/efeitos adversos , Transtornos Cerebrovasculares/etiologia , Transtornos Puerperais/etiologia , Tromboflebite/etiologia , Adulto , Angiografia Cerebral , Veias Cerebrais , Transtornos Cerebrovasculares/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , Transtornos Puerperais/diagnóstico , Tromboflebite/diagnósticoRESUMO
OBJECTIVE: To show that intrapartum prophylactic amnioinfusion (AI) in case of oligohydramnios or particulate meconium-stained amniotic fluid could be beneficial. STUDY DESIGN: From the first March 1993 until the 30th June 1995, 4031 women were delivered at the University Hospital of Poitiers. Patients presenting with oligohydramnios (G1) (71 patients with an amniotic fluid index below 5 cm) or a particulate meconium-stained amniotic fluid (G2) (64 patients) were included. Each group was compared to an historical control group constituted retrospectively according to the following criteria: oligohydramnios (CG1), particulate meconium-stained amniotic fluid (CG2), age, parity, gestational age and duration of labor. Statistical analysis was performed using the Student's t-test and the Fisher's exact test when appropriate with a level of significance of P less than 0.05. RESULTS: The mean infused volume was 893 ml in G1 and 734 ml in G2. A significant difference was found in terms of cesarean section between G1 and CG1 (11.3 vs. 24.5%; P < 0.05) and of assisted deliveries for fetal distress between G2 and CG2 (12.5 vs. 23.43%; P < 0.05). No other significant difference was found between the study groups and their control for all other studied criteria. When considering more specifically the presence of meconium below the vocal cords we also could not find any significant difference between G2 and CG2 (1.6 vs. 9.4%; P = 0.05). No neonatal or maternal adverse effect happened in this short study. COMMENT: AI is easy to perform during labour in case of oligohydramnios or particulate meconium-stained amniotic fluid. In case of oligohydramnios, a decreased rate of cesarean sections has been observed in the infused group. Considering patients with particulate meconium-stained amniotic fluid, less interventions for fetal distress and neonates with meconium below the vocal cords has been found in the infused group. Further prospective evaluation is needed to confirm these results in case of particulate meconium-stained amniotic fluid and to compare the advantage of prophylactic versus therapeutic AI performed in case of oligohydramnios and abnormal fetal heart rate.
Assuntos
Líquido Amniótico , Síndrome de Aspiração de Mecônio/prevenção & controle , Oligo-Hidrâmnio/terapia , Adulto , Feminino , Frequência Cardíaca Fetal , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos , Contração UterinaRESUMO
OBJECTIVE: To show that intrapartum prophylactic amnioinfusion in case of oligohydramnios or particulate meconium-stained amniotic fluid could be beneficial. STUDY DESIGN: From March 1st, 1993 until December 31st, 1996, 6845 women were delivered at the University Hospital of Poitiers. Patients presenting with oligohydramnios (G1) (118 patients with an amniotic fluid index below 5 cm) or a particulate meconium-stained amniotic fluid (G2)(77 patients) were included. Each group was compared with a historical control group constituted retrospectively according to the following criteria: oligohydramnios (CG1), particulate meconium-stained amniotic fluid (CG2)), age, parity, gestational age, and duration of labor. Statistical analysis was performed using the Student's t test and the Fisher's exact test when appropriate with a level of significance of p < 0.05. RESULTS: The mean infused volume was 883 ml in G1 and 751 ml in G2. A significant difference was found in terms of cesarean section between G1 and CG1 (14% versus 25%, p < 0.05) and of assisted deliveries for fetal distress between G2 and CG2 (5% versus 18%, p < 0.02). No other significant difference was found between the study groups and their control for all other studied criteria. When considering more specifically the presence of meconium below the vocal cords we also find a difference between G2 and CG2 (5% versus 14%) which was not significant. No neonatal or maternal adverse effects happened in this short study. COMMENT: Amnioinfusion is easy to perform during labor in case of oligohydramnios or particulate meconium-stained amniotic fluid. In case of oligohydramnios, a decreased rate of cesarean sections has been observed in the infused group. Considering patients with particulate meconium-stained amniotic fluid, less interventions for fetal distress and neonates with meconium below the vocal cords has been found in the infused group. Further prospective evaluation is needed to confirm these results in case of particulate meconium-stained amniotic fluid and to compare the advantage of prophylactic versus therapeutic amnioinfusion performed in case of oligohydramnios and abnormal fetal heart rate.