RESUMO
Nine cases with the association of systemic progressive sclerosis and pregnancy at Instituto Nacional de Perinatología, from 1984 to 1994, are presented. All the patients were referred with the confirmed diagnosis by histopatological study. The variety CREST type was seen in three patients. Average age of patients was 29.2 +/- 5.4 years. Acute hypertensive disease of pregnancy; pre-term birth; and retarded intrauterine growth, were the most frequent complications. Most of the pregnancies were resolved by abdominal via, due to maternal and fetal indications. No maternal deaths.
Assuntos
Complicações na Gravidez , Escleroderma Sistêmico , Adulto , Feminino , Humanos , México , Gravidez , Resultado da Gravidez , Estudos RetrospectivosRESUMO
Two hundred and ten cases with placenta previa, were reviewed (1989-1994). In 37 (17.6%) placenta accreta was present. From accretism cases in 26 (70.2%) only, there was the antecedent of cesarean section. Average age was 31 years; the highest risk group was 35-39 years with 26% of cases of accretism. Average parity was three, in the group of five gestaes, 33.3% developed placenta accreta. In the group without antecedent of cesarean section, accretism risk was 9.4%; with one section was 21.1%, but with two or more cesarean sections, it was 50%. In the presence of placenta previa advanced maternal age, and two or more cesarean sections, placenta accreta risk is high.
Assuntos
Cesárea/estatística & dados numéricos , Placenta Acreta/epidemiologia , Placenta Prévia/epidemiologia , Adulto , Cesárea/efeitos adversos , Feminino , Humanos , Idade Materna , México/epidemiologia , Paridade , Gravidez , Estudos Retrospectivos , Fatores de RiscoRESUMO
The rate of hydatidiform mole in our country oscillates from 1:144 to 1:552 pregnancies. We report the second case of hydatidiform mole coexisting with a spontaneous multiple pregnancy (three fetuses and one hydatidiform mole). The patient was a 34 year old woman. She had not received hormonal therapy for anovulation. At 13th weeks of gestation she presented vaginal spotting and hyperemesis. An ultrasonographic examination revealed three living fetuses and the multiple cystic echo typical of an hydatidiform mole. At 14 weeks of pregnancy she was diagnosed to have clinical symptoms of severe preeclampsia. We did not have an adequate response to the antihypertensive drugs and the patient underwent therapeutic termination of the pregnancy. The thyroid hormones were in normal levels. The serum beta-hCG was up to 500,000 mU/ml. Two fetuses were female weighing 55 g. each one. One fetus was male weighing 50 g. All of them had a normal karyotype. The patient development a gestational trophoblastic disease. These have been only three reports of complete hydatidiform mole in triplet pregnancy with two fetuses. These cases were pregnancies occurring after ovulation inducing therapy. We analyzed the clinical aspects and treatment of hydatidiform mole coexisting with multiple pregnancy.
Assuntos
Mola Hidatiforme , Gravidez Múltipla , Quadrigêmeos , Neoplasias Uterinas , Aborto Terapêutico , Adolescente , Adulto , Anti-Hipertensivos/uso terapêutico , Feminino , Humanos , Masculino , Pré-Eclâmpsia/tratamento farmacológico , Pré-Eclâmpsia/etiologia , GravidezRESUMO
We present a case of leiomyoma of the urethra diagnosed during pregnancy. The patient a 40 year old woman, gravida II, who presents a mass that depend of the proximal urethra, it was observed in the vaginal introitus, it's growth was progressive after 8th weeks of pregnancy. We realized local excision at 23rd weeks pregnancy. Histopathological examination reported leiomyoma of the urethra. The pregnancy was resolved through cesarean section by fetal indication. Actually the patient is free of symptoms.
Assuntos
Leiomioma/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias Uretrais/diagnóstico , Adulto , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Leiomioma/patologia , Leiomioma/cirurgia , Masculino , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/cirurgia , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Neoplasias Uretrais/patologia , Neoplasias Uretrais/cirurgiaRESUMO
One hundred and seventy cases with placenta previa, at Instituto Nacional de Perinatología, from 1989 to 1993, were reviewed. Incidence in our population was 0.62%; average maternal age was 31 years; the greater amount of cases was among nulliparae; in 72% of them there was the antecedent of uterine scar. Ultrasound diagnosis was done in 81% of the patients, and most frequent placental insertion type was the low one in 49%, and in 31%, total, central placenta. The first hemorrhagic episode occurred at a gestational age of 34 weeks. Most frequent complication was threatening pre-term delivery, and ethinyl adrianol was used as uterine inhibitor. All pregnancies were interrupted, via abdominal. Placental accretion was a frequent complication. Hemorrhage during the second half of gestation is one of the main causes of perinatal morbidity-mortality. Frequency of this complication is from 3% to 5%, of all pregnancies in an open population; and when it appears, is one of the most serious urgencies; so its early diagnosis and opportune treatment will diminish maternal and perinatal morbidity-mortality. Etiology is unknown, but diminished endometrial vascularization, at fundus and body, may be the causal factor. There are other predisposing causes as age, advanced maternal age, multiparity, tumours, scars and smoking. The objective of this study, was to analyze maternal and perinatal repercussions, of placenta previa, based on the experience at Instituto Nacional de Perinatología.
Assuntos
Placenta Prévia/complicações , Adolescente , Adulto , Índice de Apgar , Feminino , Morte Fetal/etiologia , Humanos , Recém-Nascido , Idade Materna , Pessoa de Meia-Idade , Paridade , Placenta Acreta/complicações , Placenta Prévia/diagnóstico por imagem , Placenta Prévia/etiologia , Gravidez , Fumar/efeitos adversos , UltrassonografiaRESUMO
We report the retrospective experience in the treatment of six patients with recurrent or severe stress urinary incontinence or low urethral pressure. They were treated with sling modified procedure with polytetrafluoroethylene (Gore-Tex); in the National Institute of Perinatology (INPer) at 1992-1994. The morbidity was highest, the patients in the post operatory present detrusor instability, voiding problems and tissue reaction to polytetrafluoroethylene. The patients are continent in the actuality. They were observed by 8-32 months. This surgery is easy to make and not required of more experience than the necessary for realizing the cysto-urethropexy with needle, but, the selections criteria must be carefully analyzed.
Assuntos
Incontinência Urinária por Estresse/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Métodos , Pessoa de Meia-Idade , Politetrafluoretileno , Recidiva , Estudos Retrospectivos , Fatores de TempoRESUMO
A retrospective, descriptive study at the National Institute of Perinatology (INPer), was carried out. 401 records of patients with stress urinary incontinence who underwent surgical treatment, were reviewed. The objective of this study was to know the urinary retention rate. Urinary retention was present in 103 of 401 patients (25.68%). In modified Pereyra's procedure it was present in 67 of 195 (34.35%); in modified Burch's procedure, in 25 of 131 (19.08%); in Kelly's procedure in 9 of 70 (12.85%) and in 2 of 5 patients with sling procedure with polytetrafluoroethylene (Goretex). The problem of urinary retention was observed more frequently in vaginal surgery (modified Pereyra procedure and/or sling procedure).
Assuntos
Complicações Pós-Operatórias , Incontinência Urinária por Estresse/cirurgia , Retenção Urinária/etiologia , Cefalosporinas/uso terapêutico , Feminino , Humanos , Tempo de Internação , Métodos , Politetrafluoretileno , Estudos Retrospectivos , Retenção Urinária/diagnóstico , Retenção Urinária/terapiaRESUMO
We studied 36 patients with Hellp syndrome and her newborn during seven years in the National Institute of Perinatology (INPer). The objective of this study is show the epidemiology and clinic features, unite diagnostic criteria and classification, furthermore establish morbidity and mortality maternal and perinatal. The 44.6% (16/36) was type I, and 55.6% (20) was type II. The average of pregnancies was 3. The 38.9% (14/36) received regular prenatal control. Both types were more common in patients with preterm pregnancies, between 28-36 weeks. The patients with severe preeclampsia and eclampsia were more common. The cases with type I had more complications and stayed on hospital more time. The maternal mortality was 5.55%. Perinatal outcomes were unsatisfactory, with high incidence of asphyxiated newborn. The newborn of patients with type I had more severe complications and stayed more time on the hospital. The perinatal mortality was 32.43%.