RESUMO
BACKGROUND: Prematurity is the most frequent cause of perinatal morbidity and mortality, and is responsible with 75% of neonantal deaths not related to congenital defects. OBJECTIVE: The aim of this study was to know risk factors that influence premature delivery in a third level attention in a Gyneco-Obstetric Unit. MATERIAL AND METHODS: In a case-control study, was conducted an interview with 300 mothers who had their delivery at 28 and 36 gestational weeks in group of cases and 600 mothers from 37 to 41 weeks in controls, who assisted for attention from April to September 2011. RESULTS: The factors associated eighth higher risk for prematurity were: maternal age above 35 years was more frequent in cases (14.6%), previous placenta occurred more frequent in cases (9.3%), Infectious disease were highly present in cases such as: urinary tract infection (46%). But association of 2 or more factors such as premature rupture of membranes and cervicovaginitis, were more frequent significantly in study group (76%). CONCLUSIONS: The prematurity risk factor more freqeunt were: infectouse disease in study group. A deficient prenatal attention can be increased in order to prevent premature delivery. When 2 or more factors associated in a gestation the risk also increase, and should increase the following and medical attention to reduce premature risk.
Assuntos
Nascimento Prematuro/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Fatores de RiscoRESUMO
The choledocal cyst is a defect of the biliary extrahepatic route, the incidence is 1 in 100-150,000 newborns. This paper reports the case of a female newborn with choledocal cyst detected prenatally, from a 32-year-old mother, 2nd term pregnancy, who was diagnosed in the routine obstetric ultrasound as an abdominal fetal cyst. An anatomic obstetric ultrasound confirmed the diagnosis that was defined of a probable hepatic origin. Newborn was delivered at 39 weeks by caesarean section, with weight of 3,980 g and Apgar score 9-9 in conventional time. Newborn presented a maxim bilirubin level of 16 mg, controlled with phototherapy; the hepatic function was normal. Ultrasound showed a choledocal cyst which measured 50 x 49 x 48 mm, with dilatation of the hepatic common conduct, the gall bladder was normal. The abdominal scan reported a cystic mass in the middle abdominal region of 44 x 53 x 52 mm confirming a choledocal cyst. The diagnosis was confirmed after surgery. Patient had a satisfactory post-surgical evolution.
Assuntos
Cisto do Colédoco/diagnóstico por imagem , Ultrassonografia Pré-Natal , Feminino , Humanos , Recém-Nascido , GravidezRESUMO
BACKGROUND: Traditionally an advanced maternal age have been associated with a higher risk of unfavorable perinatal results. OBJECTIVE: to know the perinatal outcomes in women giving birth at age 40 or older during a year in a concentration hospital located at Monterrey, Nuevo León. PATIENTS AND METHODS: In a retrospective, cross-sectional, study. RESULTS: 163 women and 170 newborn were included. A newborn death (5.8 x 1000 RN) and no one maternal death was observed. The most frequent maternal associated disease was gestational diabetes (16%) followed by the hypertensive disorders (10%). The cesarean rate was 71.1% and the most frequent indication was previous cesarean. The most frequent hospitalization cause was early premature labour (4.2%). Premature membrane was observed in 11% of patients. The mean delivery time was at 38 weeks with a mean body weight of 3032 g. There were 5 newborn with congenital malformations (2.9%). 21 newborns were hospitalized (12%) and the most frequent indication was prematurity. CONCLUSION: Women giving birth at age 40 or older observed a higher gestational diabetes incidence followed by the pregnancy-induced hypertension. The cesarean delivery was the most frequent mode of delivery. We consider that the perinatal outcomes in this study were favorable for both mother and child.
Assuntos
Idade Materna , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Adulto , Cesárea/estatística & dados numéricos , Anormalidades Congênitas/epidemiologia , Estudos Transversais , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido , Recém-Nascido Prematuro , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Gravidez de Alto Risco , Estudos Retrospectivos , Fatores de RiscoRESUMO
INTRODUCTION: Brain tumors are present in 2.9 per 100,000 newborn. Craniopharyngioma is a benign and slow growing brain tumor, frequently localized in the sellar and suprasellar region. There are few reports of pituitary tumor detected prenatally. CASE REPORT: We report a neonate with a craniopharyngioma detected prenatally as a pituitary tumor. In a 23 year old mother, second gestation, with no important history, was detected a sellar tumor at 31 gestation weeks, the obstetric ultrasound reported a suprasellar tumor of 2 per 3 cm diameter. Pregnancy ended in a vaginal delivery at 39 weeks, and obtained a 3.9 kg female, with cephalic diameter of 37.5 cm, the Apgar score was 8-9 at 1st and 5th minutes. In early neonatal period was scanned and confirmed a 3.2/2.3/2.9 cm suprasellar tumor with calcium deposits. The Paediatric Oncology department suggested a surgery and was realized a craniotomy at 3rd week of age. The surgery allowed to obtain 30% of the tumor and confirmed by histology craniopharyngioma. Patient had favourable evolution and was discharged at 3 months of age. CONCLUSIONS: We report a neonate in who was detected by prenatal ultrasound the presence of a suprasellar solid tumor, scan and magnetic resonance images in neonatal period defined its size and location and a craniopharyngioma was confirmed by histology. Patient had a satisfactory postsurgical evolution and was discharged at 3 months of age.
Assuntos
Craniofaringioma/congênito , Neoplasias Hipofisárias/congênito , Ultrassonografia Pré-Natal , Craniofaringioma/diagnóstico por imagem , Craniofaringioma/embriologia , Craniofaringioma/cirurgia , Craniotomia , Feminino , Humanos , Hipofisectomia/métodos , Recém-Nascido , Imageamento por Ressonância Magnética , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/embriologia , Neoplasias Hipofisárias/cirurgia , Indução de Remissão , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
BACKGROUND: The incidence of multiple pregnancies has increased over the last decade and hence the hospital stay and perinatal morbidity and mortality. OBJECTIVE: to know the perinatal mortality rate of multiple pregnancies treated in a regional hospital. MATERIAL AND METHODS: Retrospective study conducted from the hospital records of deaths that occurred from January 2002 to December 2007 at the Hospital Regional de Especialidades No. 23 IMSS, Monterrey, Nuevo Leon, Mexico. RESULTS: during the study period (six years) were 122,822 births and 95 were multiple pregnancies (0.77/1000 births): 81 (85%) of triplets, 11 (11%) of quadruplets, two of quintillizos and one sextillizos with a total of 303 newborns. 26% (25/95) of multiple pregnancies had one or more deaths. The perinatal mortality rate was 165/1000 births (50/303) compared with that of pregnancies with one fetus in the same period 14.5/1000 births (p<0.0001). 20.9% (17/81) of triplet pregnancies and 54.5% (6/11) of the four had one or more deaths (p<0.02), with a perinatal mortality rate of 131/1000 births (32/243) and 295/1000 births (13/44) (p<0.006), respectively. Only 2/10 (20%) of newborns in two pregnancies quintillizos died and 3/6 (50%) of a pregnancy sextillizos. There was no difference in the proportion of sexes, but in the average weight of newborns: the weight of the triplets was alive vs dead vs 1659 g 713 g (p<0.0001) and the quadruplets from 750 g vs 1341 g (p<0.0007), respectively. CONCLUSIONS: 26% of multiple pregnancies had one or more deaths and 15% of the neonates died (165/1000 births). Multiple pregnancies were complicated with one or more deaths at 20% of triplets, 54% of quadruplets and 100% of quintillizos. The perinatal mortality rate of pregnancies with multiple fetuses 3 and 4 was No. 131/1000 and No. 295/1000, respectively.