Perinatologia y Reproduccion Humana最新文献

{"title":"Resultados perinatales adversos en colestasis intrahepática del embarazo","authors":"J.M. Gallardo Gaona ,&nbsp;D. Lemionet Escanero ,&nbsp;S. Acevedo Gallegos ,&nbsp;B. Velázquez Torres ,&nbsp;J.A. Ramírez Calvo ,&nbsp;D.M. Camarena Cabrera","doi":"10.1016/j.rprh.2018.08.002","DOIUrl":"10.1016/j.rprh.2018.08.002","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the perinatal and maternal outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in the National Institute of Perinatology.</p></div><div><h3>Material and method</h3><p>A retrospective, observational study was conducted that included clinical files of women with single or multiple pregnancy with ICP between January 2012 and December 2015.</p></div><div><h3>Results</h3><p>A total of 25 patient files were included, 32% of whom were primiparous. On the multiparous, 2 stillbirths were recorded in their previous pregnancy (these patients had a history of ICP). The diagnosis was carried out clinically in 100% of the cases. It was then confirmed by hepatic enzyme elevation in 21 patients. Bile acids were requested for 48% of the patients, of which 67% were reported as<!--> <!-->&gt; 10 mmol/L. One patient was classified as severe ICP (bile acids<!--> <!-->&gt; 100 mmol/L. Around two-thirds (68%) of patients received ursodeoxycholic acid. The birth was preterm in 40% of the patients 24% were spontaneous and 16% iatrogenic, and 2 patients (8%) developed mild pre-eclampsia. There were a total of 26 newborns, as one of the patients was carrying twins. One newborn was small for gestational age. Admission to neonatal intensive care unit was required for 12% of the newborns, and 3 cases of meconium were reported. The mean Apgar score was 8/9.</p></div><div><h3>Conclusion</h3><p>The treatment for patients with ICP in the present hospital varies significantly. Therefore, it is essential to develop internal guidelines to homogenise the diagnosis, follow-up, and treatment of the patients.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 3","pages":"Pages 131-137"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48041831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectos biológicos adversos y seguridad del ultrasonido en el embarazo. Revisión sistemática","authors":"E.Y. Doria Reina,&nbsp;B. Velázquez Torres,&nbsp;S. Acevedo Gallegos,&nbsp;M.J. Rodríguez Sibaja","doi":"10.1016/j.rprh.2018.06.006","DOIUrl":"https://doi.org/10.1016/j.rprh.2018.06.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Nowadays ultrasound is a necessary tool in prenatal care. As no adverse effects have been reported in humans, health care professionals and patients consider an ultrasound scan in pregnancy to be a safe procedure, even making indiscriminate use of this tool.</p></div><div><h3>Objective</h3><p>To evaluate the best available scientific evidence regarding the safety and potential biological adverse effects of ultrasound in pregnancy.</p></div><div><h3>Material and methods</h3><p>A systematic search was conducted in the electronic databases PubMed and Medline. Studies that assessed the short and long term effects of ultrasound exposure during pregnancy in its different modalities were included.</p></div><div><h3>Results</h3><p>A total of 9,115 references were identified. Of the 18 studies included in the analysis, eight were conducted on animals and 10 in humans. From the latter, eight were cohort studies and two were case control studies. Due to the heterogeneity of the populations, exposures and outcomes measured, a statistical analysis was not feasible. Apart from a weak association between exposure to ultrasound and left-handedness in boys, there was no evidence that prenatal exposure to ultrasound is associated with major adverse effects.</p></div><div><h3>Conclusions</h3><p>Absence of evidence of harm is not equivalent to absence of harm; therefore it is still prudent to expose our patients to the least amount of ultrasound energy necessary. Knowledge by ultrasound operators about the safe use of ultrasound during pregnancy is the best strategy to prevent its potential adverse effects.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 3","pages":"Pages 97-111"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.06.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91975632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectos de los esteroides como inductores de maduración pulmonar en restricción del crecimiento intrauterino. Revisión sistemática","authors":"S. Acevedo Gallegos,&nbsp;N.A. Martínez Menjivar,&nbsp;J.M. Gallardo Gaona,&nbsp;B. Velázquez Torres,&nbsp;D.M. Camarena Cabrera,&nbsp;D.Y. Copado Mendoza,&nbsp;J.A. Ramírez Calvo","doi":"10.1016/j.rprh.2018.07.003","DOIUrl":"10.1016/j.rprh.2018.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. This includes increased foetal and neonatal morbidity and mortality, as well as prematurity. Glucocorticoids are given routinely to women between 24-34 weeks gestation at risk of preterm delivery. These are given to promote the production of surfactant. Although it has been postulated that the exogenous administration in IUGR may not provide any extra benefit, there is insufficient evidence to support its use in this sub-group of patients.</p></div><div><h3>Methods</h3><p>In order to perform this systematic review, a search was made of the Medline, PubMed and Cochrane databases for relevant literature references. Those studies with a higher level of evidence that administered glucocorticoids (dexamethasone or betamethasone) to induce pulmonary maturation were selected and were compared with those using no treatment, during weeks 24-34 weeks gestation in pregnancies diagnosed with IUGR.</p></div><div><h3>Results</h3><p>After assessment of the methodology, 6 items were used to create this review.</p></div><div><h3>Conclusions</h3><p>Assessing the use of glucocorticoids in the pre-term foetus population with growth restriction remains controversial, with no randomised clinical studies in humans that allow us to make recommendations suitable for use.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 3","pages":"Pages 118-126"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55288839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La práctica de la medicina materno-fetal basada en la evidencia","authors":"S. Acevedo Gallegos","doi":"10.1016/j.rprh.2018.09.001","DOIUrl":"10.1016/j.rprh.2018.09.001","url":null,"abstract":"","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 3","pages":"Pages 93-94"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55289100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importancia del diagnóstico prenatal de las cardiopatías congénitas","authors":"D.Y. Copado Mendoza ,&nbsp;A.J. Martínez García ,&nbsp;S. Acevedo Gallegos","doi":"10.1016/j.rprh.2018.08.001","DOIUrl":"https://doi.org/10.1016/j.rprh.2018.08.001","url":null,"abstract":"<div><p>According to latest official statistical results for 2015, the second cause of child death in Mexico is congenital malformation, most of which are congenital heart diseases. The neonatal period is the phase in which most deaths associated with this condition occurs. During 2013 alone, a total of 3,593 children under 1 year of age had a reported death in Mexico due to congenital heart diseases, and more than 50% of them occurred while they were newborns. Diagnosing critical heart diseases during the foetal period in countries with a structured prenatal screening process have shown a decrease in deaths during newborn stages. Foetal diagnosis of this group of diseases is crucial in order to provide proper treatment and improve prognosis for people suffering from them in our country. The National Perinatology Institute has developed a methodology for the timely diagnosis during foetal stages and the perinatal management of heart diseases, and aims to launch a national screening program for this group of diseases. Collaborating with the Nacional Health Institute, where cardiovascular surgeries are performed on paediatric patients, this program aspires to improve both the care and prognosis for patients with heart diseases.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 3","pages":"Pages 127-130"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92056850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guía de atención psicológica de la mujer con complicaciones obstétricas","authors":"M.E. Gómez López","doi":"10.1016/j.rprh.2018.06.003","DOIUrl":"10.1016/j.rprh.2018.06.003","url":null,"abstract":"<div><p>Although obstetric complications are considered an indirect cause of maternal mortality, there are currently no guidelines or recommendations that address the psychological care of pregnant women during these complications. In this guide, health personnel are offered guidelines to understand the symptomatology and emotional impact of obstetric complications in pregnant women. This includes their diagnosis and treatment and the most appropriate type of psychological intervention according to their condition. Recommendations are also given for different levels of care.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 2","pages":"Pages 85-92"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55288588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrición parenteral agresiva y velocidad media de crecimiento en recién nacidos <1,500 g en un hospital de 3.er nivel de la Ciudad de México","authors":"G. Cordero González ,&nbsp;C.G. Máynez González ,&nbsp;M.O. Echaniz-Avilés ,&nbsp;S. Carrera Muiños ,&nbsp;E. Yllescas Medrano ,&nbsp;E. Corral Kassian ,&nbsp;L.A. Fernández Carrocera","doi":"10.1016/j.rprh.2018.04.007","DOIUrl":"10.1016/j.rprh.2018.04.007","url":null,"abstract":"<div><h3>Introduction</h3><p>«Aggressive» parenteral nutrition <strong>(</strong>PN) may improve birth-weight recovery (BWR) and early weight gain.</p></div><div><h3>Objective</h3><p>To compare BWR and mean growth rate (MGR) with 2<!--> <!-->nutrition strategies.</p></div><div><h3>Material and methods</h3><p>A comparative descriptive analysis was performed on 64 newborns with birth-weight<!--> <!-->&lt;<!--> <!-->1500<!--> <!-->g admitted to the Neonatal Intensive Care Unit of the National Institute of Perinatology (México City) in 2013 (A) vs. 34 neonates of 2001 with same birth-weight (B). The variables recorded were, weight loss during first week, recovery birth-weight, MGR for weight, length, and head circumference in the 1st, 2nd, and 3rd week, intake of proteins, lipids and glucose in PN within first 24<!--> <!-->h of life, and days using PN. Statistical analysis included the mean, SD, and Student <em>t</em> test, was performed using with SPSS v. 20.</p></div><div><h3>Results</h3><p>MGR in 1st week, A<!--> <!-->=<!--> <!-->2.5 vs. B<!--> <!-->=<!--> <!-->−20 (<em>P</em> <!-->=<!--> <!-->0.004), in the 2nd, 11.7 vs. −6.4 (<em>P</em> <!-->=<!--> <!-->0.000), and in the 3rd 12.2 vs. −5.6<!--> <!-->g/kg/d (<em>P</em> <!-->=<!--> <!-->0.000); length 0.076 vs. 0.039 (<em>P</em> <!-->=<!--> <!-->0.010), and head circumference 0.075 vs. 0.035<!--> <!-->cm/day (<em>P</em> <!-->=<!--> <!-->.018). Weight loss 16.6 vs. 24.41<!--> <!-->g/day (<em>P</em> <!-->=<!--> <!-->0.000). Mean birth-weight recovery 11.5 vs. 41.4 days (<em>P</em> <!-->=<!--> <!-->0.000). PN initiated: glucose of 6.1<!--> <!-->mg/kg per min vs. 6 (<em>P</em> <!-->=<!--> <!-->0.000), protein 3.05 vs. 1.46 (<em>P</em> <!-->=<!--> <!-->0.000), and lipids 1.77 vs. 1.01<!--> <!-->g/kg per day (<em>P</em> <!-->=<!--> <!-->0.001). Calorie intake by the first PN was 48.8 vs. 35.4<!--> <!-->kcal (<em>P</em> <!-->=<!--> <!-->0.000). In group A, the mean duration of PN was 21.2 d and initiation of enteral feeding at 5 day.</p></div><div><h3>Conclusion</h3><p>Aggressive PN from first day of life showed reduced nutritional deficiency and posnatal growth restriction.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 2","pages":"Pages 54-59"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.04.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47535198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medición comparativa de la intensidad de ruido dentro y fuera de incubadoras cerradas","authors":"G.E. Valdés-de la Torre ,&nbsp;M. Martina Luna ,&nbsp;A. Braverman Bronstein ,&nbsp;J. Iglesias Leboreiro ,&nbsp;I. Bernárdez Zapata","doi":"10.1016/j.rprh.2018.06.002","DOIUrl":"10.1016/j.rprh.2018.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Excessive auditory exposure in the preterm infant generates immediate physiological responses and long-term alterations. The American Academy of Pediatrics recommends a maximum noise level in the Neonatal Intensive Care Units of 45 decibels (dB) during the day and 35<!--> <!-->dB during the night.</p></div><div><h3>Objective</h3><p>To measure and compare noise intensity outside and inside closed incubators.</p></div><div><h3>Method</h3><p>A prospective, observational study carried out in the Neonatal Intensive Care Units of the Spanish Hospital of Mexico during December 2016. The intensity of noise was measured inside and outside closed incubators, as well as a record of the presence or absence of active humidification and protective cover. Two sound level meters were used one placed inside and another outside the incubator. The noise level was recorded at the same time at one-second intervals for 36 total hours. Medians and interquartile ranges of measurements were calculated. The Wilcoxon test was performed for the comparison of medians in each case. A level of statistical significance of 0.05 was determined.</p></div><div><h3>Results</h3><p>A higher noise intensity was recorded inside closed incubators compared to outside (60.9 vs 58.7<!--> <!-->dB); <em>P</em>&lt;<!--> <!-->.001). In those with humidification, there was a higher internal noise (61.5 vs 60.2<!--> <!-->dB, <em>P</em>&lt;<!--> <!-->.001), and in the incubators with protective cover there was lower internal noise (58.8 vs 62<!--> <!-->dB, <em>P</em>&lt;<!--> <!-->.001),</p></div><div><h3>Conclusions</h3><p>The noise intensity inside closed incubators is greater than outside.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 2","pages":"Pages 65-69"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55288535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descripción de una cohorte de pacientes neonatos con diagnóstico de asfixia perinatal, tratados con hipotermia terapéutica. 2017","authors":"H. Manotas ,&nbsp;G. Troncoso ,&nbsp;J. Sánchez ,&nbsp;G. Molina","doi":"10.1016/j.rprh.2018.07.001","DOIUrl":"10.1016/j.rprh.2018.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Hypoxic-ischaemic encephalopathy (HIE) is an acute neurological dysfunction, and affects 5/1000 term newborns worldwide. Mortality due to HIE ranges from 25% to 85%. The treatment of moderate and severe HIE is therapeutic hypothermia. The literature in Colombia is limited on the management of HIE.</p></div><div><h3>Objective</h3><p>The aim of this study is to describe the clinical, para-clinical, and demographic characteristics of patients with moderate to severe perinatal asphyxia treated using a therapeutic hypothermia protocol from January 2016 to July 2017.</p></div><div><h3>Methodology</h3><p>Observational study of a cohort. Descriptive statistics were used to present the characteristics of the patients, including calculating the frequency of fatal outcomes, and non-fatal outcomes, such as prolonged stay and prolonged intubation.</p></div><div><h3>Results</h3><p>In the total of 64 patients, mortality was 6.25% (n<!--> <!-->=<!--> <!-->4). Just over half (54%) were male. The mean age on starting the protocol was 6<!--> <!-->hours. The fatal outcomes were associated with: the age on starting the protocol, changes in coagulation, lactate, glycaemia, liver and cardiac enzymes <em>(P</em>=.01). The non-fatal outcome of prolonged stay was associated with: an abnormal base excess, renal function, and pH <em>(P</em>=.01).</p></div><div><h3>Conclusion</h3><p>The fatal outcome was associated with the age on starting the hypothermia protocol, alterations in liver and cardiac enzymes, coagulation times, glycaemia and increased lactate. The non-fatal outcome of prolonged intubation was associated with impaired renal function, pH, and abnormal base excess.</p></div>","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 2","pages":"Pages 70-77"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48849601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuevas estrategias de diagnóstico y de tratamiento en los casos de sepsis neonatal y asfixia perinatal","authors":"Dra. Berenice Velázquez Torres","doi":"10.1016/j.rprh.2018.07.004","DOIUrl":"10.1016/j.rprh.2018.07.004","url":null,"abstract":"","PeriodicalId":32275,"journal":{"name":"Perinatologia y Reproduccion Humana","volume":"32 2","pages":"Page 53"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rprh.2018.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45642869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}