Importance of iodine in pregnancy.

Iodine is an essential constituent of thyroid hormones (TH). TH actively take part in critical periods of brain development during embryonic, fetal and postnatal stages. Therefore the absence of TH or iodine in these critical periods produces an irreversible brain damage. In fact, it is known that iodine deficiency is the leading cause of preventable brain damage worldwide. Because of the physiological adjustments during pregnancy iodine requirements increase significantly from 150 microg per day in non-pregnant adult women to 250 microg per day. Moreover, recent epidemiological studies around the world show that iodine intake during pregnancy is insufficient in many countries, even in developed countries like Australia, Spain and Italy. In the present work an overview of the importance of iodine nutrition during pregnancy is given.

[Satisfaction of the emergency service users at a hospital of second level]. / Satisfacción de los usuarios en el servicio de urgencias en un hospital de segundo nivel.

OBJECTIVE: To determine the degree of satisfaction of the emergency service users as the area of first hospital contact. METHODS: A descriptive cross-sectional study was made, during a five month period. A questionnaire that included 8 items, with a Likert type scale, validated by 5 experts was answered by 321 emergency service users. It explored the expectations of the users in relation to the treatment received, time of delay, quality of medical attention and facilities. Sample was chosen by a random method. The analysis was made through descriptive and inferential statistics. RESULTS: Average age was 41.60 SD 12.42 years; 60.1% were women. In the overall evaluation of the users, 61.7 % reported satisfied with the service received. The delay time average was 76 minutes SD 52.48. The 56.81% waited more than 61 minutes to receive medical attention, predominating in the night shift, dealings with the patients to be satisfactory, with the physicians attention, 77% of users responded to feel satisfied. The facilities seemed unsatisfactory for 172 patients, 53.6%. CONCLUSIONS: THE degree of satisfaction of the emergency service users was of 61.7% predominantly in the day shift.

[Risk factors associated with intrauterine growth delay]. / Factores de riesgo asociados a retraso en el crecimiento intrauterino.

INTRODUCTION: The term intrauterine growth delay (IGD) is used to refer a fetus with weight at birth lower than the 10th percentile for their gestational age. OBJECTIVE: to determine the prevalence and to identify risk factors associated with intrauterine growth delay in patients with normal fetal growth curves. MATERIAL AND METHODS: This study was made at General Hospital in Queretaro, Queretaro. There were included 70 obstetric patients with newborn with intrauterine growth delay (cases) and it was compared with 70 control patients with newborn without intrauterine growth delay. RESULTS: There were studied 70 cases of a total of 192 registered during the period of this study. There was a prevalence of 2.5. Of all the newborn with intrauterine growth delay, 40 (47.2%) were female and 30 (42.8%) were male, relating with age, mothers below 20 and above 30 were not show significant differences The risk factors associated were mainly inadequate pregnant women weight (OR 4.84, CI 95%=1.56 to 16.1) and less than five medical appointments for medical control during prenatal period (OR 6.0, CI 95%=2048 to 14.81) , hypertensive disease during pregnancy (OR 5.09, CI 95%=1.4 to 20.21) and cervicovaginal infections (OR 5.09. CI 95%=1.52 to 21.56). CONCLUSIONS: It is necessary to pay more attention to pregnant teenagers and also to general pregnant women to receive an adequate prenatal control in order to detect patients with risk of IGD and of this way to diminish morbidity and mortality in the newborn.

[Giant chorioangioma: presentation of a case]. / Corioangioma gigante. Presentación de un caso.

Placenta chorioangioma is the most frequent nontrophoblastic tumour of the placenta. Its real incidence is unknown. This incidence is reported as 1% in microscopically examined placentas and counts with clinical evidence in approximately 1:3,500 to 9,000 births. This tumour is not generally associated to maternal fetal complications, unless the tumour size surpasses a diameter of 5 cm or is near the place of umbilical cord insertion. When the tumour is big, it can complicate the pregnancy with hydramnios, postpartum bleeding, delay in the intrauterine growth, or congestive heart failure in the newborn. The clinic case belongs to a female patient, aged 23, without important antecedents. A placental tumouration, 11.6 x 9.2 x 7 cm, was detected by ultrasound to this patient in her 20th week of pregnancy. In her 24th week, she presented intense uterine activity, with uterine hypertonia, premature rupture of membranes and profuse transvaginal bleeding, which required an emergency caesarean operation, getting a female product whose weight was 670 g. The product died minutes later. The placenta histopathological study reported placental chorioangioma, which histologically matches the degenerate variety.

[Maternal risks factors associated with pre-term childbirth]. / Factores de riesgo materno asociados al parto pretémino.

UNLABELLED: Pre-term childbirth is birth before 37 weeks. The incidence in Mexico is approximately between 5 and 10% of all pregnancies and it constitutes one of the primary causes of morbidity and perinatal mortality. OBJECTIVE: To determine the maternal risk factors associated with preterm childbirth in the General Regional Hospital 1 of the Instituto Mexicano del Seguro Social, Querétaro. MATERIAL AND METHODS: A study of cases (A) and controls (B) was made from September 1st, 2001, to June 30th, 2002; group A: 138 patients who finished their pregnancy before the 37th week, group B: 138 patients whose pregnancy came to term. Chi2, Student t test, and the momios method were used for statistical analysis. RESULTS: 8910 obstetric events were attended in the study period of which 600 patients (6.73%) were pre-term. There was no significant statistical difference in the age, the pregnancy interruption process and pre-eclampsia-eclampsia variables. The factors associated with pre-term childbirth with meaningful difference (p < or = 0.05) were weight and maternal height, premature rupture membrane, cervicovaginitis, gravidic hyperemesis, urinary infection, and anemia. CONCLUSION: The incidence of pre-term childbirth as well as its associated factors were similar to those found in literature except for the preeclampsia-eclampsia syndrome.

Importance of iodine in pregnancy

Iodine is an essential constituent of thyroid hormones (TH). TH actively take part in critical periods of brain development during embryonic, fetal and postnatal stages. Therefore the absence of TH or iodine in these critical periods produces an irreversible brain damage. In fact, it is known that iodine deficiency is the leading cause of preventable brain damage worldwide. Because of the physiological adjustments during pregnancy iodine requirements increase significantly from 150 μg per day in non-pregnant adult women to 250 μg per day. Moreover, recent epidemiological studies around the world show that iodine intake during pregnancy is insufficient in many countries, even in developed countries like Australia, Spain and Italy. In the present work an overview of the importance of iodine nutrition during pregnancy is given.

Importancia del yodo en la gestación. El yodo es un nutrimento constituyente indispensable de las hormonas tiroideas (HT). Las HT participan activamente en periodos críticos del desarrollo cerebral durante las etapas embrionaria, fetal y posnatal. Por lo tanto la ausencia o deficiencia de las HT o de yodo en estas etapas del desarrollo produce un daño cerebral irreversible. De hecho, se sabe que la deficiencia de yodo es la principal causa de daño cerebral prevenible en el mundo. Debido a los ajustes fisiológicos propios de la gestación los requerimientos de yodo se incrementan notablemente, pasando de 150 μg al día en la mujer adulta no gestante a 250 μg al día durante el embarazo. Por otra parte, estudios epidemiológicos recientes hechos en todo el mundo muestran que el consumo de yodo durante la gestación es insuficiente en varios países; incluso en países desarrollados como Australia y España e Italia. En la presente revisión se da un panorama general de la importancia del consumo adecuado de yodo durante la gestación.

Cáncer cérvicouterino y virus del papiloma humano / Cervical cancer and human papillomavirus

El cáncer cérvicouterino (CaCu) es la segunda causa de muerte por cáncer en mujeres de todo el mundo, a pesar de la implementación de la citología de cérvix para su prevención. Esto se debe a la baja sensibilidad y especificidad de la prueba, lo cual apoya a un cambio urgente en la forma de tamizaje para su detección. Ahora se sabe que la infección persistente por virus del papiloma humano de alto riesgo (HR-HPV) es la causa de la totalidad de los casos de CaCu. En la actualidad se están utilizando vacunas frente a dos (Bivalente: HPV-16 y HPV-18) o cuatro (Tetravalente: HPV-6 HPV-11, HPV-16 y HPV-18) de las cepas de HR-HPV que causan la mayoría de los casos de CaCu. El propósito de este artículo es proporcionar una revisión de las características principales del virus y de los mecanismos que se echan a andar bajo la infección persistente de las células cervicales, lo cual conduce a la proliferación desordenada y a la malignización de las células infectadas. Es necesario que el virus se integre al genoma de la célula epitelial para que inicie la expresión de las oncoproteínas virales E6 y E7 lo cual conducirá al desarrollo del CaCu.

Cervical cancer (CC) is the second cause of death for cancer in women worldwide in spite of the implementation of cervix cytology screenings for its prevention. The low sensibility and specificity of the test reduce the potential benefits of these screenings and supports urgent improvements in early detection tests for CC. It is now known that persistent infection with the high-risk human papiloma virus (HR-HPV) is the causal agent of almost all cases of CC. HR-HPV vaccines effective against two (Bivalent: HPV-16 and HPV-18) or four (Tetravalent: HPV-6 HPV-11, HPV-16 and HPV-18) strains that are responsible of the majority of the CC cases have been licensed in several countries. The present study aims to provide a review of the principal characteristics of the HR-HPV virus and of the mechanisms that take to the persistent infection of the cervical cells leading to abnormal proliferation and malignancy. It is necessary that the virus integrates into the genome of the epithelial cell to initiates the expression of the E6 and E7 viral oncoproteins which will lead to the development of the CC.

Coriaoangioma gigante de la placenta: reporte de dos casos / Giant placental chorioangioma: report of two cases

Antecedentes: El corioangioma placentario es el tumor no trofoblástico más frecuente de la placenta, su incidencia real es desconocida, frecuentemente pasan desapercibidos, los tumores grandes causan complicaciones materno fetales importantes. Objetivos: Reportar dos casos de corioangioma gigante de placenta, el método diagnóstico y la evolución del embarazo. Resultados: En ambos casos el resultado fue fatal para el feto, con un producto inmaduro de 670 gramos y un óbito de 1300 gramos, obtenidos por operación cesárea urgente por sangrado transvaginal. El reporte histopatológico corroboró el diagnóstico de sospecha. Conclusión: El pronóstico de un embarazo con corioangioma gigante de placenta, depende fundamentalmente del tamaño y de la oportunidad con que se hace el diagnóstico. Se resalta la utilidad del examen ultrasonográfico para su detección oportuna.

Background: Placental choriangioma is the most frequent non trophoblastic tumor of the placenta. Its real incidence is unknown, and is frequently unnoticed. However, giant tumors cause important maternal-fetal complications. Objectives: To report two cases of giant placental chorioangioma, the diagnostic method and the evolution of pregnancy. Results: In both cases the outcome was fatal for the fetus: an immature newborn weighing 670 grams and a still born weighing 1300 grams, obtained through emergency C-section due to vaginal bleeding. The histopathological report confirmed the suspected diagnosis. Conclusion:Jhe prognosis of a pregnancy with giant placental choriangioma depends mainly on the size of the fetus and how opportunely the diagnosis is made. The ultrasonography is recommended for its opportune detection.