[Color Doppler flowmetry values in fetuses with nuchal cord encirclement]. / Valores de flujometría Doppler color en fetos con circular de cordón.

In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.

Long-term complications and survival of patients after orthotopic liver transplantation.

INTRODUCTION: The survival rates among patients after orthotopic liver transplantation (OLT) has increased to 83% and 75% at 1 and 5 years, respectively. However, these patients are at increased risk of long-term complications. OBJECTIVE: To identify long-term complications and survivals among patients after OLT. METHODS: From September 1999 to July 2009 we evaluated long-term complications among 78 consecutive patients after OLT including 46 males. RESULTS: Complications de novo after OLT were metabolic (n = 38; 67%), infections (n = 13; 23%), recurrent liver disease (n = 12; 21%), osteopenia/osteoporosis (n = 10; 18%), acute/chronic rejection (n = 8; 14%), renal failure (n = 2; 4%) and Kaposi's sarcoma (n = 1). Their overall survival at 118 months was 55%. CONCLUSIONS: The most common long-term complications after OLT were metabolic, infections, and disease recurrence.