Infeccoes de transmissao vertical em material abortivo e sangue com enfase em Toxoplasmose gondii / Vertical transmission from abortive material and blood with emphasis on Toxoplasma gondii

OBJETIVO: Analisar os resultados sorológicos, anatomopatológicos e parasitológicos de material abortivo para infecções com risco de transmissão vertical, com ênfase na toxoplasmose. MÉTODOS: Foi realizado um estudo coorte-transversal tratando da prevalência das doenças infectoparasitárias. Participaram da pesquisa 105 mulheres que sofreram aborto espontâneo completo e/ou incompleto; elas foram entrevistadas por meio de um questionário, e foram coletadas amostras de sangue e material abortivo. Foram realizados testes imunológicos para toxoplasmose, doença de Chagas, rubéola, citomegalovírus e sífilis e análise anatomopatológica nos restos ovulares. RESULTADOS: 55% das mulheres tinham entre 20 e 30 anos de idade. A maioria (68%) apresentou idade gestacional entre a 7ª e a 14ª semanas. 54,3% das mulheres tinham o ensino médio completo ou incompleto. Pela análise da sorologia, a infecção com risco de transmissão vertical mais frequente foi o citomegalovírus (CMV) com 97,1% de positividade, e em seguida a rubéola, com 95,2%. A toxoplasmose teve um percentual de 54,3%, a doença de Chagas, de 1,9% e a sífilis, de 0,95%. A análise dos laudos de biópsia demonstrou que 63,1% apresentaram inflamação e 34%, ausência de inflamação. Das análises sorológica, anatomopatológica e parasitológica das 105 mulheres, 57 foram soropositivas para T. gondii, e nenhuma teve resultado positivo para a Reação em Cadeia da Polimerase (PCR) e para inoculação em camundongos. CONCLUSÕES: A prevalência de doenças com risco de transmissão congênita nas mulheres com abortamento espontâneo é importante, sendo necessárias pesquisas visando esclarecer a etiologia do aborto. .

PURPOSE: To analyze the serological, anatomopathological and parasitological results obtained from abortive material in order to detect infections with the risk of vertical transmission, with emphasis on toxoplasmosis. METHODS: A cross-sectional cohort study was conducted in order to determine the prevalence of infectoparasitic diseases. A total of 105 women who suffered spontaneous complete or incomplete abortion participated in the study. The women were interviewed, answered a questionnaire and had their blood and abortive material collected. Immunological tests were carried out in order to detect toxoplasmosis, Chagas disease, rubeola, cytomegalovirus and syphilis, and anatomopathological analysis of the ovular remains was performed. RESULTS: 55% of the women studied were 20 to 30 years old. Most of them (68%) presented a gestational age between the 7th and 14th week. 54.3% of the women had complete or incomplete high school education. Serological analysis showed cytomegalovirus (CMV) as the most common vertically transmitted infection with 97.1% positivity, followed by rubeola with 95.2%. Toxoplasmosis showed 54.3% positivity, Chagas disease 1.9% and syphilis 0.95%. Anatomopathological analysis showed inflammation in 63.1% of the cases and absence of inflammation in 34%. The results of the serological, anatomopathological and parasitological analysis of the 105 participants showed that 57 women were T. gondii positive. However, none showed positivity in the polymerase chain reaction (PCR) or in mouse inoculation. CONCLUSIONS: The prevalence of diseases with the risk of vertical transmission is important in women with spontaneous abortion, indicating the need for more research in order to investigate the etiology of abortion. .

Manual "Código Rojo" para el manejo de la hemorragia obstétrica / Manual "Red Code" for the management of obstetric hemorrhage

El manual, corresponde a una estrategia para reducir la tasa de mortalidad materna en relación a la hemorragia obstétrica y como indica el documento: "El comportamiento de la morbi-mortalidad materna en los últimos diez años, ha situado a la hemorragia obstétrica en el primer lugar del país. Por lo anterior se priorizan las acciones que impacten en la reducción de la muerte materna implementando la estrategia de "Código Rojo", la cual estandariza los lineamientos técnicos, normativos y clínicos para la prevención y manejo de la hemorragia obstétrica y choque hipovolémico, respondiendo así al derecho reproductivo que establece que ninguna mujer debe morir por causas relacionadas al embarazo, parto y post parto." Código rojo

Detection of molecular markers of toxoplasmosis among Egyptian patients with miscarriage using avidity IGG-ELISA and western blotting

A total of 54 miscarriage patients were divided into 3 groups. GI: 10 toxoplasmosis patients with +ve IgM-ELISA; GII 24 toxoplasmosis patients with +ve IgG-ELISA, and G III: 20 non-toxoplasmosis cross-matched females as a control. All groups were subjected to IgG-avidity ELISA and IgG-avidity immunoblotting. Avidity Indices [AI] by ELISA ranged from 22.6% to 73.3% in GI and from 9.6%-75.6% in GII AI were high [>40%] in 3 [30%] patients in G I and in 8 [33.3%] patients in G II. Sera of GI recognized the 20, 28,32,60,93 and l00 Kda bands with 55% reduction in the 38 and 60 Kda bands after treatment with 6 M urea solutions. Sera of G II recognized the 20, 28, 32, 38, 45, 95-97 and 106 Kda bands. There was 12.5%, 16.6% and 16.7% reduction in the 20, 32, and 106 Kda bands, respectively, after urea. The 38 and 60 Kda bands were identified as good diagnostic markers for the recent toxoplasmosis infection [GI]. The 20, 32 and 106 Kda bands were good markers of high avidity antibodies during the chronic toxoplasmosis [GIl]

The relationship between maternal nutritional status and spontaneous abortion.

BACKGROUND: The incidence of pregnancy wastage is high among poor women. Though the aetiology of spontaneous abortion is multifactorial, nutritional deficiency is considered to be an important contributory factor. METHODS: A case-control study was conducted to assess the relationship between maternal vitamin status and spontaneous abortion. RESULTS: The incidence of anaemia (15%), and riboflavin (84%) and folate deficiency (24.5%) were similar among the cases and controls. Vitamin A levels were higher in the study group compared to those in controls. CONCLUSION: The results suggest that various nutrient deficiencies have no correlation with the occurrence of spontaneous abortion. The role of increased vitamin A levels needs to be studied further.

Niveles de estradiol plasmático como índice pronóstico en la gestación inicial / Plasma estradiol levels as a predictive pronostic of the early pregnancy

Las autores estudian el valor de los niveles plasmáticos de Estradiol como predictores de aborto en la gestación inicial. Para ello miden semanalmente estos niveles en 82 gestantes dentro de las 10 semanas de gestación. Se observa el comportamiento individual de la curva descrita por estas determinaciones a través del cálculo de su pendiente. 24 embarazadas normales constituyen el grupo control. Las 58 restantes habían recibido previamente tratamiento por esterilidad de diversas etiologías. De acuerdo al destino final de la gestación se estableció 2 categorías de pacientes: No abortadoras (44) y abortadoras(14). Estas últimas cursaron sus primeras semanas de embarazo con niveles de estradiol significativamente menores al comparar sus pendientes con las del grupo no abortadoras y las del grupo control. Se observó un valor predictivo de un 91% para una pendiente positiva de la curva de estradiol y de un 66% para una pendiente negativa