RESUMO
BACKGROUND: Intrauterine hematomas are a common pregnancy complication. The literature lacks studies about outcomes based on hematoma localization. Thus, we aimed to compare pregnancies complicated by an intraplacental hematoma to cases with a retroplacental hematoma and to a control group. METHODS: In a retrospective case-control study, 32 women with an intraplacental hematoma, 199 women with a retroplacental hematoma, and a control group consisting of 113 age-matched women with no signs of placental abnormalities were included. Main outcome measures were pregnancy complications. RESULTS: Second-trimester miscarriage was most common in the intraplacental hematoma group (9.4%), followed by women with a retroplacental hematoma (4.2%), and controls (0%; p = 0.007). The intraplacental hematoma group revealed the highest rates for placental insufficiency, intrauterine growth retardation, premature preterm rupture of membranes, preterm labor, preterm delivery <37 weeks, and early preterm delivery <34 weeks (p < 0.05), followed by the retroplacental hematoma group. When tested in multivariate models, intraplacental hematomas were independent predictors for placental insufficiency (ß = 4.19, p < 0.001) and intrauterine growth restriction (ß = 1.44, p = 0.035). Intrauterine fetal deaths occurred only in women with a retroplacental hematoma (p = 0.042). CONCLUSIONS: Intra- and retroplacental hematomas have different risk profiles for the affected pregnancy and act as independent risk factors.
Assuntos
Aborto Espontâneo/etiologia , Retardo do Crescimento Fetal/etiologia , Hematoma/complicações , Trabalho de Parto Prematuro/etiologia , Doenças Placentárias/etiologia , Adulto , Estudos de Casos e Controles , Feminino , Hematoma/patologia , Humanos , Recém-Nascido , Placenta/patologia , Doenças Placentárias/patologia , Insuficiência Placentária/etiologia , Gravidez , Resultado da Gravidez , Segundo Trimestre da Gravidez , Estudos Retrospectivos , NatimortoRESUMO
In this paper, we present two women with hypokalaemic rhabdomyolysis in the context of increased diuretic intake and gastroenteritis, respectively. While their clinical manifestations and laboratory results were strikingly similar, two different underlying disorders were subsequently unveiled. The first patient was diagnosed with Conn syndrome, and adrenalectomy led to significant improvement of hypertension and sustained normokalaemia. The diagnosis in the second patient was Gitelman syndrome. Electrolyte supplements improved long-term lassitude and the frequency of muscle cramps declined significantly. These case vignettes illustrate the importance of establishing the underlying cause of hypokalaemia.