Asunto(s)
Vasa Previa , Femenino , Humanos , Embarazo , Vasa Previa/diagnóstico por imagen , Ultrasonografía Prenatal , CesáreaAsunto(s)
Vasa Previa , Femenino , Feto , Humanos , Embarazo , Ultrasonografía Prenatal , Vasa Previa/diagnóstico por imagenRESUMEN
The Kleihauer-Betke (KB) test evaluates fetal blood in the maternal circulation, and is often used when placental abruption is suspected. At our centre, it is the protocol to perform a KB test in all suspected cases of abruption. We carried out a retrospective study of all cases of abruption that occurred at our centre over 6 years. Of the 68 confirmed cases of placental abruption, only three had positive KB tests, giving a sensitivity of only 4.4%. Thus, in the overwhelming majority of cases of confirmed abruption, the KB test was negative. Our findings indicate that the KB test has poor sensitivity for placental abruption and should not be used in the detection of abruption.
Asunto(s)
Desprendimiento Prematuro de la Placenta/sangre , Desprendimiento Prematuro de la Placenta/diagnóstico , Eritrocitos , Transfusión Fetomaterna/sangre , Adulto , Reacciones Falso Negativas , Femenino , Humanos , Embarazo , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto JovenRESUMEN
OBJECTIVES: Data on rates of cesarean delivery among pregnancies diagnosed with genetic syndromes remains limited. We examined the cesarean delivery rates for Down syndrome pregnancies over a 10-year period in the US. METHODS: We used data from the 1995-2004 US delivery data files to examine cesarean delivery rates in singleton pregnancies (at ≥20 weeks' gestation) with and without Down syndrome. We further examined if the rates of cesarean deliveries in primary and repeat cesarean deliveries among Down syndrome pregnancies differed based on the presence or absence of major structural abnormalities or stillbirth or gestational age at delivery. RESULTS: There were 35 million singleton deliveries of which 19186 were diagnosed at birth with Down syndrome (1 in 2000 births after 20 weeks gestation). The primary cesarean delivery rates were higher among Down syndrome pregnancies (17.5% in 1995 and 21.5% in 2004) compared to non-Down syndrome pregnancies (12.3% in 1995 and 16.6% in 2004). Temporal trends for cesarean deliveries were steeper among Down syndrome pregnancies with gastrointestinal and heart abnormalities than in Down syndrome cases without abnormalities. Higher cesarean delivery rates were also noted among Down syndrome pregnancies ending in third trimester live born than in control. CONCLUSION: In the US, cesarean deliveries in Down syndrome pregnancies increases over time and is greater when Down syndrome is associated with structural abnormalities and delivered during the third trimester of pregnancy.
Asunto(s)
Cesárea/estadística & datos numéricos , Síndrome de Down/epidemiología , Adolescente , Adulto , Anomalías Congénitas/epidemiología , Síndrome de Down/cirugía , Femenino , Edad Gestacional , Humanos , Edad Materna , Paridad , Embarazo , Mortinato/epidemiología , Estados Unidos/epidemiología , Adulto JovenAsunto(s)
Enfermedades Fetales/diagnóstico por imagen , Bocio/diagnóstico por imagen , Bocio/embriología , Ultrasonografía Doppler , Ultrasonografía Prenatal , Adulto , Antitiroideos/uso terapéutico , Femenino , Humanos , Hipertiroidismo/diagnóstico por imagen , Hipertiroidismo/tratamiento farmacológico , Imagenología Tridimensional , Recién Nacido , Masculino , Intercambio Materno-Fetal , Embarazo , Complicaciones del Embarazo/diagnóstico por imagen , Complicaciones del Embarazo/tratamiento farmacológico , Segundo Trimestre del Embarazo , Propiltiouracilo/uso terapéutico , Glándula Tiroides/irrigación sanguínea , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/embriología , Tiroxina/uso terapéuticoAsunto(s)
Presentación en Trabajo de Parto , Enfermedades Placentarias/diagnóstico por imagen , Cordón Umbilical/diagnóstico por imagen , Adulto , Femenino , Humanos , Recién Nacido , Enfermedades Placentarias/complicaciones , Enfermedades Placentarias/patología , Embarazo , Prolapso , Ultrasonografía Prenatal/métodos , Cordón Umbilical/patologíaAsunto(s)
Apendicitis/diagnóstico , Leiomioma/diagnóstico , Trabajo de Parto Prematuro/diagnóstico , Neoplasias Pélvicas/diagnóstico , Complicaciones del Embarazo/diagnóstico , Adulto , Apendicectomía , Cesárea , Diagnóstico Diferencial , Femenino , Humanos , Trabajo de Parto Prematuro/tratamiento farmacológico , Embarazo , Tercer Trimestre del Embarazo , Recurrencia , Rotura Espontánea , TocólisisRESUMEN
BACKGROUND: Management of pregnancy in a woman who has had a ruptured uterus on more than one occasion presents a great clinical and ethical challenge to the obstetrician. CASE: This appears to be the first report on complete uterine ruptures in three consecutive pregnancies. CONCLUSION: Prolonged hospital admission, intensive antenatal surveillance, antenatal steroid administration and elective premature delivery may give the best chance for a good outcome in these pregnancies. However, despite all these efforts, there is still a high risk of an unfavorable outcome.
Asunto(s)
Rotura Uterina/fisiopatología , Rotura Uterina/terapia , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Embarazo , Resultado del EmbarazoRESUMEN
We describe our aggressive management of a woman with a triplet pregnancy resulting from in vitro fertilization who presented at 22 weeks' gestation in labor with full cervical dilation. Successful multiagent tocolysis and delayed delivery of the two remaining fetuses after delivery of the presenting fetus led to an improved outcome for all three babies.
Asunto(s)
Trabajo de Parto Prematuro/prevención & control , Embarazo Múltiple , Ritodrina/uso terapéutico , Tocolíticos/uso terapéutico , Adulto , Cuello del Útero/fisiología , Femenino , Humanos , Recién Nacido , Infusiones Intravenosas , Embarazo , Resultado del Embarazo , Ritodrina/administración & dosificación , Tocolíticos/administración & dosificación , TrillizosRESUMEN
We report the prenatal diagnosis of vasa previa using transvaginal sonography and color Doppler. This case supports the previously reported association of vasa previa with second trimester low-lying placentas and in-vitro fertilization. Sonographic examination for vasa previa should be considered in pregnancies with low-lying placentas and those resulting from in-vitro fertilization.