[Dilated myocardiopathy and pregnancy. Report of 3 cases and review of the literature]. / Miocardiopatía dilatada y embarazo. Informe de tres casos y revisión de la literatura.

Pregnancy in association with dilated cardimyopathy is considered to be a rare entity. The incidence is unknown. The dilated cardiomyopathies (DCM) are defined as diseases of the cardiac muscle without a known cause. Three pregnancies with DCM are reported. In this article the possible hazzards of pregnancy and DCM are discussed, including a review of the literature concerning to diagnosis and management is present.

[Perinatal perspective in heart disease and pregnancy. Review of 1169 cases of pregnancy]. / Perspectiva perinatal de la cardiopatía y embarazo. Revisión de 1169 embarazos.

OBJECTIVE: To determinate the effect of maternal heart disease on pregnancy outcome. METHODS: We reviewed retrospectively 1169 pregnancies in 1093 women with heart disease. 53 women were assisted during 2 pregnancies, ten during 3 and one during 4 pregnancies. All the pregnancies were prenatal and labor assisted at the National Institute of Perinatology, México, D.F. RESULTS: In 705 (60.30%) the heart disease was of rheumatic origin, in 387 (33.10%) congenital and the remaining were a miscellaneous group. Mitral stenosis and mitral regurgitation (42.13%) was the commonest rheumatic cardiac lesion associated with pregnancy. Ventricular septal defect was seen in the 32.81%. 124 women had a heart valve prosthesis (87 mechanical and 40 bioprosthesis [3 women with double heart valve prosthesis]). Intrauterine fetal growth retardation was the commonest complication. (7.52%) in 29 cases were present complications of heart disease in pregnancy. The abortion was present in 30 cases and intrauterine fetal death in 7 cases. There were 977 term pregnancies. The caesarean section rate was 32.5 per cent, most of them were performed for obstetric or fetal indications. The neonatal weight had a average of 2864.4 +/- 526.9 grams. There were eight maternal deaths in this series (five with congenital origin and 3 rheumatic). The incidence of low birth weight was 8.46 per cent. There were two babies born with cardiac congenital malformations.

[Systemic lupus erythematosus and pregnancy (analysis of 84 cases)]. / Lupus eritematoso sistémico y embarazo (análisis de 84 casos).

We present 84 pregnancies (3 twin pregnancies) of 80 women with Systemic Lupus Erythematosus. Although there was a multidisciplinary prenatal control, in 83% of the cases there were one or more complications during pregnancy, most of them being preterm labor, premature rupture of membranes and preeclampsia-eclampsia. There were flares up in 15 of 84 cases, (17.85%). Worsening of renal function was the most common finding. There were 9 abortions, 3 stillbirths, 1 neonatal death and two newborns with congenital heart block. No maternal deaths were present.

[Multiple (quadruple) pregnancy involving complete hydatidiform mole and 3 fetuses]. / Embarazo múltiple de alto orden fetal (cuádruple), involucrando mola hidatidiforme completa y tres fetos.

The rate of hydatidiform mole in our country oscillates from 1:144 to 1:552 pregnancies. We report the second case of hydatidiform mole coexisting with a spontaneous multiple pregnancy (three fetuses and one hydatidiform mole). The patient was a 34 year old woman. She had not received hormonal therapy for anovulation. At 13th weeks of gestation she presented vaginal spotting and hyperemesis. An ultrasonographic examination revealed three living fetuses and the multiple cystic echo typical of an hydatidiform mole. At 14 weeks of pregnancy she was diagnosed to have clinical symptoms of severe preeclampsia. We did not have an adequate response to the antihypertensive drugs and the patient underwent therapeutic termination of the pregnancy. The thyroid hormones were in normal levels. The serum beta-hCG was up to 500,000 mU/ml. Two fetuses were female weighing 55 g. each one. One fetus was male weighing 50 g. All of them had a normal karyotype. The patient development a gestational trophoblastic disease. These have been only three reports of complete hydatidiform mole in triplet pregnancy with two fetuses. These cases were pregnancies occurring after ovulation inducing therapy. We analyzed the clinical aspects and treatment of hydatidiform mole coexisting with multiple pregnancy.

[Placenta praevia. Maternal and perinatal repercussions. Analysis of 170 cases]. / Placenta previa. Repercusiones maternas y perinatales. Análisis de 170 casos.

One hundred and seventy cases with placenta previa, at Instituto Nacional de Perinatología, from 1989 to 1993, were reviewed. Incidence in our population was 0.62%; average maternal age was 31 years; the greater amount of cases was among nulliparae; in 72% of them there was the antecedent of uterine scar. Ultrasound diagnosis was done in 81% of the patients, and most frequent placental insertion type was the low one in 49%, and in 31%, total, central placenta. The first hemorrhagic episode occurred at a gestational age of 34 weeks. Most frequent complication was threatening pre-term delivery, and ethinyl adrianol was used as uterine inhibitor. All pregnancies were interrupted, via abdominal. Placental accretion was a frequent complication. Hemorrhage during the second half of gestation is one of the main causes of perinatal morbidity-mortality. Frequency of this complication is from 3% to 5%, of all pregnancies in an open population; and when it appears, is one of the most serious urgencies; so its early diagnosis and opportune treatment will diminish maternal and perinatal morbidity-mortality. Etiology is unknown, but diminished endometrial vascularization, at fundus and body, may be the causal factor. There are other predisposing causes as age, advanced maternal age, multiparity, tumours, scars and smoking. The objective of this study, was to analyze maternal and perinatal repercussions, of placenta previa, based on the experience at Instituto Nacional de Perinatología.

[Hallermann-Streiff syndrome and pregnancy. Report of a case]. / Síndrome de Hallermann-Streiff y embarazo. Reporte de un caso.

The Hallermann-Streiff syndrome is characterized by dyscephaly (bird like facies), microphthalmia, cataracts, micrognathia, beaked nose, abnormal dentition, hypotrichosis, cutaneous atrophy and proportional small stature. There is no sex predilection. Productive capacity has not been studied in these patients. Successful pregnancy is rare. We present a patient with the classical signs associated with pregnancy, the outcome of which was successful. This is the first reported case of Hallermann-Streiff syndrome associated with pregnancy.