[Progression of gestational hypertension to chronic hypertension]. / Evolución de hipertensión gestacional a hipertensión crónica.

BACKGROUND: The gestational hypertension is the most frequent cause of hypertension during the pregnancy. The gestational hypertension is a provisional diagnosis only during the pregnancy; it is unknown the number of women with gestational hypertension who progress to chronic hypertension. OBJECTIVE: To determine the number of women with gestational hypertension who progress to chronic hypertension. MATERIAL AND METHODS: A cohort prospective study was carried out; we includedl96 patients with the diagnosis of gestational hypertension at the time of the interruption of the pregnancy; after 12 weeks, a follow up appointment was scheduled in order to measure the blood pressure and to determine how many patients progressed to chronic hypertension. The data were analyzed with arithmetic mean, standard error and percentage values. For the comparison of variables, the Chi2 test and a logistic regression analysis were used; an alpha value was set at 0.05. RESULTS: Thirteen patients (6.6%) with diagnosis of gestational hypertension progressed to chronic hypertension. It was found that advanced age (p = 0.007), high body mass index (p = 0.013) and the antecedent of hypertensive disease in a previous pregnancy (p = 0.048) were significantly associated with the progression to chronic hypertension. CONCLUSIONS: The overweight, advanced maternal age and the antecedent of hypertensive disorder in a previous pregnancy are the variables associated with the progression from gestational hypertension to chronic hypertension.

[Predictive value of Doppler fluxometry of umbilical and middle cerebral arteries with the perinatal outcomes in fetus with intrauterine growth restriction]. / Valor predictivo de la flujometría Doppler de las arterias umbilical y cerebral media con los resultados perinatales en fetos con restricción del crecimiento intrauterino.

OBJECTIVE: To determine the predictive value of the Doppler fluxometry of the umbilical artery and middle cerebral artery with the perinatal outcome in fetuses with intrauterine growth restriction. MATERIAL AND METHODS: We carried out a cross-sectional study. There were included 220 pregnant women with diagnosis of intrauterine growth restriction. We carried out in these women Doppler fluxometry of umbilical artery and middle cerebral artery. It was followed the perinatal outcome of the newborns. We used student's t test for comparing the fluxometry indexes; and logistic regression analysis to determine its association with the perinatal outcome. An alpha value was set at 0.05. RESULTS: The fluxometry indexes of the umbilical artery were abnormal in all the cases of intrauterine growth restriction. The fluxometry indexes of the middle cerebral artery were abnormal in a small number of fetuses with perinatal complications. In the logistic regression analysis the fluxometry index of the umbilical artery was significant in order to predict bad perinatal outcome, in the other hand, the middle cerebral artery was not significant. The perinatal complications diagnosed were: distress respiratory syndrome (37.2%) necrotizing enterocolitis (6.2%) and sepsis (6.2%). CONCLUSIONS: The Doppler fluxometry of the umbilical artery have better predictive value than the middle cerebral artery for predicting bad perinatal outcome. We recommend the assessment of umbilical artery as first choice in order to determine the well-being in fetuses with intrauterine growth restriction.

[Maternal and fetal morbidity in obese pregnant women]. / Morbilidad materno-fetal en embarazadas obesas.

OBJECTIVE: To determine the maternal and fetal morbidity in obese pregnant women compared with non-obese pregnant women. PATIENTS AND METHODS: It was carried out a case-control study. There were included 342 patients who had a body mass index previous to the pregnancy of 18.5 to 24.9 (control group) and 342 pregnant women with body mass index > 30 (group of obese women). We registered the mother and newborns' data to evaluate their morbidity. The groups were compared with Student's t test or Mann Whitney's U test for continuous data and chi-square or Fisher exact test for categorical variables. RESULTS: We found more macrosomic newborns in the group of obese women (p = 0.003) and a higher number of caesarean sections (48.8 vs 37.4%, p = 0.003). The maternal morbidity characterized by gestational diabetes was higher in the obese ones (3.5 vs 0.58%, p = 0.015). Other variables as preterm delivery, stillbirths, malformations, admissions to the neonatal intensive care unit, as well as the development of hypertensive disorders of pregnancy were not significant. CONCLUSION: We found higher maternal and fetal morbidity in obese women. Therefore, these patients should be considered as carriers of high-risk pregnancies. This strategy could avoid complications associated to this group of patients.

[Risk factors associated to ovarian cancer]. / Factores de riesgo asociados con cáncer de ovario.

OBJECTIVE: To determine the risk factors associated to ovarian cancer. PATIENTS AND METHODS: A case-control study was carried out including 31 women with ovarian cancer and 69 patients with benign ovarian tumors corroborated with a histopathological study. We analyzed 26 independent variables, which classification was clinic, sociodemographic and ultrasonographic. The dependent variable was ovarian cancer, and it was assigned a value of 1 if it was present and 0 if it was absent. The statistical analysis was done using a logistic regression analysis, with an alpha value of 0.05. RESULTS: The malignant tumor of epithelial cells was the most common histological variety and was seen in 22 cases (71%). There were 24 cases (77.4%) in clinical stage I at the time of the diagnosis. Out of the 26 studied variables late menarche (p = 0.02), multiparity (p = 0.02), loss of weight (p = 0.04), solid tumor (p = 0.02), mixed tumor (p = 0.02) and irregularities of the tumor (p = 0.03) were significant in the applied model. CONCLUSIONS: The sociodemographic variables associated to ovarian cancer were: late menarche and multiparity; the clinical significant variable was loss of weight; and the ultrasonographic variables were solid tumor, mixed tumor and irregularities of the tumor. A population screening program is recommended in women who are in reproductive age, and it should include a gynecological ultrasonographic scanning in order to make an opportune diagnosis of this pathology.