Evaluation of Fetal Lung Maturity by Quantitative Analysis (quantusFLM) in Women with Gestational Diabetes Mellitus.

OBJECTIVES: The aim of the present study was to evaluate fetal lung maturity using the noninvasive method of quantitative ultrasound analysis of fetal lung texture (quantusFLM) in women with gestational diabetes mellitus (GDM). METHODS: A total of 96 women at 36-38 weeks of gestation were enrolled. They were classified as follows: 33 GDM cases treated with diet, 30 GDM cases treated with diet plus insulin, and 33 normoglycemic women (control group). A quantitative analysis of lung texture was performed. RESULTS: There were significant differences in the lung maturity results among groups (p = 0.004). These differences were established between the insulin-treated group of patients and both the control (p = 0.006) and diet-only (p = 0.003) groups. While none of the women in the control group or in the diet group had a high risk of immaturity, 16.7% of those treated with insulin (5/30) did (p = 0.003). There was no statistically significant correlation between HbA1c and the result of the test. CONCLUSIONS: Quantitative ultrasound study of fetal lung texture suggests that a significant percentage of pregnant women with GDM treated with insulin had fetal lung immaturity in the late preterm to early term.

[Fetal complications and early neonatal outcomes on 147 triplets]. / Complicaciones fetales y resultados neonatales tempranos en 147 embarazos triples.

BACKGROUND: During the last ten years multiple pregnancies have been increased as a result of assisted reproduction techniques, increases of even 470% are published. Multiple pregnancies are related to a higher risk of maternal and neonatal morbidity and mortality, as well as to increased use of health resources. OBJECTIVES: To review the fetal and perinatal early complications in triple pregnancies. PATIENTS AND METHOD: An observational and retrospective study of triple pregnancies followed up at the Obstetrics Department of La Paz University Hospital, Madrid, Spain, from January 2000 until May 2011. RESULTS: We reviewed the medical records of 147 triplets. The prevalence of triplets was 1 in 640 deliveries (0.15%). Among all, 79% were achieved using assisted reproductive techniques, 73% were obtained by means of in vitro fertilization. Regarding the pregnancy zigosity we found: 85% trichorionic triamniotic, 10% bichorionic triamniotic and 5% monochorionic tramniotic. Out of 402 fetuses, 35 (9%) had the following complications: 19(5%) growth retardation or oligohydramnios, nine (2%) intrauterine death, three (0.74%) postnatal death due to suspected chorioamnionitis, three (0.74%) major malformations and one case (0.24%) of twin to twin transfusion. The average duration of gestation was 33 weeks: 8% were born before 28 weeks of gestation, 30% between 28 and 32 weeks and 62% after 32 weeks. The mean birth weight was 1,906 +/- 400 g. In 29 cases (7%) arterial pH was less than 7.20. Any type of resuscitation was required by 60% of newborns and 47% were admitted to the intensive care unit. There were no significant differences in neonatal early outcomes among the first, second and third newborn. CONCLUSIONS: The risk of neonatal mortality and morbidity seems to be higher in triple pregnancies. Adverse neonatal outcomes are related to the high rate of severe prematurity.

El himen imperforado como urgencia en ginecología. Caso clínico y revisión de la literatura / Imperforate hymen as a gynecological emergency: case report and literature review

El himen imperforado se presenta en aproximadamente una de cada 2.000 mujeres. Es la causa congénita más común de obstrucción del flujo genital y, por lo general, no suele presentar síntomas hasta la pubertad. Presentamos el caso de una adolescente de 13 años que acudió a nuestro servicio de urgencias refiriendo dolor abdominal y metrorragia. La exploración física reveló un himen íntegro y abombado por el que empezaba a drenar sangre oscura. La ecografía transabdominal era sugestiva de hematocolpos y hematometra. La paciente recibió tratamiento quirúrgico y la evolución postoperatoria fue favorable (AU)

Imperforate hymen occurs in approximately 1 out of every 2000 females. This entity is the most common congenital cause of genital outflow obstruction and does not usually cause symptoms until puberty. We present the case of a 13-year-old girl who attended the emergency department complaining of abdominal pain and metrorrhagia. Physical examination revealed an imperforate and bulging hymen beginning to drain dark blood. Transabdominal ultrasonography was suggestive of hematocolpos and hematometra. The patient was treated surgically and the postoperative outcome was favorable (AU)