Prevalence of HIV antibodies in pregnant women with increased risk for AIDS.

The prevalence of Human immunodeficiency virus (HIV) antibodies in pregnant women varies widely between industrialized and developing countries. There is a lack of information about the status of HIV-infected pregnant women with increased risk for AIDS. Our objective was to determine the prevalence of HIV antibodies in pregnant women with increased risk at the Hospital of Obstetrics and Gynecology of the Mexican Institute of Social Security, Leon, Mexico, from December 18, 2003, through February 28, 2006. In a cross-sectional study, 2,257 pregnant women with at least one risk factor for AIDS were recruited. In these women, a sample of blood to determine HIV antibodies was taken. There were two women with positive HIV antibodies; therefore, the HIV seroprevalence was 0.8 per 1,000. Of the two HIV-positive women, one of them had a history of chronic sexually transmitted diseases; she was married to a man who was working outside of our country for about 10 months, and also he had tattoos. The other HIV-positive woman had a history of chronic sexually transmitted diseases, and her husband had intercourse with different women. The risk factors of use of tattoos, migration to foreign countries, and use of injectable drugs were more frequent among the male partners than in the pregnant women (P < .001). We concluded that in our country as well as in other developing countries, the prevalence of HIV antibodies in pregnant women with risk factors is low but still present. Because a significant number of risk factors for AIDS also were found in their male partners, HIV testing should be performed in all pregnant women as well as in their male partners.

[Placental histopathological changes in gestational hypertension]. / Alteraciones histopatológicas placentarias en la hipertensión gestacional.

BACKGROUND: Preeclampsia develops after a partial disorder in the process of placental formation, perhaps due to a deficiency of the trophoblast invasion by its spiral arteries and acute aterosis in its miometrial segments. It has not been reported if these changes also appear in placentas of women with gestational hypertension without proteinuria. OBJECTIVE: To describe histopathological changes in the placenta of patients with hypertensive disorders during pregnancy. MATERIAL AND METHODS: Cross-sectional study carried out in 138 patients divided into three groups: 46 with normotensive pregnancy (A group or control), 46 with gestational hypertension (group B), and 46 with preeclampsia (group C). There were registered sociodemographic and clinical variables; and the histopathological study of the placenta was performed. Mean, standard error and percentages were used. We calculated analysis of variance for comparing groups and linear regression for determining correlation between histopathological changes and blood pressure (it was assigned an alpha value of 0.05). RESULTS: There were more histopathological changes in groups of gestational hypertension and preeclampsia compared with controls (p < 0.01). Most frequent changes in all groups were: sincitial hyperplasia and fibrin deposits around the villi. There was correlation between histopathological changes and blood pressure (r= 0.27, p <0.01). CONCLUSION: There are more histopathological changes in placentas of women with hypertensive disease; number of histopathological changes is correlated with the severity of hypertension.

[Symptomatic profile in peri and postmenopausal women]. / Perfil sintomático en mujeres peri y posmenopáusicas.

OBJECTIVE: To determine the symptoms that women refer during peri and postmenopause. PATIENTS AND METHOD: A cross-sectional study was carried out from April to December 2005; 500 women between 45 and 65 years old were included. We applied them the NR 1 questionnaire of symptoms for mature women. Data were obtained by means of a face-to-face interview. Results were analyzed through descriptive statistics, with percentage values, arithmetic mean and standard deviation. Differences between groups were evaluated with Student's T test, chi square test, and Fisher exact test. RESULTS: Perimenopausal women had higher levels of depression (p = 0.03). Postmenopausal women presented higher frequency of sleep disturbances (p = 0.003). We found that perimenopausal women had more night sweats (p = 0.005), excessive hot (p = 0.006), hot flashes (p = 0.001), headaches (p = 0.001), vaginal dryness (p = 0.03), and dyspareunia (p = 0.005). On the other hand, postmenopausal women presented higher frequency of changes in libido (p = 0.001). CONCLUSIONS: In general, perimenopausal women have more symptoms than posmenopausal women. It is advisable an exhaustive analysis of the perimenopausal women symptoms in order to offer them an integral substitutive treatment.

[Maternal and fetal morbidity related to delayed antenatal work incapacity]. / Morbilidad materno fetal relacionada con el aplazamiento de la incapacidad laboral prenatal.

OBJECTIVE: To determine if there is higher maternal fetal morbidity associated to delayed antenatal work incapacity. PATIENTS AND METHOD: A case-control study was carried out, including 220 pregnant workers. They were divided into 110 women who delayed their antenatal work incapacity (cases) and 110 women who took it on time (controls). Sociodemographic and clinical data, which included maternal fetal morbidity, were registered. Results were analyzed by percentage values and arithmetic mean. Differences between groups were evaluated with Student's t test, chi square test, or exact test of Fisher. An alpha value was set at 0.05. RESULTS: There were 48 (43.6%) women who had antenatal complications in the group of cases and 27 (24.5%) in the controls, p= 0.004. The most common complication in the cases was preterm labor (29.1%), and in the controls was threatening of spontaneous abortion (55.5%). Other significant variables were: higher maternal age in the cases group (32.2 vs 22.5 years, p < 0.001), and lower number of antenatal visits (8.2 vs 9.5, p < 0.001). CONCLUSIONS: We conclude that there is higher maternal morbidity in women who delayed their antenatal work incapacity. It is recommended to give this incapacity according to present normative.

[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.

[Prevalence of Streptococcus agalactiae colonization in pregnant women at term]. / Prevalencia de colonización por Streptococcus agalactiae en mujeres con embarazo a término.

OBJECTIVE: To determine the prevalence of colonization by Streptococcus agalactiae in pregnant women at term. MATERIAL AND METHODS: We carried out a cross-sectional study. Four hundred thirty three pregnant patients at term without data of cervicovaginitis were included. We processed vaginal and rectal swabs with hisopo placed in the Stuart middle of transport. They were inoculated on blood agar with nalidixic acid and gentamicine incubating itself by duplicate on Todd-Hewitt broth. The samples with suggestive result were reincubating to detect suspicious Streptococcus using the CAMP test, for final identification. Some clinical variables were included as age, gravidity, parity, abortions, cesarean sections, and vaginal infections during pregnancy. RESULTS: We found two patients with positive result for Streptococcus agalactiae in vaginal swabs that represented a prevalence of 0.46%; in those cases therapeutic measures were provided for both mother and newborn. The mean age for patients was 27 years. The median value for gravidity was 2, for parity was 1; and for spontaneous abortions and cesarean sections were 0, respectively. In our studied women 77.8% of them referred previous unspecified vaginal infections. CONCLUSIONS: In our setting the prevalence of Streptococcus agalactiae colonization in pregnant women at term is low. Due to morbidity associated to this infection, it is suggested the specific research of this microorganism both in pregnant women and in their newborns.