[Impact of perinatal mortality in multiple pregnancies over total perinatal mortality in a hospital in Monterrey, Nuevo León]. / Repercusión de la mortalidad perinatal de los embarazos múltiples en la mortalidad perinatal total en un hospital de Monterrey, Nuevo León.

BACKGROUND: The incidence of multiple pregnancies has increased on the last decade resulting in a rise of premature and underweight newborns infants, with increase of the perinatal morbidity and mortality. OBJECTIVE: To determine the impact of perinatal mortality of multiple pregnancies in the total perinatal mortality. PATIENTS AND METHOD: perinatal mortality rate of multiple pregnancies treated in the Unidad Médica de Alta Especialidad No. 23, Monterrey, Nuevo León (Mexico) were analized, from 2002 to 2008. The prevalence of multiple pregnancies, the rate of premature births, the incidence of low-birth weight products and perinatal mortality was estimated. The difference between overall mortality and multiple pregnancy rate was measured by chi2. RESULTS: Of the 144,114 births, there were 1076 (0.8%) fetal deaths and 1,617 (1.10%) neonatal deaths. There were 110 high-order fetal pregnancies (more than three fetuses): 92 triplets, 14 quadruplets, 3 quintuplets and 1 sextuplet, producing a total of 353 newborns. Multiple pregnancies represent 2.8% (59/2093) of the total perinatal mortality (p = 0.3). 79.9% (1674/2093) of the total perinatal mortality were newborns weighing less than 2500 g. In the group of multiple pregnancies, all perinatal deaths occurred in products weighing less than 2500 g. CONCLUSIONS: The perinatal mortality of multiple pregnancies does not impact significantly overall perinatal mortality.

[Prenatal diagnosis ovarian cyst with an amputation at three months of age. A case report]. / Diagnóstico prenatal de quiste de ovario con torsión y amputación a los tres meses de edad. Reporte de un caso.

UNLABELLED: In the neonate the pelvic masses regularly are usually benign until in 87%, those of ovarian origin most is of cystic and benign origin. CLINIC CASE: Of a pregnant of 26 years of age, primigesta, was detected to the fetus during the 24 weeks of gestation an abdominal cyst in pelvic hole of 3.5 diameter cm, non motive. The pregnancy culminated for caesarean operation, feminine product was obtained with weight when being born 3.400 kg. They were practiced 3 ultrasounds: when being born, to the month and two months of age, finding ovary cyst with the same characteristics. To the 3 months it is observed in 4th control ultrasound that the cystic image was no longer in pelvic hole, but it liberates in abdominal cavity for what decides to make exploratory laparotomy, where is a cyst of free amputated ovary in abdominal cavity of 3.5 x 4 diameter cm. The pathology results reported an ovary with necrosis areas and content cystic saculado.

[Prenatal diagnosis of pulmonary valve stenosis and immediate neonal valvuloplasty]. / Diagnóstico prenatal de estenosis pulmonar grave y valvuloplastia neonatal inmediata. Reporte de un caso.

UNLABELLED: There are few reports of prenatal diagnosis of severe pulmonary valvar stenosis (PVS). It affects 1/22,000 newborn and represents 8-10% of total congenital cardiac defects. Clinic CASE: we report a case of a neonate in which was prenatally detected a pulmonary valvar stenosis and was successfully corrected with early valvuloplasty. From a 36-Year-old woman sent to evaluation to the fetal maternal unit because a tricuspid valvar insufficiency detected at 36 gestation weeks (GW). A VPS was suspected before born and a pregnancy ended in programated caesarean delivery at 38 GW, obtaining a 3 kg male, in which early echocardiography reported a severe PVS, promptly was initiated prostaglandin E1 (PgE1) infusion avoiding patent ductus arteriosus (PDA) closure, following a percutaneus balloon dilatation valvuloplasty at 48 hours, improving cyanosis and transvalvular Doppler flow. CONCLUSION: we report a neonate referred with an opportune prenatal diagnosis of tricuspid insufficiency and confirmed a severe PVS, PgE1 was infused immediately after born, allowing successfully balloon dilatation valvuloplasty in first 48 hours.

[Prenatal diagnosis of polycystic kidneys and Mullerian duplication. A case report]. / Diagnóstico prenatal de riñones poliquísticos y duplicación mulleriana. Reporte de un caso.

Polycystic kidney disease is a common genetic cause of chronic kidney disease, characterized by the formation of multiple cysts in the kidneys and other organs, occurs in 1 in 20,000 live births. 30 to 50% of affected newborns die shortly after birth because of respiratory and renal insufficiency. This study reports the case of a newborn with polycystic kidney disease diagnosed by obstetric ultrasound at 26 weeks of gestation and kidneys anhidramnios due to increased volume and appearance "in sponge." Neonato a primigravida 19 years of age. At 26 weeks you will be detected in a routine obstetric evaluation that measures were in line for somatométricas fetal gestational age, and anhidramnios increase in renal mass and bilateral thorax narrow. The pregnancy ended in a cesarean section at 37 weeks with a newborn of 3140 g, women who died within minutes after birth. We requested an autopsy because of the need for genetic counseling. The findings were: enlarged kidneys with microcystic dilatation of collecting duct and in the renal cortex and medulla, liver fibrosis and Müllerian duplication with double uterine cavity. It is a rare association between polycystic kidney disease and Müllerian duplication, liver fibrosis confirmed by autopsy and has not been documented previously.