Congenital metastatic neuroblastoma with placental involvement as a rare cause of non-immune fetal hydrops.

Non-immune hydrops fetalis represents the end-stage status of a variety of diseases, including metastatic tumors. We report a case of non-immune hydrops fetalis associated with multiple disseminated echogenic nodular lesions detected by ultrasound and confirmed by magnetic resonance. Cordocentesis demonstrated anemia and thrombopenia. Differential diagnosis included histiocytosis X, acute leukemia or metastatic disease. A stillbirth was diagnosed at week 25 + 6. The autopsy revealed hydrops fetalis, a right adrenal gland mass, multiple disseminated nodules histologically composed of small round blue cells positive for synaptophysin, and placental involvement, concordant findings with congenital undifferentiated neuroblastoma Stage M. No chromosomal abnormalities were associated, nor amplification abnormalities in MYCN and ALK genes. Metastatic neuroblastoma should be considered in the differential diagnosis of non-immune hydrops fetalis associated with multiple nodular lesions.

Susac syndrome and pregnancy: a relationship to clarify. About two cases and review of the literature.

BACKGROUND: Susac syndrome is a vasculopathy that affects the central nervous system, mainly the brain parenchyma, retina and inner ear. It affects mainly young women and. Management is based on expert consensus and in pregnant women the treatment is not well established. It is necessary to start treatment early because of its potential severity and sequelae. METHOD: We present two cases of Susac syndrome related to pregnancy/puerperium and performed a review of the literature. CONCLUSIONS: Susac syndrome is a disease that requires a high clinical suspicion, especially in pregnant women. Treatment in pregnancy or puerperium is not well established. PRÉCIS: Susac syndrome is a disease that requires a high clinical suspicion, especially in pregnant women. Treatment in pregnancy or puerperium is not well established.

Impacto del confinamiento por Covid-19 en la salud mental y emocional en la población gestante / Impact of Covid-19 confinement on mental and emotional health in the pregnant population

Objetivo principal: analizar el impacto del confinamiento por Covid-19 en la salud mental de las gestantes y describir diversas variables que pudieran influir en ello. Metodología: estudio transversal exploratorio, en una muestra de 362 gestantes en el Hospital Universitario La Paz de Madrid. Resultados principales: un 51,9 % estaba de baja por enfermedad/maternidad, 3,9 % trabajaba fuera de casa. El 36,7 % vivía en piso sin posibilidad de estar al aire libre. La puntuación del Test STAI Rasgo aumentó de 16,4 ± 8,3 a 22,3 ± 12,7 en el STAI Estado en el momento del confinamiento. El 61,6 % no eran capaces de expresar sentimientos de forma adecuada. Conclusión principal: El confinamiento ha tenido un efecto negativo sobre la salud mental de las embarazadas, se ve influenciado por variables habitacionales y ocupacionales. La inteligencia emocional es una habilidad que protege frente al estrés y ansiedad en las embarazadas. (AU)

Objective: Analyses the impact of Covid-19 confinement on the mental health of the pregnant and describe various variables that could influence it. Methods: The analysis was through descriptive statistics. At last no sample of 362 pregnant women undergoing follow-up in the area of the La Paz University Hospital. Results: 51.9 % of pregnant women were on sick / maternity leave, 3.9 % worked outside the home. 36.7 % lived in an apartment without the possibility of being outdoors. The STAI Trait Test score was 16.4 ± 8.3 and increased to 22.3 ± 12.7 when assessing stress / anxiety through the STAI State Test at the time of confinement. 61.6 % were not able to express feelings adequately. Conclusions: Confinement due to SARS-Cov2 has had a negative effect on anxiety and depression in pregnant women. Adequate emotional intelligence is a skill that protects pregnant women against stress and anxiety. (AU)

Embolia de líquido amniótico: reporte de cuatro casos en el Hospital Universitario La Paz en Madrid, España, y revisión de la literatura / Amniotic fluid embolism: report of four cases at Hospital Universitario La Paz, in Madrid, Spain, and review of the literature

Introducción: la embolia de líquido amniótico (ELA) es una entidad poco frecuente, considerada como impredecible y no prevenible, que se asocia a una elevada morbimortalidad materna. El diagnóstico temprano es necesario para mejorar el pronóstico fetal. El objetivo de este reporte de casos es revisar el diagnóstico, el tratamiento y los principales puntos de discusión en la literatura respecto a esta patología.Materiales y métodos: presentamos el reporte de cuatro casos de ELA que se presentaron en un periodo de diez años en el Hospital Universitario La Paz de Madrid, España, centro de alta complejidad perteneciente el sistema nacional de salud. Se presenta de manera detallada uno de los casos por ser el más representativo del cuadro en cuanto a características clínicas y secuencia cronológica de aparición de los síntomas. Se realiza una búsqueda en las bases de datos Medline vía PubMed, en español e inglés en los últimos diez años con los términos: embolia de líquido amniótico, paro cardiaco, coagulación intravascular diseminada y mortalidad neonatal. Se buscaron series de casos, estudios de cohortes, casos y controles, y artículos de revisión.Resultados: se encontraron 150 títulos de los cuales se incluyeron 26, de estos 10 correspondieron a series de casos, 5 cohortes y 11 revisiones. El diagnóstico se basa en criterios clínicos; el tratamiento temprano se enfoca a un soporte cardiorrespiratorio y hemodinámico. Conclusión: es necesario un adecuado conocimiento de la ELA para establecer un diagnóstico de sospecha y poder orientar de la forma más adecuada el manejo terapéutico de estas pacientes en el menor tiempo posible.

Introduction: Amniotic fluid embolism (AFE) is an infrequent condition considered unpredictable and unpreventable, and it is associated with high maternal morbidity and mortality. Early diagnosis is critical in order to improve prognosis. The objective of this case report is to review the diagnosis, treatment and main discussion points found in the literature regarding this disease condition. Material and methods: We report 4 cases of AFE presenting over a period of 10 years to the Hospital Universitario La Paz, in Madrid, Spain, a high complexity center of the national health system. One of the cases is reported in detail because it is the most representative of the disease presentation in terms of the clinical characteristics and the time sequence of symptom onset. A search was conducted in English and Spanish in Medline via Pub Med for the last 10 years, using the terms amniotic fluid embolism, cardiac arrest, disseminated intravascular coagulation, neonatal mortality. The search included case series, cohort studies, cases and controls, and review articles. Results: Of a total of 150 titles found, 26 were included: 10 case series, 5 cohort studies and 11 reviews. The diagnosis is based on clinical criteria and early treatment is focused on cardiorespiratory and hemodynamic support. Conclusion: Adequate knowledge of AFE is required in order to suspect the diagnosis and guide therapeutic management in these patients as adequately and promptly as possible.

Atención ginecológica en la adolescencia / No disponible

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