Recategorisation of body mass index to achieve andrological predictive power: a study in more than 20 000 patients.

The aim of this study was to recategorise body mass index (BMI) in order to classify patients according to their risk of semen abnormalities. Patients (n=20563) presenting at an andrology laboratory were classified into five groups according to BMI: underweight (BMI <20kg m-2), normal weight (BMI 20-24.9kg m-2), overweight (BMI 25-29.9kg m-2), obese (BMI 30-39.9kg m-2) and morbidly obese (BMI >40kg m-2). Semen quality was evaluated to determine: (1) differences between groups using analysis of variance (ANOVA); (2) the chances of semen abnormalities (using generalised linear models, Chi-squared tests and odds ratios); (3) reference BMI values with andrological predictive power (multivariate conglomerate analyses and multivariate analysis of variance (MANOVA)); and (4) expected values of abnormalities for each new group resulting from BMI recategorisation. Morbidly obese and underweight patients exhibited the highest decrease in semen quality and had higher chances of semen abnormalities. The smallest number of sperm abnormalities was found at a BMI of 27kg m-2. Four reference values were identified, recategorising BMI into four groups according to their risk of semen abnormalities (from lowest to highest risk): Group1,BMI between 20 and 32kg m-2; Group2, BMI <20 and BMI >32-37kg m-2; Group3, BMI >37-42kg m-2; and Group4, BMI >42kg m-2. A BMI <20 or >32kg m-2 is negatively associated with semen quality; these negative associations on semen quality increase from a BMI >37kg m-2 and increase even further for BMI >42kg m-2. The BMI recategorisation in this study has andrological predictive power.

Longitud cervical mediante ecografía transvaginal en el segundo trimestre del embarazo para predecir el parto prematuro / Cervical length by transvaginal ultrasound in second trimester of pregnacy for predicting preterm delivery

Siendo que la prematurez es la principal causa de morbi-mortalidad neonatal, se realizó un estudio para predecir parto prematuro en una población de bajo riesgo, valorando la longitud cervical entre las 19 y 23 semanas de gestación, a través de ecografía transvaginal en 604 pacientes.

[Nine cases of HELLP syndrome (hemolysis, elevated liver enzymes and low platelets]. / Nueve casos del síndrome HELLP (hemólisis, enzimas hepáticas elevadas y plaquetopenia).

HELLP syndrome (Hemolysis, Elevated Liver Enzymes and Low Platelets) was described by Weinstein in 1982. It has a high maternal and perinatal morbi-mortality rate. We undertook this study to evaluate perinatal outcome in patients with HELLP syndrome. Patients with HELLP syndrome were identified in a retrospective study between March 1998 and March 2001 at the Hospital Privado de Córdoba. Maternal and neonatal variables were analyzed. Nine patients with HELLP syndrome were identified (incidence 2.3@1000). Mean maternal age was 24.5 (15-36) years. Five patients were nuliparous. The mean gestational age was 34.5 weeks (29-40). The main symptom was epigastric pain (77.7%). In seven women delivery was made by cesarean section. Three patients had postpartum HELLP syndrome. Three patients had difficult control hypertension; one had eclampsia and another one had disseminated intravascular coagulopathy with acute renal failure and died. Three women needed blood products transfusions. The average admission time was 4.4 days. There were six preterm infants (75%). Mean birth weight was 2030 g (736-3200). Four neonates had Apgar score < 7 at the first minute, all had > 7 at 5 minutes. Three neonates had alimentary disorders, one had hypoglucemia and another hyaline membrane disease, patent ductus arteriosus, sepsis and thrombocytopenia. The high maternal and perinatal morbi-mortality of HELLP syndrome requires management in a centre where intensive maternal and neonatal care are available.

Nueve casos del síndrome HELLP (hemólisis, enzimas hepáticas elevadas y plaquetopenia). / [Nine cases of HELLP syndrome (hemolysis, elevated liver enzymes and low platelets]

HELLP syndrome (Hemolysis, Elevated Liver Enzymes and Low Platelets) was described by Weinstein in 1982. It has a high maternal and perinatal morbi-mortality rate. We undertook this study to evaluate perinatal outcome in patients with HELLP syndrome. Patients with HELLP syndrome were identified in a retrospective study between March 1998 and March 2001 at the Hospital Privado de Córdoba. Maternal and neonatal variables were analyzed. Nine patients with HELLP syndrome were identified (incidence 2.3@1000). Mean maternal age was 24.5 (15-36) years. Five patients were nuliparous. The mean gestational age was 34.5 weeks (29-40). The main symptom was epigastric pain (77.7

). In seven women delivery was made by cesarean section. Three patients had postpartum HELLP syndrome. Three patients had difficult control hypertension; one had eclampsia and another one had disseminated intravascular coagulopathy with acute renal failure and died. Three women needed blood products transfusions. The average admission time was 4.4 days. There were six preterm infants (75

). Mean birth weight was 2030 g (736-3200). Four neonates had Apgar score < 7 at the first minute, all had > 7 at 5 minutes. Three neonates had alimentary disorders, one had hypoglucemia and another hyaline membrane disease, patent ductus arteriosus, sepsis and thrombocytopenia. The high maternal and perinatal morbi-mortality of HELLP syndrome requires management in a centre where intensive maternal and neonatal care are available.