Índice de Pulsatilidad de la Arteria Uterina como Predictor de Preeclampsia en los 3 Trimestres en Mujeres con Embarazo Úni

Objetivo Evaluar el índice medio de pulsatilidad de la arteria uterina (UtAPI) en cada trimestre del embarazo como predictor de preeclampsia (PE) temprana o tardía en gestantes colombianas. Métodos Se midió el UtAPI en embarazos únicos en cada trimestre. El índice de pulsatilidad de la arteria uterina como predictor de PE se evaluó mediante odds ratio (OR), curvas receiver operating characteristic (ROC) y diagrama de Kaplan-Meier. Los resultados del análisis en el 1er y 3er trimestre mostraron que un UtAPI anormal se asociaba con una PE precoz (OR: 5,99: Intervalo de confianza [IC] del 95%: 1,64-21,13; y OR: 10,32; IC 95%: 2,75-42,49, respectivamente). La sensibilidad y la especificidad fueron del 71,4 y el 79,6%, respectivamente, para el desarrollo de EP (área bajo la curva [AUC]: 0,922). La curva de KaplanMeier mostró que un UtAPI de 0,76 (IC 95%: 0,58-1,0) en el 1er trimestre se asociaba con una PE temprana, y un UtAPI de 0,73 (IC 95%: 0,55-0,97) en el 3er trimestre se asociaba con una PE tardía. Conclusión Las arterias uterinas demostraron ser una herramienta de predicción útil en el 1er y 3er trimestre para la PE temprana y en el 3er trimestre para la PE tardía en una población de embarazadas con alta prevalencia de PE.Objective To evaluate the mean uterine artery pulsatility index (UtAPI) in each trimester of pregnancy as a predictor of early or late pre-eclampsia (PE) in Colombian pregnant women. Methods The UtAPI was measured in singleton pregnancies in each trimester. Uterine artery pulsatility index as predictor of PE was evaluated by odds ratio (OR), receiver operating characteristic (ROC) curves, and Kaplan-Meier diagram. Results Analysis in the 1st and 3rd trimester showed that abnormal UtAPI was associated with early PE (OR: 5.99: 95% confidence interval [CI]: 1.64–21.13; and OR: 10.32; 95%CI: 2.75–42.49, respectively). Sensitivity and specificity were 71.4 and 79.6%, respectively, for developing PE (area under the curve [AUC]: 0.922). The KaplanMeier curve showed that a UtAPI of 0.76 (95%CI: 0.58–1.0) in the 1st trimester was associated with early PE, and a UtAPI of 0.73 (95%CI: 0.55–0.97) in the 3rd trimester was associated with late PE. Conclusion Uterine arteries proved to be a useful predictor tool in the 1st and 3rd trimesters for early PE and in the 3rd trimester for late PE in a pregnant population with high prevalence of PE

Anemia falciforme e gravidez: relato de caso clínico

Sickle cell anemia (SCA) is a pathology with high rates of complications, when presented in pregnancy it is a medical challenge to manage patients due to the high risk of maternal and perinatal morbidity-mortality, case report and review of literature presented at the Hospital Universitario Clínica San Rafael de Bogotá (National Clinic) in 2018, a women in the third trimester of pregnancy with diagnosis of sickle cell anemia that is complicated with preeclampsia with characteristics of severity and preterm delivery.The objective of publishing this case is to review the information regarding the incidence, the maternal and perinatal morbidity / mortality of this medical condition, its management by a multidisciplinary team and the early detection of complications in order to improve the prognosis of the motherchild binomial.La anemia de células falciformes (ACF) es una patología con altos índices de complicaciones; además, cuando se presenta durante el embarazo su manejo se convierte en un desafío médico debido al riesgo elevado de morbimortalidad materna y perinatal. A continuación, se hace una breve revisión de la literatura sobre ACF y se describe un reporte de caso presentado en el Hospital Universitario Clínica San Rafael de Bogotá, Colombia, en el año 2018. La paciente era una primigestante en tercer trimestre del embarazo con diagnóstico de ACF que se complicó con una preeclampsia con características de severidad y concluyó en parto pretérmino. El objetivo de publicar este caso es revisar la información respecto a la incidencia y la morbimortalidad materna y perinatal de la ACF, teniendo en cuenta que debe ser manejada por un equipo multidisciplinario y que se debe hacer detección temprana de complicaciones con el fin de mejorar el pronóstico del binomio madre-hijo.A anemia falciforme (ACF) é uma patologia com altas taxas de complicações; quando ocorre na gravidez, é um desafio médico para gerenciar pacientes devido ao alto risco de morbidade materna e perinatal. Apresenta-se o relato de caso e revisão de literatura apresentada no Hospital Universitário Clínico SanRafael de Bogotá (Clínica Nacional) em 2018, primigestante no terceiro trimestre de gravidez com diagnóstico de anemia falciforme complicada pela pré-eclâmpsia com características de gravidade e parto prematuro.O objetivo da publicação deste caso é revisar as informações referentes à incidência, morbimortalidade materna e perinataldessa condição médica, levando em consideração que ela deve ser gerenciada por uma equipe multidisciplinar e fazer a detecção precoce de complicações, a fim de melhorar o prognóstico binomial: mãe-filho

Biometry and pathological ultrasound findings in multiple pregnancies

Resumo Objectives: to determine the prevalence of pathological findings according to the type of chorionicity in pregnancies in two institutions in Bogotá, Colombia. Methods: descriptive, retrospective, cohort study. Biometric variables were calculated, and pathological findings were evaluated according to the type of chorionicity in multiple pregnancies. Statistical characterization was performed with absolute frequencies, calculation of relative frequencies in qualitative variables, standard deviation measures, median and interquartile range. In addition, a descriptive analysis of the information was carried out. Results: 528 studies were carried out in 141 pregnant women, 98.5% (n = 139) twins and 1.4% (n = 2) triplets. A prevalence of 35.4% of fetal complications was calculated. The most frequent was fetal growth restriction (p=0.37). According to each type of chorionicity, fetal growth restriction was presented in 50% (1/2) of the trichorionics, 16.6% (7/42) of the monochorionics, and 11.3% (11/97) of the dichorionics. Conclusion: fetal growth restriction was the most common finding, both in trichorionics, monochorionics and dichorionics pregnancies