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Background: The urinary tract infections in pregnant women are the second most frequent medical pathology in pregnancy, presenting an incidence of 5-10%. In Mexico, according to the Mexican Clinical Practice Guide, the incidence is 2%, and establishes a recurrence of 23% of them. Objective: To determine the associated epidemiologic factors with recurring infections in lower urinary tract in pregnant women during the period of May 2019 through May 2020. Material and methods: Analytical observational crosssectional and retrospective research study, where prenatal control sheets of clinical records were reviewed from the institutional program to identify frequency of recurrence and epidemiologic factors associated with lower urinary tract infections in 90 pregnant women; the variables were analyzed through descriptive statistics and analytical statistics. Results: Of a total of 90 electronic records of pregnant women, a recurrence of lower urinary tract infections was found in 41 patients (45.6%). Conclusions: The prevalence of recurring lower urinary tract infections during pregnancy in our population is alarming in whom no association was found with the presence of the epidemiologic factors studied in the present investigation; however, a tendency of recurrence urinary tract infections was identified in women that are not working, superior level of education, 2 pregnancies or less, patients under 20 years of age and in those who were treated with nitrofurantoin for a period of time less than 7 days. [ABSTRACT FROM AUTHOR]

Background: In women of reproductive age, pregestational overweight and/or obesity could result in negative outcomes for both, mother and child. Objective: To investigate the association between pregestational body mass index (PBMI) and maternal adverse outcomes (MAO) during childbirth, in women assisted during 2014, in a public hospital in Mérida, Yucatán, Mexico. Material and methods: 427 pregnant women assisted during childbirth were consecutively included, identifying among them those who did not have any MAO (n = 137), whose demographic and clinical data, including PBMI, were compared with those who did have at least one MAO (n = 290). Odds ratios (OR) and 95% confidence intervals (95% CI) were obtained using a binary logistic regression model (LRM). Results: 33% had normal PBMI, and 37% had obesity. Urgent cesarean section was the most frequent MAO (58.8%). According to the LRM, schooling (secondary school level, OR: 0.56; 95% CI: 0.34-0.94), primigravidae (OR: 6.88; 95% CI: 3.37-12.58), and secondigravidae women (OR: 5.57; 95% CI: 3.04-10.24), the number of prenatal visits (= 5, OR: 3.49; 95% CI: 1.54-7.91), and PBMI (overweight, OR: 0.41: 95% CI: 0.23-0.72) were identified as clinically and statistically significant. Conclusions: Women with overweight were at low risk for MAO, while schooling (secondary school level) reduced risk by 44%, being a primigravidae or a secondigravidae increased risk more than 6 and 5 times, respectively. Paradoxically, prenatal visits (= 5 medical visits) increased risk more than 3 times. [ABSTRACT FROM AUTHOR]

Background: Dengue and chikungunya infections are transmitted by the Aedes aegypti vector; they can affect the pregnant woman and her gestation product. Objective: To identify if dengue and chikungunya infections during pregnancy are factors associated with the presence of obstetric complications, in Colima, Mexico. Methods: We included in this study 45 patients with obstetric complications and 90 without complications, selected by a two-stage sampling. We collected the sociodemographic, anthropometric, gynecological, and obstetric complications' data. Descriptive statistics, nonparametric significance tests and crude and adjusted risk estimates (odds ratio [OR] and 95% confidence intervals [95% CI]) were calculated. Results: Out of 135 patients included, 15 had a diagnosis of dengue and 20 of chikungunya. There were obstetric complications in 60% of infected patients with chikungunya, 46.7% with dengue and 26% of non-infected (p = 0.007). Chikungunya infection (adjusted OR = 1.6) and antecedents of abortion and cesarean section (adjusted OR = 2.2) were independent risk factors associated with the presence of complications. Dengue had an adjusted OR = 1.3 without a statistically significant difference. Conclusions: Chikungunya infection and antecedents of abortion and cesarean section are risk factors associated with obstetric complications. Their timely detection is a priority as a preventive strategy. [ABSTRACT FROM AUTHOR]

Introduction: In severe preeclampsia (SP), pregnancy interruption is the first recommendation. However, some patients receive expectant treatment. Objective: To determine maternal and perinatal results of expectant treatment of SP in the intensive care unit (ICU) of a high-specialty hospital. Methods: Observational, descriptive and retrospective study; the files of 40 pregnant patients with SP managed in the ICU with expectant treatment were reviewed. The prolongation of the pregnancy, the maternal and perinatal complications, the stay in ICU and in the hospital were recorded. Descriptive statistics were used for statistical analysis. Results: Mean maternal age was 30.2 ± 5.04 years and gestational age 30.02 ± 3.18 weeks. Gestation was prolonged 7.5 ± 0.95 days. Maternal complications occurred in 60% (24 cases): thrombocytopenia 48.9%, HELLP syndrome 17.8%, pulmonary edema 4.45%, acute kidney injury 4.45%, deterioration of chronic kidney disease 4.45%, oligohydramnios 4.45%, uterine hemorrhage 4.45%, platelet transfusion 4.45%, eclampsia 2.2%, intravascular coagulation 2.2%, surgical reintervention 2.2%, without mortality. ICU stay was 3.42 ± 1.85 days and hospital stay 8.8 ± 4.82 days. 41 premature newborns were treated (100%) and complications were reported in 74.20% (23 cases): respiratory insufficiency 53.65%, neonatal intensive care 39.02%, growth restriction 21.95%, unreliable fetal status 9.75% and mortality 24.39%. Intensive care stay was 8.5 ± 5.47 days and hospital stay 26.8 ± 23.2 days. Conclusions: Prolongation of pregnancy was similar to what has been reported in previous studies. Due to the high percentage of maternal and perinatal complications, expectant treatment is not recommended. [ABSTRACT FROM AUTHOR]

Background: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. Methods: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015. Results: In 2014, were attended 3915 women due to obstetric cause; of them, 75 cases were of obstetric emergency and 3276 live births. In 2015, were 4390 women with 3842 live births and 80 cases of obstetric emergency. The main domains where performed the Immediate Response Team were: Labor, Admission and Recovery. In 2014, preeclampsia-eclampsia-Hellp ranked first as a cause of obstetric emergency: 42 cases, also in 2015: 36 cases; followed by obstetric hemorrhage with 28 and 34 cases, respectively. In 2014, there was a maternal death from severe preeclampsia and extensive liver rupture. Conclusions: Consolidation of Immediate Response Team at a hospital, according to the healthcare environment, it is essential, above all, within the meaning given by staff members. [ABSTRACT FROM AUTHOR]

Background: Maternal morbidity is a health problem for developing countries, the causes of death among obstetric patients varies according to geographic region and other factors, which include health services. The aim of this study was to identify the causes of maternal mortality and morbidity, as well as factors associated with mortality in patients attending on 2011-2012. Methods: Clinical data of the patients on admission, severity of illness, presence of comorbidity, complications that occurred during treatment and causes of death in pregnant or postpartum patients were analyzed. Results: 137 patients were analyzed, 87 (63.5 %) patients were hospitalized, 36 (41.3 %) cases with severe maternal complication (SMC); most patients with SMC were in the postpartum postcesarean. Eleven patients died, five maternal deaths and 6 late deaths. Conclusions: SMC and death were more frequent in the postpartum period. The indirect causes of death were more frequent. [ABSTRACT FROM AUTHOR]

Objective: to describe the clinical data associated to maternal deaths due to fetomaternal bleeding. Methods: we analyzed 32 of 135 cases of maternal deaths that occurred in the Instituto Mexicano del Seguro Social (IMSS) during 2011. The main inclusion feature was the presence of severe hemorrhage during pregnancy, childbirth or puerperium. Results: obstetric hemorrhage as the underlying cause of maternal death was presented in 65.6 % and in 34.4 % severe obstetric hemorrhage occurred due to different underlying cause of maternal death. The age group with the highest maternal deaths by massive bleeding was the group of 30 to 39 years. The resolution of the pregnancy was by cesarean in most cases. The cases of placenta accrete and uterine atony were others maternal death causes. Conclusions: the massive bleeding during pregnancy, birth and/or postpartum continues as the second leading cause of maternal mortality in the IMSS. It is necessary to continue training for improving (the performance) in the management of the pregnancy woman with hemorrhage. [ABSTRACT FROM AUTHOR]

Objective: to assessment the epidemiological characteristics and evolution of maternal hospital deaths at Instituto Mexicano del Seguro Social (IMSS) on the years 2000- 2005 and to analyze a possible relation with a specific program to reduce it, starting in 2001. Methods: it were collected and studied data about 253 and 144 hospital maternal deaths occurred at years 2000 and 2005, respectively. We compared rates, causes, type of obstetrical death, age, parity, history of prenatal care and preventability at admission in hospitals were the women died. Data about live births in were obtained from the official Information Medical System of IMSS. The analysis was made with descriptive statistical measures and values of χ². Results: the maternal mortality rate falling was 30.8 %, as result of a declination from 39 per 100 000 live births in 2000, to 27 in 2005; the proportion of direct obstetrical deaths showed a reduction from 77.1 to 66.7 %; all the specific-age mortality rates felt too, but with some variability. Preeclampsia-eclampsia, hemorrhages and abortion were responsible for more of 50 % of total deaths in both years compared. It was not observed significant changes in other variables. Conclusions: the reduction in general rate of hospital maternal mortality, in percentage of direct obstetrical causes of death and specific-age rates were chronologically coincidental with the development of a program to increase opportunity and quality of obstetrical care at the whole institution. The results let think in a possible cause-effect relation. It is imperative a more long observation to confirm this epidemiological phenomenon. [ABSTRACT FROM AUTHOR]

Background: urinary tract infection is a common pregnancy complication. Asymptomatic bacteriuria (AB) can trigger the development of serious complications affecting both the mother and the fetus. Objective: determine the frequency of AB among pregnant women attending to antenatal care at the family medicine clinic number 1 of the Instituto Mexicano del Seguro Social, located in Ciudad Obregón, Sonora. Methodology: a longitudinal study was carried out from September to December 2004. Seventy-two 72 pregnant women with gestational age of 24 weeks or less were followed up during four months. All pregnant women were selected by a non-probabilistic method. Every patient had a monthly urine culture during the follow up period. Results: among the 72 pregnant women, 16.7 % developed symptomatic urinary infections during the follow-up and 25% had at least one positive urine culture without urinary symptoms, being classified as AB, thus receiving treatment. Frequency of positive urine cultures was common at first and fourth months of follow-up. Conclusion: urine culture is an important component of prenatal care, and helps in identifying a significant number of urinary tract infections, which would go otherwise undetected. [ABSTRACT FROM AUTHOR]