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Copyright of Revista CONAMED is the property of Comision Nacional de Arbitraje Medico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pre-eclampsia affects maternal mortality worldwide, this has led to investigate the effects of poor placental adaptation and its systemic and fetal effects from the first quarter and try to predict events that can use existing management tools of maternal and fetal hemodynamic changes. Here is a case in point of these results is exposed. Case report: Patient 33 years old, Gesta 4, 3 abortions, she consults with 20 weeks pregnancy with blood pressure of 113/79 mmHg and asymptomatic. hemodynamic evaluation is performed with niccomo team cardiac index of 1.1 and peripheral vascular resistance of 5291 dyne/cm5 to report healthy fetus, about 25 weeks inotropic starts (digoxin 0.25 mg every 24 hours) to optimize cardiac output and manages to recover a normal hemodynamic curve (cardiac index > 3.5 L/min and vascular resistance < 1500 din/cm5). However a week 29 the fetus develops an early intrauterine growth restriction type IV, abdominal pregnancy is terminated via a single fetus, female 900 g, Apgar 6/7, height 32 cm, required mechanical ventilation support 24 is obtained hours later with weight gain was discharged and stable, as the patient. Discussion: The pathophysiology of severe intrauterine growth restriction and preeclampsia is closely related to the imbalance between angiogenic and antiangiogenic proteins systemically, these mechanisms have been described by our group observing a pattern that is characterized by high vascular resistance and low cardiac output, and has shown improvement with this pattern optimization based inotropic third quarter. Conclusions: Hemodynamic measurement is a useful tool for predicting adverse perinatal outcomes and useful for the administration of drugs that improve maternal hemodynamics so targeted and individualized more research supporting the results are required. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Anestesiología is the property of Colegio Mexicano de Anestesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) or reaction to drugs with eosinophilia and systemic symptoms is a serious drug reaction associated with the use of aromatic anticonvulsants and allopurinol. At least 44 drugs have been associated with DRESS. The aim was to present the case of a patient with DRESS syndrome associated with phenytoin., Clinical Case: a 20 year old woman, with a history of seizures since childhood, presented generalised tonic-clonic seizures for the last three months. Therefore, she began treatment with 100 mg of phenytoin, administered orally, every 8 hours. Three weeks later, she developed fever up to 42 degrees, papules in the hands extending to trunk and extremities, generalized rubicund, pruritus, pain while urinating, adding hyperoxia, dysphagia and dry cough. Consequently, she went to the emergency room., Discussion: the diagnosis is clinical and it is set according to the criteria of the scale of RegiSCAR. As the initial manifestations are unspecific, the diagnosis and treatment could be delayed. The importance of recognizing this syndrome is an early treatment to get better prognostics. The mortality is up to 10 %.

Introduction: The prevalence of acute renal failure (ARF) in obstetric patients in our country is estimated to be between 3 and 42.8%. The most important causes are preeclampsia, especially when associated with thrombotic microangiopathy and hemolysis and less frequently to hemorrhagic shock. Early peritoneal dialysis (EPD) is the temporary treatment. For these patients, 100 % recovery in renal function was observed. When ARF is associated with multiple organ failure (MOF), the reported mortality ranges between 0 and 20 %., Objective: To describe clinical features and medical outcomes of patients treated with early peritoneal dialysis in pregnancy complicated by ARF., Methods: A case series was conducted at the Research Unit of the Instituto Materno Infantil del Estado de México. We reviewed the cases of patients admitted to the ICU matching the criteria for ARF. They were divided into two groups: those who received EPD vs. those who did not require EPD. The most important national series were included describing the association with preeclampsia and thrombotic microangiopathy with hemolysis., Results: In a 5-year period, 1272 patients were admitted to the ICU; in 38 patients ARF was documented requiring peritoneal dialysis. In nine cases ARF was associated with thrombotic microangiopathy with hemolysis, two cases of stillbirth, and one case of mortality with MOF. A 100% recovery in renal function was observed in all cases, using 1.5% solution with an average of 34 dialysis treatments., Conclusions: The early use of peritoneal dialysis in obstetric patients with ARF has a good prognosis.

Introduction: Conservative treatment in severe preeclampsia has been documented by several authors citing significant improvement in neonatal outcome lacking a significant increase in maternal complications., Objective: Our objective was to inform of our preliminary results using protocolized conservative management in women with preeclampsia-eclampsia, favoring better neonate conditions., Material and Patients: We included 34 patients with average age of 28.2 years with documented severe preeclampsia-eclampsia complicating a 36-weeks or less pregnancy, admitted in the obstetric intensive care unit (OICU) between October 2001 and February 2002. Patients received protocolized management consisting of intravascular colume expansion, anti-hypertensive control, target organ protection, monitoring, and clinical observation. We considered conservative management as a 24 or more period offered to patients with satisfactory response to medical treatment and no evidence of binomial compromise., Results: Of our group, 85% corresponded to severe preeclampsia, 9% to eclampsia, 3% to imminence of eclampsia, and 3% to HELLP syndrome. Average stay in OICU was 5.5 days with 3.5 days average management before pregnancy was interrupted. These patients presented mean gestational age of 32.8 weeks during which we observed anemia, low platelets, D dimmer increments, MAP average of 112.8, PCOc 18.6, and BI 0.15. We obtained 36 live newborns of whom 12% four died, two were extremely immatures (510 g and 600 g, respectively); one 980-g newborn presented intraventricular hemorrhage, and a 1,450-g newborn had multiple organ failure. Conservative treatment in patients with severe preeclampsia-eclampsia is a feasible alternative in hospitals with an ICU. Conservative management can improve neonatal survival and prognosis in preterm newborns.