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Resumen: Introducción: Los disrafismos espinales corresponden, dentro del Instituto Nacional de Perinatología «Isidro Espinosa de los Reyes» de la Ciudad de México (INPer), a la segunda causa de atención neuroquirúrgica, después de las hidrocefalias congénitas. El objetivo del presente estudio es conocer las características demográficas y epidemiológicas de los recién nacidos vivos, durante el último año, con defectos del cierre del tubo neural. Material y métodos: Realizamos un estudio descriptivo, observacional, retrospectivo, incluyendo todos los nacidos vivos dentro del Instituto con diagnóstico al egreso de defectos craneales y/o espinales de cierre del tubo neural. El análisis se presenta con estadística descriptiva, mediante el uso de tablas de frecuencias, medianas y rangos. Resultados: Se registraron 15 nacidos vivos con defectos del cierre del tubo neural, de los cuales 3 presentaban más de un defecto independientemente de la malformación de Chiari, y el 80%, hidrocefalia. Todas las madres refirieron ingesta adecuada de ácido fólico. En ningún caso se detectó antecedente de familiares con disrafismos o consumo materno de antiepilépticos. Un paciente con defecto cerrado presento fístula y ventriculitis infecciosa como complicación. Conclusión: El número de casos atendidos en el INPer, por defectos del cierre del tubo neural, se triplicó respecto al último año. La atención posnatal brindada evidencia menos complicaciones que las reportadas en la literatura, específicamente infecciosas, y se debe a una atención oportuna multidisciplinaria así como posiblemente al hecho de realizar una corrección de todos los defectos abiertos dentro de las primeras 24 h. Abstract: Introduction: After congenital hydrocephalus, spinal dysraphisms represent the second cause of neurosurgical consultation within the National Institute of Perinatology ‘Isidro Espinosa de los Reyes’ in Mexico City (INPer). The objective of the present study is to establish the demographic and epidemiological characteristics of live newborns with neural tube defects, during the past year. Material and methods: We carried out a descriptive, observational, retrospective study, including all live births within the Institute and diagnosis at discharge of cranial and/or spinal neural tube defects. The analysis is presented with descriptive statistics, using frequency tables, medians and ranges. Results: Fifteen live births with neural tube closure defects were recorded, of which 3 had more than one defect other than the Chiari malformation, and 80% presented hydrocephalus. All the mothers reported adequate intake of folate. There was no history of relatives with dysraphisms or maternal consumption of anti epileptic drugs. One patient with a closed defect developed fistula and infectious ventriculitis as a surgical complication. Conclusion: The number of cases attended in the INPer, due to neural tube defects, tripled compared to the previous year. The post natal care provided showed fewer complications than those reported in the literature, specifically infectious complications, due to timely multidisciplinary care and possibly due to the surgical closure of all open neural tube defects within the first 24 h. Palabras clave: Tubo neural, Mielomeningocele, Espina bífida, Hidrocefalia, Diastematomielia, Keywords: Neural tube, Myelomeningocele, Spina bifida, Hydrocephalus, Diastematomyelia

Problem: Intrauterine infection is one of the most jeopardizing conditions associated with adverse outcomes, including preterm birth; however, multiple tolerance mechanisms operate at the maternal-fetal interface to avoid the rejection of the fetus. Among the factors that maintain the uterus as an immunoprivileged site, Galectin-1 (Gal-1), an immunomodulatory glycan-binding protein secreted by the maternal-fetal unit, is pivotal in promoting immune cell homeostasis. This work aimed to evaluate the role of Gal-1 during a lipopolysaccharide (LPS)-induced-inflammatory milieu., Method of Study: Using an ex vivo culture with two independent compartments, human fetal membranes at term were pretreated with 40 and 80 ng/mL of Gal-1, then to reproduce an intraamniotic inflammation, the fetal side of membranes was stimulated with 500 ng/mL of LPS for 24 h. The concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, monocyte chemoattractant protein (MCP1), macrophage inflammatory protein (MIP1) α, regulated upon activation normal T cell expressed and secreted (RANTES), and matrix metalloproteinase (MMP)-9 were measured in both amnion and choriodecidua compartments., Results: In a tissue-specific fashion profile, pretreatment with the physiologic concentration of Gal-1 significantly diminished the LPS-dependent secretion of TNF-α, IL-1β, Il-6, MCP1, MIP1α, RANTES, and MMP-9., Conclusion: Gal-1 elicits an anti-inflammatory effect on the human fetal membranes stimulated with LPS, which supports the hypothesis that Gal-1 is part of the immunomodulatory mechanisms intended to stop the harmful effect of inflammation of the maternal-fetal interface., (© 2024 The Author(s). American Journal of Reproductive Immunology published by John Wiley & Sons Ltd.)

Placentas from gestational diabetes mellitus (GDM) patients undergo significant metabolic and immunologic adaptations due to hyperglycemia, which results in an exacerbated synthesis of proinflammatory cytokines and an increased risk for infections. Insulin or metformin are clinically indicated for the treatment of GDM; however, there is limited information about the immunomodulatory activity of these drugs in the human placenta, especially in the context of maternal infections. Our objective was to study the role of insulin and metformin in the placental inflammatory response and innate defense against common etiopathological agents of pregnancy bacterial infections, such as E. coli and S. agalactiae , in a hyperglycemic environment. Term placental explants were cultivated with glucose (10 and 50 mM), insulin (50-500 nM) or metformin (125-500 µM) for 48 h, and then they were challenged with live bacteria (1 × 10 5 CFU/mL). We evaluated the inflammatory cytokine secretion, beta defensins production, bacterial count and bacterial tissue invasiveness after 4-8 h of infection. Our results showed that a GDM-associated hyperglycemic environment induced an inflammatory response and a decreased beta defensins synthesis unable to restrain bacterial infection. Notably, both insulin and metformin exerted anti-inflammatory effects under hyperglycemic infectious and non-infectious scenarios. Moreover, both drugs fortified placental barrier defenses, resulting in reduced E. coli counts, as well as decreased S. agalactiae and E. coli invasiveness of placental villous trees. Remarkably, the double challenge of high glucose and infection provoked a pathogen-specific attenuated placental inflammatory response in the hyperglycemic condition, mainly denoted by reduced TNF-α and IL-6 secretion after S. agalactiae infection and by IL-1β after E. coli infection. Altogether, these results suggest that metabolically uncontrolled GDM mothers develop diverse immune placental alterations, which may help to explain their increased vulnerability to bacterial pathogens.

Background: During pregnancy, the Zika virus (ZIKV) replicates in the placenta and central nervous system (CNS) of infected fetuses; nevertheless, the ability of ZIKV to replicate in other fetal tissues has not been extensively characterized., Methods: We researched whether dissemination of congenitally-acquired ZIKV outside the CNS exists by searching for the accumulation of the viral envelope protein, ZIKV ribonucleic acid (RNA), and infectious viral particles in different organs of a deceased newborn with Congenital Zika Syndrome. A real-time qualitative polymerase chain reaction (qPCR) was used to detect ZIKV RNA in the brain, thymus, lungs, kidneys, adrenal glands, spleen, liver, and small intestine. The same tissues were analyzed by indirect immunofluorescence and immunoperoxidase assays using the monoclonal antibody 4G2 to detect ZIKV envelope antigens. Isolation of infectious ZIKV in a cell culture was carried out using brain and kidney samples., Results: A postmortem, virological analysis of multiple organs, such as the kidneys (epithelial cells in the renal tubules), lungs (bronchial epithelia), thymus (epithelial cells inside the Hassall's corpuscles), and brain (neurons, ependymal cells, and macrophages) revealed the presence of ZIKV RNA and envelope antigens. Other tissues of the deceased newborn tested positive by qPCR for Epstein-Barr virus and human herpesvirus 6, including the brain cortex (Epstein-Barr) and the thymus, kidneys, and adrenal glands (human herpesvirus 6). The kidneys were identified as a significant niche for viral replication, given that infectious particles were successfully isolated from renal tissues., Conclusions: Our findings demonstrate the ability of congenitally-acquired ZIKV to produce disseminated infections and the viral tropism towards epithelial cells., (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.)

Historically, women have been known for their role as housewives and were held responsible for children's education. This has changed throughout the years, and they have modified their role in our society. Nowadays, in developed countries, 50% of the working population is represented by women of reproductive age. An important number of these women end up pregnant, and most of them are willing to keep theirjobs after delivery. This is the main reason why pregnancy should not compromise their employment or economic stability. Several international treaties have been signed to defend women, improve their health and reduce child mortality. Even when most countries have developed measures to protect and defend maternity, there is still, a strong difference comparing legislations in this matter, between developed and non-developed countries like Mexico. This is why it is essential to get to know and analyze the main legal dispositions and regulations about maternity issues and protection. We must be aware of the differences in legislation between Mexico and other countries that might influence our own country secondary to sociocultural, commercial and financial exchange. There have been clear and evident improvements related to women's health and maternity matters in the past 15 years. These include longer periods of rest after delivery and making the employer responsible for financing maternity leave.

The ectopic location of endometrial glands and stroma may cause the formation of a tumor known as endometrioma. It almost always occurs in the ovary, and due to its characteristic appearance has been called "chocolate cyst". Cervical localization of this disease is extremely rare, and when it occurs, tends to be an exocervical and/or endocervical injury, as a result of cervical procedures. We communicate the case of a patient with cystic endometriosis in the cervix after a subtotal abdominal hysterectomy, performed by obstetric hemorrhage. Even though there have been reports about cases of cervical endometriosis, most of them have been reported as superficial cervical endometriosis and as a discovery after a total hysterectomy or cervical biopsy, in some cases even with original diagnosis ofAGUS (atypical glandular cells of undetermined significance). We concluded that in this case, instrumented uterine curettage and subtotal hysterectomy by obstetric indication are a possible origin of cervical endometriosis, due to "seeding" endometrial tissue during the curettage in a friable cervix.