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Search Results: 1 - 10 of 228784 matches for " Alfredo Perales Marín "
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Neonatal Alloimmune Thrombocytopenia Due to Maternal Anti HPA1a Antibodies: Case Report and Management of Subsequent Pregnancy  [PDF]
Verónica Serrano-dela Cruz, Alicia Martínez-Varea, María José Nú?ez-Valera, Antonio Abad-Carrascosa, Vicente Diago, Alfredo Perales-Marín
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.45035
Abstract:

Fetoneonatal alloimmune thrombocytopenia is an infrequent and severe disease that is unexpectedly found after an uncomplicated first pregnancy. Affected infants might show unexplained purpura, intracranial hemorrhage, and/or gastrointestinal or genitourinary hemorrhage. Nevertheless, in asymptomatic newborns the thrombocytopenia may be discovered incidentally. We describe a case report that highlights that the incidental diagnosis of FNAIT allows both properly managing the newborn, and detecting maternal anti-HPA1a antibodies in order to prevent the disease in subsequent pregnancies. A non-invasive treatment based on IVIgG allowed to this patient to prevent FNAIT in her second pregnancy.

Management and Outcome of Pregnant Women with HIV Acquired by Vertical Transmission  [PDF]
Verónica Serrano de la Cruz Delgado, Alicia Martínez Varea, María José Nú?ez Valero, Vicente Diago Almela, Vicente Maiques Montesinos, Amparo García Tejedor, Alfredo Perales Marín
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.59068
Abstract: The majority of children with perinatally acquired human immunodeficiency virus (HIV) do not survive beyond childhood but this is changing due to the benefit of antiretroviral therapy for the perinatally infected cohort, so affected children are now approaching the age to be mothers. The aim of this article is to evaluate the outcomes of pregnant women with HIV acquired by vertical transmission in our centre and encourage the results obtained in “Thirty Years Later: Pregnancies in Female Perinatally Infected with Human Immunodeficiency Virus-1”, a review article published in this journal in 2012 [2]. We report 6 patients with eight pregnancies with HIV acquired by vertical transmission. They delivered a total of nine newborns between 2004 and 2013. In any case, mother-to-child transmission was reported. The management of pregnant women with HIV acquired by vertical transmission is complicated, since the patients are the most of the cases young and the compliance to the treatment may be poor. The prematurity was the more frequent complication and the cesarean section was the more frequent form of ending. In our case series, mother-to-child transmission was absent.
Arabin Cerclage Pessary as a Treatment of an Acute Urinary Retention in a Pregnant Woman with Uterine Prolapse
Alicia Martínez-Varea,Francisco Nohales-Alfonso,Vicente José Diago Almela,Alfredo Perales-Marín
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/161376
Abstract: A 35-year-old gravida 7, para 1, and abortus 5?female with hypogastric pain and inability to void urine after 14?+?3 weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed a uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. After a manual reduction of the uterine prolapse, the patient underwent an emergency catheterization for bladder drainage. A Hodge pessary (size 70) was placed, which led to spontaneous micturitions. Due to the persistence of the symptoms the following day, Hodge pessary was replaced by an Arabin cerclage pessary. Although the pessary could be removed from the beginning of the second trimester, due to the uterine prolapse as a predisposing factor in the patient and the uncomplicated progression of pregnancy, it was decided to maintain it in our patient. Therefore, Arabin cerclage pessary allowed a successful pregnancy outcome and was not associated with threatened preterm delivery or vaginal infection. 1. Introduction Acute urinary retention (AUR) is defined as the inability to void urine, with a retained volume of urine of 200?mL or greater [1]. AUR in early pregnancy is a very rare complication which leads to a real emergency [2]. 2. Case Presentation A 35-year-old gravida 7, para 1, and abortus 5 female with hypogastric pain and inability to void urine after weeks of amenorrhea was examined in the emergency department. One year before, a uterine prolapse had been diagnosed in another hospital. Examination showed an anteverted uterus and uterine prolapse grade 2 with palpable bladder. The patient was unable to void urine. Ultrasound revealed a cervical length of 30?mm and a singleton, cephalic fetus. A manual reduction of the uterine prolapse was made, and the patient underwent an emergency catheterization for bladder drainage (500?mL urine). No urinary tract infection was found. Then, it a Hodge pessary (size 70), and was placed after a spontaneous micturition, the woman was discharged for further ambulatory followup. The following day, the patient was admitted in to the emergency department because of a new AUR. Hodge pessary was replaced by another one of size 75, and due to the persistence of the symptoms, finally an Arabin cerclage pessary was placed (Figure 1). The patient was discharged after a rapid resolution of symptoms. Figure 1: Arabin cerclage pessary as a treatment for uterine prolapse in a pregnant woman. Obstetric controls, which included vaginal cultures, were made every two
Ultrasound Evaluation of Congenital Cervical Teratoma and Therapeutic Management (Ex Utero Intrapartum Treatment)
Pablo Padilla Iserte,Amparo Sanroma Pérez,Blanca Ferri Folch,Juan Rubio Moll,Vicente Diago Almela,Alfredo Perales-Marín
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/597489
Abstract: The ultrasound evaluation of the fetal neck has a high importance as a key point of the airway and digestive tract. We report the case of a fetus diagnosed with a cervical teratoma by ultrasound, which generated a compressive effect on airway, requiring a surgical approach EXIT (ex utero intrapartum treatment) to ensure the extrauterine viability. 1. Introduction The ultrasound evaluation of the fetal neck is increasingly important, because it has a high impact on fetal adaptation to extrauterine life. The presence of masses in this location can cause obstructive problems at airway, producing complications during the course of pregnancy, as the development of polyhydramnios. But the biggest problem is after delivery, with the appearance of acute neonatal asphyxia with newborn death, if you do not carry out invasive techniques for resolution. One of these approaches is the realization of EXIT surgery, a technique designed to allow partial fetal delivery by cesarean section, with establishment of a secure airway, using intubation, bronchoscopy, or tracheostomy, while fetal oxygenation is maintained by the uteroplacental circulation. 2. Case Presentation A primigravida, 25-years-old patient, it showed a cervical tumor heterogeneous solid-liquid content of 43 × 44?mm, moderately vascularized, in ultrasound study in week 22 (Figure 1), with male fetus and normal anatomical exploration, visualizing gastric chamber. We propose to make a genetic amniocentesis, but the patient rejected it. Magnetic resonance (MR) was requested in the 25th week of gestation, describing 56 × 43 × 38?mm heterogeneous mass in anterior cervical position, with high bilateral extension, solid-cystic component, without thoracic infiltration (Figure 2). We suspect a congenital cervical teratoma by ultrasound and MR images. Figure 1: Ultrasound at 22 weeks, where heterogeneous tumor is found in cervical position, moderately vascularized. Figure 2: Nuclear magnetic resonance at 25 weeks, showing heterogeneous mass in cervical situation. New ultrasound study in 26 +5 weeks, shows a significant growth of the mass, 69 × 53?mm size (Figure 3). The patient wishes to continue the pregnancy. New MR control in week 29, shows an increase of significant size, high anterior growth, without existing intrathoracic extension. Similar proportion of solid and cystic component, with a sagittal plane measurement of 61 × 63?mm and coronal plane 51 × 93?mm, with partial compression of the air-digestive track, but an adequate fetal stomach fullness. Figure 3: 3D ultrasound. During follow-up controls, we
Mesenchymal Hamartoma: Prenatal and Postnatal Diagnosis by Imaging
Alicia Martínez-Varea,Jose María Vila-Vives,Juan José Hidalgo-Mora,Antonio Abad-Carrascosa,Roberto Llorens-Salvador,Alfredo Perales-Marín
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/954241
Abstract: We present a case of a twin pregnancy in which one fetus developed a rapidly growing unilateral intrathoracic tumor. While a cystic adenomatoid malformation was suspected in the ultrasound scan, the magnetic resonance scan suggested a pulmonary blastoma or a bronchioalveolar carcinoma. Postnatal chest radiography and contrast-enhanced computed tomography of the affected newborn were performed, and it was ruled out the possibility of malignant origin. Finally, the anatomopathologic exam revealed the presence of a mesenchymal hamartoma in the chest wall. Nevertheless, parents refused any treatment for the newborn. 1. Introduction Fetal tumors are heterogeneous group of neoplasias that are unique as far as their histological characteristics, anatomical distribution, and physiopathology are concerned. The biological behavior of tumors in the fetus may differ drastically if compared with an adult [1]. Congenital thoracic malformations, which comprise a wide spectrum of abnormalities, are often detected by routine prenatal ultrasound. However, the diagnosis usually cannot be established with absolute certainty before birth. Their presence involves having to rule out if there is a pulmonary issue or if its origin lies in the costal wall and does not affect the lung since the diagnosis impression, the prognosis, and treatment differ [2]. Ultrasound scans and, more recently, fetal magnetic resonance allow us to locate, delimit, and characterize the lesion type in certain cases [3]. Mesenchymal hamartomata in the chest wall are extremely infrequent benign tumors that tend to appear during infancy, and their presence in the prenatal period is exceptionally rare [4]. Clinically, they vary from asymptomatic to severe respiratory distress which requires intubation. The definite diagnosis is anatomopathological, and thus prenatal imaging techniques help confirm suspicion and propose the best postdelivery treatment [3, 5]. The congenital cystic adenomatoid malformation of the lung is a rare fetal affection with an incidence of 1?:?25000 to 1?:?35000 pregnancies [6]. When a unilateral anechoic thoracic lesion is discovered, any cystic adenomatoid malformation (CAM) must be ruled out: type 1 (cysts with a shiny surrounding measuring 2–10?cm) or type II (between 0.5–2?cm) [6]. Three CAM types are distinguished, and a type III CAM corresponds to the ultrasound scan image of a unilateral hyperechoic lesion comprising cysts less than 0.5 centimeters. We present a case of a twin pregnancy with one fetus with a rapidly growing unilateral intrathoracic tumor. From the
Fetal Arthrogryposis Secondary to a Giant Maternal Uterine Leiomyoma
José María Vila-Vives,Juan José Hidalgo-Mora,Inmaculada Soler,Juan Rubio,Ramiro Quiroga,Alfredo Perales
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/726732
Abstract: Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications.
Fetal Arthrogryposis Secondary to a Giant Maternal Uterine Leiomyoma
José María Vila-Vives,Juan José Hidalgo-Mora,Inmaculada Soler,Juan Rubio,Ramiro Quiroga,Alfredo Perales
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/726732
Abstract: Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications. 1. Introduction Arthrogryposis multiplex congenital is a rare nonprogressive condition defined as contractures in multiple joints at birth, due to disorders starting in fetal life. Although antenatally diagnosed, arthrogryposis results often in prenatal death, many children with this disease survive and its overall prevalence is 8.5 per 100,000, without difference in sex ratio [1, 2]. 37% cases had isolated AMC, 12% had additional syndrome or chromosomal anomalies, and 51% had other major malformations [1]. The etiology of arthrogryposis is associated with many different conditions and in many instances remains unknown. Nevertheless, the final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment [3]. Causes of decreased fetal movements may be neuropathic abnormalities, muscle abnormalities, abnormalities of connective tissue, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus [2]. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios, which will limit the movements of the fetus, especially when it occurs early in gestation. The same can result from twin pregnancies, deformities of the uterus, and, theoretically, from intrauterine tumours as fibroids, although nowadays very few cases have been described
Microsatellite variability analysis in farmed catfish (Ictalurus punctatus) from Tamaulipas, Mexico
Perales-Flores, Laura E.;Sifuentes-Rincón, Ana María;León, Francisco J. García de;
Genetics and Molecular Biology , 2007, DOI: 10.1590/S1415-47572007000400011
Abstract: analysis of cultured catfish from six farms in tamaulipas, mexico was achieved using a combination of microsatellite pcr analysis and semiautomatic fluoresce-based detection, in order to provide a first assessment of the genetic variability on cultured catfish in mexico. five microsatellites showed extensive polymorphism with allele numbers ranging from 10 and 20. overall observed heterozygosity at each locus ranged between 0.76 and 0.91 and the average polymorphic information content (pic) for the five loci was 0.811, indicating that these loci can be used for studies of paternity identification, linkage and population genetics. on the basis of the fst values (fst = 0.03829; p = 0.00000) it appears that there was a small amount of genetic differentiation between the channel catfish stocks. the high intrapopulation allelic diversity was the most remarkable parameter.
PARTO PRETéRMINO Y SUFRIMIENTO FETAL SECUNDARIOS A PERITONITIS POR APENDICITIS AGUDA PERFORADA
Hidalgo M,Juan José; Molina P,Marta; Varo GM,Bego?a; Rivas R,Salvador; Bernabeu A,José Ramón; Perales M,Alfredo;
Revista chilena de obstetricia y ginecología , 2009, DOI: 10.4067/S0717-75262009000300008
Abstract: acute appendicitis is the most common non-obstetric surgical emergency in pregnancy. it has been associated with premature labour and fetal and maternal morbidity and mortality, especially when complicated with peritonitis. anatomical, physiological and biochemical changes during pregnancy may altertypical symptoms and signs associated with appendicitis. this can result in delayed diagnosis and lead to an increase in mother's and fetus morbimortality. we present a case of a pregnant woman at 35 weeks of gestation in whom the difficulty in diagnosis of acute appendicitis resulted in the appearance of peritonitis because of appendix perforation, which was the cause of preterm labour and fetal distress.
La sequía, un fenómeno climático
Ramón García Marín,Alfredo Pérez Morales
Papeles de Geografía , 2005,
Abstract:
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