Central pontine myelinolysis or osmotic demyelination syndrome is a disorder consisting of non-inflammatory demyelination, involving the pons, secondary to swallowing or neuronal edema in patients with severe hyponatremia undergoing rapid sodium replacement, which is considered the main pathophysiological mechanism. The clinical manifestations are diverse and some cases have been reported in pregnant women with hyponatremia induced by severe hyperemesis gravidarum. There is no evidence regarding optimal treatment or prognosis, so it is essential to recognize hyponatremia and perform an adequate correction of sodium levels to avoid this complication. We present the case of a 21-year-old woman with a 12-week pregnancy who presented gait distrubances, polydipsia, speech disorders, dysphonia and intense vomiting with alterations in serum sodium levels. Cerebral magnetic resonance imaging rev...

Neuromyelitis optica is a demyelinating autoimmune inflammatory disorder that affects the spinal cord and the optic nerves. The disease mechanism consists in the production of immunoglobulin G antibodies, which mainly target the aquaporin-4 channel, thus initiating an inflammatory and demyelinating process in the hypothalamic regions. Prognosis is poor. It has a prominent female predominance. Many of these patients are in childbearing age and pregnancy seems to be a factor that worsens the disease. We present a case of neuromyelitis optica during pregnancy in a 41-year-old patient with 23 weeks of gestation who suffered from cutaneous hypersensitivity, acute visual decrease of her right eye together with pain in eye movements, paresthesia and bilateral neuropathic pain of the lower and upper limbs. Magnetic resonance imaging showed an increase in the optic nerve and spinal cord uptake fr...

Maternal malignancies complicate approximately one of every 1 000 pregnancies. These neoplasms arise more frequently from the breasts, cervix and hematopoietic system. Brain tumors in pregnancy are extremely rare. Cerebellar medulloblastomas are the most common malignant brain tumors in childhood. They are considered as embryonic tumors and represent 4% of all intracranial neoplasms; they are extremely rare during pregnancy. We present the case of a 21-year-old patient with a 16-week pregnancy who suffered of intense headache in the occipital region, accompanied by photophobia, slight alteration of coordination, unstable gaits and vomiting. Neurological evaluation was normal but for positive Romberg sign and ataxic gait. Cerebral magnetic resonance imaging showed a complex, ill-defined tumor occupying the cerebellar space. The patient underwent surgical reduction of the tumor. Histopatho...

Cervical cancer is a frequent malignancy of women that spreads to lungs, supraclavicular lymph nodes, liver, and bones as distant metastasis. Prognosis is poor and survival varies from 3 to 6 months. We report the case of a 67-yearold woman with history of squamous cell carcinoma of cervix stage IIB 5 years ago treated with surgery plus radio-chemotherapy who presented walking impairment, headache and vomiting. Cranial magnetic resonance imaging revealed multiple lesions with increasing perilesional edema, T1-hypointense and T2-hyperintense. The patient died one week after the diagnosis. Necropsy findings showed poorly differentiated carcinoma of cervical origin.

The success of pregnancy is associated with a correct placentation that is essential for the growth and development of the fetus. In a normal pregnancy, the syncytiotrophoblast produces and secretes a variety of elements necessary to achieve this goal, among them placental exosomes. These carry cytoplasmic and membrane-bound proteins and nucleic acids that can reprogram the receptor cells. Depending on their interactions with the immune system, they can be divided into immunostimulants or immunosuppressants. The production and secretion of immunosuppressive placental exosomes causes a protective effect on the fetalplacental unit. Those isolated from maternal plasma are active in vitro and are incorporated into the target cells by endocytosis. Their effect, regulated by factors that include oxygen tension, correlates with placental perfusion. Preeclampsia is a syndrome characterized by a ...

Preeclampsia is a major cause of maternal morbidity and mortality worldwide. The incidence of preeclampsia has increased in the past decade, which has been attributed to various predisposing factors. Despite decades of research into the condition, the ability of clinicians to predict it prior to the onset of symptoms has not improved significantly. No single screening test has gained widespread acceptance into clinical practice. Combinations of biochemical and ultrasonographic markers improve the performance of early prediction of preeclampsia. Screening with a combination of maternal risk factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy associated plasma protein-A, and placental growth factor can identify about 95% of cases of early onset preeclampsia. Interestingly, intense research has unveiled the names of some important biomolecules which play an inf...

Pregnancy is a challenge to the maternal vascular system, requiring systemic adaptation and pronounced local changes in the uterus. The maternal cardiovascular adaptation to pregnancy involves a complex physiologic response to the presence of the growing fetus, including alterations in maternal vascular endothelial cells that contribute to a profound fall in total systemic vascular resistance. The discovery of endothelial progenitor cells has generated considerable interest in the field of vascular biology. These cells can be mobilized into the circulation by growth factors and can then support the health of the vascular endothelium by several mechanisms. These cells arise from a population of circulating mononuclear cells and have the capacity to form new blood vessels and contribute to vascular repair. Diseases of pregnancy, such as preeclampsia, increase the risk of complications and ...