We present the case of a pregnant woman with aplastic anemia. The 22-year-old patient presented with 27 weeks of gestation and lymphoproliferative syndrome at the Instituto Nacional de Perinatología in Mexico City. The bone marrow biopsy confirmed the diagnosis and the immunophenotype was negative for malignancy. The treatment consisted of transfusions and planned birth at 35 weeks. Afterwards, the patient was referred to a bone marrow transplant unit.

Objective: To determine the effectiveness of misoprostol using the International Federation of Gynecology and Obstetrics (FIGO) 2017 protocol for medical management of first trimester abortion. Methods: A cross-sectional study was performed between March and September 2018. Seventy-six patients diagnosed with first trimester spontaneous abortion were managed following the FIGO 2017 protocol for medical management of first trimester abortion. Results: Main indications for inclusion of the 76 patients were missed abortion 57.9%, incomplete abortion 25%, and anembryonic pregnancy 17.1%. Medical induction with misoprostol followed the FIGO 2017 protocol for medical management of first trimester abortion. The most frequent side effect reported was abnormal uterine bleeding associated with pelvic pain (72.3% of patients). Complete uterine evacuation was accomplished in 98.6% of the patients. C...

Objectives: To describe the perinatal results in a patient with paroxysmal nocturnal hemoglobinuria. Methods: We present the case of a patient diagnosed with paroxysmal nocturnal hemoglobinuria at the Instituto Nacional de Perinatología, Mexico. Case report: The 19-year-old patient presented a 26-week pregnancy and pancytopenia. Infectious, pharmacological and autoimmune etiologies were discarded. Flow cytometry identified paroxysmal nocturnal hemoglobinuria clone type II/III in over 50% of granulocytes and monocytes. During pregnancy, the management consisted in transfusion support and anticoagulation with acenocoumarin. Delivery occurred at 38.5 weeks of gestation. The patient was then referred to a bone marrow transplant unit.

Objective: To describe a case series of nine patients diagnosed with cervical ectopic pregnancy. Design: Descriptive retrospective study of the clinical records of nine consecutive cases of women diagnosed with cervical pregnancy attended at the Instituto Nacional de Perinatología, Mexico City. Results: 448 ectopic pregnancies were attended from January 2011 through June 2018. They represented 2.2% of all pregnancies during the period studied. Of these, nine were cervical pregnancies (2% of all ectopic pregnancies). Five of these patients were admitted because of vaginal bleeding. All nine patients were diagnosed with cervical pregnancy by ultrasonography. Eight patients were initially offered pharmacological treatment with resolution of the ectopic pregnancy confirmed by hCG in two patients. Six patients required surgical intervention, and fertility was preserved in five cases. Conclus...

Fetal ovarian cysts are the most frequent fetal abdominal tumors. With an incidence of 1 in 2 500 live births and unilateral predominance, these cysts are generally diagnosed after 29 weeks’ gestation, when the hypothalamic-pituitary-gonadal axis has reached maturity. They are usually small, self-resolving and have limited clinical impact. Follow-up every two weeks is recommended; cysts larger than 4 cm have the highest complication rates. If it consistently presents the features of a simple cyst, it is recommended to wait until term for resection. We report the case of a fetus with an abdominal tumor diagnosed as fetal cyst, which prompted weekly monitoring of fetal hemodynamic parameters and cesarean section at 37 weeks. The newborn underwent laparotomy with left salpingo-oophorectomy. Fetal ovarian cyst torsion was diagnosed by histological examination.

Objective: To present the perinatal results of two patients diagnosed with Ewing's sarcoma and alveolar rhabdomyosarcoma. Methodology: Two cases of patients with a diagnosis of sarcoma treated at the National Institute of Perinatology in Mexico City were reviewed. Results: Case 1, a 22-year-old female, with a 23.0-week pregnancy and a 20-cm tumor in the left gluteal region, pain and difficulty walking. The chest radiograph revealed multiple pulmonary nodules and the magnetic resonance imaging revealed a tumor in the gluteal region with extensive involvement. The diagnosis was stage IV metastatic Ewing sarcoma. Management consisted of symptomatic treatment with resolution of the pregnancy at 28 weeks. Case 2, a 22-year-old female with a 12.0-week pregnancy and a diagnosis of metastatic spinal cord syndrome. T9-11 decompression was performed. Absence of fetal heart rate was evidenced, so m...