Background: Intrauterine growth restriction (IUGR) increases the risk for perinatal morbidity and mortality. Diagnoses vary according to reference growth curves. In our institution, Lubchenko’s curve is used primarily. Objectives: To build our own intrauterine growth curve (IGC) and compare it with Lubchenko's and Peruvian Ministry of Health’s (MINSA) curves regarding IUGR. Design: Observational, retrospective, comparative study. Setting: Department of Gynecology and Obstetrics,  Obstetrics Critical Care Service, Hospital Nacional Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru. Participants: Neonates. Methods: We reviewed information of mothers and neonates born at HNERM between January 1, 2003, and June 30, 2010. Mothers with only one fetus were included, 24 to 43 weeks of gestation by reliable last menstrual period and/or first trimester ultrasound exam; 29 239 newborns ...

We report the case of a pregnant woman referred to our hospital for suspected partial hydatidiform mole. Ultrasound images showed a normal fetus attached to a small placenta adjacent to a honeycomb-like tumor mass. Amniocentesis revealed a normal karyotype. Due to β-hCG values greater than 800 000 IU and a mass growth of 11% by magnetic resonance imaging, an ultrasound-guided percutaneous tumor biopsy was performed; it ruled out the possibility of choriocarcinoma. The patient had symptoms of hyperthyroidism that required treatment; when the β-HCG levels exceeded one million IU, a course of chemotherapy was prescribed. At 29 weeks, the patient started labor; a cesarean hysterectomy was performed, obtaining a live newborn with Apgar 5 and 7. The pathology report informed the placental mass as an invasive mole. According to our literature search, this is the first case report where an inv...

Objective: To determine whether maternal age 35 years or older is an independent risk factor for maternal and perinatal complications. Design: Case-control, comparative study. Setting: Arzobispo Loayza National Hospital, Lima, Peru, III level teaching hospital. Participants: One hundred and sixty six 35 years or older pregnant women were compared with 324 pregnant women less than 35 years old. These patients were randomly selected of those attended in 2005. Mantel-Haenszel x2 statistics was used to compare age specifically, with P< ,05 considered statistically significant. Main outcome measures: Multiple logistic regression analysis was used to evaluate the association between maternal age and outcome variables, controlling for possible confounding factors. Results: Advanced maternal age was independently associated with abnormal fetal presentation during labor (OR 1,05; 95% IC 1,01, 1,1...

A case of pentalogy of Cantrell pathology in only one fetus of a twin pregnancy is reported; no congenital malformation was found in the second fetus. This fact would endorse epigenetic theories on its origin. Some thoughts on prenatal diagnosis, etiology and management of these cases are discussed.

Background: Fetuses with intrauterine growth restriction (IUGR) are at high risk of perinatal morbidity and mortality and there is much difficulty to differentiate fetuses with IUGR from those small for gestational age (SGA), because even Doppler ultrasound has limitations in this regard. It has been suggested that customized growth curves could shed light on this dilemma. Objectives: To design a customized growth curves software to optimize IUGR diagnosis at EsSalud. Design: Comparative, observational and descriptive study. Setting: Hospital Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru. Participants: Pregnant women and their fetuses and newborns. Methods: An intrauterine growth curve was constructed with ultrasound fetal measurements born and newborn weight recorded at HNERM and, based on this a customized growth curves software was designed. Student’s t, ANOVA and non-para...

Both fetal ductus arteriosus constriction and closure have an unknown prevalence because most of these cases have no clinical significance, but there is a suspicion that many of them are not detected due to lack of training of the sonographer. We report the case of a pregnant woman who received a dose of metamizole and the fetal echocardiographic examination showed tricuspid regurgitation. We review the association between tricuspid regurgitation and ductus arteriosus patency. The lesson of this case is that the finding of tricuspid regurgitation should prompt evaluation of the ductus arteriosus by a trained person or either opts for referral to a center with more experienced professionals.

La Isoinmunización de Rh es el mayor factor de riesgo para la anemia fetal. En casos moderados a severos la transfusión intrauterina antes de las 34 semanas y el parto después de las 37 semanas son los tratamientos aceptados. Sin embargo, en el período pretérmino tardío, no hay concenso sobre el curso de acción aceptado. Se reporta un caso de Isoinmunización de Rh con rápido progreso de anemia fetal a las 35 semanas de edad gestacional, que no fue detectado por ultrasonido Doppler. Se discute el manejo óptimo en este periodo gestacional de acuerdo a la literatura revisada.

Estudio comparativo, observacional y descriptivo realizado en el Hospital Edgardo Rebagliati Martins, de EsSalud, en Lima, Perú, con el objetivo de diseñar un software con curvas de crecimiento personalizadas para optimizar el diagnóstico de restricción de crecimiento intrauterino en la Institución. Se construyó una curva de crecimiento con mediciones ultrasónicas de fetos de gestantes del hospital cuyo peso se conoció al nacimiento y, en base a esta, se diseñó un software con curvas personalizadas. Se seleccionó 29 239 recién nacidos, atendidos entre 2003 y 2010. El peso neonatal estuvo influido por la talla materna, el peso pregestacional, la edad materna, el sexo fetal masculino y la multiparidad. Se diseñó un software, basado en estos parámetros, para la predicción del peso fetal para cada semana gestacional.

Background: Fetuses with intrauterine growth restriction (IUGR) are at high risk of perinatal morbidity and mortality and there is much difficulty to differentiate fetuses with IUGR from those small for gestational age (SGA), because even Doppler ultrasound has limitations in this regard. It has been suggested that customized growth curves could shed light on this dilemma. Objectives: To design a customized growth curves software to optimize IUGR diagnosis at EsSalud. Design: Comparative, observational and descriptive study. Setting: Hospital Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru. Participants: Pregnant women and their fetuses and newborns. Methods: An intrauterine growth curve was constructed with ultrasound fetal measurements born and newborn weight recorded at HNERM and, based on this a customized growth curves software was designed. Student’s t, ANOVA and non-para...

A case of pentalogy of Cantrell pathology in only one fetus of a twin pregnancy is reported; no congenital malformation was found in the second fetus. This fact would endorse epigenetic theories on its origin. Some thoughts on prenatal diagnosis, etiology and management of these cases are discussed.

Background: Intrauterine growth restriction (IUGR) increases the risk for perinatal morbidity and mortality. Diagnoses vary according to reference growth curves. In our institution, Lubchenko’s curve is used primarily. Objectives: To build our own intrauterine growth curve (IGC) and compare it with Lubchenko's and Peruvian Ministry of Health’s (MINSA) curves regarding IUGR. Design: Observational, retrospective, comparative study. Setting: Department of Gynecology and Obstetrics,  Obstetrics Critical Care Service, Hospital Nacional Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru. Participants: Neonates. Methods: We reviewed information of mothers and neonates born at HNERM between January 1, 2003, and June 30, 2010. Mothers with only one fetus were included, 24 to 43 weeks of gestation by reliable last menstrual period and/or first trimester ultrasound exam; 29 239 newborns ...

Objective: To determine whether maternal age 35 years or older is an independent risk factor for maternal and perinatal complications. Design: Case-control, comparative study. Setting: Arzobispo Loayza National Hospital, Lima, Peru, III level teaching hospital. Participants: One hundred and sixty six 35 years or older pregnant women were compared with 324 pregnant women less than 35 years old. These patients were randomly selected of those attended in 2005. Mantel-Haenszel x2 statistics was used to compare age specifically, with P< ,05 considered statistically significant. Main outcome measures: Multiple logistic regression analysis was used to evaluate the association between maternal age and outcome variables, controlling for possible confounding factors. Results: Advanced maternal age was independently associated with abnormal fetal presentation during labor (OR 1,05; 95% IC 1,01, ...

Con el objetivo de validar las encuestas SERVQHOS y evaluar la calidad percibida, la satisfacción e intenciones de comportamiento de pacientes en un área hospitalaria de Lima-Perú, se realizó un estudio instrumental, cuantitativo, observacional, analítico, longitudinal y prospectivo. Se entrevistó a 206 pacientes, obteniendo una tasa de respuesta de 93.2%. Se demostró su validez de contenido (V de Aiken = 0.95); su fiabilidad (coeficiente de Spearman-Brown = 0.78, Alfa de Cronbach = 0.96 y correlación intraclase ≥ 0.94); su validez de constructo con un análisis factorial exploratorio, en el cual, el 87.9 % de la varianza fue explicada por 5 factores, los cuales se redujeron a tres frente al análisis confirmatorio. Se determinó la validez convergente, divergente y de criterio, al compararla con SERVQUAL, la Escala Breve de Celos, y SERVPERF, respectivamente; y su validez disc...