Severe preeclampsia that develops at <34 weeks of gestation is associated with high perinatalmortality and morbidity rates. Management with immediate delivery leads to high neonatalmortality and morbidity rates and prolonged hospitalization in the neonatal intensivecare unit because of prematurity. Conversely, attempts to prolong pregnancy with expectantmanagement may result in fetal death or asphyxia damage in utero and increased maternalmorbidity. Expectant care has been compared with interventionist care in three randomizedcontrolled trials (RCTs) that enrolled 400 women. Interventionist care was associated withmore respiratory distress syndrome but similar neonatal intensive care unit (NICU) admissionand neonatal mortality. Expectant care was associated with a mean pregnancy prolongationof 1-2 weeks, but more small for gestational age (SGA) infants and abruptio placentae. Womenwith s...

Objective: To search for all the information and available evidence on infection with SARS-CoV-2, a virus that appeared during the first 4 months of 2020, and pregnancy. Methods: Systematic review in PubMed and Google Scholar databases until April 25, 2020. We searched for published articles related to pregnant women infected with SARS-CoV-2. There was no language restriction. The search was extended to the references of the articles found. Results: In pregnant women with COVID-19, more than 90% of patients evolve mildly, 2% require intensive care. One maternal death has been reported. Prematurity occurs in approximately 25% of the cases, with predominance of late preterm infants; premature rupture of membranes presents in about 9%. Perinatal mortality is lower or similar to that of the general population, and vertical transmission has not been shown. Conclusions: Obstetrician-...

Intrapartum fetal monitoring: New Concepts. Invasive prenatal diagnostic procedures. Fetal Magnetic Resonance Imaging. Value of lamellar bodies and phospholipids in the Diagnosis of Fetal Lung Maturity.

Severe preeclampsia that develops at <34 weeks of gestation is associated with high perinatalmortality and morbidity rates. Management with immediate delivery leads to high neonatalmortality and morbidity rates and prolonged hospitalization in the neonatal intensivecare unit because of prematurity. Conversely, attempts to prolong pregnancy with expectantmanagement may result in fetal death or asphyxia damage in utero and increased maternalmorbidity. Expectant care has been compared with interventionist care in three randomizedcontrolled trials (RCTs) that enrolled 400 women. Interventionist care was associated withmore respiratory distress syndrome but similar neonatal intensive care unit (NICU) admissionand neonatal mortality. Expectant care was associated with a mean pregnancy prolongationof 1-2 weeks, but more small for gestational age (SGA) infants and abruptio placentae. Womenwit...

Objective: To determine if simulation is more effective than conventional exposition in the improvement in nurses’ knowledge of severe preeclampsia. Methods: Crosssectional quasi-experimental study in two private clinics in Cajamarca, Peru. We compared the improvement in nurses’ knowledge of severe preeclampsia: 13 attended to a conventional exposition about severe preeclampsia (Exconv) and 16, the experimental group, had the same exposition and four simulation training sessions (Sim). We conducted a pretest in both groups and a posttest in 20participants; these were composed of multiple choice questions previously validated by experts; Spearman-Brown reliability was 0.76. The simulation training sessions were recorded in video and evaluated by an expert with a checklist adapted from the American College of Obstetricians and Gynecologists. Data was processed with SPSS 20.0. We used S...

Introduction: Eclampsia (E) and HELLP syndrome (H) are two complications of preeclampsia that increase maternal morbidity and mortality. The main complication and the main cause of death of this EH / HE association is the hemorrhagic cerebrovascular disease (HCD). Objectives: To determine differences between women with EH / HE who presented HCD and those who did not. To define the types of HCD in women with EH / HE. Design: Cross-sectional comparative study. Patients: Cases of EH / HE at the Hospital Regional Docente de Cajamarca, Peru, 2015. Interventions: Patients with EH / HE were divided into two groups: those without HCD and those with HCD. SPSS 20.0 was used. The comparison of groups was done with Mann Whitney U and chi square tests. Significant differences were when p <0.05. Results: There were 23 women with EH / HE: 18 (78.3%) without HCD and 5 (21.7%) with HCD. We compared women...

Maternal mortality from COVID-19 is rare in developed countries, but its association with other obstetric complications increases the risk. It is also associated with fetal death. Postpartum women are at risk of thrombosis that increases with COVID-19 coagulopathy. Comorbidities such as obesity, diabetes, and hypertension increase the risk of death from COVID-19, and pregnant women have more complications during the third trimester than in the first trimester, with higher risk than nonpregnant women of entering the ICU and requiring mechanical ventilation. In this report, stroke, diabetes and intracerebral hemorrhage were the three causes of death described, all within the context of stillbirth, severe preeclampsia, eclampsia and/or HELLP syndrome.

Introduction: Fewer COVID-19 cases and less lethality have been observed at high altitude compared to cases reported at sea level. There are currently no publications reporting clinical behavior of pregnant women with COVID-19 at high altitude. Methods: This is a retrospective study with review of medical records between March 6, 2020 and June 15, 2020. The first thirteen cases of pregnant women with COVID-19 who were attended at Simón Bolívar COVID-19 Hospital, located at 2750 meters above sea level, are described. The cases came from altitudes between 2 035 and 3 502 meters above sea level (masl). Statistical analysis used SPSS, version 19.0. Results: Thirteen cases of pregnant women with COVID-19 confirmed by IgM for SARS-CoV-2 were attended at 2 750 masl (9 022.31 feet) in the Peruvian Andes. Delivery by cesarean section occurred in eight cases (61.5%) and five (38.5%) delivered va...

Introduction: Acute renal injury characteristics in women with preeclampsia and HELLP syndrome have not been thoroughly described; hence, the interest to determine it in our hospital population. Design: Retrospective descriptive study. Setting: Hospital Regional de Cajamarca, Peru. Participants: Women with HELLP syndrome. Methods: Women with HELLP syndrome with and without acute renal injury were compared. T-student test and U Mann-Whitney test for independent samples were used to compare medians. Main outcome measures: Development of acute renal injury. Results: There were 71 women (2%) with HELLP syndrome in 3 411 deliveries; 54 (76%) did not present acute renal injury and 17 (24%) did (0.5% of all deliveries). The stage was severe (2 and 3) in 94% of women with HELLP syndrome and acute renal injury, and these patients showed lower platelets and hemoglobin, and higher bilirrubin and he...