K E Y W O R D S: 35.5 (range, 30-38) weeks in controls, 35.4 (range, 16-38) weeks in Type I, 30.7 (range,[27][28][29][30][31][32][33][34][35][36][37][38][39][40] weeks in Type II (P < 0.0001) and 31.6 (range, 23-39)

Oral communication abstracts umbilical artery. Wall motion filter was kept at less than 100 MHz. Waveforms were assessed in triplicate. Percent AEDV (%AEDV) was calculated as time of the cycle spent in AEDV divided by total cardiac cycle × 100. Follow-up Dopplers were performed 16-24 hours later. IUFD was recorded if the donor twin died any time prior to delivery. A p < 0.05 was considered statistically significant. Results: Sixteen patients with pre-operative AEDV were identified during the study period, of which 5 were associated with IUFD-D. Gestational age at the time of the procedure, number of anastomoses lasered, operating time or placental location were not different between patients with or without IUFD-D. The mean pre-op %AEDV was significantly higher in patients with IUFD-D than in those without (42.7% vs. 27.1%, respectively, p = 0.029). A %AEDV > 35 was 18 times more likely to be associated with IUFD-D (95% CI 1.2-260). AEDV resolved in 8 patients after surgery, with a mean %AEDV of 26.9% vs. 37% in those in whom AEDV did not resolve. However, this difference was not statistically significant. Conclusion: A %AEDV > 35 is associated with an increased risk of IUFD of the donor twin in TTTS patients treated with SLPCV. A high %AEDV is more predictive of IUFD-D than the lack of resolution of AEDV after surgery. Assessment of %AEDV should be considered part of the pre-operative evaluation of TTTS patients.

No abstract

La preeclampsia en mujeres gestantes constituye una de las principales causas de complicaciones obstétricas de mayor repercusión en la salud materno fetal, de manera conjunta con las hemorragias y las infecciones de la madre, representan las más altas tasas de morbimortalidad en todo el mundo en las unidades de alto riesgo y una considerable inversión de recursos económicos del Estado y nivel privado. Sin embargo, este estado puede ser prevenido y controlado de manera que permita llegar el embarazo a término. El objetivo de esta investigación fue demostrar que la preeclampsia es una complicación del embarazo potencialmente severa, pero que, puede ser controlada e incluso prevenida, evitando así riesgos fatales que pueden ser mortales tanto para la madre como para el bebé. Se realizó una investigación de tipo descriptiva retrospectiva, no experimental u observacional y de corte transversal, que permitió obtener como resultado información relevante sobre las causas más comunes y posibles riesgos analizados a pacientes gestantes que han presentado diagnóstico de preeclampsia. Se llegó a la conclusión de que la preeclampsia-eclampsia puede prevenirse manteniéndose informada de qué es y además resulta clave si se lleva un control desde el principio del embarazo y se mantienen hábitos saludables.

Oral communication abstractsMethods: Eight early (< 17 wks), and 3 late (> 26 wks) cases were identified. Results: In EARLY cases, mean age at laser was 16.4 (14.8-16.9) wks. Maximum liquor pocket (MVP) in the recipient (R) was 8.2 (7.0-9.0) cm. Donor (D) bladder was small in 3 and empty in 5. Recipient bladder was large in 3, moderate size in 4, normal in 1. No fetus had systolic dysfunction, but 3 recipients had diastolic cardiac dysfunction. One was stage IV, 5 stage III, 2 stage II. Endoscopy time was 62 mins, laser time 42 mins; all had remifentanyl. Mean number of major anastomoses was 6.6 (2-11), mean amnioreduction was 920 (+610 to 2650) mL. There were no stillbirths (SB) or early neonatal deaths (NND); one late NND occurred in a donor. Delivery was at 32.1 (27.5-36) wks and mean latent interval was 16.2 (11-19.6) wks.; 6/8 were delivered vaginally. In LATE cases, mean age at laser was 26.7 (26.0-27.7) wks. Recipient MVP was 12.4 (9.0-14.3) cm. Donor's bladders were empty and recipient's distended in all cases. One recipient had systolic, and one diastolic cardiac dysfunction. Two were stage IV, one stage III. Endoscopy time was 61 mins, laser time 28 mins. Mean number of major anastomoses was 11.7 (11-12), mean amnioreduction was 1600 (800-2700) mL. There were 2 SB (1 donor, 1 recipient) but no NND. Delivery was at 33.3 (26.4-37) wks, and mean latent interval was 6.6 (0.4-10.6) wks.; 2/3 were delivered vaginally. Conclusion: We propose a role for laser therapy for TTTS beyond conventional gestational age guidelines. Diagnostic US criteria for TTTS must be modified in very early cases. The latent interval in very early cases is significanly longer than in our other laser cases (16.2 : 10.1 wks), and survival in this small series of very early TTTS was 95%. We suggest that laser may be a reasonable therapeutic option even > 26 wks, especially when the alternative is the delivery of a sick hydropic baby.