Objective: To assess the value of gestational age and cardiovascular Doppler indices in predicting perinatal mortality in a multicenter cohort of early-onset intrauterine growth-restricted (IUGR) fetuses. Methods: A multicenter prospective cohort study including 157 early-onset (<34 weeks) IUGR cases with abnormal umbilical artery (UA) Doppler was conducted. Cardiovascular assessment included the ductus venosus (DV), the aortic isthmus flow index (IFI), and the myocardial performance index (MPI). Isolated and combined values to predict the risk of perinatal death were evaluated by logistic regression and by decision tree analysis, where the gestational age at delivery, UA, and middle cerebral artery (MCA) were also included as covariates. Results: Perinatal mortality was 17% (27/157). All parameters were significantly associated with perinatal death, with individual odds ratios (OR) of 25.2 for gestational age below 28 weeks, 12.1 for absent/reversed DV atrial flow, 5.3 for MCA pulsatility index <5th centile, 4.6 for UA absent/reversed diastolic end-flow, 1.8 for IFI <5th centile, and 1.6 for MPI >95th centile. Decision tree analysis identified gestational age at birth as the best predictor of death (<26 weeks, 93% mortality; 26–28 weeks, 29% mortality, and >28 weeks, 3% mortality). Between 26 and 28 weeks, DV atrial flow allowed further stratification between high (60%) and low risk (18%) of mortality. Conclusions: Gestational age largely determines the risk of perinatal mortality in early-onset IUGR before 26 weeks and later than 28 weeks of gestation. The DV may improve clinical management by stratifying the probability of death between 26 and 28 weeks of gestation.

Objective To evaluate the role of cervical length (CL) and uterine artery pulsatility index (UtA-PI)

ABSTRACT

This manuscript reports an effective new alternative for the management of bone infection by the development of an antibiotic nanocarrier able to penetrate bacterial biofilm, thus enhancing antimicrobial effectiveness. This nanosystem, also denoted as “nanoantibiotic”, consists in mesoporous silica nanoparticles (MSNs) loaded with an antimicrobial agent (levofloxacin, LEVO) and externally functionalized with N-(2-aminoethyl)-3-aminopropyltrimethoxysilane (DAMO) as targeting agent. This amine functionalization provides MSNs of positive charges, which improves the affinity towards the negatively charged bacteria wall and biofilm. Physical and chemical properties of the nanoantibiotic were studied using different characterization techniques, including Xray diffraction (XRD), transmission electron microscopy (TEM), N

Preterm PE can be predicted by a combination of maternal characteristics and biophysical markers. However, first trimester screening is less valuable for term PE.

esde que Hebra, en 1872, describió por primera vez esta enfermedad de rara ocurrencia 1 , el pronóstico feto-materno del impétigo herpetiforme (IH) ha presentado una gran mejoría, secundaria esencialmente al apoyo clínico multidisciplinario al binomio madre-hijo y a la corticoterapia. Cuando estas medidas son insuficientes para el control de la enfermedad se ha planteado la asociación terapéutica con ciclosporina.Se presenta un caso clínico de impétigo herpetiforme recidivado en un segundo embarazo y refractario al tratamiento de apoyo multisistémico y corticoidal, por lo que se decidió asociar terapia con ciclosporina, obteniéndose una buena respuesta clínica materna y un buen resultado perinatal. CASO CLÍNICOPaciente de 24 años, con antecedentes de psoriasis en control desde los 12 años; fórmula obstétri-Rev Méd

Oral poster abstractsConclusion: Fetal PCAD causes stress at different fetal ages resulting in a wide range of secondary pathology. Disproportionate RV hypertrophy is the most common prenatal finding. Clinical outcomes range from mild symptomatology to lethal respiratory insufficiency. (TABLE). MV E/A ratio, but not TV E/A ratio, was slightly higher in hydropic CCAM. No fetus had pathologic ductus venosus flow. Conclusions: There is no evidence of significant systolic or diastolic dysfunction in hydropic CCAM. Reduced CTR and CCO, in the absence of elevated central venous pressure, suggests reduced cardiac filling without tamponade physiology. Further investigation on the mechanism of hydrops in CCAM is needed. OP04.03

No abstract