Preeclampsia increases maternal and perinatal morbidity and mortality rates. Much research has been done to identify unique screening tests that would predict the risk of developing preeclampsia before the classic symptoms appear. The possible use of a screening test with high predictive accuracy in patients with high-risk or low-risk of preeclampsia remains to be investigated. At present, the search for additional tests continues. There is growing interest in the use of combinations of tests. Effective primary prevention is not possible because the causes are still unknown, but to identify and to modify susceptible risk factors might decrease the frequency of preeclampsia. A community guideline improves the screening and early detection of preeclampsia, and uniforms the referral thresholds and assessment procedures. Secondary prevention with calcium supplementation and aspirin administration during pregnancy are beneficial in low calcium intake women and in the patient at a very high risk of developing severe early onset disease. Lifestyle choices, dietary nutritional measures (antioxidant as vitamin C, vitamin E, lycopene, selenium, zinc, magnesium and the mitochondrial antioxidants nicotine, coenzyme Q(10) and melatonin; and other dietary nutritional measures as low dietary salt, omega 3 fatty acids, folic acid, garlic, nutritional advice, protein and energy supplementation, isocaloric balanced protein and protein and energy restriction for obese women) and others drugs; have not shown benefits or there is insufficient evidence to recommend clinical use. Proper antenatal care and timed delivery are of utmost importance in tertiary prevention.
Intrahepatic cholestasis of pregnancy is caused by a dysfunction of the hepatocytes, typical of pregnancy. High concentrations of sex hormones and genetic predisposition appear to be important factors for their development. The incidence depends on the ethnic composition of the population and the diagnostic criteria used. It is characterized by increasing and persistent pruritus, increased concentrations of bile acids, usually in the late second or third trimester of pregnancy. It leads to the occurrence of uteroplacental hypoxia that increases the risk of meconium amniotic fluid, preterm delivery, preeclampsia, postpartum hemorrhage, neonatal respiratory distress syndrome, and perinatal death. Therapeutic management is aimed at reducing clinical symptoms, normalizing maternal biochemical changes, and preventing fetal complications. The main pharmacological treatment consists of the administration of ursodeoxycholic acid. The objective of this research is to evaluate the diagnosis and management of intrahepatic cholestasis of pregnancy
El síndrome de Goldenhar, o espectro óculo-aurículo-vertebral, es un síndrome congénito caracterizado por alteraciones en diferentes grados de las estructuras faciales. En ocasiones también existen alteraciones de la columna vertebral y otros defectos óseos, malformaciones cardíacas y anomalías del sistema nervioso central. Un aspecto importante es que, en la mayoría de los casos, estas lesiones son unilaterales. La causa es desconocida. El diagnóstico prenatal solo es posible mediante la identificación de alteraciones morfológicas, ya que no existen marcadores genéticos para el diagnóstico. La enfermedad no es mortal, pero las alteraciones cráneo-faciales graves pueden poner en peligro la vida en el periodo posnatal. El tratamiento consiste en cirugía plástica reconstructiva. Se presenta un caso de diagnóstico prenatal del síndrome de Goldenhar.
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