Biomedical subjects

Josefina Lira Plascencia

Publications and source records attributed to Josefina Lira Plascencia.

7 recordsLinked to original sources

PubMed2006

[Analysis of the perinatal results of the first five years of the functioning of a clinic for pregnant teenagers].

OBJECTIVE: To evaluate the perinatal outcomes within a pregnant cohort of adolescents aged 16 years and younger. PATIENTS AND METHODS: Case review prospective study. All pregnant adolescents who attended to the Coordination for assistance of the adolescent patient from June 1998 to July 2003 were included. INCLUSION CRITERIA: age, irrespective from antenatal care inside or outside of the Coordination and delivering inside the institution. Variables analyzed were: age, occupation, marital status, gestational age at first antenatal visit, number of antenatal visits, medical complications during pregnancy, gestational age on delivery, mode of delivery and contraceptive acceptance on discharge. Neonatal variables: weight at birth and intensive care admissions. Statistical analysis included descriptive measures. RESULTS: We identified 2723 pregnant adolescents, from whom only 2,315 met the inclusion criteria. Mean maternal age was 15.3 (SD 0.87). From the total 58% were single and 83.4% were households while only. Mean gestational age on first visit at the coordination was 24.26 (SD 6.79) weeks. The average number of antenatal visits was 4.78 (SD 3.99). The most frequent medical complications affected the genital and urinary tract, with a 54.2% of cervical and vaginal infections, and a 23.8% of urinary tract infections; anemia in 16.7%, threatened preterm delivery in 9.2% and pregnancy induced hypertension in 3.8%. From the total of cases the 79.1% presented with any morbidity. Mean gestational age concluded at 37.58 (SD 3.03), the preterm delivery rate was 15.4%. The most frequent way of delivery was vaginal with a 55.8% rate. On the neonatal outcomes, the mean birth weight was 2819.07 (SD 613.85). The contraceptive acceptance on the discharge was 98%. CONCLUSIONS: The adolescent pregnant has a high risk of suffering major complications, such as genital and urinary tract infections, anemia and preterm delivery.

Adolescent↗

PubMed2005

[Quantification of perinatal risk in Mexican adolescents: consequences of maternal low weight].

OBJECTIVE: To determine whether a pregnant adolescent whose weight-for-age is less than 90% is on the risk of delivering a baby who is small for gestational age. PATIENTS AND METHOD: Six hundred and one adolescents aged 12-16 years, at 40 weeks of gestation were included. Body weight was measured at baseline with Mexican reference tables. Low maternal weight was considered less than 90%. Rate of small for gestational age at birth was determined for each group. Comparisons were made using chi2 and relative risks were estimated. RESULTS: The rate of small for gestational age among adolescents with low body weight was 16.1% (30/186), it differed significantly (36/415) from the others (8.7%). Relative risk for small for gestational age babies among adolescents with low body weight was 1.9 (95% CI, 1.2 - 2.9). An exploratory analysis suggests that this effect depends on gestational age. CONCLUSIONS: If body weight of a pregnant adolescent is to be evaluated in the absence of a previous record, tables by Arroyo can be used as reference; if body weight is less than 90%, then you have an indicator of perinatal risk.

Adolescent↗

PubMed2005

[Perinatal implications of pregnancy in adolescent women].

OBJECTIVE: To establish if there are differences on obstetric and perinatal outcomes between adolescents who are younger than 16 with young adults aging 20 to 24 years old. PATIENTS AND METHOD: A double-cohort prospective and comparative study in 328 Mexican pregnant women. Cohort I included 153 pregnant adolescents younger than 16 years old and cohort II included 175 young adults aging 20 to 24 years old. Inclusion criteria for both groups were: healthy, singleton, primigravidas, with 4 or more antenatal care visits and delivery at institution. STATISTICAL ANALYSIS: descriptive, t-test, chi-squared and Fisher's exact test. RESULTS: Cohort I: Mean age, 15 years old. Mean gestational age on first visit, 22.35 +/- 6.75 weeks. Morbidity was due mainly by vaginitis and vaginosis (p = 0.0001), urinary tract infection (p = 0.110) and anemia (p = 0.0001). Maternal weight on first visit was 54.11 +/- 9.11 (p = 0.001). In cohort II mean maternal age was 22 years old with a mean gestational age on first visit of 19.58 +/- 7.94 weeks. Main morbidity was: urinary tract infections, vaginitis-vaginosis and preeclampsia (p = 0.191). Mean maternal weight on first visit was 60.37 +/- 9.99. Gestational age on delivery and birth weight were not statistically different between newborns in each group. CONCLUSIONS: Pregnancy in adolescents should be considered of risk; nevertheless, adequacy in antenatal care provides good obstetric and perinatal outcomes.

Adolescent↗

PubMed2003

[Conservative management of secondary ectopic abdominal pregnancy. Case report with literature review].

Abdominal pregnancy is a rare condition representing 1-2% of all pregnancies; early diagnosis is difficult, but the challenge is the advanced pregnancy with adequate clinical condition for conservative management. There are few cases in which conservative management can improve, even though when the abdominal pregnancy is secondary to ruptured interstitial localization. A case of secondary (interstitial) abdominal pregnancy with conservative management and post-operative eventful for the mother and fetus is discussed.

Adult↗

PubMed2002

[Emergency cerclage].

OBJECTIVE: To evaluate the maternal and fetal morbility as well as the odds and conditions of pregnancy when performing an emergency cerclage. MATERIAL AND METHODS: We performed a transversal, prospective and descriptive study of all the patients to which an emergency cerclage was performed in the Instituto Nacional de Perinatología between January 1, 1995 and December 31, 1996 having all the inclusion criteria. At such time 261 cerclages were performed in our Institute upon unique pregnancies being only 22 considered as emergency cerclages. We performed studies of their obstetrics background, their incidental as per their age group, complications during the inclusion for the technique used as well as restitution of fetal membranes, complications before, during and after surgery: as well as the time elapsed as from the inclusion of the cerclage to birth and the data of the new born. RESULTS: 21 patients had previous pregnancies and only one of them was her first one; only 6 of their children were alive. The average age was 29.5 +/- 3.8 years and the gestational average age of the inclusion of the procedure was of 18 +/- 2.6 weeks, having a cervical dilatation of 2.5 cm +/- 0.9 cm. In 10 patients we had to restitute fetal membranes. The long extended average time between the colocation of the cerclage and labor was 66.8 days (more than 9 weeks) and the 86.4% of the resolution was via vaginal. CONCLUSIONS: It was observed that with the inclusion of the urgency cerclage we were able to prolong gestation in around 66 days, in which the main indicator of the perinatal forecast was the presence of fetal membranes or if they were bulging through internal cervical os. In this type of patients there is a major risk of having preterm labor and infectious maternal morbility. Notwithstanding that we believe that it is not an ideal procedure, the urgency cerclage has a place in current obstetrics. Prior to performing this procedure, we will have to study the patient as well as to have an adequate neonatal service.

Adult↗

PubMed2002

[Perinatal outcome in patients with meconial amniotic fluid in labor].

PURPOSE: To evaluate the perinatal morbidity and mortality with the presence of meconial amniotic fluid. MATERIAL AND METHODS: Retrospective study of case review, performed from 1st of June 1995 to May 1997. The patients included were at delivery, with a pregnancy of 32 weeks or older and had meconial amniotic fluid. The variables analyzed were: motherhood age, pre-existing associated illness, resolution of the pregnancy, PSS interpretation, fetal weight, Apgar and final destiny of the product. RESULTS: Of the 432 patients the motherhood aged varied from 13 to 43 years old, mean 27.4; with a number of pregnancies from 1 to 10, mean 2.25. The gestational age went from 32.2 to 42.4 weeks. The fetal weight varied form 1025 to 5080 g. The Apgar grade mean was 7 at the first minute and 8 at the fifth. The pregnancy was interrupted by cesarean in 52.5%. Although there was not a significant difference with the arterial gas, the density of the amniotic fluid did determine the final destiny of the product. CONCLUSIONS: There is a relation between the presence of amniotic fluid and the Apgar grade; both determining the final destiny of the product. When the amniotic fluid had thick meconium the products had a greater morbidity.

Adolescent↗

PubMed2002

[Maternal morbidity in adolescent pregnancy].

OBJECTIVE: To evaluate the maternal morbidity in < or = 16 year old pregnant teenagers. MATERIAL AND METHODS: A prospective study of the reviewed cases was carried out from June 1998 to May 1999. All pregnant teenagers which attended the Coordination for the Attention of the Teenage Patient and whose pregnancy came to term during the study period were included. The following variables were analyzed: maternal age, preexisting related diseases, number of pregnancies, number of prenatal control medical visits and the time at which these were started, and maternal morbidity secondary to pregnancy. RESULTS: Two hundred and ninety six of 330 case were included. The average maternal age was 15.1 years old (10-16 range); 68.9% had finished middle school; 82.2% were housekeepers, and 61.4% were single. Prenatal control was initiated in the 2nd trimester by 50.7% of them, while 39.5% started it in the 3rd trimester and the remaining 9.8% in the 1st trimester. The most frequent previous pathologies were: bronchial asthma (2.5%), drug addiction (2%), hypothyroidism (2%), cardiopathy (1.5%). The most common complications during pregnancy: urinary system infections (20.4%), anemia (9.8%), threats of premature labour (9.8%), premature membrane rupture (9%), hypertensive disease induced by pregnancy (3.2%), delayed intrauterine growth (2.4%) and fetal malformation (2.4%). About 44.1% of the pregnancies were interrupted by cesarean section, 35.6% by eutochia and 20.3% by instrumented labour. The most frequent complications during the puerperium were: tearing of the canal of the cervix (7%), decidual endometritis (3.3%), dehiscence of surgical wounds (2.7%), and pyelonephritis (1.6%). CONCLUSIONS: The pregnant teenager is a "special" patient form the biopsychosocial point of view, thus, she must be managed by a multidisciplinary team, with special emphasis in the problems analyzed in this study.

Adolescent↗