Quiste de Tarlov: diagnóstico durante el puerperio

Tarlov cysts, also called extradural cysts, consist of perineural space ectasia of the spinal nerve roots, usually located distal to the dorsal root ganglia or in the junction with this structure. The most frequent location is in the sacral region. The etiology remains uncertain. Most Tarlov cysts are asymptomatic, but they can cause lumbar or root irritative symptoms¹. We describe a case of Tarlov cyst presenting as radicular symptoms during the postpartum period.     

Desórdenes psiquiátricos en el puerperio: nuestro papel como obstetras

Mental illness is a serious public health problem in our setting, leading to high morbidity and very high social costs. The incidence of mental illness is higher in women. Pregnancy and the puerperium are stressors that can trigger or exacerbate preexisting psychiatric disorders. This review aims to raise awareness of the importance of hidden psychological morbidity in women both for individuals and for society as a whole, to identify the most common major psychiatric syndromes -distinguishing those that can be treated by gynecologists from those that require referral to a specialist mental health service- and to examine in greater depth the disorders that are closely related to Obstetrics during the puerperium (depression and postpartum psychosis).     

Hipertensión arterial pulmonar presentada en el puerperio. Reporte de caso

Pulmonary hypertension is a complex, serious and low incidence disease. It is a haemodynamically pathological state with a pulmonary artery pressure that exceeds 25 mmHg. The presence of pulmonary hypertension in the puerperium is rare, and carries a high risk to the mother. The case is presented of a 31 year-old female in the subacute postpartum period of a normal delivery with data of low cardiac output. The echocardiogram showed that the pressure of the pulmonary artery was equal to the systemic. A thoracic helical angio-tomography ruled out pulmonary thromboembolism, making a diagnosis of pulmonary artery hypertension of unknown aetiology.     

Influence of introducing a maneuverable vacuum extractor cup on maternal hospital stay after instrumental birth. Retrospective cohort study

ObjectivesThe aim of our study is to evaluate the impact of the introduction of a maneuverable vacuum extractor cup on the length of hospital stay after assisted vaginal birth in nulliparous women in a hospital where no vacuum devices were used.MethodsThis single center retrospective analytical study included two groups of nulliparous women who had undergone an assisted vaginal birth. The 2 groups differ according to the availability or not of a maneuverable vacuum extractor cup. The first group includes the last 54 instrumental births until May 2017, when only obstetric forceps and Thierry's spatulas were available in our center; the second group includes the first 54 instrumental births since May 2018 in our center, when obstetric forceps, Thierry's spatulas and maneuverable vacuum extractor cup were available. Maneuverable vacuum extractor cups had been available for 12 months in the second group.ResultsIn the no vacuum cup group, Kjelland forceps and Thierry's spatulas were used in 29 (53.7%) and 25 (46.3%) of the 54 assisted vaginal births, respectively. In the vacuum available group, a vacuum cup was chosen in 30 (55.6%), Kjelland forceps were used in 18 (33.3%) and Thierry's spatulas in 6 (11.1%) of the assisted vaginal births. 22 women (40.7%) had a postpartum hospital stay longer than 3 days in the group with no maneuverable vacuum extractor cup availability, versus 3 women (5.6%) in the group with availability of a maneuverable vacuum extractor cup, p < 0.001. Average postpartum hospital stay length was 3.17 ± 0.803 days versus 2.81 ± 0.585, p < 0.001. There was also a significant reduction in the number of episiotomies.ConclusionThe introduction of a maneuverable vacuum extractor cup in a center where only forceps and Thierry's spatulas had been used resulted in a decrease in postpartum hospital stay in nulliparous women.     

Hemofilia A adquirida posparto: guía de diagnóstico y tratamiento a raíz de un caso clínico

Postpartum acquired hemophilia A is an extremely rare (100 cases in the literature) and potentially serious disease. Anti-circulating factor viii (FVIII) antibodies develop in the puerperium, leading to hemorrhagic symptoms without fetal danger. In general, the antibodies disappear spontaneously in the first few weeks or months after delivery and do not recur in subsequent pregnancies.     

Revisión de las histerectomías puerperales en el Hospital Universitario Materno Infantil de Canarias: ¿son posibles tratamientos alternativos? Revisión de conjunto

Uterine atony is one of the main causes of deliveryrelated deaths in developed countries with an estimated risk of 1/100,000. The main difficulty in the diagnosis of this entity is underestimation of blood loss. Maternal deaths are directly related to the time to diagnosis.