ObjectivesThis study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic.DesignCase-control study.SettingsSeven National Reference Hospitals from different regions of the Dominican Republic.ParticipantsA probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1=0.5, P2=0.6, and β=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports.Primary outcome measuresA protocol was created to obtain maternal and obstetric information.ResultsThe main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=−10.294, p<0.001).ConclusionMaternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.

Fetal lymphangioma is an uncommon congenital malformation that is mainly comprised of the subcutaneous tissue of the neck. This malformation can develop in other areas like the thoracic and axillary regions, though rarely. We report 6 consecutive cases of lymphatic malformation in a fetal center in Dominican Republic. In our case series fetal chest lymphangiomas were present in 2 fetuses. In addition, 2 cases of axillary lymphangiomas also involved the thoracic region. Adequate management by a multidiciplinary team is necessary to provide a better approach to delivery.

Introducción: la hemorragia obstétrica es una de las causas de morbilidad y mortalidad materna más común en todo el mundo. La placenta previa es un factor de riesgo importante para la hemorragia obstétrica. El propósito de este estudio es determinar los factores de riesgo relacionados con placenta previa en mujeres embarazadas en Santo Domingo. Métodos: los casos fueron mujeres cuyos partos fueron complicados con placenta previa y los controles fueron partos sin placenta previa. Se analizaron 16 casos y 76 controles. Se condujo análisis estadístico y se calculó razón de probabilidades (OR). Resultados: se demostró relación entre placenta previa con antecedente de dos o más abortos con un OR = 5.3; con cesárea previa OR = 3.02, que aumentaba con más de 2 cesáreas con un OR = 5.91, con embarazo ectópico previo y antecedente de placenta previa. Las pacientes con placenta previa y antecedente de cirugía tuvieron un mayor riesgo de requerir una histerectomía. Las mujeres con placenta previa y antecedentes de cesáreas múltiples (2 o más) tuvieron un mayor riesgo de padecer placenta acreta con un OR = 18. Discusión: nuestro estudio sugiere que abortos múltiples, cesárea previa, múltiples cesáreas anteriores, antecedente de placenta previa y antecedente de embarazo ectópico son factores de riesgo de desarrollar placenta previa.