Objective: To describe the development of an artificial placenta (AP) system in sheep with learning curve and main bottlenecks to allow survival up to one week. Methods: A total of 28 fetal sheep were transferred to an AP system at 110–115 days of gestation. The survival goal in the AP system was increased progressively in three consecutive study groups: 1–3 h (n = 8), 4–24 h (n = 10) and 48–168 h (n = 10). Duration of cannulation procedure, technical complications, pH, lactate, extracorporeal circulation (EC) circuit flows, fetal heart rate, and outcomes across experiments were compared. Results: There was a progressive reduction in cannulation complications (75%, 50% and 0%, p = 0.004), improvement in initial pH (7.20 ± 0.06, 7.31 ± 0.04 and 7.33 ± 0.02, p = 0.161), and increment in the rate of experiments reaching survival goal (25%, 70% and 80%, p = 0.045). In the first two groups, cannulation accidents, air bubbles in the extracorporeal circuit, and thrombotic complications were the most common cause of AP system failure. Conclusions: Achieving a reproducible experimental setting for an AP system is extremely challenging, time- and effort-consuming, and requires a highly multidisciplinary team. As a result of the learning curve, we achieved reproducible transition and survival up to 7 days. Extended survival requires improving instrumentation with custom-designed devices.

Objetivo: determinar la prevalencia de infección del tracto urinario (ITU), el perfil microbiológico y la resistencia a los antibióticos en mujeres gestantes con sospecha de infección del tracto urinario. Materiales y métodos: estudio de corte transversal. Ingresaron gestantes con sospecha de infección del tracto urinario adquirida en la comunidad, remitidas a consulta externa desde su control prenatal o atención por urgencias, y hospitalizadas entre agosto de 2013 y septiembre de 2015 en un hospital universitario de referencia ubicado en Medellín, Colombia. Se excluyeron gestantes que hubieran recibido antibióticos el día anterior a la admisión. Muestreo aleatorio simple. Variables medidas: sociodemográficas, clínicas y bacteriológicos. Se aplicó estadística descriptiva. Resultados: la prevalencia de infección del tracto urinario fue del 29 %. Predominaron los aislamientos de bacterias Gram negativas, principalmente E. coli y K. pneumoniae en un 57,7 y 11,4 % respectivamente. Se observó resistencia a trimetoprim-sulfametoxazol en el 19,5 % y ampicilina-sulbactam en el 17,5 % de los aislamientos. Conclusiones: se requieren estudios de base poblacional para una mejor aproximación a la resistencia de las bacterias causantes de la ITU en la comunidad. Por otra parte, la alta resistencia observada podría sugerir que algunos antibióticos expuestos no sean incluidos en las guías locales de manejo de la ITU.

Palabras claves: Prolapso de Órgano Pélvico; Pesarios; Embarazo; Trastornos del Suelo Pélvico

Objective: This study describes the role of pre‐EXIT (Ex Utero Intrapartum Treatment) fetoscopic airway evaluation in fetuses with suspected airway obstruction. Methods: Single center, retrospective, observational study including fetuses with suspected airway obstruction undergoing fetoscopic airway evaluation prior to EXIT between 2013 and 2025. Results: Nine fetuses underwent EXIT with previous fetoscopy at a median gestational age of 35 + 6 weeks (IQR 34 + 4, 37 + 1). The most frequent indications were cervical teratoma ( n = 3) and lymphangioma ( n = 3). Fetoscopy confirmed airway patency in one case (11.1%), allowing de‐escalation to conventional cesarean section. Airway was secured by endotracheal intubation in seven cases (77.8%) and tracheostomy was required in one (11.1%). Survival at the delivery room was 100%, and one neonate died prior to discharge. Conclusion: Fetoscopic airway evaluation prior to EXIT is a valuable adjunct in fetuses with suspected airway obstruction. It can confirm the need for EXIT, optimize the trajectory for airway access, and potentially avoid tracheostomy, improving the safety and efficiency of airway management.