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  • Original Article

    Gestational and perinatal outcomes of pregnancies with cervical incompetence submitted to elective cerclage

    Rev Bras Ginecol Obstet. 2003;25(7):483-489

    Summary

    Original Article

    Gestational and perinatal outcomes of pregnancies with cervical incompetence submitted to elective cerclage

    Rev Bras Ginecol Obstet. 2003;25(7):483-489

    DOI 10.1590/S0100-72032003000700004

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    PURPOSE: to describe the pregnancy outcome of women submitted to cervical cerclage during pregnancy. METHODS: a series of 123 pregnancies in 116 women submitted to elective cervical cerclage by Espinosa-Bahamondes, Palmer and MacDonald techniques and followed at the High-Risk Antenatal Care Unit at CAISM/UNICAMP is described. Variables were analyzed through frequency, mean and standard deviation, comparisons were made using c² or Fisher exact tests. RESULTS: 73% had at least one previous abortion, 17.9% had had 3 prior abortions, and 48% had prior preterm deliveries. The mean gestational age at cerclage was 16 weeks. Cerclage by the Espinosa-Bahamondes technique predominated (94.3%). The overall complication rate was 69%, with preterm labor as the most frequent (31.7%), followed by vaginitis (26%), preterm premature rupture of membranes (10.5%) and fetal death (8.7%). Other clinical complications were less common and included urinary tract infections (5.6%), hypertensive disorders (4%) and gestational diabetes (2.4%). Fetal loss occurred in 8.9% of pregnancies (11 stillbirths). Premature deliveries were present in 18%. History of previous premature deliveries was associated with the occurrence of premature deliveries. CONCLUSION: Obstetrical history compatible with cervical incompetence was frequent, and prior preterm delivery was associated with a preterm delivery in the pregnancy under analysis. The use of cerclage by the Espinosa-Bahamondes technique resulted in 18% of premature newborns, and 104 per thousand rate of perinatal death. Prospective, controlled trials are needed to evaluate the real benefits of cervical cerclage performed during pregnancy.

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  • Review Article

    The severe maternal morbidity for the qualification of care: utopia or necessity?

    Rev Bras Ginecol Obstet. 2007;29(9):484-489

    Summary

    Review Article

    The severe maternal morbidity for the qualification of care: utopia or necessity?

    Rev Bras Ginecol Obstet. 2007;29(9):484-489

    DOI 10.1590/S0100-72032007000900008

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    In Brazil, where 90% of the childbirths occur in hospitals, 67.1% of the cases of maternal death are due to direct obstetric causes, mainly hypertensive disorders, but a quarter of the deaths are due to indirect obstetric causes. As maternal death is a rare event, estimated in 76/100,000, the study of severe maternal morbidity, following international literature, can contribute to qualify obstetrical care. Maternal morbidity is a continuum that ends with death, but there is a separate group, with extreme severity, known as near miss. From the literature review, there are the difficulties to obtain an operational definition of the cases of extremely severe morbidity or near miss. The prevalence ranged from 0.80-8.23%, according to the defining criteria and health care provided at the region. The characterization of severe maternal morbidity and near miss allows for monitoring the process of obstetrical care and could help to qualify treatment of maternal urgencies and emergencies, interrupting the process that can lead to death.

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  • Original Article

    Route of Delivery and Perinatal Outcomes of Diabetic Pregnant Women

    Rev Bras Ginecol Obstet. 1999;21(9):519-525

    Summary

    Original Article

    Route of Delivery and Perinatal Outcomes of Diabetic Pregnant Women

    Rev Bras Ginecol Obstet. 1999;21(9):519-525

    DOI 10.1590/S0100-72031999000900004

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    Purpose: to present the perinatal outcomes resulting from the use of a protocol for assistance to diabetic pregnant women used at the Center for Integral Assistance to Women's Health (CAISM), of the University of Campinas. Methods: ninety diabetic pregnant women, who were assisted at the institution with this protocol, were compared with two control grups: the first consisted of 180 pregnant women with equal number of gestations and same age (control A) and the second consisted of 180 randomly selected pregnant women (control B). The study variables were route of delivery, indication for cesarean section, gestational age, Apgar score at first and fifth minute, weight, adequacy of weight for gestational age and perinatal morbidity and mortality. For the statistical analysis Student's t-test and the chi2 test were used. Results: there was a higher incidence of cesarean sections, prematures and large to gestational age (LGA) babies among diabetic women, as well as higher occurrence of neonatal morbidity such as hypoglycemia, hypocalcemia, hyperbilirubinemia, respiratory distress and neonatal depression. The incidence of low Apgar score and perinatal mortality was significantly higher than in the randomly selected group, but the same as in the group matched regarding age and number of pregnancies. Conclusions: although this protocol intends to obtain a perfect metabolic control among diabetic pregnant women, the perinatal outcomes are still unfavorable in comparison to nondiabetic pregnant women.

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  • Editorial

    Syphilis during pregnancy and fetal death: back to the future

    Rev Bras Ginecol Obstet. 2012;34(2):52-55

    Summary

    Editorial

    Syphilis during pregnancy and fetal death: back to the future

    Rev Bras Ginecol Obstet. 2012;34(2):52-55

    DOI 10.1590/S0100-72032012000200002

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  • Original Article

    Infection rate and Streptococcus agalactiae serotypes in samples of infected neonates in the city of Campinas (São Paulo), Brazil

    Rev Bras Ginecol Obstet. 2012;34(12):544-549

    Summary

    Original Article

    Infection rate and Streptococcus agalactiae serotypes in samples of infected neonates in the city of Campinas (São Paulo), Brazil

    Rev Bras Ginecol Obstet. 2012;34(12):544-549

    DOI 10.1590/S0100-72032012001200003

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    PURPOSE: To describe the epidemiological cases and microbiological profile of Streptococcus agalactiae serotypes isolated from infected newborns of a Women's Health Reference Centre of Campinas, São Paulo, Brazil. METHODS: Cross-sectional laboratory survey conducted from January 2007 to December 2011. The newborns' strains, isolated from blood and cerebrospinal fluid samples, were screened by hemolysis on blood ágar plates, Gram stain, catalase test, CAMP test, hippurate hydrolysis or by microbiological automation: Vitek 2 BioMerieux®. They were typed by PCR, successively using specific primers for species and nine serotypes of S. agalactiae. RESULTS: Seven blood samples, one cerebrospinal fluid sample and an ocular sample, were isolated from nine newborns with infections caused by S. agalactiae, including seven cases of early onset and two of late onset. Only one of these cases was positive for paired mother-child samples. Considering that 13,749 deliveries were performed during the study period, the incidence was 0.5 cases of GBS infections of early onset per 1 thousand live births (or 0.6 per 1 thousand, including two cases of late onset) with 1, 3, 2, zero and 3 cases (one early and two late onset cases), respectively, for the years from 2007 to 2011. It was possible to apply PCR to seven of nine samples, two each of serotypes Ia and V and three of serotype III, one from a newborn and the other two from a paired mother-child sample. CONCLUSIONS: Although the sample was limited, the serotypes found are the most prevalent in the literature, but different from the other few Brazilian studies available, except for type Ia.

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  • Editorial

    The teaching and learning of gynecology and obstetrics at the undergraduate level: challenges and trends

    Rev Bras Ginecol Obstet. 2007;29(11):551-554

    Summary

    Editorial

    The teaching and learning of gynecology and obstetrics at the undergraduate level: challenges and trends

    Rev Bras Ginecol Obstet. 2007;29(11):551-554

    DOI 10.1590/S0100-72032007001100001

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  • Review Article

    Characterization of Placental Infection by Zika Virus in Humans: A Review of the Literature

    Rev Bras Ginecol Obstet. 2020;42(9):577-585

    Summary

    Review Article

    Characterization of Placental Infection by Zika Virus in Humans: A Review of the Literature

    Rev Bras Ginecol Obstet. 2020;42(9):577-585

    DOI 10.1055/s-0040-1712126

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    Abstract

    Objective

    The aim of the current review is to present a systematic evaluation of reported human placental findings in cases of zika virus (ZIKV) infection.

    Data

    sources We reviewed the EMBASE, PUBMED, and SCIELO databases until June 2019, without language restrictions. Selection of studies The search terms placenta AND zika virus were used. The inclusion criteria of the studies were studies that reported placental findings in humans. Experimental studies, reviews, notes or editorials were excluded. A total of 436 studies were retrieved; after duplicate exclusion, 243 articles had their titles screened, and 128 had their abstract read; of those, 32 were included in the final analysis (18 case reports, 10 case series, and 4 cohorts)

    Data collection

    We collected data concerning the author, year of publication, study design, number of participants, number of placental samples, onset of symptoms, perinatal outcomes, and main findings on histological analysis.

    Data synthesis

    The placental pathologic findings were described as mild and nonspecific, similar to those of other placental infections, including chronic placentitis, chronic villitis, increased Hofbauer cells, irregular fibrin deposits, increased mononuclear cells in the villus stroma, villous immaturity, edema, hypervascularization, stromal fibrosis, calcification, and focal necrosis of syncytiotrophoblasts.

    Conclusion

    Zika infection presents unspecific placental findings, similar to other infections in the toxoplasmosis, other agents, rubella, cytomegalovirus, and herpes (TORCH)group. Characterizing and standardizing placental findings after zika virus infection is key to understanding the mechanisms of congenital diseases.

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    Characterization of Placental Infection by Zika Virus in Humans: A Review of the Literature
  • Original Article

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Rev Bras Ginecol Obstet. 2000;22(9):579-584

    Summary

    Original Article

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Rev Bras Ginecol Obstet. 2000;22(9):579-584

    DOI 10.1590/S0100-72032000000900007

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    Purpose: to evaluate the avoidable mortality among women in reproductive age, living in Campinas, SP, comparing two five-year periods: 1985-89 and 1990-94. Methods: death certificates of 3.086 women aged 10 to 49 years were studied, representing the total number of deaths during the period from January 1985 through December 1994. The criteria for avoidance were applied to these deaths using preventive, sanitary, early diagnosis and treatment, and mixed measures. The deaths were also classified as: with hardly avoidable causes, not well-defined causes and other causes. The specific mortality coefficient for each period of five years and the ratio between these coefficients were calculated. Results: there was a 20% increase in the avoidable mortality rate from the first to the second period. The main failure was observed among the group of avoidable causes by preventive and sanitary measures. The main increase in death causes by preventive measures resulted from AIDS. Among the causes of death avoidable by mixed measures, the increase of 50% in maternal mortality caused by abortion, as well as causes due to violence specially homicides, are emphasized. Conclusion: there was an increase in the proportion of avoidable death causes. Measures to prevent AIDS, abortion and to reduce violent deaths, specially homicides, should be political and social priorities in our Country.

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