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Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):15-20
DOI 10.1590/S0100-72032001000100003
Purpose: to evaluate the seroprevalence of infection caused by HSV-2 among pregnant women delivering at the University Hospital, Faculty of Medicine of Ribeirão Preto (UHFMRP-USP) and to standardize laboratory techniques to be used for this purpose. Methods: a total of 1500 blood samples from pregnant women seen at the Obstetric Center of the Department of Gynecology and Obstetrics, UHFMRP-USP, between January 1st and October 31st, 1996, were evaluated. To determine the real prevalence of HSV-2 infection, the ELISA technique was standardized but, during its initial use, it was found to be not sufficiently specific to discriminate between the two viral types (75%). Thus, it became necessary to use a more specific technique and the method standardized for this purpose was Western blot, which can detect the specific HSV-2 viral protein. Results: the seroprevalence of herpes infection induced by the two viral types (HSV-1 and HSV-2) was 94.5% when ELISA was used. With the use of Western blot, a 32% seroprevalence of HSV-2 infection was detected in the studied population, whether symptomatic or asymptomatic. Conclusion: a high prevalence of carrier status for HSV-2 and HSV-1 infection was detected, as shown by the high rate of positivity for antibodies against this virus. ELISA did not show sufficient specificity to discriminate between HSV-2 and HSV-1 antibodies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):15-20
DOI 10.1590/S0100-72032001000100003
Purpose: to evaluate the seroprevalence of infection caused by HSV-2 among pregnant women delivering at the University Hospital, Faculty of Medicine of Ribeirão Preto (UHFMRP-USP) and to standardize laboratory techniques to be used for this purpose. Methods: a total of 1500 blood samples from pregnant women seen at the Obstetric Center of the Department of Gynecology and Obstetrics, UHFMRP-USP, between January 1st and October 31st, 1996, were evaluated. To determine the real prevalence of HSV-2 infection, the ELISA technique was standardized but, during its initial use, it was found to be not sufficiently specific to discriminate between the two viral types (75%). Thus, it became necessary to use a more specific technique and the method standardized for this purpose was Western blot, which can detect the specific HSV-2 viral protein. Results: the seroprevalence of herpes infection induced by the two viral types (HSV-1 and HSV-2) was 94.5% when ELISA was used. With the use of Western blot, a 32% seroprevalence of HSV-2 infection was detected in the studied population, whether symptomatic or asymptomatic. Conclusion: a high prevalence of carrier status for HSV-2 and HSV-1 infection was detected, as shown by the high rate of positivity for antibodies against this virus. ELISA did not show sufficient specificity to discriminate between HSV-2 and HSV-1 antibodies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):15-20
DOI 10.1590/S0100-72032002000100003
Purpose: to evaluate the effects of ascending infection on the mother and newborn in the cases of premature rupture of membranes. Methods: this was a prospective study, carried out to evaluate 50 pregnant women with premature rupture of membranes (PROM) and their newborns. The clinical chorioamnionitis was investigated by clinical findings (thermal curve, abdominal pain by groping and/or uterine softening, smell and other characteristics of vaginal secretion) and subsidiary tests (white blood cell count and C-reactive protein). The histologic chorioamnionitis was investigated by macroscopic and microscopic study (placenta, membranes and cord). In the microscopic study optic microscopy with hematoxylin-eosin staining was used. The newborns were evaluated as to weight and Apgar score in the first and fifth minutes of life. White blood cell count, culture of auditory canal swab and aspirated gastric material culture complemented the study. Statistical analysis was performed using the Fisher exact test and the Student t-test, with level of significance set at 5% (p < 0.05). Results: The rate of clinical chorioamnionitis was 29.4% (15/50), while for histologic chorioamnionitis it was 40% (20/50). All the cases of clinical chorioamnionitis had latency times (LT) higher than 24 hours. The newborns presented signal of infection in 31.4% of the cases (16/51), all with LT higher than 24 hours. The main isolated microorganisms of auditive duct and gastric aspirate of newborns were Klebsiella pneumoniae, Staphylococcus aureus, Gram positive coccus and group B Streptococcus. The infected newborns presented lower Apgar scores in the first and fifth minute of life, lower weight and higher perinatal morbidity and mortality when compared with newborns without infection. Conclusions: based on the analysis of results obtained in the present study, it was possible to conclude that the prolonged latency times increase the possibility of ascending infection, leading to higher possibility of premature delivery and high maternal morbidity (clinical chorioamnionitis), as well as perinatal morbidity and mortality.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):15-20
DOI 10.1590/S0100-72032002000100003
Purpose: to evaluate the effects of ascending infection on the mother and newborn in the cases of premature rupture of membranes. Methods: this was a prospective study, carried out to evaluate 50 pregnant women with premature rupture of membranes (PROM) and their newborns. The clinical chorioamnionitis was investigated by clinical findings (thermal curve, abdominal pain by groping and/or uterine softening, smell and other characteristics of vaginal secretion) and subsidiary tests (white blood cell count and C-reactive protein). The histologic chorioamnionitis was investigated by macroscopic and microscopic study (placenta, membranes and cord). In the microscopic study optic microscopy with hematoxylin-eosin staining was used. The newborns were evaluated as to weight and Apgar score in the first and fifth minutes of life. White blood cell count, culture of auditory canal swab and aspirated gastric material culture complemented the study. Statistical analysis was performed using the Fisher exact test and the Student t-test, with level of significance set at 5% (p < 0.05). Results: The rate of clinical chorioamnionitis was 29.4% (15/50), while for histologic chorioamnionitis it was 40% (20/50). All the cases of clinical chorioamnionitis had latency times (LT) higher than 24 hours. The newborns presented signal of infection in 31.4% of the cases (16/51), all with LT higher than 24 hours. The main isolated microorganisms of auditive duct and gastric aspirate of newborns were Klebsiella pneumoniae, Staphylococcus aureus, Gram positive coccus and group B Streptococcus. The infected newborns presented lower Apgar scores in the first and fifth minute of life, lower weight and higher perinatal morbidity and mortality when compared with newborns without infection. Conclusions: based on the analysis of results obtained in the present study, it was possible to conclude that the prolonged latency times increase the possibility of ascending infection, leading to higher possibility of premature delivery and high maternal morbidity (clinical chorioamnionitis), as well as perinatal morbidity and mortality.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):15-20
DOI 10.1590/S0100-72032004000100003
PURPOSE: to analyze the values of Doppler ultrasound for blood flow velocity in the ductus venosus between the 10th and the 14th week of gestation, during the different phases of the cardiac cycle: ventricular systole (wave S), ventricular diastole (wave D), atrial systole (wave a), and angle-independent indexes. METHODS: Doppler was used in this prospective cross-sectional study to examine 276 single pregnancies. Fetus malformations, abnormal nuchal translucency, and women with clinical pathologies were excluded. A Toshiba SSH-140 ultrasound equipment was used. The derivation of Doppler frequency spectra was carried out according to standardized measurement procedures: less than 30ºinsonation angle and 50-70 Hz high-pass filter. The ductus venosus was identified in a median sagittal and ventral plane with the presence of color aliasing due to increase in blood flow velocity. The sample volume (1-2 mm³) was placed immediately at the origin of the ductus venosus. At least three clearly and subsequent waves were available for measurement of standard values. The Levene test and the Bonferroni method were used for statistical analysis. RESULTS: increase in blood flow velocity from 29 cm/s to 37 cm/s (p=0.013) was observed during ventricular systole between the 10th and the 14th week of gestation. Similarly, increase in blood flow velocity was recorded during the ventricular diastole (from 25 cm/s to 32 cm/s, p=0.026). There were no changes in wave a, pulsatility index, and S/a ratio in this period. CONCLUSION: the reference ranges established by this study may serve as the basis for Doppler ultrasound follow-up in a normal patient population. Further studies are required to determine the validity of these parameters and, in particular, for the fetus at risk.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):15-20
DOI 10.1590/S0100-72032004000100003
PURPOSE: to analyze the values of Doppler ultrasound for blood flow velocity in the ductus venosus between the 10th and the 14th week of gestation, during the different phases of the cardiac cycle: ventricular systole (wave S), ventricular diastole (wave D), atrial systole (wave a), and angle-independent indexes. METHODS: Doppler was used in this prospective cross-sectional study to examine 276 single pregnancies. Fetus malformations, abnormal nuchal translucency, and women with clinical pathologies were excluded. A Toshiba SSH-140 ultrasound equipment was used. The derivation of Doppler frequency spectra was carried out according to standardized measurement procedures: less than 30ºinsonation angle and 50-70 Hz high-pass filter. The ductus venosus was identified in a median sagittal and ventral plane with the presence of color aliasing due to increase in blood flow velocity. The sample volume (1-2 mm³) was placed immediately at the origin of the ductus venosus. At least three clearly and subsequent waves were available for measurement of standard values. The Levene test and the Bonferroni method were used for statistical analysis. RESULTS: increase in blood flow velocity from 29 cm/s to 37 cm/s (p=0.013) was observed during ventricular systole between the 10th and the 14th week of gestation. Similarly, increase in blood flow velocity was recorded during the ventricular diastole (from 25 cm/s to 32 cm/s, p=0.026). There were no changes in wave a, pulsatility index, and S/a ratio in this period. CONCLUSION: the reference ranges established by this study may serve as the basis for Doppler ultrasound follow-up in a normal patient population. Further studies are required to determine the validity of these parameters and, in particular, for the fetus at risk.
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Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):150-154
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):150-154
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):150-157
DOI 10.1590/S0100-72032011000700006
PURPOSE: the purpose of this study was to evaluate mortality, weight and body length, and the gastrocnemius muscle of the offspring of pregnant rats submitted to a swimming program associated with second-hand smoke. METHODS: twenty-four rats were divided into four groups: GF (exposed to cigarette smoke), GC (control), GFN (submitted to the swimming program and exposed to cigarette smoke), and GN (submitted to the swimming program). The mortality, weight and length of the offspring were measured at four time points. The gastrocnemius muscle of the pups was obtained for evaluation of muscle development. RESULTS: the average number of offspring was lower for GF (10.2) and GFN (10.3) and higher for GN (12.8). At birth, only GFN showed significantly lower weight (p=0.016) and length (p=0.02), whereas during lactation the groups exposed to cigarette smoke showed significantly lower weight. GFN had delayed muscle development compared to GC (p=0.03). CONCLUSIONS: Passive smoking during pregnancy and lactation negatively influenced number, weight and body length of offspring from birth to weaning and muscle development, and the swimming program positively influenced these variables at birth, although it did not provide the same benefits during lactation; and their association negatively affected these measures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):150-157
DOI 10.1590/S0100-72032011000700006
PURPOSE: the purpose of this study was to evaluate mortality, weight and body length, and the gastrocnemius muscle of the offspring of pregnant rats submitted to a swimming program associated with second-hand smoke. METHODS: twenty-four rats were divided into four groups: GF (exposed to cigarette smoke), GC (control), GFN (submitted to the swimming program and exposed to cigarette smoke), and GN (submitted to the swimming program). The mortality, weight and length of the offspring were measured at four time points. The gastrocnemius muscle of the pups was obtained for evaluation of muscle development. RESULTS: the average number of offspring was lower for GF (10.2) and GFN (10.3) and higher for GN (12.8). At birth, only GFN showed significantly lower weight (p=0.016) and length (p=0.02), whereas during lactation the groups exposed to cigarette smoke showed significantly lower weight. GFN had delayed muscle development compared to GC (p=0.03). CONCLUSIONS: Passive smoking during pregnancy and lactation negatively influenced number, weight and body length of offspring from birth to weaning and muscle development, and the swimming program positively influenced these variables at birth, although it did not provide the same benefits during lactation; and their association negatively affected these measures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):151-151
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):151-151
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):151-157
DOI 10.1590/S0100-72032006000300003
PURPOSE: the absence of fetal nasal bone is correlated with trisomy 21. Although a hypoplastic nasal bone is also correlated with trisomy 21, there is no clear definition of this term in the literature. Our objective was to establish the reference values for fetal nasal bone size throughout gestation in a local population in Brazil. METHODS: it is a cross-sectional study on 902 fetuses at 10 to 39 weeks of gestation. After having excluded fetal malformations and maternal diseases which are known to interfere with fetal growth, 625 fetuses were selected. We obtained a mid-sagittal view of the fetal profile by holding the ultrasound bean at an angle of 45º or 135º. The nasal bone size mean was calculated by using polynomial regression. The Anderson-Darling test proved the normal distribution of the measurements (p>0.05). RESULTS: of the 625 fetuses, 88.3% were from single gestations and 11.7% from multiple ones. There was a direct correlation between fetal nasal bone size and gestational age. The variability of nasal bone size became larger as gestational age increased. Minimal length of 1.0 and 4.7 mm in the first and second trimesters, respectively, were found. CONCLUSIONS: there is a direct correlation between fetal nasal bone size and gestational age. This correlation is valid either for a single gestation or a multiple one. These measurements of the fetal nasal bone will allow us to use them as a screening test for cromosomal abnormalities. This is a useful study if we consider the large miscegenation of the Brazilian population. However, further systematic and standardized approach to study the fetal nasal bone is needed to establish its real value in fetuses once classified as at high or low risk for aneuploidies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):151-157
DOI 10.1590/S0100-72032006000300003
PURPOSE: the absence of fetal nasal bone is correlated with trisomy 21. Although a hypoplastic nasal bone is also correlated with trisomy 21, there is no clear definition of this term in the literature. Our objective was to establish the reference values for fetal nasal bone size throughout gestation in a local population in Brazil. METHODS: it is a cross-sectional study on 902 fetuses at 10 to 39 weeks of gestation. After having excluded fetal malformations and maternal diseases which are known to interfere with fetal growth, 625 fetuses were selected. We obtained a mid-sagittal view of the fetal profile by holding the ultrasound bean at an angle of 45º or 135º. The nasal bone size mean was calculated by using polynomial regression. The Anderson-Darling test proved the normal distribution of the measurements (p>0.05). RESULTS: of the 625 fetuses, 88.3% were from single gestations and 11.7% from multiple ones. There was a direct correlation between fetal nasal bone size and gestational age. The variability of nasal bone size became larger as gestational age increased. Minimal length of 1.0 and 4.7 mm in the first and second trimesters, respectively, were found. CONCLUSIONS: there is a direct correlation between fetal nasal bone size and gestational age. This correlation is valid either for a single gestation or a multiple one. These measurements of the fetal nasal bone will allow us to use them as a screening test for cromosomal abnormalities. This is a useful study if we consider the large miscegenation of the Brazilian population. However, further systematic and standardized approach to study the fetal nasal bone is needed to establish its real value in fetuses once classified as at high or low risk for aneuploidies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(3):151-154
DOI 10.1590/S0100-72031998000300005
A retrospective study examining medical records of female prostitutes attending the STD/AIDS Reference Center in Vitória, Brazil from January/93 to December/96 was conducted. During this period, 180 women received medical and psychological care in this clinic. Mean age was 25.9 year (SD=6.8). Out of 180, 140 agreed to be tested for HIV, of whom 12 (8.6%) had a positive result. Among 157 women who agreed to be tested for syphilis, 144 (91.7%) had a negative result, while 13 (8.3%) had a positive one. According to the educational degree, 6 (3.3%) women were illiterate, 114 (63.3%) attended elementary school, 37 (20.6%) attended secondary school, 7 (3.9%) went to college and 16 gave no information. One hundred and forty-one patients (78.3%) were single, 17 (9.4%) married, 10 (5,5%) divorced and 4 (2.2%) widows. The frequency of condom use was: always, 56 (31.3%), sometimes, 93 (52.0%), and 30 (16.8%) never used condoms. Other STDs were reported by 89 (49.4%) women and 9 (5.0%) reported intravenous (IV) drug use. There was a significant difference between the HIV positive and the negative group only regarding IV drug abuse (p=0.031) and syphilis infection (p=0.014). The present study showed prevalence rates of HIV infection among prostitutes in Vitória much higher than those found in the general population. There is a pressing need to improve medical assistance and educational campaigns especially designed to reach this population of women, and focusing the importance of regular condom use and the risks associated with IV drug abuse.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(3):151-154
DOI 10.1590/S0100-72031998000300005
A retrospective study examining medical records of female prostitutes attending the STD/AIDS Reference Center in Vitória, Brazil from January/93 to December/96 was conducted. During this period, 180 women received medical and psychological care in this clinic. Mean age was 25.9 year (SD=6.8). Out of 180, 140 agreed to be tested for HIV, of whom 12 (8.6%) had a positive result. Among 157 women who agreed to be tested for syphilis, 144 (91.7%) had a negative result, while 13 (8.3%) had a positive one. According to the educational degree, 6 (3.3%) women were illiterate, 114 (63.3%) attended elementary school, 37 (20.6%) attended secondary school, 7 (3.9%) went to college and 16 gave no information. One hundred and forty-one patients (78.3%) were single, 17 (9.4%) married, 10 (5,5%) divorced and 4 (2.2%) widows. The frequency of condom use was: always, 56 (31.3%), sometimes, 93 (52.0%), and 30 (16.8%) never used condoms. Other STDs were reported by 89 (49.4%) women and 9 (5.0%) reported intravenous (IV) drug use. There was a significant difference between the HIV positive and the negative group only regarding IV drug abuse (p=0.031) and syphilis infection (p=0.014). The present study showed prevalence rates of HIV infection among prostitutes in Vitória much higher than those found in the general population. There is a pressing need to improve medical assistance and educational campaigns especially designed to reach this population of women, and focusing the importance of regular condom use and the risks associated with IV drug abuse.