Adrenal cortex hormones Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Correlation between antenatal corticosteroid therapy, resuscitation and mortality in very low birth weight infants

    Rev Bras Ginecol Obstet. 2014;36(5):211-215

    Summary

    Artigos Originais

    Correlation between antenatal corticosteroid therapy, resuscitation and mortality in very low birth weight infants

    Rev Bras Ginecol Obstet. 2014;36(5):211-215

    DOI 10.1590/S0100-7203201400050005

    Views1

    PURPOSE:

    To evaluate the correlation between the use of antenatal corticosteroid therapy (AC), the frequency of resuscitation in delivery room and mortality of newborn infants under 1,500 g and gestational age less than or equal to 34 weeks.

    METHODS:

    A cohort study was conducted on all newborn infants under 1,500 g and with a gestational age less than or equal to 34 weeks admitted at the neonatal ICU between January 2006 and December 2011. Newborns who had congenital anomalies, genetic syndromes, congenital infections and those who were transferred to or came from other institutions were excluded. The studied infants were divided into 2 groups: those who received (n=182) and those who did not receive (n=38) AC. The main outcomes studied were the necessity of neonatal resuscitation, the presence of the main neonatal diseases and mortality during hospitalization. The means of the variables were compared using Student's t-test or non-parametric test and frequencies were compared by χ2test with Fisher's correction. The variables that presented difference between groups were assessed by logistic regression. The Statistical Package for the Social Sciences (SPSS) 16.0 was used and the significance level was set at 0.05.

    RESULTS:

    In this study, 220 patients were evaluated. The groups were similar concerning birth weight, gestational age and the presence of the main neonatal morbidity during hospitalization. The infants who received antenatal corticosteroids showed lower mortality (OR=3.0; 95%CI 1.4-6.5) and required less resuscitation (OR=2.4; 95%CI 1.1-5.0). Besides, they required less advanced resuscitation procedures, such as tracheal cannula (OR=3.7; 95%CI 1.7-7.6), cardiac massage (OR=5.7; 95%CI 2.0-16.5) and medications (OR=8.9; 95%CI 2.0-39.4).

    CONCLUSIONS:

    The use of antenatal corticosteroids reduced the need for resuscitation in delivery room, especially advanced procedures, and reduced the mortality in the studied groups.

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  • Original Article

    Facial palsy and pregnancy: management and treatment

    Rev Bras Ginecol Obstet. 2013;35(8):368-372

    Summary

    Original Article

    Facial palsy and pregnancy: management and treatment

    Rev Bras Ginecol Obstet. 2013;35(8):368-372

    DOI 10.1590/S0100-72032013000800006

    Views4

    PURPOSE: To compare the degree of peripheral facial palsy of pregnant women and puerperae at admission and at discharge and to evaluate related factors. METHODS: Retrospective, cross-sectional study, with analysis of medical records of pregnant and postpartum women with facial palsy, over a period of 12 months, with application of a standardized protocol for patient evaluation and of the House-Brackmann scale on the occasion of the first visit and at discharge. RESULTS: Six patients were identified, mean age of 22.6 years. Five cases were classified as stage IV and one as stage II on the House-Brackmann scale, being two of them puerperae and four pregnant. All showed improvement on the House-Brackmann scale. CONCLUSION: The Bell's palsy has a good prognosis even in pregnant and postpartum women, being important to perform the correct treatment to reduce the sequelae in this group identified as more susceptible to peripheral facial palsy.

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    Facial palsy and pregnancy: management and treatment
  • Review Article

    Management of preterm labor

    Rev Bras Ginecol Obstet. 2009;31(8):415-422

    Summary

    Review Article

    Management of preterm labor

    Rev Bras Ginecol Obstet. 2009;31(8):415-422

    DOI 10.1590/S0100-72032009000800008

    Views4

    The main purpose of using uterulytic in preterm delivery is to prolong gestation in order to allow the administration of glucocorticoid to the mother and/or to accomplish the mother's transference to a tertiary hospital center. Decisions on uterolytic use and choice require correct diagnosis of preterm delivery, as well as the knowledge of gestational age, maternal-fetal medical condition, and medicine's efficacy, side-effects and cost. All the uterolytics have side-effects, and some of them are potentially lethal. Studies suggest that beta-adrenergic receptor agonists, calcium blockers and cytokine receptor antagonists are effective to prolong gestation for at least 48 hours. Among these three agents, atosiban (a cytokine receptor antagonist) is safer, though it presents a high cost. Magnesium sulfate is not efficient to prolong gestation and presents significant side-effects. Cyclooxygenase inhibitors also present significant side-effects. Up till now, there is not enough evidence to recommend the use of nitric oxid donors to inhibit preterm delivery. There is no basis for the use of antibiotics to avoid prematurity in face of preterm labor.

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    Management of preterm labor

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