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Artigos Originais
Sublingual versus vaginal misoprostol for labor induction of term pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):24-31
07-05-2005
Summary
Artigos OriginaisSublingual versus vaginal misoprostol for labor induction of term pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):24-31
07-05-2005DOI 10.1590/S0100-72032005000100006
Views115See morePURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg) versus vaginal misoprostol (25 µg) (Prostokos®) for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE), in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22), or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11). The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95), meconium incidence (5.2 vs 4.8%, p=0.74), Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98) and other adverse effects. CONCLUSION: twenty-five micrograms of sublingual misoprostol every six h presented the same effectiveness and safety as an equal vaginally administered dose of this substance. Sublingual misoprostol seems to be acceptable and is another option to be considered for labor induction.
Views115
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisSublingual versus vaginal misoprostol for labor induction of term pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):24-31
07-05-2005DOI 10.1590/S0100-72032005000100006
Views115See morePURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg) versus vaginal misoprostol (25 µg) (Prostokos®) for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE), in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22), or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11). The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95), meconium incidence (5.2 vs 4.8%, p=0.74), Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98) and other adverse effects. CONCLUSION: twenty-five micrograms of sublingual misoprostol every six h presented the same effectiveness and safety as an equal vaginally administered dose of this substance. Sublingual misoprostol seems to be acceptable and is another option to be considered for labor induction.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Primigravid expectations about the delivery method and the causal factors for their choice
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):791-798
02-16-2004
Summary
Trabalhos OriginaisPrimigravid expectations about the delivery method and the causal factors for their choice
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):791-798
02-16-2004DOI 10.1590/S0100-72032004001000006
Views94See morePURPOSE: to find out the preference in regard to the way of delivery among primigravidae, as well as the reasons for their choice, in order to improve the quality of the doctor-patient relationship. METHODS: a qualitative-type study was conducted through analysis of the collective subject, including primigravidae attended from September to November 2003 at the emergency rooms of the hospital of the "Faculdade de Medicina de Jundiaí". A questionnaire, specially developed to accomplish the proposed objectives was applied. An informed and free consent, signed by the pregnant woman and one of the researchers in charge was obtained. This questionnaire was based on doubts of patients attended at this hospital some months before the trial. For the purpose of sample standardization, the patients' selection followed some inclusion criteria: age above 16, primigravidae that were receiving prenatal assistance and a post-informed and free consent. Mental disorders and clinical and/or obstetric pathologies that could interfere in the patient's choice were considered exclusion criteria. RESULTS: the studied population had as prevailing profile women in the third quarter of gestation, above 21 years of age, white, married and with completed school. Most of the women (90%) preferred vaginal delivery for the following main reasons: ease to be done (94%) and the fear of suffering and pain during the postpartum period caused by cesarean section. There was a relationship between older and married women and the preference for vaginal delivery, with no significant difference between races. CONCLUSION: these results show an enormous contrast between women's preference and the high cesarean section rates in Brazil. We conclude that there may be a lack of information and dialogue between the health professionals and patients about the possible difficulties, doubts and anxieties that involve the women's choice for a specific way of delivery. From an ethical point of view, we conclude that obstetricians should question every cesarean section indication and take into account the women's right to choose, without ignoring clinical criteria, when making the medical decision about the way of delivery.
Views94This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisPrimigravid expectations about the delivery method and the causal factors for their choice
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):791-798
02-16-2004DOI 10.1590/S0100-72032004001000006
Views94See morePURPOSE: to find out the preference in regard to the way of delivery among primigravidae, as well as the reasons for their choice, in order to improve the quality of the doctor-patient relationship. METHODS: a qualitative-type study was conducted through analysis of the collective subject, including primigravidae attended from September to November 2003 at the emergency rooms of the hospital of the "Faculdade de Medicina de Jundiaí". A questionnaire, specially developed to accomplish the proposed objectives was applied. An informed and free consent, signed by the pregnant woman and one of the researchers in charge was obtained. This questionnaire was based on doubts of patients attended at this hospital some months before the trial. For the purpose of sample standardization, the patients' selection followed some inclusion criteria: age above 16, primigravidae that were receiving prenatal assistance and a post-informed and free consent. Mental disorders and clinical and/or obstetric pathologies that could interfere in the patient's choice were considered exclusion criteria. RESULTS: the studied population had as prevailing profile women in the third quarter of gestation, above 21 years of age, white, married and with completed school. Most of the women (90%) preferred vaginal delivery for the following main reasons: ease to be done (94%) and the fear of suffering and pain during the postpartum period caused by cesarean section. There was a relationship between older and married women and the preference for vaginal delivery, with no significant difference between races. CONCLUSION: these results show an enormous contrast between women's preference and the high cesarean section rates in Brazil. We conclude that there may be a lack of information and dialogue between the health professionals and patients about the possible difficulties, doubts and anxieties that involve the women's choice for a specific way of delivery. From an ethical point of view, we conclude that obstetricians should question every cesarean section indication and take into account the women's right to choose, without ignoring clinical criteria, when making the medical decision about the way of delivery.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Breech presentation in term pregnancy in patients with previous vaginal deliveries
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):781-786
02-16-2004
Summary
Trabalhos OriginaisBreech presentation in term pregnancy in patients with previous vaginal deliveries
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):781-786
02-16-2004DOI 10.1590/S0100-72032004001000005
Views118See morePURPOSE: to assess the obstetric and perinatal outcomes in cases of term newborns in breech presentation, in patients with previous vaginal deliveries, comparing them to term newborns in vertex presentation. METHODS: 8,350 deliveries retrospectively from March 1998 to July 2003 were analysed. Of 419 deliveries (5.1%) in breech presentation, 58 cases were selected for the study (breech group), according to the following criteria: patients who had had one or more babies through vaginal delivery, gestational age ³37 weeks, no fetal malformation, no complications in the current pregnancy, birth weight between 2,500 and 3,750 g, and no previous cesarean section. The breech group was matched to 1,327 newborns in vertex position from pregnant women with no previous cesarean section (vertex group). Maternal age, parity, gestational age, delivery way, birth weight, meconium-stained amniotic fluid, 1- and 5-min Apgar score, need of neonatal intensive care unit, and small- and big-for-gestational age newborns were analyzed. Statistical analysis was performed by the c² test and by Student's t test, with the level of significance set at p<0.05. RESULTS: when breech and vertex groups were compared, they showed significant differences regarding the following variables: birth weight (3,091±538 g vs 3,250±497 g; p<0.01), vaginal delivery (63.8 vs 95.0%; p<0.0001), cesarean section (36.2 vs 5.0%; p<0,0001), and 1-min Apgar score (p<0.0001), respectively. CONCLUSIONS: we conclude that in term fetuses in breech position from pregnant women with previous vaginal deliveries, birth weight, delivery way, and 1-min Apgar score were different compared to fetuses in vertex position from women with the same characteristics.
Views118This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisBreech presentation in term pregnancy in patients with previous vaginal deliveries
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):781-786
02-16-2004DOI 10.1590/S0100-72032004001000005
Views118See morePURPOSE: to assess the obstetric and perinatal outcomes in cases of term newborns in breech presentation, in patients with previous vaginal deliveries, comparing them to term newborns in vertex presentation. METHODS: 8,350 deliveries retrospectively from March 1998 to July 2003 were analysed. Of 419 deliveries (5.1%) in breech presentation, 58 cases were selected for the study (breech group), according to the following criteria: patients who had had one or more babies through vaginal delivery, gestational age ³37 weeks, no fetal malformation, no complications in the current pregnancy, birth weight between 2,500 and 3,750 g, and no previous cesarean section. The breech group was matched to 1,327 newborns in vertex position from pregnant women with no previous cesarean section (vertex group). Maternal age, parity, gestational age, delivery way, birth weight, meconium-stained amniotic fluid, 1- and 5-min Apgar score, need of neonatal intensive care unit, and small- and big-for-gestational age newborns were analyzed. Statistical analysis was performed by the c² test and by Student's t test, with the level of significance set at p<0.05. RESULTS: when breech and vertex groups were compared, they showed significant differences regarding the following variables: birth weight (3,091±538 g vs 3,250±497 g; p<0.01), vaginal delivery (63.8 vs 95.0%; p<0.0001), cesarean section (36.2 vs 5.0%; p<0,0001), and 1-min Apgar score (p<0.0001), respectively. CONCLUSIONS: we conclude that in term fetuses in breech position from pregnant women with previous vaginal deliveries, birth weight, delivery way, and 1-min Apgar score were different compared to fetuses in vertex position from women with the same characteristics.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Route of delivery in successive gestations in adolescents: study of 714 cases
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):703-707
01-19-2004
Summary
Trabalhos OriginaisRoute of delivery in successive gestations in adolescents: study of 714 cases
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):703-707
01-19-2004DOI 10.1590/S0100-72032004000900005
Views94See morePURPOSE: to analyze the association between modes of consecutive deliveries of 714 adolescents attended at the Maternity sector of the Hospital das Clínicas da Universidade Federal de Pernambuco (Federal University of Pernambuco), from January to December 2001. PATIENTS AND METHODS: according to a prospective, analytic, transversal, and incidence type study, the sequence of delivery modes was analyzed from the first to the fourth parturition of 714 pregnant adolescents, aged from 13 to 19 years (mean17.2±1.5 years). Every day, after identifying the adolescents who delivered, by the parturition room register, they were invited to participate in this study. Those who agreed, after signing a free informed consent answered a structured questionnaire with 65 direct questions with precodified closed options, among which were delivery mode and number of gestations. RESULTS: it was found that 527 (73.8%) adolescents had only one delivery, 149 (20.9%) two deliveries, 35 (4.9%) three deliveries, and 3 (0.4%) had had four deliveries. Among the 273 cesarean sections, 207 (75.8%) occurred in primiparae, 65 (23.8%) in secundiparae and one (0.4%) in a multipara. There was a statistically significant association between the first and the second deliveries for 83 (55.7%) adolescents who had transvaginal delivery, as well as for 41 (27.5%) by cesarean section. There was also coincidence about the second and third deliveries, regarding transvaginal delivery of 23 (65.7%) adolescents, as well as cesarean section of 10 (28.6%) adolescents. CONCLUSION: a tendency to coincidence of subsequent delivery modes was identified for adolescents until the third parturition.
Views94This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisRoute of delivery in successive gestations in adolescents: study of 714 cases
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):703-707
01-19-2004DOI 10.1590/S0100-72032004000900005
Views94See morePURPOSE: to analyze the association between modes of consecutive deliveries of 714 adolescents attended at the Maternity sector of the Hospital das Clínicas da Universidade Federal de Pernambuco (Federal University of Pernambuco), from January to December 2001. PATIENTS AND METHODS: according to a prospective, analytic, transversal, and incidence type study, the sequence of delivery modes was analyzed from the first to the fourth parturition of 714 pregnant adolescents, aged from 13 to 19 years (mean17.2±1.5 years). Every day, after identifying the adolescents who delivered, by the parturition room register, they were invited to participate in this study. Those who agreed, after signing a free informed consent answered a structured questionnaire with 65 direct questions with precodified closed options, among which were delivery mode and number of gestations. RESULTS: it was found that 527 (73.8%) adolescents had only one delivery, 149 (20.9%) two deliveries, 35 (4.9%) three deliveries, and 3 (0.4%) had had four deliveries. Among the 273 cesarean sections, 207 (75.8%) occurred in primiparae, 65 (23.8%) in secundiparae and one (0.4%) in a multipara. There was a statistically significant association between the first and the second deliveries for 83 (55.7%) adolescents who had transvaginal delivery, as well as for 41 (27.5%) by cesarean section. There was also coincidence about the second and third deliveries, regarding transvaginal delivery of 23 (65.7%) adolescents, as well as cesarean section of 10 (28.6%) adolescents. CONCLUSION: a tendency to coincidence of subsequent delivery modes was identified for adolescents until the third parturition.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Previous cesarean section as a risk factor for abruptio placentae
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):709-714
01-19-2004
Summary
Trabalhos OriginaisPrevious cesarean section as a risk factor for abruptio placentae
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):709-714
01-19-2004DOI 10.1590/S0100-72032004000900006
Views80See morePURPOSE: to study the relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age (< or > 30 weeks), maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%). The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases) and in the control group it was 21.2% (36 cases). No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34). CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.
Views80This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisPrevious cesarean section as a risk factor for abruptio placentae
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):709-714
01-19-2004DOI 10.1590/S0100-72032004000900006
Views80See morePURPOSE: to study the relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age (< or > 30 weeks), maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%). The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases) and in the control group it was 21.2% (36 cases). No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34). CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Social indicators of pregnant adolescents: a case control study
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):633-639
11-23-2004
Summary
Trabalhos OriginaisSocial indicators of pregnant adolescents: a case control study
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):633-639
11-23-2004DOI 10.1590/S0100-72032004000800007
Views98See morePURPOSE: to check whether there were differences in some social indicators between adolescent and adult pregnant women in the city of Ribeirão Preto, from January 1992 to December 1996. METHODS: the information was obtained from hospital discharge forms and was analyzed at the Hospital Data Processing Center of the FMRP-USP. The analyzed parameters were: number and types of deliveries, category of hospital admission, occupation, and obstetric diagnosis. The 6.04a text processor Epi-Info System, a data bank and statistics of epidemiology produced by the Centers of Disease Control and Prevention (Atlanta, GA, USA), and Dbase IV were used to process the information. The association between variables was tested by the chi² test, with level of significance set at 5%, using the GraphPad Prism version 2.0, 1995 software. RESULTS: a total of 43,253 deliveries occurred during this period, among which 7,134 (16.5%) corresponded to adolescent deliveries, while 36,119 (83.5%) to adult deliveries. The number of deliveries by adolescent girls increased 25.5% along this period. The proportion of adolescent deliveries in the unified health system category of admission increased, and it was higher than that of the adults'. Only 14.1% of the adolescents belonged to the economically active population, comparing with 34.8% of the adults. Only 6.8% of the adolescents were students, while 79.0% were house-workers or had a nonpaid occupation. In the analyzed period, the ratio of vaginal delivery increased among the adolescents, as compared to that of the adults. The ratio of cesarean delivery persisted stable and higher among the adults. Premature delivery and false labor were significantly more frequent among the adolescents. CONCLUSION: the number of deliveries increased among the adolescents, and most of them were normal. The ratio of admission by the unified health system category and that of vaginal delivery were higher among the adolescents. There were more adolescents without an economically active work. Thus, we recommend strategies to prevent adolescent pregnancy, mainly among the poor population.
Views98This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisSocial indicators of pregnant adolescents: a case control study
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):633-639
11-23-2004DOI 10.1590/S0100-72032004000800007
Views98See morePURPOSE: to check whether there were differences in some social indicators between adolescent and adult pregnant women in the city of Ribeirão Preto, from January 1992 to December 1996. METHODS: the information was obtained from hospital discharge forms and was analyzed at the Hospital Data Processing Center of the FMRP-USP. The analyzed parameters were: number and types of deliveries, category of hospital admission, occupation, and obstetric diagnosis. The 6.04a text processor Epi-Info System, a data bank and statistics of epidemiology produced by the Centers of Disease Control and Prevention (Atlanta, GA, USA), and Dbase IV were used to process the information. The association between variables was tested by the chi² test, with level of significance set at 5%, using the GraphPad Prism version 2.0, 1995 software. RESULTS: a total of 43,253 deliveries occurred during this period, among which 7,134 (16.5%) corresponded to adolescent deliveries, while 36,119 (83.5%) to adult deliveries. The number of deliveries by adolescent girls increased 25.5% along this period. The proportion of adolescent deliveries in the unified health system category of admission increased, and it was higher than that of the adults'. Only 14.1% of the adolescents belonged to the economically active population, comparing with 34.8% of the adults. Only 6.8% of the adolescents were students, while 79.0% were house-workers or had a nonpaid occupation. In the analyzed period, the ratio of vaginal delivery increased among the adolescents, as compared to that of the adults. The ratio of cesarean delivery persisted stable and higher among the adults. Premature delivery and false labor were significantly more frequent among the adolescents. CONCLUSION: the number of deliveries increased among the adolescents, and most of them were normal. The ratio of admission by the unified health system category and that of vaginal delivery were higher among the adolescents. There were more adolescents without an economically active work. Thus, we recommend strategies to prevent adolescent pregnancy, mainly among the poor population.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
The influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003
Summary
Trabalhos OriginaisThe influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003DOI 10.1590/S0100-72032003001000007
Views55See morePURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.
Views55This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisThe influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003DOI 10.1590/S0100-72032003001000007
Views55See morePURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Maternal mortality at a tertiary hospital in Rio Grande do Sul – Brazil: a twenty-year study
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):431-436
10-07-2003
Summary
Trabalhos OriginaisMaternal mortality at a tertiary hospital in Rio Grande do Sul – Brazil: a twenty-year study
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):431-436
10-07-2003DOI 10.1590/S0100-72032003000600008
Views88PURPOSE: to analyze maternal death cases that occurred at the "Hospital de Clínicas de Porto Alegre", a reference university hospital for high-risk pregnancies in the state of Rio Grande do Sul, Brazil. METHODS: we carried out a retrospective study of medical records of 10- to 49-year-old women who died at the hospital between 1980 and 1999. Deaths related to pregnancy and puerperium were analyzed independently of the kind and duration of pregnancy. The causes were classified into direct obstetric, indirect obstetric and nonobstetric, according to their association with pregnancy, delivery and puerperium disorders. RESULTS: a total of 81 patients with a mean age of 28.5 years were studied. The maternal mortality rate was 109 per 100,000 live births. Direct obstetric causes made up 61.7% of deaths. Indirect causes made up 23.5% of deaths. Nonobstetric causes made up 15.0% of the total. Among direct obstetric causes, arterial hypertension (18.5%), post-cesarean infection (16%), and septic abortion (12.3%) were the most prevalent. The main maternal mortality events among indirect obstetric causes were cardiopathy (8.6%), acute fatty liver disease (3.5%), and systemic lupus erythematosus (2.5%). Among the nonobstetric causes, malignant neoplasia (7.4%) and AIDS (3.7%) were the most important. CONCLUSIONS: the prevailing causes of maternal death have not changed in the last two decades. The main cause is still hypertension. There is an expressive number of deaths related to cesarean section and infections. The high prevalence of direct obstetric causes shows the low maternal mortality prevention capacity of our health care system.
Key-words Cesarean sectionHigh-risk pregnanciesHypertensionMaternal mortalityPost-cesarean infectionSeptic abortionSee moreViews88This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisMaternal mortality at a tertiary hospital in Rio Grande do Sul – Brazil: a twenty-year study
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):431-436
10-07-2003DOI 10.1590/S0100-72032003000600008
Views88PURPOSE: to analyze maternal death cases that occurred at the "Hospital de Clínicas de Porto Alegre", a reference university hospital for high-risk pregnancies in the state of Rio Grande do Sul, Brazil. METHODS: we carried out a retrospective study of medical records of 10- to 49-year-old women who died at the hospital between 1980 and 1999. Deaths related to pregnancy and puerperium were analyzed independently of the kind and duration of pregnancy. The causes were classified into direct obstetric, indirect obstetric and nonobstetric, according to their association with pregnancy, delivery and puerperium disorders. RESULTS: a total of 81 patients with a mean age of 28.5 years were studied. The maternal mortality rate was 109 per 100,000 live births. Direct obstetric causes made up 61.7% of deaths. Indirect causes made up 23.5% of deaths. Nonobstetric causes made up 15.0% of the total. Among direct obstetric causes, arterial hypertension (18.5%), post-cesarean infection (16%), and septic abortion (12.3%) were the most prevalent. The main maternal mortality events among indirect obstetric causes were cardiopathy (8.6%), acute fatty liver disease (3.5%), and systemic lupus erythematosus (2.5%). Among the nonobstetric causes, malignant neoplasia (7.4%) and AIDS (3.7%) were the most important. CONCLUSIONS: the prevailing causes of maternal death have not changed in the last two decades. The main cause is still hypertension. There is an expressive number of deaths related to cesarean section and infections. The high prevalence of direct obstetric causes shows the low maternal mortality prevention capacity of our health care system.
Key-words Cesarean sectionHigh-risk pregnanciesHypertensionMaternal mortalityPost-cesarean infectionSeptic abortionSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cesarean section Archives - Page 3 of 8 - Revista Brasileira de Ginecologia e Obstetrícia
