Embryo and fetal development Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):137-142
DOI 10.1590/S0100-72032005000300007
PURPOSE: to evaluate if there is any difference between Doppler indexes in the middle cerebral artery in two different sites of insonation in healthy patients and in patients with diseases. METHODS: a random prospective survey, in the period from June 2003 to March 2004 that analyzed the Doppler indexes of 100 patients: patient group (n = 50) included patients admitted to Clemente Farias University Hospital, which is part of UNIMONTES-MG, havinfg as inclusion criteria: to be in the 28th to 34th gestational week, diagnosis of chronic arterial hypertension, pre-eclampsia, intrauterine growth restriction. As control group, 50 healthy pregnant patients between the 28th and the 34th week, originary from SEMESP's clinic. The Doppler variables were the resistance index (RI), the pulsatility index (PI) and the relation systole/diastole (SD). All three Doppler indexes were assessed at two different sites of the cerebral artery: the first measurement in the diencephalons region, soon after the beginning of the middle cerebral artery and the second on a distal location in the telencephalon. The median Doppler indexes in the patient group in the first and second measurements were 1.55 and 1.69 for the PI, 0.77 and 0.79 for RI and 4.29 and 4.86 for SD, respectively. In the control group, the values were 1.73 and 1.86 for the PI; 0.83 and 0.79 for RI and 5.83 and 5.46 for SD. There were no differences between sites with a p value of 0.38, 0.29 and 0.39 for PI, RI and SD, respectively. In 15t fetuses with centralization (brain sparing effects), in the diencephalon the median indexes were 1.02 for PI, 0.63 for RI and 2.68 for SD. In the epencephalon the median indexes were 0.95 for IP, 0.62 for RI and 2.44 for SD. There were no differences between sites, with a p value of 0.53 for PI; 0.56 for IR and 0.31 for SD. The Doppler index site of assessment in the middle cerebral arteries does not interfere with the results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):137-142
DOI 10.1590/S0100-72032005000300007
PURPOSE: to evaluate if there is any difference between Doppler indexes in the middle cerebral artery in two different sites of insonation in healthy patients and in patients with diseases. METHODS: a random prospective survey, in the period from June 2003 to March 2004 that analyzed the Doppler indexes of 100 patients: patient group (n = 50) included patients admitted to Clemente Farias University Hospital, which is part of UNIMONTES-MG, havinfg as inclusion criteria: to be in the 28th to 34th gestational week, diagnosis of chronic arterial hypertension, pre-eclampsia, intrauterine growth restriction. As control group, 50 healthy pregnant patients between the 28th and the 34th week, originary from SEMESP's clinic. The Doppler variables were the resistance index (RI), the pulsatility index (PI) and the relation systole/diastole (SD). All three Doppler indexes were assessed at two different sites of the cerebral artery: the first measurement in the diencephalons region, soon after the beginning of the middle cerebral artery and the second on a distal location in the telencephalon. The median Doppler indexes in the patient group in the first and second measurements were 1.55 and 1.69 for the PI, 0.77 and 0.79 for RI and 4.29 and 4.86 for SD, respectively. In the control group, the values were 1.73 and 1.86 for the PI; 0.83 and 0.79 for RI and 5.83 and 5.46 for SD. There were no differences between sites with a p value of 0.38, 0.29 and 0.39 for PI, RI and SD, respectively. In 15t fetuses with centralization (brain sparing effects), in the diencephalon the median indexes were 1.02 for PI, 0.63 for RI and 2.68 for SD. In the epencephalon the median indexes were 0.95 for IP, 0.62 for RI and 2.44 for SD. There were no differences between sites, with a p value of 0.53 for PI; 0.56 for IR and 0.31 for SD. The Doppler index site of assessment in the middle cerebral arteries does not interfere with the results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):130-136
DOI 10.1590/S0100-72032005000300006
PURPOSE: to analyze birth weight in a cohort of newborns for the year 2000, in Goiânia, by determining the coefficient of mortality and neonatal survival probability, stratified by categories of birth weight, and also, through the identification of factors associated with low birth weight (LBW). METHODS: a retrospective cohort study, made possible by the linkage of data from the ISM (Information System on Mortality) and ISLB (Information System on Live Births) files. Coefficients of neonatal mortality were calculated for the categories of birth weight and a neonatal survival probability chart was constructed with the help of linear regression analysis. Risk factors for LBW were identified by univariate analysis (RR) and logistic regression analysis, and the level of significance was set at 5%. RESULTS: the incidence of LBW was 6.9% and 140 (66.8%) neonatal deaths took place in this group. Thirty percent of these deaths occurred in the 1,500-2,500 g weight bracket. The following risk factors were identified for LBW: preterm pregnancy, presence of congenital malformations, mothers at the extreme ages for reproduction, mothers living in the northwestern region of the city, insufficient prenatal appointments with the doctor, delivery in a public hospital, and female babies. CONCLUSION: Goiânia had an incidence of LBW which is comparable to that of developed countries and coefficients of neonatal mortality by category of weight were below those found for those countries. These results recommend that we pay attention to: prematurity, public hospitals, and the northwestern region of Goiânia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):130-136
DOI 10.1590/S0100-72032005000300006
PURPOSE: to analyze birth weight in a cohort of newborns for the year 2000, in Goiânia, by determining the coefficient of mortality and neonatal survival probability, stratified by categories of birth weight, and also, through the identification of factors associated with low birth weight (LBW). METHODS: a retrospective cohort study, made possible by the linkage of data from the ISM (Information System on Mortality) and ISLB (Information System on Live Births) files. Coefficients of neonatal mortality were calculated for the categories of birth weight and a neonatal survival probability chart was constructed with the help of linear regression analysis. Risk factors for LBW were identified by univariate analysis (RR) and logistic regression analysis, and the level of significance was set at 5%. RESULTS: the incidence of LBW was 6.9% and 140 (66.8%) neonatal deaths took place in this group. Thirty percent of these deaths occurred in the 1,500-2,500 g weight bracket. The following risk factors were identified for LBW: preterm pregnancy, presence of congenital malformations, mothers at the extreme ages for reproduction, mothers living in the northwestern region of the city, insufficient prenatal appointments with the doctor, delivery in a public hospital, and female babies. CONCLUSION: Goiânia had an incidence of LBW which is comparable to that of developed countries and coefficients of neonatal mortality by category of weight were below those found for those countries. These results recommend that we pay attention to: prematurity, public hospitals, and the northwestern region of Goiânia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):323-330
DOI 10.1590/S0100-72032005000600006
PURPOSE: to determine the validity of uterine artery Doppler velocimetry for the prediction of pregnancy complications in a population of low-risk nulliparae. SUBJECTS: a prospective study was conducted on 45 patients in their first pregnancy with no history of chronic diseases. Uterine artery Doppler velocimetry was performed between 24 and 26 weeks, with the determination of resistance index (RI), pulsatility index (PI), S/D ratio, and the presence or absence of incisure in the flow velocity wave. Data were analyzed by the Mann-Whitney test for non-parametric samples, and the Fisher exact test was used in the evaluation of the qualitative parameters. RESULTS: pregnancy complications were observed in twelve patients, with four cases of preeclampsia, one case of small for gestational age newborn (SGA NB), one case of SGA NB + preterm delivery (PTD), three cases of PTD, one case of fetal centralization, and two cases of presence of thick meconium in the amniotic fluid at the time of pregnancy resolution. We noted that RI (median 0.56 x 0.68), PI (median 0.98 x 1.29) and S/D ratio (median 2.2 x 2.9) were higher at the examination performed between 24 and 26 weeks in patients with complications and did not differ in preeclampsia and SGA cases. The presence of bilateral incisure showed 100 and 90% sensitivity, 60.2 and 62.5% specificity, 29.4 and 42,9% positive predictive value (PPV), and 100 and 95.2% negative predictive value (NPV) for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. An altered Doppler showed 83.3 and 83.3% sensitivity, 69.7 and 69.7% specificity, 33.3 and 50.0% PPV, and 95.8 and 92.0% NPV for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. CONCLUSION: high impedance indices and the presence of a bilateral incisure in the uterine arteries between 24 and 26 weeks of pregnancy seem to be good predictors of pregnancy and perinatal complications.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):323-330
DOI 10.1590/S0100-72032005000600006
PURPOSE: to determine the validity of uterine artery Doppler velocimetry for the prediction of pregnancy complications in a population of low-risk nulliparae. SUBJECTS: a prospective study was conducted on 45 patients in their first pregnancy with no history of chronic diseases. Uterine artery Doppler velocimetry was performed between 24 and 26 weeks, with the determination of resistance index (RI), pulsatility index (PI), S/D ratio, and the presence or absence of incisure in the flow velocity wave. Data were analyzed by the Mann-Whitney test for non-parametric samples, and the Fisher exact test was used in the evaluation of the qualitative parameters. RESULTS: pregnancy complications were observed in twelve patients, with four cases of preeclampsia, one case of small for gestational age newborn (SGA NB), one case of SGA NB + preterm delivery (PTD), three cases of PTD, one case of fetal centralization, and two cases of presence of thick meconium in the amniotic fluid at the time of pregnancy resolution. We noted that RI (median 0.56 x 0.68), PI (median 0.98 x 1.29) and S/D ratio (median 2.2 x 2.9) were higher at the examination performed between 24 and 26 weeks in patients with complications and did not differ in preeclampsia and SGA cases. The presence of bilateral incisure showed 100 and 90% sensitivity, 60.2 and 62.5% specificity, 29.4 and 42,9% positive predictive value (PPV), and 100 and 95.2% negative predictive value (NPV) for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. An altered Doppler showed 83.3 and 83.3% sensitivity, 69.7 and 69.7% specificity, 33.3 and 50.0% PPV, and 95.8 and 92.0% NPV for the detection of preeclampsia or SGA and of any complication of pregnancy, respectively. CONCLUSION: high impedance indices and the presence of a bilateral incisure in the uterine arteries between 24 and 26 weeks of pregnancy seem to be good predictors of pregnancy and perinatal complications.
