-
Artigos Originais
Evaluation of blood flow in the fetal renal artery between the 22nd and 38th week in normal pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):494-498
11-27-2008
Summary
Artigos OriginaisEvaluation of blood flow in the fetal renal artery between the 22nd and 38th week in normal pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):494-498
11-27-2008DOI 10.1590/S0100-72032008001000003
Views60See morePURPOSE: to describe values found for the resistance index (RI), pulsatility index (PI) and the systole/diastole (S/D) ratio of fetal renal arteries in non-complicated gestations between the 22nd and the 38th week, and to evaluate whether those values vary along that period. METHODS: observational study, where 45 fetuses from non-complicated gestations have been evaluated in the 22nd, 26th, 30th and 38th weeks of gestational age. Doppler ultrasonography has been performed by the same observer, using a device with 4 to 7 MHz transducer. For the acquisition of the renal arteries velocity record, a 1 mm to 2 mm probe has been placed in the mean third of the renal artery for the evaluation through pulsed Doppler ultrasonography. The measurement of RI, PI and S/D ratio from three consecutive waves was performed with the automatic mode. To detect significant differences in the indexes' values along gestation, we have compared values obtained at the different gestational ages, through repeated measures ANOVA, followed by Tukey's post-hoc test. RESULTS: There were no significant differences between the right and left renal arteries, when the RI, IP and S/D ratio were compared. Nevertheless, a change in the values of these parameters has been observed between the 22nd week (RI=0.9 ± 0.02; PI=2.4 ± 0.02; S/D ratio=11.6 ± 2.2; mean ± standard deviation of the combined mean values of the right and left renal artery) and the 38th week (RI=0.8 ± 0.03; PI=2.1 ± 0.2; S/D ratio=8.7 ± 2.3) of gestation. CONCLUSIONS: the parameters evaluated (RI, PI and S/D ratio) have presented decreasing values between the 22nd and 38th, with no difference between the fetus's right and left sides.
PlumX Metrics- Citations
- Citation Indexes: 4
- Usage
- Full Text Views: 11332
- Abstract Views: 960
- Captures
- Readers: 3
-
Artigos Originais
Maternal factors associated with fetal weight estimated by ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(9):459-465
10-23-2008
Summary
Artigos OriginaisMaternal factors associated with fetal weight estimated by ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(9):459-465
10-23-2008DOI 10.1590/S0100-72032008000900006
Views109PURPOSE: to evaluate the effect of maternal, socioeconomic and obstetric variables, as well the presence of artery incisions in the 20th and 24th weeks on the fetal weight estimated at the end of pregnancy (36th week) in pregnant women attended by Programa Saúde da Família, in an inland town of the northeast of Brazil. METHODS: a longitudinal study including 137 pregnant women, who have been followed up every four weeks in order to assess clinical, socioeconomic and obstetric conditions, including their weight. The uterine arteries were evaluated by Doppler in the 20th and 24th weeks, the fetal weight and the amniotic fluid index (AFI), determined in the 36th week. The initial maternal nutritional state has been determined by the body mass index (BMI), the pregnant women being classified as low weight, eutrophic, over weight and obese. Weight gain during gestation has been evaluated, according to the initial nutritional state, being classified at the end of the second and third trimester as insufficient, adequate and excessive weight gain. Analysis of variance was performed to evaluate the association of the fetal weight in the 36th week with the predictor variables, adjusted by multiple linear regression. RESULTS: an association between the fetal weight estimated in the 36th week and the mother's age (p=0.02), mother's job (p=0.02), initial nutritional state (p=0.04), weight gain in the second trimester (p=0.01), presence of incisions in the uterine arteries (p=0.02), and AFI (p=0.007) has been observed. The main factors associated to the fetal weight estimated in the 36th week, after the multiple regression analysis were: BMI at the pregnancy onset, weight gain in the second trimester, AFI and tabagism. CONCLUSIONS: in the present study, the fetal weight is positively associated with the initial maternal nutritional state, the weight gain in the second trimester and the volume of amniotic fluid, and negatively, to tabagism.
Key-words Amniotic fluidFetal weightLaser-doppler flowmetryNutritional statusUltrasonography, prenatalWeight gainSee morePlumX Metrics- Citations
- Citation Indexes: 5
- Usage
- Full Text Views: 26829
- Abstract Views: 887
- Captures
- Readers: 15
-
Artigos Originais
Predictive value for fetal outcome of Doppler velocimetry of the ductus venosus between the 11th and the 14th gestation week
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(1):5-11
04-07-2008
Summary
Artigos OriginaisPredictive value for fetal outcome of Doppler velocimetry of the ductus venosus between the 11th and the 14th gestation week
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(1):5-11
04-07-2008DOI 10.1590/S0100-72032008000100002
Views59See morePURPOSE: to study the value of Doppler velocimetry of the ductus venosus, between the 11th and 14th weeks of pregnancy, associated to the nuchal translucency thickness measurement, in the detection of adverse fetal outcome. METHODS: a transversal and prospective study in which a total of 1,268 fetuses were studied consecutively. In 56 cases, a cytogenetic study was performed on material obtained from a biopsy of the chorionic villus and, in 1,181 cases, the postnatal phenotype was used as a basis for the result. In addition to the routine ultrasonographic examination, all the fetuses were submitted to measurement of the nuchal translucency thickness and to Doppler velocimetry of the ductus venosus. Aiming at prevalence and accuracy indices, sensitivity, specificity, positive predictive value, negative predictive value, probability of false-positive, probability of false-negative, reason of positive probability and reason of negative probability were calculated and analyzed. RESULTS: from the total of 1,268 fetuses, 1,183 cases were selected for analysis. From this number, 1,170 fetuses were normal (98.9%) and 13 fetuses presented adverse outcome at birth (1.1%), including fetal death (trisomy 21 and 22) in two cases; genetic syndrome (Nooman) in one case; two cases of polymalformed fetuses; cardiopathy in three cases; and other structural defects in five cases. The prevalence of the modified ductus venosus (wave A zero/reverse) in the studied population was of 14 cases (1.2%), with a false-positive rate of 0.7%. CONCLUSIONS: there is a significant correlation between the alteration of the ductus venosus Doppler velocimetry and the thickness of the nuchal translucency as an ultrasonographic marker for the first trimester of gestation, in the detection of adverse fetal outcome, especially serious malformations. The ductus venosus was able to diminish the false-positive result in comparison to the isolated use of the nuchal translucency thickness, improving considerably the positive predictive value of the test.
PlumX Metrics- Citations
- Citation Indexes: 7
- Usage
- Full Text Views: 29683
- Abstract Views: 764
- Captures
- Readers: 7
-
Artigos Originais
Central retinal artery blood flow variation during menstrual cycle
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):147-152
06-21-2007
Summary
Artigos OriginaisCentral retinal artery blood flow variation during menstrual cycle
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):147-152
06-21-2007DOI 10.1590/S0100-72032007000300006
Views56PURPOSE: to evaluate the vascular blood flow of the central retinal arteries using dopplervelocimetry in the different phases of the ovulatory menstrual cycle. METHODS: we performed an observational, longitudinal and prospective study evaluating 34 healthy and ovulatory women. All women were submitted to Doppler scan of the eye to evaluate the vascular resistance of the central retinal arteries, either lying down or on a seated position, during four phases of the menstrual cycle. Confirmation of ovulation was performed by measuring serum progesterone during the luteal phase. We analyzed the pulsatility and resistance index and the maximum, minimum and mean velocity. RESULTS: mean age was 29.7 years. No differences were observed between the indexes obtained in both eyes, therefore a mean index was used for comparisons. As the comparison between the positions used for the exams showed a higher PI for the seated position, the analyses were performed separately. The pulsatility index in the lying position was different among the different phases of the menstrual cycle. The arterial resistance was significantly lower during the intermediate follicular and the periovulatory phases, as compared to the early follicular and luteal phases. When the comparison was performed with the patient in the seated position, no differences were observed. CONCLUSIONS: Our results demonstrate a reduction in the vascular resistance of the cerebral microcirculation and a posterior reversal, as shown by changes in the PI.
Key-words Laser-doppler flowmetryMenstrual cycleProspective studiesRetinal arteryVascular resistanceSee morePlumX Metrics- Citations
- Citation Indexes: 1
- Usage
- Full Text Views: 9556
- Abstract Views: 1188
- Captures
- Readers: 8
-
Artigos Originais
Effects of isoflavones on the pelvic floor and the periurethral vascularization of postmenopausal women
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):545-550
01-18-2006
Summary
Artigos OriginaisEffects of isoflavones on the pelvic floor and the periurethral vascularization of postmenopausal women
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):545-550
01-18-2006DOI 10.1590/S0100-72032006000900007
Views112See morePURPOSE: to evaluate muscular strength of the pelvic floor and the periurethral vessels of postmenopausal women before and after six months of soybean extract treatment. METHODS: the study was conducted on 30 postmenopausal women before and after six consecutive months of soyabean extract (100 mg/day) administration. Urinary loss and muscular strength of the pelvic floor were investigated through digital perineometer and functional evaluation. Digital color Doppler in the periurethral region was used to count the number of vessels. For statistical analysis, the paired Student t test was applied to compare the results before and after the treatment. RESULTS: twenty women reported urinary incontinence before the treatment period. The amelioration of this symptom was observed in 15 (75%) women after the treatment. Vaginal pressure (muscular strength of the pelvic floor) was 12.95±1.73 and 15.86±1.86 Sauers, before and after the treatment, respectively (p<0.001). Twenty-two women (73.3%) presented an increase in the pressure at the end of this study. In relation to the function evaluation, 18 (60%) had improvement in muscular strength and 12 women did not present any change. On ultrasonography (Doppler), the number of vessels was 2.20±0.15 blood vessels/field in the beginning of this study and 3.46±0.25 blood vessels/field at the end of the treatment (p<0.001). An increase in the number of periurethral vessels was detected in 21 women (70%). CONCLUSION: it is important to emphasize that these are preliminary results. A double blind randomized and placebo-controlled clinical trial with a high number of participants is necessary. However, the treatment with concentrated soybean extract (100 mg per day) for six consecutive months may determine an improvement in pelvic floor muscular strength and an increase in the number of periurethral vessels in postmenopausal women.
PlumX Metrics- Citations
- Citation Indexes: 2
- Usage
- Full Text Views: 11496
- Abstract Views: 857
- Captures
- Readers: 15
-
Artigos Originais
Fetal heart rate and umbilical artery Dopplervelocimetry between the 18th and 20th weeks of gestation in pregnancies complicated by pregestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):453-459
12-05-2006
Summary
Artigos OriginaisFetal heart rate and umbilical artery Dopplervelocimetry between the 18th and 20th weeks of gestation in pregnancies complicated by pregestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):453-459
12-05-2006DOI 10.1590/S0100-72032006000800003
Views56PURPOSE: to analyze the fetal heart rate (FHR) and umbilical artery Dopplervelocimetry between 18th and 20th weeks of gestation in pregnant women complicated by pregestational diabetes mellitus. METHODS: twenty-eight pregnancies with pregestational diabetes and 27 normal pregnant women were analyzed prospectively, in a cross-sectional and case-control study. The inclusion criteria were the following: singleton pregnancy between 18 and 29 weeks, no other associated maternal diseases and no fetal abnormality. Ultrasonography was performed and FHR was calculated by the interval between the beginnings of two consecutive cardiac cycles, in the three umbilical artery Doppler sonograms, obtained in the umbilical cord near to the placental insertion, using color Doppler. Five consecutive FHR cycles from each sonogram were measured, to analyze mean FHR and its variation. The following Doppler indices were studied: systolic/diastolic ratio, pulsatility index (PI) and resistance index (RI). Student's t test and Mann-Whitney Utest were applied to comparative study. p values were considered significant when p<0.05. Results: no significant difference was observed in mean FHR between the studied groups (diabetic group: 149.2 bpm, control group: 147.2 bpm; p = 0.12). FHR variation revealed similar results between the groups (diabetic group: 5.3 bpm; control group: 5.3 bpm; p=0.50). No significant difference was found in the Doppler indices S/D (p=0.79), PI (p=0.25) and RI (p=0.71) between the groups. CONCLUSIONS: the absence of differences in FHR characteristics between the 18th and 20th gestational weeks indicates similar neurological maturation of FHR regulatory systems in this period, between fetuses of diabetic mothers and controls. Abnormalities in the uteroplacental resistance were not identified in the studied period, in pregnancies complicated by pregestational diabetes.
Key-words Diabetes mellitusDopplerfetalHeart rateLaser-doppler flowmetryUltrasonographyUmbilical arteriesSee more -
Artigos Originais
Effects of maternal smoking on placental ultrasound and uterine-placental Doppler
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):340-344
10-20-2006
Summary
Artigos OriginaisEffects of maternal smoking on placental ultrasound and uterine-placental Doppler
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):340-344
10-20-2006DOI 10.1590/S0100-72032006000600004
Views52See morePURPOSE: the study the effects of maternal cigarette smoking during pregnancy on placental maturation (calcifications) and the placental-uterine circulation, evaluated through umbilical and uterine Doppler. METHODS: prospective cohort study involving 244 pregnant women, 210 of them non-smokers and 34 smokers. Participants were submitted to four serial sonograms. The first was performed up to the 16th week of pregnancy to determine gestational age, and the other three at 28, 32 and 36 weeks for fetal biometry, evaluation of placental texture and Doppler studies of the uterine and umbilical arteries. Premature placental calcification was defined as grade III before 36 weeks. The chi2 and Fisher exact tests were used to compare placental grading, and the Mann-Whitney test to evaluate the resistance index of uterine and umbilical arteries. RESULTS: the frequency of grade III placenta and the resistance of the uterine arteries did not differ significantly between smokers and non-smokers, at all gestational ages. Umbilical artery Doppler was significantly higher in smokers than in non-smokers at 32 weeks. CONCLUSIONS: no association was found between cigarette smoking and premature placental calcification. Smoking was associated with increased umbilical artery resistance at 32 weeks.
PlumX Metrics- Citations
- Citation Indexes: 1
- Usage
- Full Text Views: 12888
- Abstract Views: 1160
- Captures
- Readers: 4
-
Artigos Originais
Study of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):238-243
08-25-2006
Summary
Artigos OriginaisStudy of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):238-243
08-25-2006DOI 10.1590/S0100-72032006000400006
Views95See morePURPOSE: to evaluate the relationship between S/A ratio in ductus venosus (DV) and perinatal outcomes in fetuses with brain sparing reflex. METHODS: the study was designed as an observational, sectional study with prospectively collected data. Forty-one fetuses with brain sparing reflex and gestational age between 25 and 33 weeks were studied between November 2002 and July 2005. The newborns were observed during the neonatal period in the intensive care unit of "Clínica Perinatal Laranjeiras" in order to find adverse outcomes. The study population was divided into two groups according to DV assessment. In the normal group all the fetuses with S/A ratio values of 3.6 or less were included, and in the abnormal group the fetuses with values of S/A ratio greater than 3.6. The statistical analysis was performed by the Mann-Whitney U-test, chi2 test and Fisher exact test. The results were considered significant when p<0.05. Gestational age, birth weight and Apgar score less than 7 at 5 min were evaluated. Perinatal outcome parameters were: intrauterine death, neonatal mortality, seizures, intraventricular hemorrhage, leukomalacia, need of surfactant, mechanical ventilation, myocardical failure, necrotizing enterocolitis, and length of stay in the intensive care unit. RESULTS: among the assessed 41 fetuses, 26 (63.4%) showed normal DV S/A ratio and the other 15 (36.6%) developed an abnormal DV S/A ratio (>3.6). There was no statistically signicant difference between the groups according to gestational age at delivery and Apgar <7. The only significant association was between abnormal DV S/A ratio and neonatal death (p=0.049; Fisher's exact test). No statistically significant association was observed for the other studied variables. CONCLUSIONS: our results suggest that abnormal DV blood flow detected by Doppler examination is not associated with adverse perinatal outcomes, except for neonatal mortality. This association may be considered statistically borderline (p=0.049). Excluding fetuses with birth weight less than 400 g, there was no other association between DV and neonatal mortality. The abnormal DV S/A ratio was not associated, in our study, with perinatal mortality in viable preterm fetuses.