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Artigos Originais
Amniotic fluid volume and maternal outcomes in women with preterm premature rupture of membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):146-151
03-25-2014
Summary
Artigos OriginaisAmniotic fluid volume and maternal outcomes in women with preterm premature rupture of membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):146-151
03-25-2014DOI 10.1590/S0100-720320140050.0003
Views106See morePURPOSE:
To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM).
METHODS:
An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume. Pregnant women were compared at two cut-off points: those with AFI <5.0 and ≥5.0 cm and AFI <3.0 and ≥3.0 cm. We excluded women with hypertensive disorders, diabetesmellitus, fetal malformations and a diagnosis of infections at admission. For statistical analysis, we used the χ2test or Fisher's exact test, when appropriate, and simple linear regression analysis, with the level of significance set at 5%. We calculated the Risk Ratio (RR) and its 95% confidence interval (95%CI).
RESULTS:
When maternal outcomes were assessed by comparing ILA ≥5.0versus <5.0 cm, no significant differences were detected. However, when considering ILA <3.0 and ≥3.0 cm, there was an increased risk of chorioamnionitis (36.7 versus10.7%, RR: 3.4, 95%CI 1.4 -8.3, p=0.004), with no significant differences for the other variables. There was also a statistically significant positive correlation between AFI and gestational age at delivery (R2=0.78, p<0.0001).
CONCLUSIONS:
AFI <3.0 cm causes a three-fold increase in the risk for chorioamnionitis; also, the higher the ILA, the higher the gestational age at delivery.
Views106
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 OriginaisAmniotic fluid volume and maternal outcomes in women with preterm premature rupture of membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):146-151
03-25-2014DOI 10.1590/S0100-720320140050.0003
Views106See morePURPOSE:
To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM).
METHODS:
An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume. Pregnant women were compared at two cut-off points: those with AFI <5.0 and ≥5.0 cm and AFI <3.0 and ≥3.0 cm. We excluded women with hypertensive disorders, diabetesmellitus, fetal malformations and a diagnosis of infections at admission. For statistical analysis, we used the χ2test or Fisher's exact test, when appropriate, and simple linear regression analysis, with the level of significance set at 5%. We calculated the Risk Ratio (RR) and its 95% confidence interval (95%CI).
RESULTS:
When maternal outcomes were assessed by comparing ILA ≥5.0versus <5.0 cm, no significant differences were detected. However, when considering ILA <3.0 and ≥3.0 cm, there was an increased risk of chorioamnionitis (36.7 versus10.7%, RR: 3.4, 95%CI 1.4 -8.3, p=0.004), with no significant differences for the other variables. There was also a statistically significant positive correlation between AFI and gestational age at delivery (R2=0.78, p<0.0001).
CONCLUSIONS:
AFI <3.0 cm causes a three-fold increase in the risk for chorioamnionitis; also, the higher the ILA, the higher the gestational age at 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. -
Artigos Originais
Maternal mortality in a reference center in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):388-393
11-06-2013
Summary
Artigos OriginaisMaternal mortality in a reference center in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):388-393
11-06-2013DOI 10.1590/S0100-72032013000900002
Views87PURPOSE: To describe the prevalence of maternal mortality at a tertiary care hospital and to assessits preventability. METHODS: This study, through the analysis of maternal deaths that occurred during the period from 1999 to 2010 at a reference in Campinas - Brazil, CAISM/ UNICAMP, discusses some of the factors associated with the main causes of death and some structural problems of structure of the health services. It is a retrospective descriptive study with evaluation of sociodemographic variables and the medical and obstetric history of women, and the causes of death. RESULTS: The majority of maternal deaths occurred due to direct obstetric (45%) and avoidable (36%) causes, in women with preterm gestation, who delivered by cesarean section (56%) and received various management procedures, including blood transfusion, ICU admission and need for laparotomy and/or hysterectomy. The hospital transfer was associated with the predominance of direct obstetric (19 versus 6, p=0.02) and avoidable causes (22 versus 9, p=0.01). CONCLUSIONS: We conclude that, despite current advances in Obstetrics, infections and hypertensive disorders are still the predominant causes of maternal mortality. We observed an increase of clinical-surgical conditions and neoplasms as causes of death among women during pregnancy.
Key-words BrazilMaternal mortalityMaternal welfarePregnancy complications, infectiousPregnancy, high riskSee moreViews87This 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 OriginaisMaternal mortality in a reference center in the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):388-393
11-06-2013DOI 10.1590/S0100-72032013000900002
Views87PURPOSE: To describe the prevalence of maternal mortality at a tertiary care hospital and to assessits preventability. METHODS: This study, through the analysis of maternal deaths that occurred during the period from 1999 to 2010 at a reference in Campinas - Brazil, CAISM/ UNICAMP, discusses some of the factors associated with the main causes of death and some structural problems of structure of the health services. It is a retrospective descriptive study with evaluation of sociodemographic variables and the medical and obstetric history of women, and the causes of death. RESULTS: The majority of maternal deaths occurred due to direct obstetric (45%) and avoidable (36%) causes, in women with preterm gestation, who delivered by cesarean section (56%) and received various management procedures, including blood transfusion, ICU admission and need for laparotomy and/or hysterectomy. The hospital transfer was associated with the predominance of direct obstetric (19 versus 6, p=0.02) and avoidable causes (22 versus 9, p=0.01). CONCLUSIONS: We conclude that, despite current advances in Obstetrics, infections and hypertensive disorders are still the predominant causes of maternal mortality. We observed an increase of clinical-surgical conditions and neoplasms as causes of death among women during pregnancy.
Key-words BrazilMaternal mortalityMaternal welfarePregnancy complications, infectiousPregnancy, high riskSee 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. -
Artigos Originais
Causes of maternal mortality according to levels of hospital complexity
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(12):536-543
01-11-2012
Summary
Artigos OriginaisCauses of maternal mortality according to levels of hospital complexity
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(12):536-543
01-11-2012DOI 10.1590/S0100-72032012001200002
Views88See morePURPOSES: To identify and to analyze maternal mortality causes, according to hospital complexity levels. METHODS: A descriptive-quantitative cross-sectional study of maternal deaths that occurred in hospitals in Paraná, Brazil, during the periods from 2005 to 2007 and from 2008 to 2010. Data from case studies of maternal mortality, obtained by the State Committee for Maternal Mortality Prevention, were utilized. The study focused on variables such as site and causes of death, hospital transfer, and avoidability. Maternal mortality rate, proportions, and hospital lethality ratio were calculated according to subgroups of low and high-risk pregnancy reference hospitals. RESULTS: Maternal mortality rate, including late maternal deaths, was 65.9 per 100.000 live-borns (from 2008 to 2010). Almost 90% of all maternal deaths occurred in the hospital environment, in both periods. The hospital lethality ratio at the high-risk pregnancy reference hospital was 158.4 deaths per 100,000 deliveries during the first period and 132.5/100,000 during the second, and the main causes were pre-eclampsia/eclampsia, puerperal infection, urinary tract infection, and indirect causes. At the low-risk pregnancy reference hospitals, the hospital lethality ratios were 76.2/100,000 and 80.0/100,000, and the main causes of death were hemorrhage, embolism, and anesthesia complications. In 64 (2005 - 2007) and in 71% (2008 - 2010) of the cases, the patients died in the same hospital of admission. During the second period, 90% of the casualties were avoidable. CONCLUSIONS: Hospitals of both levels of complexity are having difficulties in treating obstetric complications. Professional training for obstetric emergency assistance and the monitoring of protocols at all hospital levels should be considered by the managers as a priority strategy to reduce avoidable maternal deaths.
Views88This 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 OriginaisCauses of maternal mortality according to levels of hospital complexity
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(12):536-543
01-11-2012DOI 10.1590/S0100-72032012001200002
Views88See morePURPOSES: To identify and to analyze maternal mortality causes, according to hospital complexity levels. METHODS: A descriptive-quantitative cross-sectional study of maternal deaths that occurred in hospitals in Paraná, Brazil, during the periods from 2005 to 2007 and from 2008 to 2010. Data from case studies of maternal mortality, obtained by the State Committee for Maternal Mortality Prevention, were utilized. The study focused on variables such as site and causes of death, hospital transfer, and avoidability. Maternal mortality rate, proportions, and hospital lethality ratio were calculated according to subgroups of low and high-risk pregnancy reference hospitals. RESULTS: Maternal mortality rate, including late maternal deaths, was 65.9 per 100.000 live-borns (from 2008 to 2010). Almost 90% of all maternal deaths occurred in the hospital environment, in both periods. The hospital lethality ratio at the high-risk pregnancy reference hospital was 158.4 deaths per 100,000 deliveries during the first period and 132.5/100,000 during the second, and the main causes were pre-eclampsia/eclampsia, puerperal infection, urinary tract infection, and indirect causes. At the low-risk pregnancy reference hospitals, the hospital lethality ratios were 76.2/100,000 and 80.0/100,000, and the main causes of death were hemorrhage, embolism, and anesthesia complications. In 64 (2005 - 2007) and in 71% (2008 - 2010) of the cases, the patients died in the same hospital of admission. During the second period, 90% of the casualties were avoidable. CONCLUSIONS: Hospitals of both levels of complexity are having difficulties in treating obstetric complications. Professional training for obstetric emergency assistance and the monitoring of protocols at all hospital levels should be considered by the managers as a priority strategy to reduce avoidable maternal deaths.
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. -
Artigo de Revisão
Evaluation of the main prenatal routine exams: part 2
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(7):367-374
10-09-2009
Summary
Artigo de RevisãoEvaluation of the main prenatal routine exams: part 2
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(7):367-374
10-09-2009DOI 10.1590/S0100-72032009000700008
Views51A good quality prenatal assistance is essential to warrant perinatal and maternal health. Nowadays, due to the evolution of diagnostic methods and the change in illness prevalence, such as the increase in diabetes and sexually transmitted diseases, several propedeutic procedures are available. This introduces further difficulty for clinicians to select the most adequate procedures and when to apply them during gestation, assuring the best results for both mother and infant. The present review aimed at evaluating the main prenatal routine tests on the basis of the best scientific evidence presently available.
Key-words Evidence-based medicineMaternal welfarePerinatal assistancePregnancyPrenatal careQuality of health careSee moreViews51This 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
Artigo de RevisãoEvaluation of the main prenatal routine exams: part 2
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(7):367-374
10-09-2009DOI 10.1590/S0100-72032009000700008
Views51A good quality prenatal assistance is essential to warrant perinatal and maternal health. Nowadays, due to the evolution of diagnostic methods and the change in illness prevalence, such as the increase in diabetes and sexually transmitted diseases, several propedeutic procedures are available. This introduces further difficulty for clinicians to select the most adequate procedures and when to apply them during gestation, assuring the best results for both mother and infant. The present review aimed at evaluating the main prenatal routine tests on the basis of the best scientific evidence presently available.
Key-words Evidence-based medicineMaternal welfarePerinatal assistancePregnancyPrenatal careQuality of health careSee 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. -
Artigo de Revisão
Evaluation of the main prenatal routine exams (Part 1)
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):148-155
06-09-2009
Summary
Artigo de RevisãoEvaluation of the main prenatal routine exams (Part 1)
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):148-155
06-09-2009DOI 10.1590/S0100-72032009000300008
Views44See moreGood prenatal care is essential to guarantee maternal and perinatal health. Nowadays, with the constant progress on the diagnostic methods and changes in diseases panorama, like increased frequency of diabetes and sexually transmitted diseases, several diagnostic procedures have been studied. These challenges difficult the selection of prenatal exams by the clinicians, in order to improve maternal and perinatal outcome. This review aimed to evaluate the main prenatal routine exams, according to the best current scientific evidences.
Views44This 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
Artigo de RevisãoEvaluation of the main prenatal routine exams (Part 1)
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):148-155
06-09-2009DOI 10.1590/S0100-72032009000300008
Views44See moreGood prenatal care is essential to guarantee maternal and perinatal health. Nowadays, with the constant progress on the diagnostic methods and changes in diseases panorama, like increased frequency of diabetes and sexually transmitted diseases, several diagnostic procedures have been studied. These challenges difficult the selection of prenatal exams by the clinicians, in order to improve maternal and perinatal outcome. This review aimed to evaluate the main prenatal routine exams, according to the best current scientific evidences.
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.
Maternal welfare Archives - Revista Brasileira de Ginecologia e Obstetrícia
