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Trabalhos Originais
Epidemiology of abortion during adolescence
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):161-165
03-13-1999
Summary
Trabalhos OriginaisEpidemiology of abortion during adolescence
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):161-165
03-13-1999DOI 10.1590/S0100-72031999000300007
Views77See morePurpose: to evaluate the social, demographic and obstetrical profile of adolescents as compared with adult women hospitalized for abortion complications. Material and methods: this is a descriptive study that evaluated 230 women with abortion complications. Among them, 59 were adolescents hospitalized at the IMIP Maternity (Recife, Brazil) from August 1994 to July 1995. The variables studied were: educational level, marital status, any paid activity, gestation age, number of pregnancies, desire to become pregnant, use of anticonceptive method, kind of relationship, reason for voluntary interruption, clinical classification of abortion and associated complications. The procedure for data analysis was the distribution of variables among adolescents and adults, the differences being evaluated through chi² and chi² for trend. Results: compared with the adult women who aborted, the adolescents showed a lower number of paid activity and multiparity and a higher number of pregnancies resulting from an unstable relationship. Conclusions: the results indicated that biologicallly the adolescents who were hospitalized for abortion have a similar profile to adult women. What differentiates them are the unfavorable social and demographic conditions that they are faced with at their generally unplanned first pregnancies.
Views77
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
Trabalhos OriginaisEpidemiology of abortion during adolescence
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):161-165
03-13-1999DOI 10.1590/S0100-72031999000300007
Views77See morePurpose: to evaluate the social, demographic and obstetrical profile of adolescents as compared with adult women hospitalized for abortion complications. Material and methods: this is a descriptive study that evaluated 230 women with abortion complications. Among them, 59 were adolescents hospitalized at the IMIP Maternity (Recife, Brazil) from August 1994 to July 1995. The variables studied were: educational level, marital status, any paid activity, gestation age, number of pregnancies, desire to become pregnant, use of anticonceptive method, kind of relationship, reason for voluntary interruption, clinical classification of abortion and associated complications. The procedure for data analysis was the distribution of variables among adolescents and adults, the differences being evaluated through chi² and chi² for trend. Results: compared with the adult women who aborted, the adolescents showed a lower number of paid activity and multiparity and a higher number of pregnancies resulting from an unstable relationship. Conclusions: the results indicated that biologicallly the adolescents who were hospitalized for abortion have a similar profile to adult women. What differentiates them are the unfavorable social and demographic conditions that they are faced with at their generally unplanned first pregnancies.
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. -
Revisão
Assisted reproduction as a cause of maternal and perinatal morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):759-767
04-13-2005
Summary
RevisãoAssisted reproduction as a cause of maternal and perinatal morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):759-767
04-13-2005DOI 10.1590/S0100-72032005001200009
Views54See morePURPOSE: to carry out a literature review to evaluate the impact of assisted reproductive techniques (ART) on maternal and perinatal morbidity. METHODS: specialized data bases such as SCI and MEDLINE were used to identify studies related to the terms: "in vitro fertilization", "assisted reproduction" and "reproductive techniques" in combination with "morbidity", "maternal mortality", "perinatal mortality", and "neonatal mortality". RESULTS: data from published studies allow us to conclude that maternal morbidity is related to an increase in the number of multiple pregnancies. In addition, some studies have reported an increased incidence of pregnancy-induced hypertension and gestational diabetes. Specialized multidisciplinary prenatal care has been recommended to obtain optimal results. An increase in the number of multiple pregnancies considerably increases maternal, fetal and neonatal complications. There is also evidence of an increase in congenital malformations. The particular characteristics of this group of women and the different techniques of assisted reproduction, particularly ICSI, in the etiology of congenital defects were discussed, but no clear differences have been established between the various procedures. Some recent metanalyses show that the number of fetal malformations in infants born as a result of ICSI is greater than in spontaneously conceived infants, but not more frequent than in those born as a result of other ART. There is no consensus regarding whether this fact is a result of the procedure itself, of manipulation of the gametes, ovulation induction, if it is due to the fact that these couples are infertile or a result of the time they take to become pregnant. Few studies have carried out a prolonged, consistent and systematic evaluation of the perinatal evolution of infants born following the use of frozen embryos. CONCLUSIONS: with respect to fetal malformations, there is definitely a higher incidence rate among infants born as a result of ART compared to those conceived naturally (RR: 1.4-2.0; 95% CI: 1.3-2.7). Insufficient time and data do not yet permit analysis of the outcome of pregnancies resulting from the use of frozen embryos. It is not clear whether these findings are due to the characteristics of the couples who are submitted to these procedures or to the peculiarities of each method. Many of the problems related to maternal and perinatal morbidity are due to the significant number of multiple pregnancies originating from ART. More studies are required in order to clarify these aspects of human reproduction.
Views54This 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
RevisãoAssisted reproduction as a cause of maternal and perinatal morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):759-767
04-13-2005DOI 10.1590/S0100-72032005001200009
Views54See morePURPOSE: to carry out a literature review to evaluate the impact of assisted reproductive techniques (ART) on maternal and perinatal morbidity. METHODS: specialized data bases such as SCI and MEDLINE were used to identify studies related to the terms: "in vitro fertilization", "assisted reproduction" and "reproductive techniques" in combination with "morbidity", "maternal mortality", "perinatal mortality", and "neonatal mortality". RESULTS: data from published studies allow us to conclude that maternal morbidity is related to an increase in the number of multiple pregnancies. In addition, some studies have reported an increased incidence of pregnancy-induced hypertension and gestational diabetes. Specialized multidisciplinary prenatal care has been recommended to obtain optimal results. An increase in the number of multiple pregnancies considerably increases maternal, fetal and neonatal complications. There is also evidence of an increase in congenital malformations. The particular characteristics of this group of women and the different techniques of assisted reproduction, particularly ICSI, in the etiology of congenital defects were discussed, but no clear differences have been established between the various procedures. Some recent metanalyses show that the number of fetal malformations in infants born as a result of ICSI is greater than in spontaneously conceived infants, but not more frequent than in those born as a result of other ART. There is no consensus regarding whether this fact is a result of the procedure itself, of manipulation of the gametes, ovulation induction, if it is due to the fact that these couples are infertile or a result of the time they take to become pregnant. Few studies have carried out a prolonged, consistent and systematic evaluation of the perinatal evolution of infants born following the use of frozen embryos. CONCLUSIONS: with respect to fetal malformations, there is definitely a higher incidence rate among infants born as a result of ART compared to those conceived naturally (RR: 1.4-2.0; 95% CI: 1.3-2.7). Insufficient time and data do not yet permit analysis of the outcome of pregnancies resulting from the use of frozen embryos. It is not clear whether these findings are due to the characteristics of the couples who are submitted to these procedures or to the peculiarities of each method. Many of the problems related to maternal and perinatal morbidity are due to the significant number of multiple pregnancies originating from ART. More studies are required in order to clarify these aspects of human reproduction.
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
Intrauterine growth retardation diagnosed by Rohrer’s ponderal index and its association with morbidity and early neonatal mortality
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):303-309
11-11-2005
Summary
Artigos OriginaisIntrauterine growth retardation diagnosed by Rohrer’s ponderal index and its association with morbidity and early neonatal mortality
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):303-309
11-11-2005DOI 10.1590/S0100-72032005000600003
Views84PURPOSE: to diagnose intrauterine growth restriction (IGR) and its connection with early neonatal morbidity and mortality, through Roher's ponderal index (PI). METHODS: this was a retrospective, descriptive study of transversal cohort, in which 2741 newborns (NB) were included, 2053 of them from healthy pregnant women, 228 from women with mild pregnancy-related hypertension, 52 from those with severe pregnancy-related hypertension, 25 from those with mild pregnancy-related hypertension that evolved to eclampsia, 136 from those with premature membrane rupture, and 247 from women who smoked along gestation. Roher's PI was calculated by the equation: PI = weight/height ³ x 100 and the values 2.25 and 3.10 of Lubchenco's 10 and 90 percentiles were used to classify the types of IGR. IGR was classified as asymmetric for NB with PI < 2.25 and weight lower than percentile 10, as symmetric, with PI from 2.25 to 3.10 and weight lower than percentile 10, and adequate for gestational age with PI from 2.25 to 3.10, and weight from 10 to 90 percentiles. Statistical analysis was performed using the non-paired t test, the non-parametric chi2 test and Fisher's exact test, with significance set at a value of p<0.05. RESULTS: low birth weight (< 2,500 g) was present in 3.6% (100/2741) of the cases, while the rate of IGR diagnosed through PI was 15.7% (430/2741), 14.0% being asymmetric and 1.7% symmetric. The most frequent complication among the asymmetric IGRNB was transient tachypnea (8.3%), followed by asphyxia (5.7%) and infection (2.6%). Transient tachypnea was present in 6.5% of symmetric IGRNB, followed by asphyxia (4.3%), meconium aspiration syndrome (2.2%), hypoglycemia (2.2%) and infection (2.2%). Early neonatal death was similar for NB with restricted IGR and adequate IGR for gestational age, both groups reaching a rate of 0.3%. CONCLUSIONS: Rohrer's PI was able to diagnose the different IGR patterns, which would not be known if the birth weight had been calculated in terms of gestational age. The asymmetric NB presented a higher incidence of transient tachypnea and asphyxia, without statistical significance in relation the other IGR patterns. The frequency of early neonatal death was similar for the asymmetric and adequate for gestational age NB groups.
Key-words AnthropometryFetal growth retardationFetal mortalityHeight weightMorbidityPregnancy complicationsSee moreViews84This 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 OriginaisIntrauterine growth retardation diagnosed by Rohrer’s ponderal index and its association with morbidity and early neonatal mortality
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(6):303-309
11-11-2005DOI 10.1590/S0100-72032005000600003
Views84PURPOSE: to diagnose intrauterine growth restriction (IGR) and its connection with early neonatal morbidity and mortality, through Roher's ponderal index (PI). METHODS: this was a retrospective, descriptive study of transversal cohort, in which 2741 newborns (NB) were included, 2053 of them from healthy pregnant women, 228 from women with mild pregnancy-related hypertension, 52 from those with severe pregnancy-related hypertension, 25 from those with mild pregnancy-related hypertension that evolved to eclampsia, 136 from those with premature membrane rupture, and 247 from women who smoked along gestation. Roher's PI was calculated by the equation: PI = weight/height ³ x 100 and the values 2.25 and 3.10 of Lubchenco's 10 and 90 percentiles were used to classify the types of IGR. IGR was classified as asymmetric for NB with PI < 2.25 and weight lower than percentile 10, as symmetric, with PI from 2.25 to 3.10 and weight lower than percentile 10, and adequate for gestational age with PI from 2.25 to 3.10, and weight from 10 to 90 percentiles. Statistical analysis was performed using the non-paired t test, the non-parametric chi2 test and Fisher's exact test, with significance set at a value of p<0.05. RESULTS: low birth weight (< 2,500 g) was present in 3.6% (100/2741) of the cases, while the rate of IGR diagnosed through PI was 15.7% (430/2741), 14.0% being asymmetric and 1.7% symmetric. The most frequent complication among the asymmetric IGRNB was transient tachypnea (8.3%), followed by asphyxia (5.7%) and infection (2.6%). Transient tachypnea was present in 6.5% of symmetric IGRNB, followed by asphyxia (4.3%), meconium aspiration syndrome (2.2%), hypoglycemia (2.2%) and infection (2.2%). Early neonatal death was similar for NB with restricted IGR and adequate IGR for gestational age, both groups reaching a rate of 0.3%. CONCLUSIONS: Rohrer's PI was able to diagnose the different IGR patterns, which would not be known if the birth weight had been calculated in terms of gestational age. The asymmetric NB presented a higher incidence of transient tachypnea and asphyxia, without statistical significance in relation the other IGR patterns. The frequency of early neonatal death was similar for the asymmetric and adequate for gestational age NB groups.
Key-words AnthropometryFetal growth retardationFetal mortalityHeight weightMorbidityPregnancy complicationsSee 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
Factors associated with the severity of maternal morbidity for the characterization of near miss
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):197-203
07-30-2005
Summary
Artigos OriginaisFactors associated with the severity of maternal morbidity for the characterization of near miss
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):197-203
07-30-2005DOI 10.1590/S0100-72032005000400006
Views67See morePURPOSE: to apply a severity score to cases of severe maternal morbidity (SMM) and to compare the classification criteria. METHODS: a control-case study was performed as a secondary analysis of cases of SMM in a tertiary level maternity unit for a period of 12-month. A specific score for assessing the degree of severity was applied to cases identified as SMM. Twenty cases of near miss maternal morbidity (higher severity) were compared to 104 control cases (lower severity) of other severe morbidities, regarding risk factors, primary determinants and assistance requirements. Analyses were performed with means and proportions, using Student's t, Wilcoxon and chi2 statistical tests, and estimations of OR and 95% CI. RESULTS: the higher severity (near miss) was identified in 16.1% of cases and the history of abortion was the only factor statistically associated with it (OR=3.41, 95% CI 1.08-10.79). In fact, the indices of assistance complexity were more frequent in the near-miss morbidity group, which also presented less hypertension (30% against 62.5%) and more hemorrhage (35.5% against 10.6%) as primary determinant factors of severe morbidity. CONCLUSIONS: the higher severity of maternal morbidity was associated with a history of abortion and with hemorrhage as a cause. The applied score was able to identify a higher severity subgroup (near miss), which needs more complex professional and institutional care in order to avoid the occurrence of death.
Views67This 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 OriginaisFactors associated with the severity of maternal morbidity for the characterization of near miss
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):197-203
07-30-2005DOI 10.1590/S0100-72032005000400006
Views67See morePURPOSE: to apply a severity score to cases of severe maternal morbidity (SMM) and to compare the classification criteria. METHODS: a control-case study was performed as a secondary analysis of cases of SMM in a tertiary level maternity unit for a period of 12-month. A specific score for assessing the degree of severity was applied to cases identified as SMM. Twenty cases of near miss maternal morbidity (higher severity) were compared to 104 control cases (lower severity) of other severe morbidities, regarding risk factors, primary determinants and assistance requirements. Analyses were performed with means and proportions, using Student's t, Wilcoxon and chi2 statistical tests, and estimations of OR and 95% CI. RESULTS: the higher severity (near miss) was identified in 16.1% of cases and the history of abortion was the only factor statistically associated with it (OR=3.41, 95% CI 1.08-10.79). In fact, the indices of assistance complexity were more frequent in the near-miss morbidity group, which also presented less hypertension (30% against 62.5%) and more hemorrhage (35.5% against 10.6%) as primary determinant factors of severe morbidity. CONCLUSIONS: the higher severity of maternal morbidity was associated with a history of abortion and with hemorrhage as a cause. The applied score was able to identify a higher severity subgroup (near miss), which needs more complex professional and institutional care in order to avoid the occurrence of death.
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.
Morbidity Archives - Revista Brasileira de Ginecologia e Obstetrícia
