Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(7):417-422
DOI 10.1590/S0100-72032001000700002
Purpose: to investigate risk factors associated with accretion in placenta previa (PP) patients. Methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at Maternidade Escola de Vila Nova Cachoeirinha (São Paulo) with a diagnosis of placenta previa. The groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of PP and predominant area of placental attachment. Possible associations between the dependent (accretion) and independent (maternal and placental characteristics) variables were evaluated using the chi² test, univariate and multivariate analyses. Results: reviewing 245 cases of PP, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (OR): 2.93) and two or more previous cesarean sections(OR: 2.54). Based on these data, a predictive model was constructed, according to which a patient with central PP and two more previous cesarean sections has a 44.4% risk for accretion. Conclusions: results of the current study may help obstetricians in the classification of their patients with PP in different risk categories for accretion. This could be useful in preparing for possible delivery complications in those patients considered at a higher risk for accretion.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):212-216
DOI 10.1590/S0100-72032002001000006
PURPOSE: to compare two methodologies for the calculation of placental volume in normal term pregnancies: one according to the Archimedes principle and the other to the cylinder volume, to estimate the absolute placental densities. Also, to define the methodology which relates to the weight and to the newborn classification. METHOD: fifty placentas from normal term pregnancies were tested by the two methodologies to estimate the placental volume and absolute density: a) Archimedes principle, and b) the cylinder volume with two possible different heights. The absolute placental densities were calculated, respectively, by the quotient between the placenta weight, properly standardized, and the different estimated volumes. RESULTS: most of the pregnant women had more than one gestation, average age of 25.4 years, mean placental volume between 547.8 and 610 cm³ and mean density between 0.94 and 1.14 g/cm³, depending on the used methodology. CONCLUSIONS: the Archimedes principle was the most appropriate methodology to estimate the term placental volume, best correlating with the newborn weight, the placental index and the classification of newborn weight in relation to gestational age.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(7):485-489
DOI 10.1590/S0100-72032002000700009
The most frequently nontrophoblastic tumor of the placenta found is chorioangioma, with an incidence of about 1%. When they are small, they do not significantly affect the fetus, but the large ones can cause intrauterine growth restriction, polyhydramnios, premature delivery, congestive heart failure and fetal death. The authors report a case of chorioangioma in a 28-year-old woman, second gestation, whose diagnosis was established at the 32nd week by ultrasound and confirmed by the anatomopathological examination. Ultrasonography evaluations showed chronic fetal distress and the delivery was performed at 36 weeks. The newborn results were satisfactory with Apgar 9-10 and fetal weight 2.460 g.