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Original Article04-01-2015
Podocyturia in pregnant women with chronic hypertension may predict kidney injury?
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):172-177
Abstract
Original ArticlePodocyturia in pregnant women with chronic hypertension may predict kidney injury?
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):172-177
DOI 10.1590/SO100-720320150005238
Views166See morePURPOSE:
To evaluate the presence of podocyturia in chronic hypertensive pregnant women in the third trimester of pregnancy and its possible association with renal disease.
METHODS:
This was an observational study of a convenience sample of 38 chronic hypertensive pregnant women. The podocytes were labeled by the indirect immunofluorescence technique with anti-podocin and diamidino-phenylindole (DAPI). The count was made on 30 random fields analyzed and corrected according to urinary creatinine (podocytes/mg creatinine). The patients were assigned to two groups: NG (normal glomerular function), up to 100 podocytes, and GP (probable glomerulopathy), more than 100 podocytes. Urinary creatinine was measured by the alkaline picrate method. The variables analyzed were body mass index, gestational age, and systolic and diastolic blood pressure at the time of sample collection. Data were analyzed using the SPSS - version 16.0 (IBM - USA). Statistical analysis was performed by the χ2 test, and significant differences were considered when p<0.05.
RESULTS:
The median podocyte count was 20.3 (0.0-98.1) for group GN, and 176.9 (109.1-490.6) for GP. The mean body mass index was 30.2 kg/m2 (SD=5.6), mean gestational age was 35.1 weeks (SD=2.5), median systolic blood pressure was 130.0 mmHg (100.0-160.0) and median diastolic blood pressure was 80.0 mmHg (60.0-110.0). There was no significant correlation between podocyturia and body mass index (p=0.305), gestational age (p=0.392), systolic blood pressure (p=0.540) or diastolic blood pressure (p=0.540).
CONCLUSIONS:
In this study, there was no podocyturia pattern consistent with the presence of active renal disease, although some of the women studied (15.8%) exhibited a significant loss. We believe that it is premature to recommend the inclusion of the determination of podocyturia in routine prenatal clinical practice in chronically hypertensive pregnant women.
Views166
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. Abstract
Original ArticlePodocyturia in pregnant women with chronic hypertension may predict kidney injury?
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):172-177
DOI 10.1590/SO100-720320150005238
Views166See morePURPOSE:
To evaluate the presence of podocyturia in chronic hypertensive pregnant women in the third trimester of pregnancy and its possible association with renal disease.
METHODS:
This was an observational study of a convenience sample of 38 chronic hypertensive pregnant women. The podocytes were labeled by the indirect immunofluorescence technique with anti-podocin and diamidino-phenylindole (DAPI). The count was made on 30 random fields analyzed and corrected according to urinary creatinine (podocytes/mg creatinine). The patients were assigned to two groups: NG (normal glomerular function), up to 100 podocytes, and GP (probable glomerulopathy), more than 100 podocytes. Urinary creatinine was measured by the alkaline picrate method. The variables analyzed were body mass index, gestational age, and systolic and diastolic blood pressure at the time of sample collection. Data were analyzed using the SPSS - version 16.0 (IBM - USA). Statistical analysis was performed by the χ2 test, and significant differences were considered when p<0.05.
RESULTS:
The median podocyte count was 20.3 (0.0-98.1) for group GN, and 176.9 (109.1-490.6) for GP. The mean body mass index was 30.2 kg/m2 (SD=5.6), mean gestational age was 35.1 weeks (SD=2.5), median systolic blood pressure was 130.0 mmHg (100.0-160.0) and median diastolic blood pressure was 80.0 mmHg (60.0-110.0). There was no significant correlation between podocyturia and body mass index (p=0.305), gestational age (p=0.392), systolic blood pressure (p=0.540) or diastolic blood pressure (p=0.540).
CONCLUSIONS:
In this study, there was no podocyturia pattern consistent with the presence of active renal disease, although some of the women studied (15.8%) exhibited a significant loss. We believe that it is premature to recommend the inclusion of the determination of podocyturia in routine prenatal clinical practice in chronically hypertensive pregnant women.
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. -
Original Article10-03-2014
Protective role of the G allele of the polymorphism in the Interleukin 10 gene (-1082G/A) against the development of preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):456-460
Abstract
Original ArticleProtective role of the G allele of the polymorphism in the Interleukin 10 gene (-1082G/A) against the development of preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):456-460
DOI 10.1590/SO100-720320140005075
Views121See morePURPOSE:
To identify the frequency of polymorphism in the IL-10 gene, rs1800896 (-1082 A/G), in women with preeclampsia (PE) and in women in a control group and to associate the presence of this polymorphism with protection against the development of PE.
METHODS:
This was a case-control study conducted on 54 women with PE, classified according to the criteria of the National High Blood Pressure Education Program, and on 172 control women with at least two healthy pregnancies. The proposed polymorphism was studied by the technique of real time polymerase chain reaction (qPCR), with hydrolysis probes. Statistical analysis was performed using the χ2 test. Odds ratio and confidence interval of 95% were used to measure the strength of association between the studied polymorphism and the development of PE.
RESULTS:
Statistically increased frequency of the AG genotype was observed among control women (85 versus 15% in women with PE). The G allele was significantly more frequent among control women than PE women (χ2test, p = 0.01). The odds ratio for carriers of the G allele was 2.13, indicating a lower risk of developing PE compared to non-carriers.
CONCLUSIONS:
Thus, an association is suggested to occur between the presence of the G allele of the polymorphism in the IL-10 rs1800896 (-1082 A/G) gene and protection against the development of PE. More studies investigating the contribution of these variations and the mechanisms by which they affect the risk of developing PE still need to be undertaken.
Views121This 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. Abstract
Original ArticleProtective role of the G allele of the polymorphism in the Interleukin 10 gene (-1082G/A) against the development of preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):456-460
DOI 10.1590/SO100-720320140005075
Views121See morePURPOSE:
To identify the frequency of polymorphism in the IL-10 gene, rs1800896 (-1082 A/G), in women with preeclampsia (PE) and in women in a control group and to associate the presence of this polymorphism with protection against the development of PE.
METHODS:
This was a case-control study conducted on 54 women with PE, classified according to the criteria of the National High Blood Pressure Education Program, and on 172 control women with at least two healthy pregnancies. The proposed polymorphism was studied by the technique of real time polymerase chain reaction (qPCR), with hydrolysis probes. Statistical analysis was performed using the χ2 test. Odds ratio and confidence interval of 95% were used to measure the strength of association between the studied polymorphism and the development of PE.
RESULTS:
Statistically increased frequency of the AG genotype was observed among control women (85 versus 15% in women with PE). The G allele was significantly more frequent among control women than PE women (χ2test, p = 0.01). The odds ratio for carriers of the G allele was 2.13, indicating a lower risk of developing PE compared to non-carriers.
CONCLUSIONS:
Thus, an association is suggested to occur between the presence of the G allele of the polymorphism in the IL-10 rs1800896 (-1082 A/G) gene and protection against the development of PE. More studies investigating the contribution of these variations and the mechanisms by which they affect the risk of developing PE still need to be undertaken.
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. -
Original Article10-03-2014
Clinical and laboratory characteristics of pregnant women with preeclampsia versus gestational hypertension
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):461-466
Abstract
Original ArticleClinical and laboratory characteristics of pregnant women with preeclampsia versus gestational hypertension
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):461-466
DOI 10.1590/SO100-720320140005029
Views146See morePURPOSE:
To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension.
METHODS:
A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2test, with the level of significance set at p<0.05.
RESULTS:
Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group.
CONCLUSION:
Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes.
Views146This 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. Abstract
Original ArticleClinical and laboratory characteristics of pregnant women with preeclampsia versus gestational hypertension
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):461-466
DOI 10.1590/SO100-720320140005029
Views146See morePURPOSE:
To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension.
METHODS:
A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2test, with the level of significance set at p<0.05.
RESULTS:
Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group.
CONCLUSION:
Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes.
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. -
Original Article06-01-2014
Factors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
Abstract
Original ArticleFactors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
DOI 10.1590/S0100-720320140004812
Views82See morePURPOSE:
To analyze the factors related to route of delivery in patients with pre-eclampsia.
METHODS:
A retrospective analytical study was conducted from January 2009 to January 2011, during which 250 medical records of patients diagnosed with pre-eclampsia who gave birth to live fetuses with a gestational age of 28 weeks or more were selected. The variables evaluated were: maternal age (19 years, 20−34 years and over 35 full years), gestational age at delivery (28−37 weeks and more than 37 weeks), parity (primiparous or multiparous), previous cesarean section, history of pre-eclampsia or chronic hypertension, current diagnosis of mild or severe pre-eclampsia, and birth weight of the newborn. The information was transcribed to a questionnaire based on the variables being investigated. The chi-square test was applied to identify the relationship between the variables, with the level of significance set at p<0.05, and the Odds Ratio (OR) was calculated only for the variables showing a statistically significant difference in order to determine the odds for the patient to be submitted to a cesarean section.
RESULTS:
In this study, we observed a 78.4% rate of cesarean delivery, with 54.1% of the patients submitted to the procedure having a gestational age of 28 to 37 weeks (OR=3.1; p<0.01). Patients with a history of pre-eclampsia were 2.5 times more likely to have cesarean delivery (OR=2.5; p<0.02). All patients who had had a previous cesarean were submitted to cesarean delivery in the current pregnancy (p<0.01). Pregnant women with severe pre-eclampsia were 3.3 times more likely to progress to cesarean delivery than those with mild pre-eclampsia (OR=3.3; p<0.01).
CONCLUSION:
After individual analysis, only gestational age and a diagnosis of severe pre-eclampsia showed significant differences, representing risk factors for this type of delivery.
Views82This 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. Abstract
Original ArticleFactors associated with mode of delivery in women with pre-eclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):259-263
DOI 10.1590/S0100-720320140004812
Views82See morePURPOSE:
To analyze the factors related to route of delivery in patients with pre-eclampsia.
METHODS:
A retrospective analytical study was conducted from January 2009 to January 2011, during which 250 medical records of patients diagnosed with pre-eclampsia who gave birth to live fetuses with a gestational age of 28 weeks or more were selected. The variables evaluated were: maternal age (19 years, 20−34 years and over 35 full years), gestational age at delivery (28−37 weeks and more than 37 weeks), parity (primiparous or multiparous), previous cesarean section, history of pre-eclampsia or chronic hypertension, current diagnosis of mild or severe pre-eclampsia, and birth weight of the newborn. The information was transcribed to a questionnaire based on the variables being investigated. The chi-square test was applied to identify the relationship between the variables, with the level of significance set at p<0.05, and the Odds Ratio (OR) was calculated only for the variables showing a statistically significant difference in order to determine the odds for the patient to be submitted to a cesarean section.
RESULTS:
In this study, we observed a 78.4% rate of cesarean delivery, with 54.1% of the patients submitted to the procedure having a gestational age of 28 to 37 weeks (OR=3.1; p<0.01). Patients with a history of pre-eclampsia were 2.5 times more likely to have cesarean delivery (OR=2.5; p<0.02). All patients who had had a previous cesarean were submitted to cesarean delivery in the current pregnancy (p<0.01). Pregnant women with severe pre-eclampsia were 3.3 times more likely to progress to cesarean delivery than those with mild pre-eclampsia (OR=3.3; p<0.01).
CONCLUSION:
After individual analysis, only gestational age and a diagnosis of severe pre-eclampsia showed significant differences, representing risk factors for this type of 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. -
Original Article10-10-2013
Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):357-362
Abstract
Original ArticleReference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):357-362
DOI 10.1590/S0100-72032013000800004
Views140PURPOSE: To establish reference values for the first trimester uterine artery resistance index (UtA-RI) and pulsatility index (UtA-PI) in healthy singleton pregnant women from Northeast Brazil. METHODS: A prospective observational cohort study including 409 consecutive singleton pregnancies undergoing routine early ultrasound screening at 11 - 14 weeks of gestation was performed. The patients responded to a questionnaire to assess maternal epidemiological characteristics. The left and right UtA-PI and UtA-RI were examined by color and pulsed Doppler by transabdominal technique and the mean UtA-PI, mean UtA-RI and the presence of bilateral protodiastolic notching were recorded. Quartile regression was used to estimate reference values. RESULTS: The mean±standard deviation UtA-RI and UtA-PI were 0.7±0.1 and 1.5±0.5, respectively. When segregated for gestation age, mean UtA-PI was 1.6±0.5 at 11 weeks, 1.5±0.6 at 12 weeks, 1.4±0.4 at 13 weeks and 1.3±0.4 at 14 weeks' gestation and mean UtA-RI was 0.7±0.1 at 11 weeks, 0.7±0.1 at 12 weeks, 0.6±0.1 at 13 weeks and 0.6±0.1 at 14 weeks' gestation. Uterine artery bilateral notch was present in 261 (63.8%) patients. We observed that the 5th and 95th percentiles of the UtA-PI and UtA-RI uterine arteries were 0.7 and 2.3 and, 0.5 and 0.8, respectively. CONCLUSION: Normal reference range of uterine artery Doppler in healthy singleton pregnancies from Northeast Brazil was established. The 95th percentile of UtA-PI and UtA-RI values may serve as a cut-off for future prediction of pregnancy complications studies (i.e., pre-eclampsia) in Northeast Brazil.
Key-words Fetal growth retardationPlacental circulationPre-eclampsiaPregnancy trimester, firstUltrasonography, dopplerSee moreViews140This 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. Abstract
Original ArticleReference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):357-362
DOI 10.1590/S0100-72032013000800004
Views140PURPOSE: To establish reference values for the first trimester uterine artery resistance index (UtA-RI) and pulsatility index (UtA-PI) in healthy singleton pregnant women from Northeast Brazil. METHODS: A prospective observational cohort study including 409 consecutive singleton pregnancies undergoing routine early ultrasound screening at 11 - 14 weeks of gestation was performed. The patients responded to a questionnaire to assess maternal epidemiological characteristics. The left and right UtA-PI and UtA-RI were examined by color and pulsed Doppler by transabdominal technique and the mean UtA-PI, mean UtA-RI and the presence of bilateral protodiastolic notching were recorded. Quartile regression was used to estimate reference values. RESULTS: The mean±standard deviation UtA-RI and UtA-PI were 0.7±0.1 and 1.5±0.5, respectively. When segregated for gestation age, mean UtA-PI was 1.6±0.5 at 11 weeks, 1.5±0.6 at 12 weeks, 1.4±0.4 at 13 weeks and 1.3±0.4 at 14 weeks' gestation and mean UtA-RI was 0.7±0.1 at 11 weeks, 0.7±0.1 at 12 weeks, 0.6±0.1 at 13 weeks and 0.6±0.1 at 14 weeks' gestation. Uterine artery bilateral notch was present in 261 (63.8%) patients. We observed that the 5th and 95th percentiles of the UtA-PI and UtA-RI uterine arteries were 0.7 and 2.3 and, 0.5 and 0.8, respectively. CONCLUSION: Normal reference range of uterine artery Doppler in healthy singleton pregnancies from Northeast Brazil was established. The 95th percentile of UtA-PI and UtA-RI values may serve as a cut-off for future prediction of pregnancy complications studies (i.e., pre-eclampsia) in Northeast Brazil.
Key-words Fetal growth retardationPlacental circulationPre-eclampsiaPregnancy trimester, firstUltrasonography, dopplerSee 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. -
Original Article10-10-2013
Evaluation of perinatal factors that influence the incidence of necrotizing enterocolitis in very low birth weight infants
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):363-367
Abstract
Original ArticleEvaluation of perinatal factors that influence the incidence of necrotizing enterocolitis in very low birth weight infants
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):363-367
DOI 10.1590/S0100-72032013000800005
Views89See morePURPOSE: To evaluate the perinatal factors that influence the incidence of necrotizing enterocolitis (NEC) in newborns infants (NBI) weighing less than 1,500 g. METHODS: A prospective study that analyzed all infants with birth weight (BW) less than 1,500 g born between January 2006 to December 2010 (n=183). They were divided into two groups, i.e. infants diagnosed with NEC (n=18) and infants without a diagnosis of NEC (n=165), which were compared in terms of perinatal factors that could influence the incidence of NEC. Mean data were compared by Student's t-test or nonparametric tests and percentages of categorical variables were compared by the χ² test. When the variables showed differences between groups, they were analyzed using logistic regression with the dependent variable as the presence of NEC. The statistical package used was SPSS 16.0 for Windows. RESULTS: The two groups were similar in terms of most of the clinical and demographic neonatal and maternal data, except for the presence of preeclampsia (PE), which was higher in patients whose children developed NEC (61.1 versus 35,6%). The presence of PE increased the chance of occurrence of NEC by 2.84 times (95%CI 1.0 - 7.7). CONCLUSION: The only factor that can interfere with the incidence of NEC in infants of very low birth weight was the presence of PE. Awareness of this fact can guide the perinatal team in providing more judicious care regarding the prevention of NEC in this specific population.
Views89This 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. Abstract
Original ArticleEvaluation of perinatal factors that influence the incidence of necrotizing enterocolitis in very low birth weight infants
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):363-367
DOI 10.1590/S0100-72032013000800005
Views89See morePURPOSE: To evaluate the perinatal factors that influence the incidence of necrotizing enterocolitis (NEC) in newborns infants (NBI) weighing less than 1,500 g. METHODS: A prospective study that analyzed all infants with birth weight (BW) less than 1,500 g born between January 2006 to December 2010 (n=183). They were divided into two groups, i.e. infants diagnosed with NEC (n=18) and infants without a diagnosis of NEC (n=165), which were compared in terms of perinatal factors that could influence the incidence of NEC. Mean data were compared by Student's t-test or nonparametric tests and percentages of categorical variables were compared by the χ² test. When the variables showed differences between groups, they were analyzed using logistic regression with the dependent variable as the presence of NEC. The statistical package used was SPSS 16.0 for Windows. RESULTS: The two groups were similar in terms of most of the clinical and demographic neonatal and maternal data, except for the presence of preeclampsia (PE), which was higher in patients whose children developed NEC (61.1 versus 35,6%). The presence of PE increased the chance of occurrence of NEC by 2.84 times (95%CI 1.0 - 7.7). CONCLUSION: The only factor that can interfere with the incidence of NEC in infants of very low birth weight was the presence of PE. Awareness of this fact can guide the perinatal team in providing more judicious care regarding the prevention of NEC in this specific population.
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. -
Original Article09-27-2013
Factors associated with fetal brain-sparing effect in patients with hypertension in pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(7):309-316
Abstract
Original ArticleFactors associated with fetal brain-sparing effect in patients with hypertension in pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(7):309-316
DOI 10.1590/S0100-72032013000700005
Views114PURPOSE: To determine perinatal outcomes and factors associated with fetal brain sparing effect diagnosed by Doppler flow velocimetry in patients with arterial hypertension. METHODS: We performed a cross-sectional retrospective study including 129 pregnant women with arterial hypertension and submitted to Doppler flow velocimetry, within fifteen days before delivery. Women with multiple pregnancies, fetal malformations, genital bleeding, placenta praevia, premature rupture of membranes, smoking, illicit drug use and chronic diseases were excluded. We analyzed the biological, socio-demographic and obstetric characteristics, as well the perinatal outcomes. To determine the association between variables, we used the χ² test, Fisher's exact test and Student's t-test. Multiple logistic regression analysis was performed to determine the factors associated with fetal centralization. RESULTS: Pre-eclampsia was the most frequent hypertensive disorder (53.5%) and fetal brain sparing effect was observed in 24.0% of fetuses. The prenatal factors associated with fetal brain sparing were the persistence of bilateral protodiastolic notches in uterine arteries (OR 3.6; 95%CI 1.4 - 9.4; p=0.009) and intrauterine growth restriction (IUGR) (OR 3.3; 95%CI 1.2 - 9.3; p=0.02). The perinatal outcomes associated with fetal brain sparing were gestational age <32 weeks, small for gestational age (SGA) infants, birth weight <2,500 g and perinatal death. There was no association with other maternal or neonatal variables. CONCLUSIONS: The main factors associated with fetal brain sparing were persistence of uterine arteries notches, IUGR, and increased frequency of adverse perinatal outcomes.
Key-words DopplerHypertension, pregnancy-inducedMiddle cerebral arteryPre-eclampsiaUltrasonographyUmbilical arteriesSee moreViews114This 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. Abstract
Original ArticleFactors associated with fetal brain-sparing effect in patients with hypertension in pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(7):309-316
DOI 10.1590/S0100-72032013000700005
Views114PURPOSE: To determine perinatal outcomes and factors associated with fetal brain sparing effect diagnosed by Doppler flow velocimetry in patients with arterial hypertension. METHODS: We performed a cross-sectional retrospective study including 129 pregnant women with arterial hypertension and submitted to Doppler flow velocimetry, within fifteen days before delivery. Women with multiple pregnancies, fetal malformations, genital bleeding, placenta praevia, premature rupture of membranes, smoking, illicit drug use and chronic diseases were excluded. We analyzed the biological, socio-demographic and obstetric characteristics, as well the perinatal outcomes. To determine the association between variables, we used the χ² test, Fisher's exact test and Student's t-test. Multiple logistic regression analysis was performed to determine the factors associated with fetal centralization. RESULTS: Pre-eclampsia was the most frequent hypertensive disorder (53.5%) and fetal brain sparing effect was observed in 24.0% of fetuses. The prenatal factors associated with fetal brain sparing were the persistence of bilateral protodiastolic notches in uterine arteries (OR 3.6; 95%CI 1.4 - 9.4; p=0.009) and intrauterine growth restriction (IUGR) (OR 3.3; 95%CI 1.2 - 9.3; p=0.02). The perinatal outcomes associated with fetal brain sparing were gestational age <32 weeks, small for gestational age (SGA) infants, birth weight <2,500 g and perinatal death. There was no association with other maternal or neonatal variables. CONCLUSIONS: The main factors associated with fetal brain sparing were persistence of uterine arteries notches, IUGR, and increased frequency of adverse perinatal outcomes.
Key-words DopplerHypertension, pregnancy-inducedMiddle cerebral arteryPre-eclampsiaUltrasonographyUmbilical arteriesSee 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. -
Original Article06-06-2013
Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
Abstract
Original ArticleObstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
DOI 10.1590/S0100-72032013000400003
Views87PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.
Key-words Cesarean sectionDelivery, obstetricsInfant, newbornObstetric labor, prematurePre-eclampsiaPregnancyPregnancy outcomeSee 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. Abstract
Original ArticleObstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):148-152
DOI 10.1590/S0100-72032013000400003
Views87PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.
Key-words Cesarean sectionDelivery, obstetricsInfant, newbornObstetric labor, prematurePre-eclampsiaPregnancyPregnancy outcomeSee 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.
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