Pregnancy complications Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article04-13-2005

    T-cell leukemia virus infection in pregnant women in a Central-Western state of Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):719-725

    Abstract

    Original Article

    T-cell leukemia virus infection in pregnant women in a Central-Western state of Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):719-725

    DOI 10.1590/S0100-72032005001200003

    Views130

    PURPOSE: to evaluate the prevalence, epidemiological profile (age and origin) and vertical transmission rate of HTLV I/II infection in pregnant women screened by the Pregnant Protection Program of the State of Mato Grosso do Sul Brazil. METHODS: it is a descriptive and transversal study of 32,512 pregnant women submitted to a prenatal screening from November 2002 to October 2003. HTLV I/II infection was diagnosed in all pregnant women by ELISA, confirmed by Western blot and PCR. Congenital HTLV infection was investigated by ELISA test, Western blot and PCR performed on the child's blood sample. The associations between data (age, origin and HTLV infection) were statistically analyzed by the chi2 test considering p<0.05 to reject the null hypothesis. RESULTS: a prevalence of 0.1% (37) 0.1% HTLV I/II among 32,512 pregnant women was found. The mean age of the infected women was 25.4 ± 6.4 years, and 78.4% of them were from other areas than the capital. There was no association between maternal age and the patients' origin and infection. In all the eight evaluated newborns, which represented 21.6% of the sample, HTLV I/II serum antibodies were found. Only one newborn infant was breast-fed. CONCLUSIONS : HTLV I/II prevalence among pregnant women of the State of Mato Grosso do Sul Brazil was lower than the rates reported by endemic HTLV countries. This rate was almost the same as that described for non-endemic areas and in some Brazilian reports. The vertical transmission rate of HTLV I/II was 100%, in spite of breast-feeding having been proscribed. Improving the follow-up of the pregnant women and their newborns in the State is mandatory, since only a few infants were investigated.

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    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 Article01-30-2005

    Abdominal trauma in pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):541-547

    Abstract

    Original Article

    Abdominal trauma in pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):541-547

    DOI 10.1590/S0100-72032005000900007

    Views135

    PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores) of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with abdominal trauma and surgical treatment, from 1990 to 2002. Thirteen pregnant women with abdominal injury were identified. All cases were registered in the Epi-Info 6.04 protocol and data were analyzed statistically by the Fisher exact test, with confidence interval of 95%. RESULTS: ages ranged from 13 to 34 years (mean of 22.5). Six women (46.2%) were in the third trimester of pregnancy. Penetrating trauma accounted for 53.8% of injuries and in six of these patients the mechanism of trauma was gunshot wounds. Three patients had uterine injuries associated with fetal death. There were no maternal deaths and fetal mortality was 30.7%. The use of trauma scores was not associated with maternal and fetal mortality. Uterine injury was the only predictive risk factor for fetal loss (p=0.014). CONCLUSIONS: this is a retrospective study analyzing a small number of pregnant women victims of severe trauma. However, the results show that there are no predictive accuracy scores to evaluate maternal and fetal outcomes.

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  • Original Article01-30-2005

    Fetal macrosomia risk factors in pregnancies complicated by diabetes or daily hyperglycemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):580-587

    Abstract

    Original Article

    Fetal macrosomia risk factors in pregnancies complicated by diabetes or daily hyperglycemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):580-587

    DOI 10.1590/S0100-72032005001000003

    Views126

    PURPOSE: to identify risk factors for fetal macrosomia in pregnant women with diabetes or daily hyperglycemia. METHODS: retrospective study, control-case, including 803 pairs of mothers and newborns belonging to this specific population, divided into two groups - macrosomic (cases, n=242) and non-macrosomic (controls, n=561). Variables regarding age, parity, weight and body mass index (BMI), weight gain (WG), diabetes history, high blood pressure and tabagism, diabetes type and classification, and glycemic control indicators in the third trimester were compared. The means were evaluated by the F test and the categorized variables were submitted to univariate analysis using the chi² test. The significative results were included in the multiple regression model for the identification of macrosomia independent risk considering OR, 95% CI and p value. The statistical significance limit of 5% was established for all analyses. RESULTS: there was a significative association between macrosomia and WG >16 kg, BMI >25 kg/m², personal, obstetric and macrosomic history, classification in the Rudge groups (IB and IIA + IIB), glycemic mean (GM) >120 mg/dL and postprandial glycemic mean >130 mg/dL in the third trimester. In the multiple regression analysis, WG >16 kg (OR=1,79; 95% CI: 1,23-1.60), BMI >25 kg/m² (OR=1.83; 95% CI: 1.27-2.64), personal history of diabetes (OR=1.56; 95% CI: 1.05-2.31) and of macrosomia (OR=2.37; 95% CI: 1.60-3.50) and GM >120 mg/dL in the third trimester (OR=1.78; 95% CI: 1.13-2.80) confirmed to be independent risk factors for macrosomia in these pregnancies. CONCLUSION: WG >16 kg, BMI >25 kg/m², GM >120 mg/dL in the third trimester and personal history of macrosomia and diabetes were identified as risk factors for fetal macrosomia in pregnant women with diabetes or daily hyperglycemia.

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    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.
  • Case Report01-27-1999

    Abdominal pregnancy at term with live fetus: a case report

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(10):611-615

    Abstract

    Case Report

    Abdominal pregnancy at term with live fetus: a case report

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(10):611-615

    DOI 10.1590/S0100-72031999001000009

    Views118

    Term abdominal pregnancy with live fetus is an obstetrical rarity with high fetal and maternal morbidity and mortality. The authors present a case of abdominal pregnancy in a 43-year-old woman. The diagnosis was made only at term (37 weeks) by clinical findings and echography. Exploratory laparotomy was performed and a living female newborn weighing 2,570 g was extracted. Apgar scores were 3, 6 and 8 at the 1st, 5th and 10th minutes, respectively. Placenta was inserted in the omentum and was removed without complications. Postoperative course was uneventful and both mother and child were discharged healthy.

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    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 Article11-22-2005

    Effects of alcohol consumption during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):376-381

    Abstract

    Original Article

    Effects of alcohol consumption during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):376-381

    DOI 10.1590/S0100-72032005000700002

    Views190

    PURPOSE: to check alcohol consumption during pregnancy and to estimate teratogenic effects on the fetus. METHODS: the T-ACE questionnaire was applied to 150 women who had just given birth in a maternity hospital in Ribeirão Preto/SP, from April to November 2004. The patients were divided into those who consumed and those did not consume alcohol during gestation. The newborns of these women were evaluated regarding weight, length and head circumference at birth. These anthropometric measurements were compared with the alcoholic beverage consumption by the women. The data analysis was performed by Student's t test, Mann-Whitney U-test and chi2 test, with the level of significance set at 5%. RESULTS: among the interviewed women, 79.3% (119) were not identified as alcohol consumers by the T-ACE questionnaire and 20.7% (31) were considered consumers by this questionnaire. The newborns whose mothers did not consume alcohol had a mean length of 48.2 cm. On the other hand, those whose mothers used alcohol were 46.7 cm long, and such difference was statistically significant. A mean decrease of 109 g in weight and 0.42 cm in head circumference was observed in the children whose mothers had consumed alcohol. In the female fetuses the weight decrease was more pronounced (186 g). CONCLUSION: the T-ACE questionnaire was an effective screening instrument for detecting alcohol consumption during pregnancy. The use of alcohol during pregnancy was associated with fetal growth restriction. Apparently, the female fetuses were more susceptible to the effects of the use of alcohol during pregnancy.

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    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 Article11-11-2005

    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

    Abstract

    Original Article

    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

    DOI 10.1590/S0100-72032005000600003

    Views127

    PURPOSE: 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.

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  • Original Article10-17-2000

    Gestational and delivery complications as perinatal risk factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):19-26

    Abstract

    Original Article

    Gestational and delivery complications as perinatal risk factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):19-26

    DOI 10.1590/S0100-72032000000100004

    Views105

    Purpose: to evaluate gestational and delivery complications as risk factors for perinatal death. Methodology - Patients: the cases (perinatal deaths) were identified among a total of 3,031 deliveries from the maternity of the Rio de Janeiro State Military Police. Methods: the study design was a nested case-control one. Cases (n = 82) were perinatal deaths with a minimum gestational age of 28 weeks or a weight of 1,000 g. Controls (n = 246) were live babies for the first week of life. The analysis was made in three steps: univariate, stratified and multivariate (logistic regression). Results: the gestational complications showed an odds ratio of 4.21 and the delivery complications, 5.26. The newborn weight showed an OR = 0.999 per gram over 1,000 g weight. The gestational age showed an OR = 0.729 per week of gestation over 28 weeks. Conclusions: the gestational complications and the delivery complications were important risk factors for perinatal death. The gestational age and the weight of the newborn were important protective factors.

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  • Case Report10-10-2000

    Takayasu’s Arteritis and Pregnancy: a Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):113-116

    Abstract

    Case Report

    Takayasu’s Arteritis and Pregnancy: a Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):113-116

    DOI 10.1590/S0100-72032000000200009

    Views81

    Takayasu's arteritis is an idiopathic occlusive inflammation of the aorta and its major branches. The disease shows a striking predilection for young women and thus is occasionally associated with pregnancy. The authors describe a case of a pregnant patient with Takayasu's arteritis. The pregnancy was accompanied by a multidisciplinary group in a satisfactory way. There was only one hospitalization due to an exacerbation of the symptoms during the 32nd week of gestation, controlled by medical treatment. A vaginal delivery occurred at 37 weeks. A live infant weighing 2,750 g was delivered and the patient had an uncomplicated course.

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