-
Case Report02-01-2010
Acute abdomen in pregnant woman treated for bariatric surgery for obesity: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(10):516-519
Abstract
Case ReportAcute abdomen in pregnant woman treated for bariatric surgery for obesity: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(10):516-519
DOI 10.1590/S0100-72032010001000008
Views95Bariatric surgery is currently considered as an alternative for the treatment of morbid obesity refractory to conventional clinical treatments. The surgeries more frequently used, which are radical and invasive, yield better and faster results, but are subject to clinical and surgical complications such as intestinal obstructions and subocclusions. Pregnancies in women submitted to this type of surgery are increasingly frequent, and the related complications have been increasingly reported. We present the case of a pregnant woman previously submitted to bariatric surgery who developed subocclusion with intestinal intussusception. This extremely serious complication requires attention for its diagnosis, i.e. , imaging and laboratory exams that are not usually employed during pregnancy. Gestation confuses and impairs their interpretation. In addition to the fact that the only treatment that reaches a good result is invasive, exploratory laparotomy is undesirable during this period. Maternal, fetal and perinatal mortality is usually high. In the present case, delivery occurred spontaneously during the first hours of hospitalization before the surgical procedure. Evolution was good and both mother and newborn, although premature, had good course and were discharged in good conditions.
Key-words Acute abdomenBariatric surgeryIntestinal obstructionObesity, morbidPregnancy complicationsSee moreViews95
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
Case ReportAcute abdomen in pregnant woman treated for bariatric surgery for obesity: case report
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(10):516-519
DOI 10.1590/S0100-72032010001000008
Views95Bariatric surgery is currently considered as an alternative for the treatment of morbid obesity refractory to conventional clinical treatments. The surgeries more frequently used, which are radical and invasive, yield better and faster results, but are subject to clinical and surgical complications such as intestinal obstructions and subocclusions. Pregnancies in women submitted to this type of surgery are increasingly frequent, and the related complications have been increasingly reported. We present the case of a pregnant woman previously submitted to bariatric surgery who developed subocclusion with intestinal intussusception. This extremely serious complication requires attention for its diagnosis, i.e. , imaging and laboratory exams that are not usually employed during pregnancy. Gestation confuses and impairs their interpretation. In addition to the fact that the only treatment that reaches a good result is invasive, exploratory laparotomy is undesirable during this period. Maternal, fetal and perinatal mortality is usually high. In the present case, delivery occurred spontaneously during the first hours of hospitalization before the surgical procedure. Evolution was good and both mother and newborn, although premature, had good course and were discharged in good conditions.
Key-words Acute abdomenBariatric surgeryIntestinal obstructionObesity, morbidPregnancy 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. -
Original Article09-28-2010
Maternal complications following endoscopic surgeries in fetal Medicine
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):260-266
Abstract
Original ArticleMaternal complications following endoscopic surgeries in fetal Medicine
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):260-266
DOI 10.1590/S0100-72032010000600002
Views164PURPOSE: to describe the maternal complications due to therapeutic endoscopic procedures in fetal Medicine performed at an university center in Brazil. METHODS: retrospective observational study including patients treated from April 2007 to May 2010 who underwent laser ablation of placental vessels (LAPV) for severe twin-twin transfusion syndrome (TTTS); fetal tracheal occlusion (FETO) and endoscopic removal of tracheal balloon in cases of severe congenital diaphragmatic hernia (CDH); LAPV with or without bipolar coagulation of the umbilical cord in cases of twin reversed arterial perfusion (TRAP) sequence. The main variables described for each disease/type of surgery were maternal complications and neonatal survival (discharge from nursery). RESULTS: fifty-six patients underwent 70 procedures: Severe TTTS (34 patients; 34 surgeries); severe CDH (16 patients; 30 surgeries), and TRAP sequence (6 patients; 6 surgeries). Among 34 women who underwent LAPV for TTTS, two (2/34=5.9%) experienced amniotic fluid leakage to the peritoneal cavity and seven (7/34=20.6%) miscarried after the procedure. Survival of at least one twin was 64.7% (22/34). Among 30 interventions performed in cases of CDH, there was amniotic fluid leakage into the maternal peritoneal cavity in one patient (1/30=3.3%) and premature preterm rupture of membranes after three (3/30=30%) fetoscopies for removal of the tracheal balloon. Infant survival with discharge from nursery was 43.8% (7/16). Among six cases of TRAP sequence, there was bleeding into the peritoneal cavity after surgery in one patient (1/6=16.7%) and neonatal survival with discharge from nursery was 50% (3/6). CONCLUSIONS: in agreement with the available data in literature, at our center, the benefits related to therapeutic endoscopic interventions for TTTS, CDH and TRAP sequence seem to overcome the risks of maternal complications, which were rarely considered severe.
Key-words Fetal heartFetofetal transfusionHernia diaphragmaticPlacental circulationPregnancy complicationsSee moreViews164This 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 ArticleMaternal complications following endoscopic surgeries in fetal Medicine
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):260-266
DOI 10.1590/S0100-72032010000600002
Views164PURPOSE: to describe the maternal complications due to therapeutic endoscopic procedures in fetal Medicine performed at an university center in Brazil. METHODS: retrospective observational study including patients treated from April 2007 to May 2010 who underwent laser ablation of placental vessels (LAPV) for severe twin-twin transfusion syndrome (TTTS); fetal tracheal occlusion (FETO) and endoscopic removal of tracheal balloon in cases of severe congenital diaphragmatic hernia (CDH); LAPV with or without bipolar coagulation of the umbilical cord in cases of twin reversed arterial perfusion (TRAP) sequence. The main variables described for each disease/type of surgery were maternal complications and neonatal survival (discharge from nursery). RESULTS: fifty-six patients underwent 70 procedures: Severe TTTS (34 patients; 34 surgeries); severe CDH (16 patients; 30 surgeries), and TRAP sequence (6 patients; 6 surgeries). Among 34 women who underwent LAPV for TTTS, two (2/34=5.9%) experienced amniotic fluid leakage to the peritoneal cavity and seven (7/34=20.6%) miscarried after the procedure. Survival of at least one twin was 64.7% (22/34). Among 30 interventions performed in cases of CDH, there was amniotic fluid leakage into the maternal peritoneal cavity in one patient (1/30=3.3%) and premature preterm rupture of membranes after three (3/30=30%) fetoscopies for removal of the tracheal balloon. Infant survival with discharge from nursery was 43.8% (7/16). Among six cases of TRAP sequence, there was bleeding into the peritoneal cavity after surgery in one patient (1/6=16.7%) and neonatal survival with discharge from nursery was 50% (3/6). CONCLUSIONS: in agreement with the available data in literature, at our center, the benefits related to therapeutic endoscopic interventions for TTTS, CDH and TRAP sequence seem to overcome the risks of maternal complications, which were rarely considered severe.
Key-words Fetal heartFetofetal transfusionHernia diaphragmaticPlacental circulationPregnancy 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. -
Thesis Abstract03-15-2010
Monoamniotic pregnancy and umbilical cord entanglement: case report and literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(2):94-98
Abstract
Thesis AbstractMonoamniotic pregnancy and umbilical cord entanglement: case report and literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(2):94-98
DOI 10.1590/S0100-72032010000200008
Views99See moreMonoamniotic twin pregnancies are very rare, but they are associated with high fetal morbidity and mortality. There is much controversy regarding the follow-up and obstetric procedures towards prenatal diagnosis of intertwined umbilical cords. In this article, we describe a case of monoamniotic pregnancy with diagnosis of intertwined umbilical cords, and we discuss aspects related to the follow-up and obstetric procedures through a brief literature review.
Views99This 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
Thesis AbstractMonoamniotic pregnancy and umbilical cord entanglement: case report and literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(2):94-98
DOI 10.1590/S0100-72032010000200008
Views99See moreMonoamniotic twin pregnancies are very rare, but they are associated with high fetal morbidity and mortality. There is much controversy regarding the follow-up and obstetric procedures towards prenatal diagnosis of intertwined umbilical cords. In this article, we describe a case of monoamniotic pregnancy with diagnosis of intertwined umbilical cords, and we discuss aspects related to the follow-up and obstetric procedures through a brief literature review.
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 Article01-18-2009
High-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):604-608
Abstract
Original ArticleHigh-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):604-608
DOI 10.1590/S0100-72032009001200005
Views142See morePURPOSE: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. METHODS: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. RESULTS: from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11th week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. CONCLUSIONS: all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.
Views142This 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 ArticleHigh-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):604-608
DOI 10.1590/S0100-72032009001200005
Views142See morePURPOSE: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. METHODS: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. RESULTS: from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11th week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. CONCLUSIONS: all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.
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 Article01-18-2009
Effects of maternal anemia on computerized cardiotocography and fetal biophysical profile
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):615-620
Abstract
Original ArticleEffects of maternal anemia on computerized cardiotocography and fetal biophysical profile
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):615-620
DOI 10.1590/S0100-72032009001200007
Views150See morePURPOSES: to evaluate the influence of maternal hemoglobin (Hb) levels in the patterns of fetal heart rate (FHR) and in the fetal biophysical profile (FBP) in term gestations. METHODS: pregnant women with anemia (Hb<11.0 g/dL) were prospectively evaluated between the 36th and the 40th week of gestation, from January 2008 to March 2009. The Control Group was composed of term and healthy pregnant women, with normal values of hemoglobin (Hb>11,0 g/dL). Cases of anomalies or fetal growing restrictions were excluded. The FHR evaluation was performed by computerized cardiotocography (8002 System-Sonicaid), and by record analysis during 30 minutes of exam. The FBP was done in all the patients. Student's, χ2 and Fisher's exact tests were used, with 0.05 significance level. RESULTS: The average of maternal Hb in the group with anemia (n=18) was 9.4 g/dL (DP=1.4 g/dL), and in the control group, 12.4g/dL (DP=1.3 g/dL). There has been no significant mean differences between groups concerning the cardiotocography parameters, respectively: basal FHR(131.3 versus 133.7 bpm, p=0.5), FHR accelerations > 10b pm (7.9 versus 8.2, p=0.866), FHR accelerations > 15 bpm (5.2 versus. 5.4, p=0.9), episodes of high variation of the FHR (17.1 versus 15.5 min, p=0,5), episodes of variation of the FHR (4.4 versus 3.6 min, p=06), and short term variation (10.5 versus 10.9 ms, p=0.5). In both groups, all patients presented normal FBP. CONCLUSIONS: this study suggests that light or moderate maternal anemia, without other maternal or fetal comorbidity, is not associated with abnormalities in the parameters of fetal biophysical profile and of the FHR analyzed by computerized cardiotocography.
Views150This 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 ArticleEffects of maternal anemia on computerized cardiotocography and fetal biophysical profile
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):615-620
DOI 10.1590/S0100-72032009001200007
Views150See morePURPOSES: to evaluate the influence of maternal hemoglobin (Hb) levels in the patterns of fetal heart rate (FHR) and in the fetal biophysical profile (FBP) in term gestations. METHODS: pregnant women with anemia (Hb<11.0 g/dL) were prospectively evaluated between the 36th and the 40th week of gestation, from January 2008 to March 2009. The Control Group was composed of term and healthy pregnant women, with normal values of hemoglobin (Hb>11,0 g/dL). Cases of anomalies or fetal growing restrictions were excluded. The FHR evaluation was performed by computerized cardiotocography (8002 System-Sonicaid), and by record analysis during 30 minutes of exam. The FBP was done in all the patients. Student's, χ2 and Fisher's exact tests were used, with 0.05 significance level. RESULTS: The average of maternal Hb in the group with anemia (n=18) was 9.4 g/dL (DP=1.4 g/dL), and in the control group, 12.4g/dL (DP=1.3 g/dL). There has been no significant mean differences between groups concerning the cardiotocography parameters, respectively: basal FHR(131.3 versus 133.7 bpm, p=0.5), FHR accelerations > 10b pm (7.9 versus 8.2, p=0.866), FHR accelerations > 15 bpm (5.2 versus. 5.4, p=0.9), episodes of high variation of the FHR (17.1 versus 15.5 min, p=0,5), episodes of variation of the FHR (4.4 versus 3.6 min, p=06), and short term variation (10.5 versus 10.9 ms, p=0.5). In both groups, all patients presented normal FBP. CONCLUSIONS: this study suggests that light or moderate maternal anemia, without other maternal or fetal comorbidity, is not associated with abnormalities in the parameters of fetal biophysical profile and of the FHR analyzed by computerized cardiotocography.
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 Article01-12-2009
Comparison of two methods for the investigation of maternal mortality in a municipality of the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(11):559-565
Abstract
Original ArticleComparison of two methods for the investigation of maternal mortality in a municipality of the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(11):559-565
DOI 10.1590/S0100-72032009001100006
Views107PURPOSE: to compare maternal death data from the National Death Information System (DIS), with a death survey of 10 to 49 year-old women at reproductive age (RAMOS), in order to identify sub-notification and to search for causes of maternal death (MD) from 1999 to 2006. METHODS: population based temporal series taken from death certificate (DC) information from Fundação Sistema Estadual de Análise de Dados (SEADE) database, with the death causes codified by the International Classification of Diseases (ICD), tenth revision, and the number of born alive babies (BA). Death was categorized into declared, presumptive MD and non-maternal. The identification of cases was done from a list with both the birth and death dates in the municipal morgues, and further information was obtained in the epidemiological sector of the Municipal Committee of Surveillance of Maternal Death (MCSMD). Information on MD was raised in the DIS. Sub-notification rates in cases of declared and non-declared MD were identified, maternal official death rates (MDR) and the adjusted factor for the period were calculated and corrected, and MD cases were reviewed and classified. RESULTS: twelve MD were identified, six of them declared and six non-declared. Sub-notification rate was 50%, giving an adjusting factor equal to 2. The official MDR was 14.7 and the corrected one was 29.4 deaths by 100,000 born alive. In most of the cases, the basic causes of death were mistaken. Direct obstetric causes were more prevalent, among them eclampsia and HELLP syndrome, followed by infections. CONCLUSIONS: political and administrative measures are needed for the effective action of MD survey committees. The prevalence of direct obstetric causes indicates failures in maternal and perinatal care.
Key-words Death certificatesHypertension, pregnancy-inducedMaternal mortalityPregnancy complicationsUnderlying cause of deathSee moreViews107This 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 ArticleComparison of two methods for the investigation of maternal mortality in a municipality of the Brazilian Southeast
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(11):559-565
DOI 10.1590/S0100-72032009001100006
Views107PURPOSE: to compare maternal death data from the National Death Information System (DIS), with a death survey of 10 to 49 year-old women at reproductive age (RAMOS), in order to identify sub-notification and to search for causes of maternal death (MD) from 1999 to 2006. METHODS: population based temporal series taken from death certificate (DC) information from Fundação Sistema Estadual de Análise de Dados (SEADE) database, with the death causes codified by the International Classification of Diseases (ICD), tenth revision, and the number of born alive babies (BA). Death was categorized into declared, presumptive MD and non-maternal. The identification of cases was done from a list with both the birth and death dates in the municipal morgues, and further information was obtained in the epidemiological sector of the Municipal Committee of Surveillance of Maternal Death (MCSMD). Information on MD was raised in the DIS. Sub-notification rates in cases of declared and non-declared MD were identified, maternal official death rates (MDR) and the adjusted factor for the period were calculated and corrected, and MD cases were reviewed and classified. RESULTS: twelve MD were identified, six of them declared and six non-declared. Sub-notification rate was 50%, giving an adjusting factor equal to 2. The official MDR was 14.7 and the corrected one was 29.4 deaths by 100,000 born alive. In most of the cases, the basic causes of death were mistaken. Direct obstetric causes were more prevalent, among them eclampsia and HELLP syndrome, followed by infections. CONCLUSIONS: political and administrative measures are needed for the effective action of MD survey committees. The prevalence of direct obstetric causes indicates failures in maternal and perinatal care.
Key-words Death certificatesHypertension, pregnancy-inducedMaternal mortalityPregnancy complicationsUnderlying cause of deathSee 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 Article10-22-2009
Pica: epidemiology and association with pregnancy complications
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
Abstract
Original ArticlePica: epidemiology and association with pregnancy complications
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
Views195See morePURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
Views195This 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 ArticlePica: epidemiology and association with pregnancy complications
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
Views195See morePURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
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 Article10-09-2009
Group B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(8):397-403
Abstract
Original ArticleGroup B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(8):397-403
DOI 10.1590/S0100-72032009000800005
Views88PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS) in pregnant women with premature labor (PL) and/or premature membrane rupture (PMR). METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval) and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases). The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS detection rate was significantly higher with the use of a selective milieu and collection from both anal and vaginal sources. The neonatal colonization rate was 3.1%. Two cases of early sepsis by GBS occurred in the sample, with prevalence of 10.8 cases per one thousand live births and 50% mortality rate. CONCLUSION: the studied sample showed high maternal colonization rates by Streptococcus agalactiae. To increase GBS detection rate, it is necessary to use a selective culture milieu and to combine anal-rectal and vaginal cultures. There was a high incidence of early neonatal sepsis.
Key-words Fetal membranes, premature ruptureObstetric labor, prematurePregnancy complicationsStreptococcus agalactiaeSee moreViews88This 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 ArticleGroup B streptococcus maternal and neonatal colonization in preterm rupture of membranes and preterm labor
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(8):397-403
DOI 10.1590/S0100-72032009000800005
Views88PURPOSE: to indentify the prevalence and risk factors of maternal colonization by group B streptococcus (GBS) in pregnant women with premature labor (PL) and/or premature membrane rupture (PMR). METHODS: two anal and two vaginal swabs were collected from 203 pregnant women with diagnosis of PL or PMR assisted at the practice along one year. Pregnant women with imminent labor at admission were excluded. One swab of each source was placed in a transfer milieu and sent for culture in blood-agar plates; the two remaining swabs were incubated for 24 hours in Todd-Hewitt milieu for further sowing in blood-agar plates. Risk factors were analyzed by the chi-square test, Student's t-test (p-value set at 0.05 and 95% confidence interval) and logistic regression. The following variables were analyzed: age, race, parity and mother schooling; culture results by source and type of culture; admission diagnosis; gestational age at admission; asymptomatic bacteriuria; gestational age at delivery; type of delivery; neonatal GBS colonization rate and immediate neonatal condition. RESULTS: prevalence of maternal GBS colonization was 27.6% (56 cases). The colonization rates according to gestational complications were 30% for PMR, 25.2% for PL and 17.8% for PL + PMR. Univariate analysis has shown that the variables Caucasian race, low level of schooling and bacteriuria were associated with higher colonization rates. Multivariate analysis showed that the presence of urinary infection was the only variable associated with maternal colonization. The GBS detection rate was significantly higher with the use of a selective milieu and collection from both anal and vaginal sources. The neonatal colonization rate was 3.1%. Two cases of early sepsis by GBS occurred in the sample, with prevalence of 10.8 cases per one thousand live births and 50% mortality rate. CONCLUSION: the studied sample showed high maternal colonization rates by Streptococcus agalactiae. To increase GBS detection rate, it is necessary to use a selective culture milieu and to combine anal-rectal and vaginal cultures. There was a high incidence of early neonatal sepsis.
Key-words Fetal membranes, premature ruptureObstetric labor, prematurePregnancy complicationsStreptococcus agalactiaeSee 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.
Pregnancy complications Archives - Page 3 of 11 - Revista Brasileira de Ginecologia e Obstetrícia
