pregnancy trimester, second Archives - Revista Brasileira de Ginecologia e Obstetrícia
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Rev Bras Ginecol Obstet. 2020;42(9):540-546
, , , , , The aim of the present study was to compare the obstetric history and both two- and tri-dimensional ultrasound parameters according to different cervical lengths.
The present cross-sectional study analyzed 248 midtrimester pregnant women according to cervical length and compared the data with the obstetric history and 2D/3D ultrasound parameters. Patients were divided into 3 groups according to cervical length: The Short Cervix group for cervical lengths ≥ 15mm and< 25mm(n= 68), the Very Short Cervix group for cervical lengths< 15mm (n = 18) and the Control group, composed of 162 pregnant women with uterine cervical lengths ≥ 25mm.
When analyzing the obstetric history of only non-nulliparous patients, a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth was reported (p = 0.021). Cervical length and volume were positively correlated (Pearson coefficient = 0.587, p < 0.0001). The flow index (FI) parameter of cervical vascularization was significantly different between the Control and Very Short Cervix groups. However, after linear regression, in the presence of volume information, we found no association between the groups and FI. Uterine artery Doppler was also not related to cervical shortening.
The present study showed a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth. None of the vascularization indexes correlate with cervical length as an independent parameter. Uterine artery Doppler findings do not correlate with cervical length.
Summary
Rev Bras Ginecol Obstet. 2020;42(9):540-546
, , , , , The aim of the present study was to compare the obstetric history and both two- and tri-dimensional ultrasound parameters according to different cervical lengths.
The present cross-sectional study analyzed 248 midtrimester pregnant women according to cervical length and compared the data with the obstetric history and 2D/3D ultrasound parameters. Patients were divided into 3 groups according to cervical length: The Short Cervix group for cervical lengths ≥ 15mm and< 25mm(n= 68), the Very Short Cervix group for cervical lengths< 15mm (n = 18) and the Control group, composed of 162 pregnant women with uterine cervical lengths ≥ 25mm.
When analyzing the obstetric history of only non-nulliparous patients, a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth was reported (p = 0.021). Cervical length and volume were positively correlated (Pearson coefficient = 0.587, p < 0.0001). The flow index (FI) parameter of cervical vascularization was significantly different between the Control and Very Short Cervix groups. However, after linear regression, in the presence of volume information, we found no association between the groups and FI. Uterine artery Doppler was also not related to cervical shortening.
The present study showed a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth. None of the vascularization indexes correlate with cervical length as an independent parameter. Uterine artery Doppler findings do not correlate with cervical length.
Summary
Rev Bras Ginecol Obstet. 2015;37(8):359-365
DOI 10.1590/SO100-720320150005415
To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy.
A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.
Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04).
Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.
Summary
Rev Bras Ginecol Obstet. 2015;37(8):359-365
DOI 10.1590/SO100-720320150005415
To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy.
A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.
Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04).
Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
O objetivo do presente estudo longitudinal foi avaliar o valor da ultrassonografia Doppler das artérias uterinas no segundo e terceiro trimestres de gestação para a predição de desfecho adverso da gravidez em mulheres de baixo risco.
De julho de 2011 até agosto de 2012, 205 gestantes de feto único atendidas em nossa clínica de pré-natal foram incluídas no presente estudo prospectivo e avaliadas em termos de dados demográficos e obstétricos. As pacientes foram submetidas à avaliação de ultrassom durante o segundo e terceiro trimestres, incluindo avaliação Doppler das artérias uterinas bilaterais, visando determinar os valores do índice de pulsatilidade (IP) e do índice de resistência (IR), bem como a presença de incisura diastólica precoce. O desfecho do presente estudo foi a avaliação da sensibilidade, especificidade, valor preditivo positivo (VPP) e valor negativo preditivo (VNP) da ultrassonografia Doppler das artérias uterinas para a predição de desfechos adversos da gravidez, incluindo pré-eclâmpsia, natimortalidade, descolamento prematuro da placenta e trabalho de parto prematuro.
A média de idade das gestantes foi de 26,4±5,11 anos. Os valores de IP e IR das artérias uterinas para o primeiro (IP: 1,1±0,42 versus 1,53±0,59, p=0,002; IR: 0,55±0,09 versus 0.72±0.13, p=0,000, respectivamente) e para o terceiro trimestre (IP: 0,77±0,31 versus 1,09±0,46, p=0,000; IR: 0,46±0,10 versus 0,60±0,14, p=0,010, respectivamente) foram significativamente maiores em pacientes com desfecho adverso da gravidez em relação às mulheres com desfecho normal. A combinação de IP e IR > percentil 95 e a presença de incisura bilateral apresentou sensibilidade e especificidade de 36,1 e 97%, respectivamente, no segundo trimestre e de 57,5 e 98,2% no terceiro trimestre.
Com base no presente estudo, o Doppler das artérias uterinas parece ser ferramenta valiosa para a predição de uma variedade de desfechos adversos no segundo e terceiro trimestres de gestação.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
O objetivo do presente estudo longitudinal foi avaliar o valor da ultrassonografia Doppler das artérias uterinas no segundo e terceiro trimestres de gestação para a predição de desfecho adverso da gravidez em mulheres de baixo risco.
De julho de 2011 até agosto de 2012, 205 gestantes de feto único atendidas em nossa clínica de pré-natal foram incluídas no presente estudo prospectivo e avaliadas em termos de dados demográficos e obstétricos. As pacientes foram submetidas à avaliação de ultrassom durante o segundo e terceiro trimestres, incluindo avaliação Doppler das artérias uterinas bilaterais, visando determinar os valores do índice de pulsatilidade (IP) e do índice de resistência (IR), bem como a presença de incisura diastólica precoce. O desfecho do presente estudo foi a avaliação da sensibilidade, especificidade, valor preditivo positivo (VPP) e valor negativo preditivo (VNP) da ultrassonografia Doppler das artérias uterinas para a predição de desfechos adversos da gravidez, incluindo pré-eclâmpsia, natimortalidade, descolamento prematuro da placenta e trabalho de parto prematuro.
A média de idade das gestantes foi de 26,4±5,11 anos. Os valores de IP e IR das artérias uterinas para o primeiro (IP: 1,1±0,42 versus 1,53±0,59, p=0,002; IR: 0,55±0,09 versus 0.72±0.13, p=0,000, respectivamente) e para o terceiro trimestre (IP: 0,77±0,31 versus 1,09±0,46, p=0,000; IR: 0,46±0,10 versus 0,60±0,14, p=0,010, respectivamente) foram significativamente maiores em pacientes com desfecho adverso da gravidez em relação às mulheres com desfecho normal. A combinação de IP e IR > percentil 95 e a presença de incisura bilateral apresentou sensibilidade e especificidade de 36,1 e 97%, respectivamente, no segundo trimestre e de 57,5 e 98,2% no terceiro trimestre.
Com base no presente estudo, o Doppler das artérias uterinas parece ser ferramenta valiosa para a predição de uma variedade de desfechos adversos no segundo e terceiro trimestres de gestação.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women.
From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor.
The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester.
According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women.
From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor.
The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester.
According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters.