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Resumos de Teses
Quimioterapia primáriaem câncer de mama localmente avançado: estudo comparativo entre dois esquemas terapêuticos com intensificação de doses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):361-362
04-11-1998
Summary
Resumos de TesesQuimioterapia primáriaem câncer de mama localmente avançado: estudo comparativo entre dois esquemas terapêuticos com intensificação de doses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):361-362
04-11-1998DOI 10.1590/S0100-72031998000600011
Views42Quimioterapia Primáriaem Câncer de Mama Localmente Avançado. Estudo Comparativo entre Dois Esquemas Terapêuticos com Intensificação de Doses […]See more
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. -
Resumos de Teses
Correlação entre as concentrações plasmáticas e foliculares de IGF-I
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):361-361
04-11-1998
Summary
Resumos de TesesCorrelação entre as concentrações plasmáticas e foliculares de IGF-I
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):361-361
04-11-1998This 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. -
Relato de Caso
A bilateral fallopian tube pregnancy: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):357-360
04-11-1998
Summary
Relato de CasoA bilateral fallopian tube pregnancy: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):357-360
04-11-1998DOI 10.1590/S0100-72031998000600009
Views85See moreBilateral ectopic pregnancy is the most unusual twin gestation considering that less than 250 cases have been reported in the literature. Our case fulfills the diagnostic criterion determined by Norris9 which requires demonstration of chorionic villi in each fallopian tube. We report the case of a 36-year-old multiparous woman who had an hemorrhagic acute abdomen. A laparotomy performed under general anesthesia revealed hemoperitoneum of 1.8 liters and both swelled tubes with laceration of their walls, besides two embryos with 2,7 and 3,0 cm in length free in the intra-abdominal blood. A literature review on bilateral ectopic pregnancy is presented.
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. -
Trabalhos Originais
Prevention of preterm birth: use of digital examination and transvaginal ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):350-356
04-11-1998
Summary
Trabalhos OriginaisPrevention of preterm birth: use of digital examination and transvaginal ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):350-356
04-11-1998DOI 10.1590/S0100-72031998000600008
Views92See moreObjective: to evaluate the uterine cervix by digital and transvaginal ultrasound examinations in pregnant women at high risk of having premature delivery. Methods: during the period between February 1995 and September 1997, 38 pregnant women at high risk of having premature delivery between the 20th and 36th week of gestation were examined. These patients were submitted weekly to both digital and transvaginal ultrasound examinations. The digital examination evaluated the uterine cervix using two parameters: length and dilation. The transvaginal ultrasound studied the length and the anteroposterior diameter of the uterine cervix. The behavior of these cervical measurements was analyzed throughout the pregnancies. The two methods were compared regarding cervical evaluation and accuracy of premature birth diagnosis. Results: the rate of premature deliveries was 18.4% (7/38). Digital examination resulted in cervical evaluations with variation coefficients of 30.3% for length and 193% for dilation. Transvaginal ultrasound resulted in cervical evaluations with variation coefficients of 14.7% and 26.5% for the anteroposterior diameter and length, respectively. The cervical length measures obtained on ultrasound were always greater than those obtained on digital examination. Through analysis with the hypothesis test, an indirect relationship was observed between the cervical length and the gestational period for digital examination and ultrasound study (p<0.05 and p<0.01, respectively), and a direct relationship between the cervical dilation and the gestational age observed on the digital examination (p<0.01). Conclusions: among the parameters studied by means of the digital and transvaginal ultrasound examinations, the ultrasound cervical length presented the best accuracy in the diagnosis of premature birth, proving to be more reliable for the evaluation of cervical alterations in pregnant women at high risk of premature 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. -
Trabalhos Originais
Prognostic factors for vaginal delivery after cesarian section
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):342-349
04-11-1998
Summary
Trabalhos OriginaisPrognostic factors for vaginal delivery after cesarian section
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):342-349
04-11-1998DOI 10.1590/S0100-72031998000600007
Views113See moreObjectives: to determine prognostic factors for vaginal delivery in pregnant women after previous cesarean section admitted to CAM-IMIP in labor.Patients and Methods: a case-control study was performed, analyzing all deliveries of patients with previous cesarean section admitted to CAM-IMIP between January 1991 and December 1994. Patients who had a cesarean section (n=156) were considered cases while patients with a vaginal birth were the controls (n=338). Inclusion criteria were: gestational age > 36 weeks, previous cesarean section at least 1 year before, alive fetus, spontaneous labor and vertex presentation. Patients with high-risk pregnancies, acute fetal distress and a previous vaginal delivery after cesarean section were excluded. Statistical analysis was performed with in Epi-Info 6.0 and Epi-Soft, using c² test, Fisher’s exact test and Student’s “t” test. Odds ratio and its 95% confidence interval was calculated and multiple logistic regression analysis was performed for the control of confounding factors. Results: overall rate of cesarean section was 31.6%. Maternal factors significantly associated with vaginal delivery were age < 20 years (OR = 2.07, 95% CI = 1.18-3.66) or > 35 years (OR = 0.54, 95% CI = 0.36-0.82), history of vaginal delivery (OR = 1.6, 95% CI = 1.01-2.55) and complications of pregnancy as indication for previous cesarean section (OR = 3.67, 95% CI =1.19-12.02). A significant association with vaginal delivery could not be detected for other variables: interval between previous cesarean section and present delivery, other indications for cesarean section and type of uterine suture. In a multiple logistic regression model the variables that remained associated with vaginal delivery were maternal age and previous vaginal delivery. Conclusions: maternal age below 20 years, previous cesarean section indicated due to gestational complications and previous vaginal delivery were favorably associated with vaginal delivery in patients with prior cesarean section. Risk of repeated cesarean section is increased in pregnant women aged 35 years or above. These factors should be contemplated when obstetrical evaluation of the delivery route is performed.
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. -
Trabalhos Originais
Maternal and fetal serum and red blood cell folate levels in pregnancies complicated by neural tube defects
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):335-341
04-11-1998
Summary
Trabalhos OriginaisMaternal and fetal serum and red blood cell folate levels in pregnancies complicated by neural tube defects
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):335-341
04-11-1998DOI 10.1590/S0100-72031998000600006
Views71Objective: to analyze maternal and fetal folate status in cases of neural tube defects (NTD). Methods: a case-control study was designed with 14 cases of fetuses with neural tube defects (study group) and 14 cases of fetuses with other unrelated malformations (control group) gestational age matched, in low-risk pregnant women. Both total and methylated folic acid levels in fetal and maternal compartments using serum and tissular (red blood cells) concentrations and also average corpuscular volume, hematocrit and hemoglobin levels were determined. Fetal and maternal samples were obtained immediately before termination of pregnancy. Results in both groups were compared using a gestational age paired t-test. Results: there were no statistically significant differences in fetal folate levels and fetal hematologic parameters between both groups However, both total (239.9 ng/mL in NTD against 399.1 ng/mL in control group, p=0.01) and methylated (201.9 ng/mL in NTD against 314.0 ng/mL in control group, p=0.02) maternal red blood cells folate levels were significantly lower in the neural tube defect group. Maternal serum folate levels were similar in study and control groups. Conclusion: this study showed that maternal red blood cell folate but not serum folate was significantly reduced in mothers of fetuses with neural tube defects.
Key-words Folic acidNeural tube defectsSee 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. -
Trabalhos Originais
Effects of the association of an opioid with epidural analgesia for labor and delivery
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):325-331
04-11-1998
Summary
Trabalhos OriginaisEffects of the association of an opioid with epidural analgesia for labor and delivery
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):325-331
04-11-1998DOI 10.1590/S0100-72031998000600005
Views75See moreThe purpose of the present study was to evaluate the efficacy and safety of the association bupivacaine with sufentanil for labor and delivery analgesia through a continuous epidural blockade, for both mother and the neonate. A randomized double blind prospective clinical trial was performed including sixty nulliparous women at the Maternity of CAISM/UNICAMP. When requesting analgesia, the women were randomly allocated to two groups: BS, receiving 12.5 mg of bupivacaine with adrenaline plus 30 µg of sufentanil and BP, receiving 12.5 mg of bupivacaine with adrenaline plus placebo. The parameters concerning the quality and duration of analgesia, duration of labor, and also possible effects on the neonate were evaluated. The results showed the superiority of the addition of sufentanil regarding the degree of analgesia during the time of action of the first dose of the local anesthetic. There was no increase in the duration of labor after the onset of analgesia when comparing both groups, nor any difference in the route of delivery. Concerning neonate evaluation, there were no differences between the two groups. It is concluded that the association of 30 µg of sufentanil with the first dose of bupivacaine is safe and efficacious. It improved the quality of analgesia, increased its duration, and did not affect the progress of labor and neonatal outcome.
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. -
Trabalhos Originais
Prenatal diagnosis of fetal lung maturity in high-risk pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):315-321
04-11-1998
Summary
Trabalhos OriginaisPrenatal diagnosis of fetal lung maturity in high-risk pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):315-321
04-11-1998DOI 10.1590/S0100-72031998000600004
Views59See moreThe objective was to evaluate the accuracy of the foam stability test, lecithin/sphingomyelin (LS) ratio, presence of phosphatidylglycerol (PG) and lung profile (L/S ratio > 1.7 and PG present simultaneously) in 121 consecutive high-risk gestations at the São Paulo Hospital from January 1990 to January 1995. Delivery occurred within 3 days of fetal lung maturation testing. This is a prospective study in which the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of all the tests were determined. Neonatal respiratory outcome and amniocentesis results were stratified by gestational age for comparison. The distribution of the studied population according to maternal pathology was diabetes mellitus (48), hypertensive disorders (41), Rh isoimmunization (14) and miscellaneous (18). Respiratory distress (RD) was present in 33 infants (27.2%), mainly in the diabetic group. There was no false negative using lung profile (all patients) and foam stability tests among hypertensive pregnancies (specificity 100%), but there were about 20% to 50% false positives in the other tests. Overall, all four tests had a low PPV: 23% for foam test, 51% for L/S ratio, 63% for PG, 61% for lung profile, and high NPV: 92% for foam test, 88% for L/S ratio, 89% for PG and 100% for lung profile. All tests had less accuracy in the diabetic pregnant women. This study shows that the presence of PG and L/S ratio > 1.7 in the amniotic fluid of high-risk pregnancies confirms maturity with a very low risk to develop RD and that the foam stability test was useful as a first-line test to predict the absence of surfactant-deficient respiratory distress syndrome, particularly in 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.
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