Artigos Originais Archives - Page 2 of 3 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2014;36(2):90-96
DOI 10.1590/S0100-72032014000200008
To evaluate the frequency of sleep disorders, such as obstructive sleep apnea,
restless leg syndrome and insomnia in overweight/obese postmenopausal women seen
in a climacteric sleep disorders clinic.
Thirty-four postmenopausal women were selected using the following inclusion
criteria: age between 50 and 70 years; at least 12 months of amenorrhea; body mass
index (BMI) greater than or equal to 25 kg/m2; and sleep-related
complaints with at least one previous polysomnography. Patients provided responses
to 6 questionnaires related to sleep characteristics and menopausal symptoms.
Weight and height were measured using standardized scales, and abdomen and hip
circumferences were also measured. The statistical analyses were performed using
the χ2 test for qualitative variables and using Student's t-test for
quantitative variables.
Patients' characteristics were as follows: mean age of 60.35 years; mean BMI of
31.62; an average of 11.61 postmenopausal years and an average Kupperman Index of
19. A total of 85.2% of the patients had a waist/hip ratio of less than 0.8. The
Epworth Scale score was greater than or equal to 9 in 50% of patients; 68% had
sleep disturbances according to the Pittsburgh Index, and 68% were classified as
high-risk for sleep apnea by the Berlin Questionnaire. On polysomnography, 70.58%
of the patients had a sleep efficiency lower than 85%; 79.41% had a sleep latency
of less than 30 min; 58.82% had a REM sleep latency of less than 90 min, and
44.11% had mild apnea. When the groups were compared, a linear association was
identified between BMI and the AHI average, and a relationship between high BMI
and use of drugs for thyroid treatment was found.
There was a high prevalence of sleep-disordered breathing, initial insomnia,
fragmented sleep, and thyroid disorders in the group with higher BMI.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):90-96
DOI 10.1590/S0100-72032014000200008
To evaluate the frequency of sleep disorders, such as obstructive sleep apnea,
restless leg syndrome and insomnia in overweight/obese postmenopausal women seen
in a climacteric sleep disorders clinic.
Thirty-four postmenopausal women were selected using the following inclusion
criteria: age between 50 and 70 years; at least 12 months of amenorrhea; body mass
index (BMI) greater than or equal to 25 kg/m2; and sleep-related
complaints with at least one previous polysomnography. Patients provided responses
to 6 questionnaires related to sleep characteristics and menopausal symptoms.
Weight and height were measured using standardized scales, and abdomen and hip
circumferences were also measured. The statistical analyses were performed using
the χ2 test for qualitative variables and using Student's t-test for
quantitative variables.
Patients' characteristics were as follows: mean age of 60.35 years; mean BMI of
31.62; an average of 11.61 postmenopausal years and an average Kupperman Index of
19. A total of 85.2% of the patients had a waist/hip ratio of less than 0.8. The
Epworth Scale score was greater than or equal to 9 in 50% of patients; 68% had
sleep disturbances according to the Pittsburgh Index, and 68% were classified as
high-risk for sleep apnea by the Berlin Questionnaire. On polysomnography, 70.58%
of the patients had a sleep efficiency lower than 85%; 79.41% had a sleep latency
of less than 30 min; 58.82% had a REM sleep latency of less than 90 min, and
44.11% had mild apnea. When the groups were compared, a linear association was
identified between BMI and the AHI average, and a relationship between high BMI
and use of drugs for thyroid treatment was found.
There was a high prevalence of sleep-disordered breathing, initial insomnia,
fragmented sleep, and thyroid disorders in the group with higher BMI.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):84-89
DOI 10.1590/S0100-72032014000200007
To identify and relate body fat percentage (skin fold measures), body mass index
(BMI) and age at menarcheto aerobic capacity using the indirect VO2
maximum value (VO2 max) of girls in the second cycle of primary school.
A total of 197 girls aged 13.0±1.2 years on average, students from two public
schools in the city of Atibaia in São Paulo, were evaluated. Anthropometric
evaluation of skin folds was performed using the Slaughter protocol for teenage
girls, and BMI (kg/m2) was based on "Z score" (graphic of percentile)
according to WHO recommendations. The Léger protocol was used to determine
VO2 max. Pearson linear regression and the Student t-test were used
for statistical analysis.
22.3% of the girls were overweight and 3.5% were obese according to the
classification proposed by the WHO; 140 (71.1%) girls reported menarche. The
average age at menarche was 12.0±1.0 years and was significantly higher in the
group with normal BMI (12.2±0.9 years) than in the overweight or obese groups
(11.6±1.0 years). The average indirect VO2 max value was 39.6±3.7
mL/kg/min, ranging from 30.3 to 50.5 mL/kg/min. The advance of chronological age
and early age at menarche were positively correlated with lower VO2 max
values.
This study showed that 25.8% of the girls had aBMI value above WHO
recommendations. Girls with higher BMI and higher body fat percentage had lower
VO2 max. The earlier age at menarche and the advance of
chronological age were the most important factors for the reduction of aerobic
capacity. The ageat menarche was higher in girls with adequate BMI compared
tooverweight or obese girls.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):84-89
DOI 10.1590/S0100-72032014000200007
To identify and relate body fat percentage (skin fold measures), body mass index
(BMI) and age at menarcheto aerobic capacity using the indirect VO2
maximum value (VO2 max) of girls in the second cycle of primary school.
A total of 197 girls aged 13.0±1.2 years on average, students from two public
schools in the city of Atibaia in São Paulo, were evaluated. Anthropometric
evaluation of skin folds was performed using the Slaughter protocol for teenage
girls, and BMI (kg/m2) was based on "Z score" (graphic of percentile)
according to WHO recommendations. The Léger protocol was used to determine
VO2 max. Pearson linear regression and the Student t-test were used
for statistical analysis.
22.3% of the girls were overweight and 3.5% were obese according to the
classification proposed by the WHO; 140 (71.1%) girls reported menarche. The
average age at menarche was 12.0±1.0 years and was significantly higher in the
group with normal BMI (12.2±0.9 years) than in the overweight or obese groups
(11.6±1.0 years). The average indirect VO2 max value was 39.6±3.7
mL/kg/min, ranging from 30.3 to 50.5 mL/kg/min. The advance of chronological age
and early age at menarche were positively correlated with lower VO2 max
values.
This study showed that 25.8% of the girls had aBMI value above WHO
recommendations. Girls with higher BMI and higher body fat percentage had lower
VO2 max. The earlier age at menarche and the advance of
chronological age were the most important factors for the reduction of aerobic
capacity. The ageat menarche was higher in girls with adequate BMI compared
tooverweight or obese girls.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):79-83
DOI 10.1590/S0100-72032014000200006
To investigate the presence of depressive symptoms in women with chronic pelvic
pain.
This descriptive cross-sectional study was performed with women aged 18 years or
older, diagnosed with chronic pelvic pain, with no pregnancy history in the
previous year, and with no cancer history. The sample was established by
calculating the representative sample, estimated as 50 women. All women were
undergoing treatment at a gynecology outpatient clinic, referred by the primary
health care network of the Brazilian national health system. Data collection was
performed from October2009 to May 2010. The women's sociodemographic, economic and
clinical characteristics were analyzed. Pain intensity was evaluated using a
visual analogue scale. The depressive symptoms were investigated using Beck's
Depression Inventory. Statistical analysis was performed using position measures
(mean, median), dispersion (standard deviation) and the χ2 test. Values
of p≤ .05 were considered statistically significant.
The participants' mean age was 41.6±9.4 years. The following features
predominated: secondary education level; pardo (brown) skin color; Catholic
religion; and living with a steady partner. Most (98%) were economically active
and worked with general domestic services. Regarding the participants' subjective
perception of pain, 52% reported experiencing intense pain, while 48% reported
experiencing moderate pain. Most women (52%) had been living with pain for five
years or less, and 30%, for over 11 years. The mean BDI score was 17.4 (±9.4). It
was observed that 58% of the women presented mild, moderate and severe depressive
symptoms according to the BDI. The most frequent depressive symptoms were
fatigability, loss of libido, irritability, difficulty to work, somatic
preoccupations, crying, dissatisfaction, sadness, and insomnia.
Depressive symptoms were frequent among these women suffering with chronic pelvic
pain.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):79-83
DOI 10.1590/S0100-72032014000200006
To investigate the presence of depressive symptoms in women with chronic pelvic
pain.
This descriptive cross-sectional study was performed with women aged 18 years or
older, diagnosed with chronic pelvic pain, with no pregnancy history in the
previous year, and with no cancer history. The sample was established by
calculating the representative sample, estimated as 50 women. All women were
undergoing treatment at a gynecology outpatient clinic, referred by the primary
health care network of the Brazilian national health system. Data collection was
performed from October2009 to May 2010. The women's sociodemographic, economic and
clinical characteristics were analyzed. Pain intensity was evaluated using a
visual analogue scale. The depressive symptoms were investigated using Beck's
Depression Inventory. Statistical analysis was performed using position measures
(mean, median), dispersion (standard deviation) and the χ2 test. Values
of p≤ .05 were considered statistically significant.
The participants' mean age was 41.6±9.4 years. The following features
predominated: secondary education level; pardo (brown) skin color; Catholic
religion; and living with a steady partner. Most (98%) were economically active
and worked with general domestic services. Regarding the participants' subjective
perception of pain, 52% reported experiencing intense pain, while 48% reported
experiencing moderate pain. Most women (52%) had been living with pain for five
years or less, and 30%, for over 11 years. The mean BDI score was 17.4 (±9.4). It
was observed that 58% of the women presented mild, moderate and severe depressive
symptoms according to the BDI. The most frequent depressive symptoms were
fatigability, loss of libido, irritability, difficulty to work, somatic
preoccupations, crying, dissatisfaction, sadness, and insomnia.
Depressive symptoms were frequent among these women suffering with chronic pelvic
pain.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):56-64
DOI 10.1590/S0100-72032014000200003
To evaluate the adequacy of the process of prenatal care according to the
parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the
procedures provided by the Stork Network of Unified Health System (SUS) in the
microregion of Espirito Santo state, Brazil.
A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing
the records of 742 women during the postpartum period and of their newborns in 7
hospitals in the region chosen for the research. The information was collected,
processed and analyzed by the χ2 and Fisher's exact test to determine
the difference in proportion between the criteria adopted by the PHPN and the
Stork Network and the place of residence, family income and type of coverage of
prenatal service. The level of significance was set at 5%.
The parameters showing the lowest adequacy rate were quick tests and repeated
exams, with frequencies around 10 and 30%, respectively, in addition to
educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk
management (92.6%) and the fasting plasma glucose test (91.3%) showed the best
results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect
to the parameters of normal risk pregnancies, and 0 for high risk pregnancies.
There was a significant difference between puerperae according to housing location
regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated
fasting glucose tests, and monthly income influenced the execution of blood
type/Rh factor tests, VDRL, hematocrit and anti-HIV test.
Prenatal care in the SUS proved to be inadequate regarding the procedures
required by the PHPN and Stork Network in the micro-region of a state in
southeastern Brazil, especially for women of lower income, PACS users and
residents of rural areas.
Summary
Rev Bras Ginecol Obstet. 2014;36(2):56-64
DOI 10.1590/S0100-72032014000200003
To evaluate the adequacy of the process of prenatal care according to the
parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the
procedures provided by the Stork Network of Unified Health System (SUS) in the
microregion of Espirito Santo state, Brazil.
A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing
the records of 742 women during the postpartum period and of their newborns in 7
hospitals in the region chosen for the research. The information was collected,
processed and analyzed by the χ2 and Fisher's exact test to determine
the difference in proportion between the criteria adopted by the PHPN and the
Stork Network and the place of residence, family income and type of coverage of
prenatal service. The level of significance was set at 5%.
The parameters showing the lowest adequacy rate were quick tests and repeated
exams, with frequencies around 10 and 30%, respectively, in addition to
educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk
management (92.6%) and the fasting plasma glucose test (91.3%) showed the best
results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect
to the parameters of normal risk pregnancies, and 0 for high risk pregnancies.
There was a significant difference between puerperae according to housing location
regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated
fasting glucose tests, and monthly income influenced the execution of blood
type/Rh factor tests, VDRL, hematocrit and anti-HIV test.
Prenatal care in the SUS proved to be inadequate regarding the procedures
required by the PHPN and Stork Network in the micro-region of a state in
southeastern Brazil, especially for women of lower income, PACS users and
residents of rural areas.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):5-9
DOI 10.1590/S0100-72032014000100003
To analyze and compare the knowledge, attitudes and opinions of medical students about abortion in Brazil during the progression of the course.
This was a cross-sectional study involving 174 medical students. A questionnaire was applied whose dependent variables were degree of information about abortion, including its legal aspects in Brazil, situations in which the students would agree with the expansion of permitted legal abortion, knowledge of someone undergoing abortion, and discomfort about performing the procedure legally. The independent variables were sociodemographic data, religion, and academic standing (first or second half of the course). For data analysis it was used χ2 and Fisher's exact tests, with the level of significance set at 5%.
Among the interviewees, 59.8 % considered themselves well informed about the topic. Students demonstrated knowledge about the complications of abortion, with no differences with the progression of the course. Knowledge about the legal aspects of abortion in Brazil was shown by 48.9% of the sample, being significantly higher among students in the second half of the course (34.0 and 68.9%, respectively; p<0.001). Experiencing situations of clandestine abortion was significantly higher among students in the final half of the course (3.05 and 59.4%, respectively; p<0.001), the same being observed about knowing someone who underwent the procedure illegally (5.0 and 18.9%, respectively; p<0.001). The expansion of permissive legal abortion in Brazil was agreed about by 86.2% students, although 54.6% of the students reported that they felt uncomfortable about performing the procedure even legally, without statistical significance with the evolution of the course regarding the two situations.
The experiences of abortion and the knowledge of legal aspects were significantly higher among students in the second half of the course, with no significant changes in attitudes or opinions about abortion being observed with the competences acquired during medical training.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):5-9
DOI 10.1590/S0100-72032014000100003
To analyze and compare the knowledge, attitudes and opinions of medical students about abortion in Brazil during the progression of the course.
This was a cross-sectional study involving 174 medical students. A questionnaire was applied whose dependent variables were degree of information about abortion, including its legal aspects in Brazil, situations in which the students would agree with the expansion of permitted legal abortion, knowledge of someone undergoing abortion, and discomfort about performing the procedure legally. The independent variables were sociodemographic data, religion, and academic standing (first or second half of the course). For data analysis it was used χ2 and Fisher's exact tests, with the level of significance set at 5%.
Among the interviewees, 59.8 % considered themselves well informed about the topic. Students demonstrated knowledge about the complications of abortion, with no differences with the progression of the course. Knowledge about the legal aspects of abortion in Brazil was shown by 48.9% of the sample, being significantly higher among students in the second half of the course (34.0 and 68.9%, respectively; p<0.001). Experiencing situations of clandestine abortion was significantly higher among students in the final half of the course (3.05 and 59.4%, respectively; p<0.001), the same being observed about knowing someone who underwent the procedure illegally (5.0 and 18.9%, respectively; p<0.001). The expansion of permissive legal abortion in Brazil was agreed about by 86.2% students, although 54.6% of the students reported that they felt uncomfortable about performing the procedure even legally, without statistical significance with the evolution of the course regarding the two situations.
The experiences of abortion and the knowledge of legal aspects were significantly higher among students in the second half of the course, with no significant changes in attitudes or opinions about abortion being observed with the competences acquired during medical training.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):40-45
DOI 10.1590/S0100-72032014000100009
To analyze the cytological findings of women with cervical adenocarcinoma, taking
into account the patient's history in the year prior to diagnosis and the
histopathological aspects of the lesions.
A retrospective comparative study was conducted using data from women with
cervical adenocarcinoma or squamous carcinoma detected between 2002 and 2008. The
cytological reports were synthesized according to the Bethesda System revised in
2001 and were compared to the histopathological findings of cervical
adenocarcinoma and squamous carcinoma. The distributions of cytological findings
were calculated, as well as the global agreement and chance-corrected agreement
using the Cohen's Kappa Coefficient. For this purpose, the cytological findings
were grouped according to the epithelial origin, forming the glandular cell and
squamous cell groups, with the histopathologically confirmed tumor types
(adenocarcinoma versus squamous carcinoma) being used as the gold
standard.
A total of 284 cases of cervical cancer were diagnosed during the study period.
The effectively studied cases were 27 and 54 patients with adenocarcinoma and
squamous carcinoma, respectively. The adenocarcinoma group represented 9.5% of the
total cases diagnosed, and 56.0% of the women in this group were younger than 50
years. Cervical cytology was collected on average 92 days before the cancer
diagnosis (range: 19 days to 310 days). In 41.6% of cases the cytological results
were consistent with glandular alterations such as adenocarcinoma cells or
atypical glandular cells. The global agreement and Cohen's Kappa Coefficient were
73.7 and 48.7%, suggesting substantial and moderate agreement, respectively.
In this population, the cytological smears had an important role in screening
women with adenocarcinoma, although some of them were referred to clarify the
clinical symptoms. The agreement between cytological and histopathological
findings was moderate.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):40-45
DOI 10.1590/S0100-72032014000100009
To analyze the cytological findings of women with cervical adenocarcinoma, taking
into account the patient's history in the year prior to diagnosis and the
histopathological aspects of the lesions.
A retrospective comparative study was conducted using data from women with
cervical adenocarcinoma or squamous carcinoma detected between 2002 and 2008. The
cytological reports were synthesized according to the Bethesda System revised in
2001 and were compared to the histopathological findings of cervical
adenocarcinoma and squamous carcinoma. The distributions of cytological findings
were calculated, as well as the global agreement and chance-corrected agreement
using the Cohen's Kappa Coefficient. For this purpose, the cytological findings
were grouped according to the epithelial origin, forming the glandular cell and
squamous cell groups, with the histopathologically confirmed tumor types
(adenocarcinoma versus squamous carcinoma) being used as the gold
standard.
A total of 284 cases of cervical cancer were diagnosed during the study period.
The effectively studied cases were 27 and 54 patients with adenocarcinoma and
squamous carcinoma, respectively. The adenocarcinoma group represented 9.5% of the
total cases diagnosed, and 56.0% of the women in this group were younger than 50
years. Cervical cytology was collected on average 92 days before the cancer
diagnosis (range: 19 days to 310 days). In 41.6% of cases the cytological results
were consistent with glandular alterations such as adenocarcinoma cells or
atypical glandular cells. The global agreement and Cohen's Kappa Coefficient were
73.7 and 48.7%, suggesting substantial and moderate agreement, respectively.
In this population, the cytological smears had an important role in screening
women with adenocarcinoma, although some of them were referred to clarify the
clinical symptoms. The agreement between cytological and histopathological
findings was moderate.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):29-34
DOI 10.1590/S0100-72032014000100007
To evaluate the maternal risk factors that require newborn assistance in neonatal Intensive Care Units (ICU).
A prospective observational case-control study was conducted on 222 pregnant women (1:1 case-control ratio) attended at a public maternity. The following variables were analyzed in the puerperae: age at menarche, age at first sexual intercourse, history of chronic diseases, habits, prenatal care, obstetric history, clinical complications during pregnancy and childbirth, and sociodemographic variables. The variables of the newborns were: Apgar scores, gestational age, birth weight, presence or absence of malformation, need for resuscitation, and complications during the first 24 hours. Proportions were compared using the Fisher exact test or the Person γ2 test. Multivariable models were developed by logistic regression analysis using adjusted Odds Ratio with a 95% confidence interval (CI).
Regarding reproductive history, ≥3 pregnancies and 2 or 3 previous cesareans were sytatistically significant (p=0.0 and 0.0, respectively). Among the complications that required assistance in the neonatal ICU, prematurity was responsible for 61 cases (55.5%), followed by risk of intrapartum infection in 46 cases (41.8%). Regarding the maternal history, the presence of hypertensive disease showed statistical significance (p=0.0). Premature rupture of membranes was strongly associated with the need for the neonatal ICU (Odds Ratio - OR=6.1, 95%CI 2.6-14.4).
Premature rupture of membranes and hypertensive disease should receive special attention in prenatal care due to their strong association with newborns requiring assistance in the neonatal ICU.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):29-34
DOI 10.1590/S0100-72032014000100007
To evaluate the maternal risk factors that require newborn assistance in neonatal Intensive Care Units (ICU).
A prospective observational case-control study was conducted on 222 pregnant women (1:1 case-control ratio) attended at a public maternity. The following variables were analyzed in the puerperae: age at menarche, age at first sexual intercourse, history of chronic diseases, habits, prenatal care, obstetric history, clinical complications during pregnancy and childbirth, and sociodemographic variables. The variables of the newborns were: Apgar scores, gestational age, birth weight, presence or absence of malformation, need for resuscitation, and complications during the first 24 hours. Proportions were compared using the Fisher exact test or the Person γ2 test. Multivariable models were developed by logistic regression analysis using adjusted Odds Ratio with a 95% confidence interval (CI).
Regarding reproductive history, ≥3 pregnancies and 2 or 3 previous cesareans were sytatistically significant (p=0.0 and 0.0, respectively). Among the complications that required assistance in the neonatal ICU, prematurity was responsible for 61 cases (55.5%), followed by risk of intrapartum infection in 46 cases (41.8%). Regarding the maternal history, the presence of hypertensive disease showed statistical significance (p=0.0). Premature rupture of membranes was strongly associated with the need for the neonatal ICU (Odds Ratio - OR=6.1, 95%CI 2.6-14.4).
Premature rupture of membranes and hypertensive disease should receive special attention in prenatal care due to their strong association with newborns requiring assistance in the neonatal ICU.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):23-28
DOI 10.1590/S0100-72032014000100006
To evaluate changes in body and internal organ weight of autopsied children in the perinatal period and their relationship with the cause of death.
One hundred and fifty three cases of perinatal autopsies performed at a university hospital in Southeastern Brazil ere included. Information about cause of perinatal death, date of autopsy, gestational age, perinatal weight and organ weight was obtained from the autopsy protocols and medical records of the mother and/or the newborn. Four groups of causes of death were defined: congenital malformations, perinatal hypoxia/anoxia, ascending infection and hyaline membrane. Brain, liver, lungs, heart, spleen, thymus and adrenals were analyzed.
The weight of children with perinatal hypoxia/anoxi (1,834.6±1,090.1 g versus 1,488 g), hyaline membranes (1,607.2±820.1 g versus 1,125 g) and ascending infection (1,567.4±1,018.9 g versus 1,230 g) was higher than expected for the population. Lung weight was higher in cases with ascending infection (36.6±22.6 g versus 11 g) and lower in cases with congenital malformations (22.0±9.5 g versus 40 g). Spleen weight was higher in children with ascending infection (8.6±8.9 g versus 3.75 g ) and adrenal weight was lower in cases with congenital malformations (3.9±2.1 g versus 5.5 g). Thymus weight was lower in cases with miscellaneous causes (3.7±1.2 g versus 7.5 g) and spleen weight was lower in patients with lung immaturity (0.4±0.1 g versus 1.7 g). All results showed significant differences.
This study demonstrates that variations in the weight of children and the weight of their organs are related to the types of cause of perinatal death. These data may contribute to a better interpretation of autopsy findings and their anatomical and clinical relationship.
Summary
Rev Bras Ginecol Obstet. 2014;36(1):23-28
DOI 10.1590/S0100-72032014000100006
To evaluate changes in body and internal organ weight of autopsied children in the perinatal period and their relationship with the cause of death.
One hundred and fifty three cases of perinatal autopsies performed at a university hospital in Southeastern Brazil ere included. Information about cause of perinatal death, date of autopsy, gestational age, perinatal weight and organ weight was obtained from the autopsy protocols and medical records of the mother and/or the newborn. Four groups of causes of death were defined: congenital malformations, perinatal hypoxia/anoxia, ascending infection and hyaline membrane. Brain, liver, lungs, heart, spleen, thymus and adrenals were analyzed.
The weight of children with perinatal hypoxia/anoxi (1,834.6±1,090.1 g versus 1,488 g), hyaline membranes (1,607.2±820.1 g versus 1,125 g) and ascending infection (1,567.4±1,018.9 g versus 1,230 g) was higher than expected for the population. Lung weight was higher in cases with ascending infection (36.6±22.6 g versus 11 g) and lower in cases with congenital malformations (22.0±9.5 g versus 40 g). Spleen weight was higher in children with ascending infection (8.6±8.9 g versus 3.75 g ) and adrenal weight was lower in cases with congenital malformations (3.9±2.1 g versus 5.5 g). Thymus weight was lower in cases with miscellaneous causes (3.7±1.2 g versus 7.5 g) and spleen weight was lower in patients with lung immaturity (0.4±0.1 g versus 1.7 g). All results showed significant differences.
This study demonstrates that variations in the weight of children and the weight of their organs are related to the types of cause of perinatal death. These data may contribute to a better interpretation of autopsy findings and their anatomical and clinical relationship.