Artigos Originais Archives - Page 2 of 81 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):479-484
DOI 10.1590/S0100-72032005000800008
PURPOSE: to evaluate the prevalence of overweight and obesity among climacteric women. METHODS: this cross-sectional study included 611 women aged between 45 and 60 years attended at a climacteric clinic from January to June 2003. The prevalence of overweight and obesity was evaluated through the body mass index (BMI). Overweight or obesity was considered when there was a BMI equal or higher than 25 kg/m². Sociodemographic and reproductive variables as well as life style were also evaluated. The chi2 test followed by logistic regression was performed for statistical analysis. RESULTS: the average age of the studied women was 51.4 (±4.4) years, whereas 52.9% of them were postmenopausal. About 63.7% of them had a BMI equal or higher than 25 kg/m². The prevalence of overweight and obesity was 33.6 and 30.1%, respectively. The prevalence of overweight and obesity was higher among older women (OR=1.2; 95%IC: 1.1-1.4) or non hormonal therapy users (OR=1.8; 95%IC: 1.2-2.8). The opposite was observed among the women without a professional occupation (OR=0.6; 95%IC: 0.5-0.9) or a steady partner (OR=0.7; 95%IC: 0,4-0,9). CONCLUSIONS: in this study, the prevalence of overweight and obesity was influenced by age, but not by the menopausal status. The association between the marital status and occupation and the BMI strengthens the hypothesis that the health of the climacteric women may be influenced by biological factors as well as by psychosocial factors and life style. The lowest prevalence of overweight and obesity among the users of hormonal therapy may be explained by possible restrictions in relation to its prescription for women with previous overweight or obesity. Further studies are necessary to get more conclusive results, in particular with longitudinal studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):479-484
DOI 10.1590/S0100-72032005000800008
PURPOSE: to evaluate the prevalence of overweight and obesity among climacteric women. METHODS: this cross-sectional study included 611 women aged between 45 and 60 years attended at a climacteric clinic from January to June 2003. The prevalence of overweight and obesity was evaluated through the body mass index (BMI). Overweight or obesity was considered when there was a BMI equal or higher than 25 kg/m². Sociodemographic and reproductive variables as well as life style were also evaluated. The chi2 test followed by logistic regression was performed for statistical analysis. RESULTS: the average age of the studied women was 51.4 (±4.4) years, whereas 52.9% of them were postmenopausal. About 63.7% of them had a BMI equal or higher than 25 kg/m². The prevalence of overweight and obesity was 33.6 and 30.1%, respectively. The prevalence of overweight and obesity was higher among older women (OR=1.2; 95%IC: 1.1-1.4) or non hormonal therapy users (OR=1.8; 95%IC: 1.2-2.8). The opposite was observed among the women without a professional occupation (OR=0.6; 95%IC: 0.5-0.9) or a steady partner (OR=0.7; 95%IC: 0,4-0,9). CONCLUSIONS: in this study, the prevalence of overweight and obesity was influenced by age, but not by the menopausal status. The association between the marital status and occupation and the BMI strengthens the hypothesis that the health of the climacteric women may be influenced by biological factors as well as by psychosocial factors and life style. The lowest prevalence of overweight and obesity among the users of hormonal therapy may be explained by possible restrictions in relation to its prescription for women with previous overweight or obesity. Further studies are necessary to get more conclusive results, in particular with longitudinal studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE - 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women's failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women's failure to submit to the Pap smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE - 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women's failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women's failure to submit to the Pap smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):376-381
DOI 10.1590/S0100-72032005000700002
PURPOSE: to check alcohol consumption during pregnancy and to estimate teratogenic effects on the fetus. METHODS: the T-ACE questionnaire was applied to 150 women who had just given birth in a maternity hospital in Ribeirão Preto/SP, from April to November 2004. The patients were divided into those who consumed and those did not consume alcohol during gestation. The newborns of these women were evaluated regarding weight, length and head circumference at birth. These anthropometric measurements were compared with the alcoholic beverage consumption by the women. The data analysis was performed by Student's t test, Mann-Whitney U-test and chi2 test, with the level of significance set at 5%. RESULTS: among the interviewed women, 79.3% (119) were not identified as alcohol consumers by the T-ACE questionnaire and 20.7% (31) were considered consumers by this questionnaire. The newborns whose mothers did not consume alcohol had a mean length of 48.2 cm. On the other hand, those whose mothers used alcohol were 46.7 cm long, and such difference was statistically significant. A mean decrease of 109 g in weight and 0.42 cm in head circumference was observed in the children whose mothers had consumed alcohol. In the female fetuses the weight decrease was more pronounced (186 g). CONCLUSION: the T-ACE questionnaire was an effective screening instrument for detecting alcohol consumption during pregnancy. The use of alcohol during pregnancy was associated with fetal growth restriction. Apparently, the female fetuses were more susceptible to the effects of the use of alcohol during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):376-381
DOI 10.1590/S0100-72032005000700002
PURPOSE: to check alcohol consumption during pregnancy and to estimate teratogenic effects on the fetus. METHODS: the T-ACE questionnaire was applied to 150 women who had just given birth in a maternity hospital in Ribeirão Preto/SP, from April to November 2004. The patients were divided into those who consumed and those did not consume alcohol during gestation. The newborns of these women were evaluated regarding weight, length and head circumference at birth. These anthropometric measurements were compared with the alcoholic beverage consumption by the women. The data analysis was performed by Student's t test, Mann-Whitney U-test and chi2 test, with the level of significance set at 5%. RESULTS: among the interviewed women, 79.3% (119) were not identified as alcohol consumers by the T-ACE questionnaire and 20.7% (31) were considered consumers by this questionnaire. The newborns whose mothers did not consume alcohol had a mean length of 48.2 cm. On the other hand, those whose mothers used alcohol were 46.7 cm long, and such difference was statistically significant. A mean decrease of 109 g in weight and 0.42 cm in head circumference was observed in the children whose mothers had consumed alcohol. In the female fetuses the weight decrease was more pronounced (186 g). CONCLUSION: the T-ACE questionnaire was an effective screening instrument for detecting alcohol consumption during pregnancy. The use of alcohol during pregnancy was associated with fetal growth restriction. Apparently, the female fetuses were more susceptible to the effects of the use of alcohol during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):407-414
DOI 10.1590/S0100-72032005000700007
PURPOSE: to evaluate the prevalence of vulval squamous intraepithelial lesions and associated factors in HIV-infected patients attended at the public health services of Rio de Janeiro city. METHOD: a total of 374 HIV-infected patients were attended at public services in Rio de Janeiro city and submitted to gynecological examination, Pap smear and colposcopic examination of the cervix and vulva. The association of vulval intraepithelial lesion was analyzed according to the results of clinical (age and cervical lesions), laboratorial (CD4 count) and behavioral (number of partners and smoking habit) variables. The study (independent) variables were the epidemiological data, the immunologic status and the results of gynecological propaedeutic. Thus, age, the smoking habit, number of sexual partners, count of T CD4 lymphocites, and cervical intraepithelial lesion were selected. In the beginning, a bivariate analysis was performed, aiming at assessing the association between the presence of vulval intraepithelial lesion (ultimate variable) and the independent variables (age, smoking habits, number of sexual partners, cytology, colposcopy and CD4 count). Thereafter, the results with statistical significance (p<0.05) were submitted to a multiple logistic regression, and the probability ratio with the respective 95% confidence interval was established. RESULTS: the prevalence of vulval intraepithelial lesions was 40%. In the multivariate analysis CD4 count below 500 cells/mm³ OR=2.69 [IC 95%: 1.61-4.52], abnormal colposcopy OR=1.64 [IC 95%: 1.01-2.67] and age under 26 OR=1.98 [IC 95%: 1.18-3.30] were significant. In the vulval and cervical simultaneous lesion subgroup, age under 26 OR=3.30 [IC 95%: 1.65-6.59] and CD4 count below 500 cells/mm³ OR=4.15 [IC 95%: 1.92-8.96], were significant on analysis. CONCLUSIONS: the prevalence of vulval squamous intraepithelial lesions in HIV-infected patients is high. Immunodeficiency, presence of cervical intraepithelial lesions and age under 26 were associated with the presence of vulval intraepithelial lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):407-414
DOI 10.1590/S0100-72032005000700007
PURPOSE: to evaluate the prevalence of vulval squamous intraepithelial lesions and associated factors in HIV-infected patients attended at the public health services of Rio de Janeiro city. METHOD: a total of 374 HIV-infected patients were attended at public services in Rio de Janeiro city and submitted to gynecological examination, Pap smear and colposcopic examination of the cervix and vulva. The association of vulval intraepithelial lesion was analyzed according to the results of clinical (age and cervical lesions), laboratorial (CD4 count) and behavioral (number of partners and smoking habit) variables. The study (independent) variables were the epidemiological data, the immunologic status and the results of gynecological propaedeutic. Thus, age, the smoking habit, number of sexual partners, count of T CD4 lymphocites, and cervical intraepithelial lesion were selected. In the beginning, a bivariate analysis was performed, aiming at assessing the association between the presence of vulval intraepithelial lesion (ultimate variable) and the independent variables (age, smoking habits, number of sexual partners, cytology, colposcopy and CD4 count). Thereafter, the results with statistical significance (p<0.05) were submitted to a multiple logistic regression, and the probability ratio with the respective 95% confidence interval was established. RESULTS: the prevalence of vulval intraepithelial lesions was 40%. In the multivariate analysis CD4 count below 500 cells/mm³ OR=2.69 [IC 95%: 1.61-4.52], abnormal colposcopy OR=1.64 [IC 95%: 1.01-2.67] and age under 26 OR=1.98 [IC 95%: 1.18-3.30] were significant. In the vulval and cervical simultaneous lesion subgroup, age under 26 OR=3.30 [IC 95%: 1.65-6.59] and CD4 count below 500 cells/mm³ OR=4.15 [IC 95%: 1.92-8.96], were significant on analysis. CONCLUSIONS: the prevalence of vulval squamous intraepithelial lesions in HIV-infected patients is high. Immunodeficiency, presence of cervical intraepithelial lesions and age under 26 were associated with the presence of vulval intraepithelial lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):415-420
DOI 10.1590/S0100-72032005000700008
PURPOSE: to evaluate the cost of preventive mammographic screening in climacteric women, as compared to the cost of breast cancer treatment in more advanced stages. METHODS: one thousand and fourteen patients attended at the Climacteric outpatient service of the Gynecology Department, Federal University of São Paulo Paulista School of Medicine, were included in the study and submitted to mammographic test. All mammographic test's were analyzed by the same two physicians and classified according to the BI-RADS (Breast Imaging Reporting and Data System American College of Radiology) categories. The detected lesions were submitted to cytological and histological examination. RESULTS: the final diagnostic impression of the 1014 examinations, according to the classification of BI-RADS categories was: 1=261, 2=671, 3=59, 4=22 and 5=1. The invasive procedures were performed through a needle guided by ultrasound or stereotactic examinations: 33 fine-needle aspiration biopsies, 6 core biopsies guided by ultrasound and 20 core biopsies guided by stereotactic examination. Five cancer diagnoses were established. The total cost of this screening based on Brazilian procedure values was R$ 76,593.79 (25,534 dollars). Therefore, the cost of the diagnosis of the five cases of cancer in this screening was R$ 15,318.75 (5,106 dollars) each. However, the average cost per patient screened was R$ 75.53 (25 dollars). CONCLUSIONS: considering that the total treatment cost of only one case of breast cancer in advanced stage including hospital costs, surgery, chemotherapy, radiotherapy and hormonal treatment is similar to the cost of 1,000 mammographic screenings in climacteric women, it may be concluded that the cost of the early cancer diagnosis program is worth it and should be included in the public health program, as a way of lowering the public health expense.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):415-420
DOI 10.1590/S0100-72032005000700008
PURPOSE: to evaluate the cost of preventive mammographic screening in climacteric women, as compared to the cost of breast cancer treatment in more advanced stages. METHODS: one thousand and fourteen patients attended at the Climacteric outpatient service of the Gynecology Department, Federal University of São Paulo Paulista School of Medicine, were included in the study and submitted to mammographic test. All mammographic test's were analyzed by the same two physicians and classified according to the BI-RADS (Breast Imaging Reporting and Data System American College of Radiology) categories. The detected lesions were submitted to cytological and histological examination. RESULTS: the final diagnostic impression of the 1014 examinations, according to the classification of BI-RADS categories was: 1=261, 2=671, 3=59, 4=22 and 5=1. The invasive procedures were performed through a needle guided by ultrasound or stereotactic examinations: 33 fine-needle aspiration biopsies, 6 core biopsies guided by ultrasound and 20 core biopsies guided by stereotactic examination. Five cancer diagnoses were established. The total cost of this screening based on Brazilian procedure values was R$ 76,593.79 (25,534 dollars). Therefore, the cost of the diagnosis of the five cases of cancer in this screening was R$ 15,318.75 (5,106 dollars) each. However, the average cost per patient screened was R$ 75.53 (25 dollars). CONCLUSIONS: considering that the total treatment cost of only one case of breast cancer in advanced stage including hospital costs, surgery, chemotherapy, radiotherapy and hormonal treatment is similar to the cost of 1,000 mammographic screenings in climacteric women, it may be concluded that the cost of the early cancer diagnosis program is worth it and should be included in the public health program, as a way of lowering the public health expense.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):382-386
DOI 10.1590/S0100-72032005000700003
PURPOSE: to evaluate periodontal conditions and need for treatment supplied by Periodontal Screening and Recording (PSR) in mothers, in order to clarify the relationship between periodontal disease and low birth weight premature newborns. METHODS: PSR was used in a sample of 40 mothers, divided into: test group, consisting of mothers of premature newborns with weight less than 2,500 g (n=20), and the control group, consisting of mothers of term newborns with a weight equal to or over 2,500 g (n=20). The collected data were analyzed by descriptive statistics, and the results of PSR were submitted to statistical analysis in order to verify differences in periodontal condition and need for treatment of the mothers, using the Kolmogorov-Smirnov test, with a significance level of 5%. RESULTS: the presence of periodontal pocket of 3.5 to 5.5 mm was the most common finding among the mothers of newborns with low weight (39.2% of the cases), while the presence of bleeding at probing and absence of a periodontal pocket were the most frequent findings among the mothers of newborns with normal weight (37.5% of the cases). There was a statistically significant difference between periodontal conditions of the mothers of the groups (p=0.0494), but in relation to the need for treatment, there was no significant difference between the studied groups (p>0.05). CONCLUSION: the mothers of preterm newborns with low weight presented worse periodontal conditions, suggesting that periodontal infection may be related to preterm low birth weight newborns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):382-386
DOI 10.1590/S0100-72032005000700003
PURPOSE: to evaluate periodontal conditions and need for treatment supplied by Periodontal Screening and Recording (PSR) in mothers, in order to clarify the relationship between periodontal disease and low birth weight premature newborns. METHODS: PSR was used in a sample of 40 mothers, divided into: test group, consisting of mothers of premature newborns with weight less than 2,500 g (n=20), and the control group, consisting of mothers of term newborns with a weight equal to or over 2,500 g (n=20). The collected data were analyzed by descriptive statistics, and the results of PSR were submitted to statistical analysis in order to verify differences in periodontal condition and need for treatment of the mothers, using the Kolmogorov-Smirnov test, with a significance level of 5%. RESULTS: the presence of periodontal pocket of 3.5 to 5.5 mm was the most common finding among the mothers of newborns with low weight (39.2% of the cases), while the presence of bleeding at probing and absence of a periodontal pocket were the most frequent findings among the mothers of newborns with normal weight (37.5% of the cases). There was a statistically significant difference between periodontal conditions of the mothers of the groups (p=0.0494), but in relation to the need for treatment, there was no significant difference between the studied groups (p>0.05). CONCLUSION: the mothers of preterm newborns with low weight presented worse periodontal conditions, suggesting that periodontal infection may be related to preterm low birth weight newborns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):387-392
DOI 10.1590/S0100-72032005000700004
PURPOSE: to assess peak systolic velocity (PSV) and the resistance index (RI) in the middle cerebral artery (MCA), suprarenal aorta (SRA) and infrarenal aorta (IRA) of the fetus and in the umbilical artery (UA) between the 22nd and 38th week of gestation. METHODS: a prospective study which evaluated the parameters of 33 normal fetuses in the 22nd, 26th, 30th, and 38th week of gestation. Pregnant women with a singleton fetus with no diseases or complications and who agreed to participate were included in the study. Exclusion criteria were fetal malformations, discontinuation of prenatal care visits and mothers who smoked, used alcohol or illicit drugs. Ultrasound examinations were performed by a single observer. For the acquisition of the Doppler velocimetry tracing in the MCA, SRA, IRA and UA, the sample volume was 1 to 2 mm, placed in the center of the arteries. The insonation angle was 5º to 19º in the MCA, below 45º in the SRA and IRA, and less than 60º in the UA. We used a wall filter of 50-100 Hz. The parameters were calculated automatically with the frozen image, three measurements being made. The final result was obtained by the arithmetic mean of the three values. Data were analyzed by analysis of variance (ANOVA), post hoc Bonferroni test, Pearson's correlation, and regression analysis. The level of significance was set at p<0.05 in all analyses. RESULTS: PSV increased from 26.3 to 57.7 cm/s in the MCA between the 22nd and the 38th week of gestation (p<0.05). In the SRA and in the IRA, PSV increased between the 22nd and 34th week of gestation, from 74.6 and 59.0 cm/s to 106.0 and 86.6 cm/s, respectively (p<0.05). In the UA, PSV increased between the 22nd and the 34th week of gestation, but decreased from 55.5 to 46.2 cm/s between the 34th and the 38th week of gestation. In the MCA, the RI was lower in the 22nd (0.81) and 38th week of gestation (0.75) and higher (0.85) in the 26th week (p<0.05). In the SRA, the RI values were stable in all weeks and in the IRA they were stable in most weeks (p>0.05). In the UA, RI decreased from 0.69 to 0.56 between the 22nd and 38th week of gestation (p<0.05). CONCLUSION: in normal fetuses, in the second half of gestation PSV increased in the MCA, SRA and IRA, decreasing in the UA between the 34th and 38th week of gestation. RI was lower in the 22nd and 38th weeks of gestation in the MCA, decreased between the 22nd and the 38th week in the UA, and was constant in most of the gestational weeks in the SRA and IRA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):387-392
DOI 10.1590/S0100-72032005000700004
PURPOSE: to assess peak systolic velocity (PSV) and the resistance index (RI) in the middle cerebral artery (MCA), suprarenal aorta (SRA) and infrarenal aorta (IRA) of the fetus and in the umbilical artery (UA) between the 22nd and 38th week of gestation. METHODS: a prospective study which evaluated the parameters of 33 normal fetuses in the 22nd, 26th, 30th, and 38th week of gestation. Pregnant women with a singleton fetus with no diseases or complications and who agreed to participate were included in the study. Exclusion criteria were fetal malformations, discontinuation of prenatal care visits and mothers who smoked, used alcohol or illicit drugs. Ultrasound examinations were performed by a single observer. For the acquisition of the Doppler velocimetry tracing in the MCA, SRA, IRA and UA, the sample volume was 1 to 2 mm, placed in the center of the arteries. The insonation angle was 5º to 19º in the MCA, below 45º in the SRA and IRA, and less than 60º in the UA. We used a wall filter of 50-100 Hz. The parameters were calculated automatically with the frozen image, three measurements being made. The final result was obtained by the arithmetic mean of the three values. Data were analyzed by analysis of variance (ANOVA), post hoc Bonferroni test, Pearson's correlation, and regression analysis. The level of significance was set at p<0.05 in all analyses. RESULTS: PSV increased from 26.3 to 57.7 cm/s in the MCA between the 22nd and the 38th week of gestation (p<0.05). In the SRA and in the IRA, PSV increased between the 22nd and 34th week of gestation, from 74.6 and 59.0 cm/s to 106.0 and 86.6 cm/s, respectively (p<0.05). In the UA, PSV increased between the 22nd and the 34th week of gestation, but decreased from 55.5 to 46.2 cm/s between the 34th and the 38th week of gestation. In the MCA, the RI was lower in the 22nd (0.81) and 38th week of gestation (0.75) and higher (0.85) in the 26th week (p<0.05). In the SRA, the RI values were stable in all weeks and in the IRA they were stable in most weeks (p>0.05). In the UA, RI decreased from 0.69 to 0.56 between the 22nd and 38th week of gestation (p<0.05). CONCLUSION: in normal fetuses, in the second half of gestation PSV increased in the MCA, SRA and IRA, decreasing in the UA between the 34th and 38th week of gestation. RI was lower in the 22nd and 38th weeks of gestation in the MCA, decreased between the 22nd and the 38th week in the UA, and was constant in most of the gestational weeks in the SRA and IRA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):393-400
DOI 10.1590/S0100-72032005000700005
PURPOSE: to evaluate T cell proliferation and cytokine production in HIV-1-infected pregnant women and their impact on in vitro virus replication. METHODS: peripheral blood from 12 HIV-1-infected pregnant women and from their neonates was collected. As control, 10 samples from non-infected pregnants were also colleted. The CD4+ and CD8+ T cell counts were assayed by flow cytometry. Peripheral blood mononuclear cells (PBMC) and plasma were obtained by centrifugation with and without Ficoll-Hypaque gradient, respectively. The freshly purified PBMC were kept in cultures for seven days with PHA plus r-IL-2, and the lymphoproliferative response was assayed by Trypan blue dye exclusion. In some experiments we added anti-IL-10 monoclonal antibody. The plasma samples and supernatants from cell cultures were stored to determine both peripheral cytokine levels, by ELISA sandwich, and viral load, by RT-PCR. RESULTS: the results showed that the lymphoproliferative response was smaller in cultures obtained from HIV-1-infected women than in control cultures [4.2±0.37 vs 2.4±0.56 (x 10(6) cell/mL), p<0.005]. In both control and infected pregnant women who had low plasma viral load, the level of IL-10 was higher than in those with high viral replication (9.790±3.224 vs 1.256±350 pg/mL, p=0.002). The elevated TNF-alpha production detected in serum (7.200±2.440 pg/mL) and supernatants (21.350±15.230 pg/mL) was associated with higher plasma viral loads and vertical infection. The IL-10 blockade by anti-IL-10 antibodies augmented viral replication in the cell cultures. CONCLUSION: these results indicate that IL-10 production exerts a negative influence on virus replication, diminishing the probability of intrauterine HIV-1 infection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(7):393-400
DOI 10.1590/S0100-72032005000700005
PURPOSE: to evaluate T cell proliferation and cytokine production in HIV-1-infected pregnant women and their impact on in vitro virus replication. METHODS: peripheral blood from 12 HIV-1-infected pregnant women and from their neonates was collected. As control, 10 samples from non-infected pregnants were also colleted. The CD4+ and CD8+ T cell counts were assayed by flow cytometry. Peripheral blood mononuclear cells (PBMC) and plasma were obtained by centrifugation with and without Ficoll-Hypaque gradient, respectively. The freshly purified PBMC were kept in cultures for seven days with PHA plus r-IL-2, and the lymphoproliferative response was assayed by Trypan blue dye exclusion. In some experiments we added anti-IL-10 monoclonal antibody. The plasma samples and supernatants from cell cultures were stored to determine both peripheral cytokine levels, by ELISA sandwich, and viral load, by RT-PCR. RESULTS: the results showed that the lymphoproliferative response was smaller in cultures obtained from HIV-1-infected women than in control cultures [4.2±0.37 vs 2.4±0.56 (x 10(6) cell/mL), p<0.005]. In both control and infected pregnant women who had low plasma viral load, the level of IL-10 was higher than in those with high viral replication (9.790±3.224 vs 1.256±350 pg/mL, p=0.002). The elevated TNF-alpha production detected in serum (7.200±2.440 pg/mL) and supernatants (21.350±15.230 pg/mL) was associated with higher plasma viral loads and vertical infection. The IL-10 blockade by anti-IL-10 antibodies augmented viral replication in the cell cultures. CONCLUSION: these results indicate that IL-10 production exerts a negative influence on virus replication, diminishing the probability of intrauterine HIV-1 infection.
