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Original Article12-21-2020
Type of Childbirth and its Association with the Maternal-Filial Interaction
- Crystiane Hereny dos Santos Neto
, - Fábio Sagula Oliveira ,
- Graciele Fernanda Gomes ,
- Edward Araujo Júnior ,
- Mary Uchiyama Nakamura , [ ... ],
- Eduardo de Souza
Abstract
Original ArticleType of Childbirth and its Association with the Maternal-Filial Interaction
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):597-606
- Crystiane Hereny dos Santos Neto ,
- Fábio Sagula Oliveira ,
- Graciele Fernanda Gomes ,
- Edward Araujo Júnior ,
- Mary Uchiyama Nakamura ,
- Eduardo de Souza
Views176See moreAbstract
Objective
The purpose of the present study was to evaluate the quality of mother-child bonding in three different contexts related to the labor, that is, vaginal delivery, elective cesarean section, and intrapartum cesarean section.
Methods
This was an observational, cross-sectional clinical study conducted in two cities within the state of São Paulo, Brazil. The study sample consisted of 81 babies born without any major complications during pregnancy and labor, aged 3 to 4 months, and their respective mothers, aged between 20 and 35 years old, primiparous, living in the cities of Palmital and Ourinhos, state of São Paulo, Brazil. The evaluation of the quality of the maternal-filial interaction was performed through video-image analysis, using the Mother-baby Interaction Observation Protocol from 0 to 6 months (POIMB 0-6, in the Portuguese acronym).
Results
Mothers who had vaginal delivery had higher amount of visual contact or attempted visual contact (p = 0.034), better response to the social behavior of the child (p = 0.001) and greater sensitivity (p = 0.007) than the others. Their children also showed more interaction with them, as they looked more frequently at the mother's face (p ≤ 0.008) and responded more frequently to the mother's communicative stimulus (p < 0.001).
Conclusion
Considering the occurrence of vaginal delivery, it is concluded that the interaction between the mother-child dyad is quantitatively larger and qualitatively better when compared with intrapartum or elective cesarean section.
Views176
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleType of Childbirth and its Association with the Maternal-Filial Interaction
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):597-606
- Crystiane Hereny dos Santos Neto ,
- Fábio Sagula Oliveira ,
- Graciele Fernanda Gomes ,
- Edward Araujo Júnior ,
- Mary Uchiyama Nakamura ,
- Eduardo de Souza
Views176See moreAbstract
Objective
The purpose of the present study was to evaluate the quality of mother-child bonding in three different contexts related to the labor, that is, vaginal delivery, elective cesarean section, and intrapartum cesarean section.
Methods
This was an observational, cross-sectional clinical study conducted in two cities within the state of São Paulo, Brazil. The study sample consisted of 81 babies born without any major complications during pregnancy and labor, aged 3 to 4 months, and their respective mothers, aged between 20 and 35 years old, primiparous, living in the cities of Palmital and Ourinhos, state of São Paulo, Brazil. The evaluation of the quality of the maternal-filial interaction was performed through video-image analysis, using the Mother-baby Interaction Observation Protocol from 0 to 6 months (POIMB 0-6, in the Portuguese acronym).
Results
Mothers who had vaginal delivery had higher amount of visual contact or attempted visual contact (p = 0.034), better response to the social behavior of the child (p = 0.001) and greater sensitivity (p = 0.007) than the others. Their children also showed more interaction with them, as they looked more frequently at the mother's face (p ≤ 0.008) and responded more frequently to the mother's communicative stimulus (p < 0.001).
Conclusion
Considering the occurrence of vaginal delivery, it is concluded that the interaction between the mother-child dyad is quantitatively larger and qualitatively better when compared with intrapartum or elective cesarean section.
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. - Crystiane Hereny dos Santos Neto
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Original Article12-21-2020
The Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes
- Joana Sousa Nunes ,
- Rita Ladeiras,
- Luísa Machado ,
- Diana Coelho ,
- Carla Duarte , [ ... ],
- José Manuel Furtado
Abstract
Original ArticleThe Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):607-613
- Joana Sousa Nunes ,
- Rita Ladeiras,
- Luísa Machado ,
- Diana Coelho ,
- Carla Duarte ,
- José Manuel Furtado
Views291See moreAbstract
Objective
The present study aims to analyze adverse fetal or neonatal outcomes in women with gestational diabetes, including fetal death, preterm deliveries, birthweight, neonatal morbidity and mortality, as well as the synergic effect of concomitant pregnancy risk factors and poor obstetric outcomes, as advanced maternal age, maternal obesity and pre-eclampsia in their worsening.
Methods
The present cohort retrospective study included all pregnant women with gestational diabetes, with surveillance and childbirth at the Hospital da Senhora da Oliveira during the years of 2017 and 2018. The data were collected from the medical electronic records registered in health informatic programs Sclinico and Obscare, and statistical simple and multivariate analysis was done using IBM SPSS Statistics.
Results
The study participants included 301 pregnant women that contributed to 7.36% of the total institution childbirths of the same years, in a total of 300 live births. It was analyzed the influence of pre-eclampsia coexistence in neonatal morbidity (p = 0.004), in the occurrence of newborns of low and very low birthweight (p < 0.01) and in preterm deliveries (p < 0.01). The influence of maternal obesity (p = 0.270; p = 0.992; p = 0.684) and of advanced maternal age in these 3 outcomes was also analyzed (p = 0,806; p = 0.879; p = 0.985).Using a multivariate analysis, the only models with statistic significance to predict the three neonatal outcomes included only pre-eclampsia (p = 0.04; p < 0.01; p < 0.01).
Conclusion
Only coexistence of pre-eclampsia showed an association with adverse neonatal outcomes (neonatal morbidity, newborns of low and very low birthweight and preterm deliveries) and can be used as a predictor of them in women with gestational diabetes.
Views291This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleThe Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):607-613
- Joana Sousa Nunes ,
- Rita Ladeiras,
- Luísa Machado ,
- Diana Coelho ,
- Carla Duarte ,
- José Manuel Furtado
Views291See moreAbstract
Objective
The present study aims to analyze adverse fetal or neonatal outcomes in women with gestational diabetes, including fetal death, preterm deliveries, birthweight, neonatal morbidity and mortality, as well as the synergic effect of concomitant pregnancy risk factors and poor obstetric outcomes, as advanced maternal age, maternal obesity and pre-eclampsia in their worsening.
Methods
The present cohort retrospective study included all pregnant women with gestational diabetes, with surveillance and childbirth at the Hospital da Senhora da Oliveira during the years of 2017 and 2018. The data were collected from the medical electronic records registered in health informatic programs Sclinico and Obscare, and statistical simple and multivariate analysis was done using IBM SPSS Statistics.
Results
The study participants included 301 pregnant women that contributed to 7.36% of the total institution childbirths of the same years, in a total of 300 live births. It was analyzed the influence of pre-eclampsia coexistence in neonatal morbidity (p = 0.004), in the occurrence of newborns of low and very low birthweight (p < 0.01) and in preterm deliveries (p < 0.01). The influence of maternal obesity (p = 0.270; p = 0.992; p = 0.684) and of advanced maternal age in these 3 outcomes was also analyzed (p = 0,806; p = 0.879; p = 0.985).Using a multivariate analysis, the only models with statistic significance to predict the three neonatal outcomes included only pre-eclampsia (p = 0.04; p < 0.01; p < 0.01).
Conclusion
Only coexistence of pre-eclampsia showed an association with adverse neonatal outcomes (neonatal morbidity, newborns of low and very low birthweight and preterm deliveries) and can be used as a predictor of them in women with gestational diabetes.
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. - Joana Sousa Nunes
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Original Article12-21-2020
Hypertensive Disorders: Prevalence, Perinatal Outcomes and Cesarean Section Rates in Pregnant Women Hospitalized for Delivery
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):690-696
Abstract
Original ArticleHypertensive Disorders: Prevalence, Perinatal Outcomes and Cesarean Section Rates in Pregnant Women Hospitalized for Delivery
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):690-696
Views171See moreAbstract
Objective:
To evaluate the prevalence of hypertensive disorders, perinatal outcomes (preterm infants, low birthweight infants and Apgar score < 7 at the 5th minute and fetal deaths) and the cesarean rates in pregnant women hospitalized for delivery at the Maternidade Hilda Brandão da Santa Casa de Belo Horizonte, Belo Horizonte, state of Minas Gerais, Brazil, from March 1, 2008 to February 28, 2018.
Methods:
A case-control study was performed, and the groups selected for comparison were those of pregnant women with and without hypertensive disorders. Out of the 36,724 women, 4,464 were diagnosed with hypertensive disorders and 32,260 did not present hypertensive disorders
Results:
The prevalence of hypertensive disorders was 12.16%; the perinatal outcomes and cesarean rates between the 2 groups with and without hypertensive disorders were: preterm infants (21.70% versus 9.66%, odds ratio [OR] 2.59, 95% confidence interval [CI], 2.40-2.80, p < 0.001); low birthweight infants (24.48% versus 10.56%; OR 2.75; 95% CI, 2.55-2.96; p < 0.001); Apgar score < 7 at the 5th minute (1.40% versus 1.10%; OR 1.27; 95% CI, 0.97-1.67; p = 0.84); dead fetuses diagnosed prior to delivery (1.90% versus 0.91%; OR 2.12; 95% CI, 1.67-2.70; p < 0.001); cesarean rates (60.22% versus 31.21%; OR 3.34; 95% CI, 3.14-3.55; p < 0.001).
Conclusion:
Hypertensive disorders are associated with higher rates of cesarean deliveries and higher risk of preterm infants, low birthweight infants and a higher risk of fetal deaths.
Views171This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleHypertensive Disorders: Prevalence, Perinatal Outcomes and Cesarean Section Rates in Pregnant Women Hospitalized for Delivery
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):690-696
Views171See moreAbstract
Objective:
To evaluate the prevalence of hypertensive disorders, perinatal outcomes (preterm infants, low birthweight infants and Apgar score < 7 at the 5th minute and fetal deaths) and the cesarean rates in pregnant women hospitalized for delivery at the Maternidade Hilda Brandão da Santa Casa de Belo Horizonte, Belo Horizonte, state of Minas Gerais, Brazil, from March 1, 2008 to February 28, 2018.
Methods:
A case-control study was performed, and the groups selected for comparison were those of pregnant women with and without hypertensive disorders. Out of the 36,724 women, 4,464 were diagnosed with hypertensive disorders and 32,260 did not present hypertensive disorders
Results:
The prevalence of hypertensive disorders was 12.16%; the perinatal outcomes and cesarean rates between the 2 groups with and without hypertensive disorders were: preterm infants (21.70% versus 9.66%, odds ratio [OR] 2.59, 95% confidence interval [CI], 2.40-2.80, p < 0.001); low birthweight infants (24.48% versus 10.56%; OR 2.75; 95% CI, 2.55-2.96; p < 0.001); Apgar score < 7 at the 5th minute (1.40% versus 1.10%; OR 1.27; 95% CI, 0.97-1.67; p = 0.84); dead fetuses diagnosed prior to delivery (1.90% versus 0.91%; OR 2.12; 95% CI, 1.67-2.70; p < 0.001); cesarean rates (60.22% versus 31.21%; OR 3.34; 95% CI, 3.14-3.55; p < 0.001).
Conclusion:
Hypertensive disorders are associated with higher rates of cesarean deliveries and higher risk of preterm infants, low birthweight infants and a higher risk of fetal deaths.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article12-21-2020
Worldwide Original Research Production on Maternal Near-Miss: A 10-year Bibliometric Study
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):614-620
Abstract
Original ArticleWorldwide Original Research Production on Maternal Near-Miss: A 10-year Bibliometric Study
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):614-620
Views165See moreAbstract
Objective
To evaluate the global productivity regarding original articles on maternal near-miss (MNM).
Methods
We conducted a bibliometric analysis of original articles published from 2008 to November 2019 in the journals indexed in the Scopus database. The averages of the number of articles by author, of the number of authors by article, of the number of citations by article, and the total number of documents with one or more authors were obtained. An analysis of the co-citation of authors and a co-occurrence analysis of the terms included in the titles and abstracts were performed and were presented as network visualization maps.
Results
A total of 326 original articles were analyzed. There was an increase in the number of articles (p < 0.001; average annual growth rate = 12.54%;). A total of 1,399 authors, an average number of articles per author of 4.29, with an index of authors per document of 0.23, and an index of co-authors per document of 8.16 were identified. A total of 85 countries contributed with original articles on MNM. Among the top ten countries regarding the contribution of articles, five were low and middle-income countries (LMICs). Brazil had the highest volume of production (31.1%;), followed by the US (11.5%;). Terms related to countries and the measurement of the rates and cases of MNM and the associated factors were found in recent years in the analysis of the co-occurrence of terms.
Conclusion
There was an increase in the production of original articles on MNM, with a significant participation of authors and institutions from LMICs, which reveals a growing interest in the use of MNM indicators to improve the quality of maternal health care.
Views165This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleWorldwide Original Research Production on Maternal Near-Miss: A 10-year Bibliometric Study
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):614-620
Views165See moreAbstract
Objective
To evaluate the global productivity regarding original articles on maternal near-miss (MNM).
Methods
We conducted a bibliometric analysis of original articles published from 2008 to November 2019 in the journals indexed in the Scopus database. The averages of the number of articles by author, of the number of authors by article, of the number of citations by article, and the total number of documents with one or more authors were obtained. An analysis of the co-citation of authors and a co-occurrence analysis of the terms included in the titles and abstracts were performed and were presented as network visualization maps.
Results
A total of 326 original articles were analyzed. There was an increase in the number of articles (p < 0.001; average annual growth rate = 12.54%;). A total of 1,399 authors, an average number of articles per author of 4.29, with an index of authors per document of 0.23, and an index of co-authors per document of 8.16 were identified. A total of 85 countries contributed with original articles on MNM. Among the top ten countries regarding the contribution of articles, five were low and middle-income countries (LMICs). Brazil had the highest volume of production (31.1%;), followed by the US (11.5%;). Terms related to countries and the measurement of the rates and cases of MNM and the associated factors were found in recent years in the analysis of the co-occurrence of terms.
Conclusion
There was an increase in the production of original articles on MNM, with a significant participation of authors and institutions from LMICs, which reveals a growing interest in the use of MNM indicators to improve the quality of maternal health care.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article12-21-2020
Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
- Catherine Primo Nogueira de Sá ,
- Mirela Foresti Jiménez ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Antonio Celso Koehler Ayub , [ ... ],
- Patrícia El Beitune
Abstract
Original ArticleEvaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):697-704
- Catherine Primo Nogueira de Sá ,
- Mirela Foresti Jiménez ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Antonio Celso Koehler Ayub ,
- Rodrigo Bernardes Cardoso ,
- Régis Kreitchmann ,
- Patrícia El Beitune
Views312See moreAbstract
Objective:
Recent observations support the hypothesis that an imbalance between angiogenic factors has a fundamental role in the pathogenesis of pre-eclampsia and is responsible for the clinical manifestations of the disease. The goal of the present study was to evaluate the sensitivity, specificity, and the best accuracy level of Soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in maternal serum and protein/creatinine ratio in urine sample to define the best cutoff point of these tests to discriminate between the patients with gestational hypertension and the patients with pre-eclampsia, to evaluate the possibility of using them as diagnostic methods.
Methods:
A prospective longitudinal study was performed, and blood samples were collected from 95 pregnant patients with hypertension to measure serum concentrations of biomarkers sFlt-1 and PlGF. Urine samples were collected for protein screening. Significance was set as p < 0.05.
Results:
The sFlt-1/PlGF ratio demonstrated a sensitivity of 57.5% and a specificity of 60% using 50.4 as a cutoff point. The test that showed the best accuracy in the diagnosis of pre-eclampsia was protein/creatinine ratio, with a sensitivity of 78.9% and a specificity of 70% using 0.4 as a cutoff point and showing an area under the receiver operating characteristic curve of 0.80 (p < 0.001).
Conclusion:
No studied laboratory test proved to be fairly accurate for the diagnosis of pre-eclampsia, except for the protein/creatinine ratio. The evidence is insufficient to recommend biomarkers sFlt-1 and PlGF to be used for the diagnosis of pre-eclampsia.
Views312This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleEvaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):697-704
- Catherine Primo Nogueira de Sá ,
- Mirela Foresti Jiménez ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Antonio Celso Koehler Ayub ,
- Rodrigo Bernardes Cardoso ,
- Régis Kreitchmann ,
- Patrícia El Beitune
Views312See moreAbstract
Objective:
Recent observations support the hypothesis that an imbalance between angiogenic factors has a fundamental role in the pathogenesis of pre-eclampsia and is responsible for the clinical manifestations of the disease. The goal of the present study was to evaluate the sensitivity, specificity, and the best accuracy level of Soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in maternal serum and protein/creatinine ratio in urine sample to define the best cutoff point of these tests to discriminate between the patients with gestational hypertension and the patients with pre-eclampsia, to evaluate the possibility of using them as diagnostic methods.
Methods:
A prospective longitudinal study was performed, and blood samples were collected from 95 pregnant patients with hypertension to measure serum concentrations of biomarkers sFlt-1 and PlGF. Urine samples were collected for protein screening. Significance was set as p < 0.05.
Results:
The sFlt-1/PlGF ratio demonstrated a sensitivity of 57.5% and a specificity of 60% using 50.4 as a cutoff point. The test that showed the best accuracy in the diagnosis of pre-eclampsia was protein/creatinine ratio, with a sensitivity of 78.9% and a specificity of 70% using 0.4 as a cutoff point and showing an area under the receiver operating characteristic curve of 0.80 (p < 0.001).
Conclusion:
No studied laboratory test proved to be fairly accurate for the diagnosis of pre-eclampsia, except for the protein/creatinine ratio. The evidence is insufficient to recommend biomarkers sFlt-1 and PlGF to be used for the diagnosis of pre-eclampsia.
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. - Catherine Primo Nogueira de Sá
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Original Article12-21-2020
Cervical Pessary Plus Progesterone for Twin Pregnancy with Short Cervix Compared to Unselected and Non-Treated Twin Pregnancy: A Historical Equivalence Cohort Study (EPM Twin Pessary Study)
- Marcelo Santucci França ,
- Alan Roberto Hatanaka ,
- Valter Lacerda de Andrade Junior ,
- Julio Elito Junior ,
- David Baptista Silva Pares , [ ... ],
- Antonio Fernandes Moron
Abstract
Original ArticleCervical Pessary Plus Progesterone for Twin Pregnancy with Short Cervix Compared to Unselected and Non-Treated Twin Pregnancy: A Historical Equivalence Cohort Study (EPM Twin Pessary Study)
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):621-629
- Marcelo Santucci França ,
- Alan Roberto Hatanaka ,
- Valter Lacerda de Andrade Junior ,
- Julio Elito Junior ,
- David Baptista Silva Pares ,
- Tatiana Emy Nishimoto Kawanami Hamamoto ,
- Stephanno Gomes Pereira Sarmento ,
- Rosiane Mattar ,
- Antonio Fernandes Moron
Views420Abstract
Objective
The present study aims to determine if the use of cervical pessary plus progesterone in short-cervix (≤ 25 mm) dichorionic-diamniotic (DC-DA) twin pregnancies is equivalent to the rate of preterm births (PBs) with no intervention in unselected DC-DA twin pregnancies.
Methods
A historical cohort study was performed between 2010 and 2018, including a total of 57 pregnant women with DC-DA twin pregnancies. The women admitted from 2010 to 2012 (n = 32) received no treatment, and were not selected by cervical length (Non-Treated group, NTG), whereas those admitted from 2013 to 2018 (n = 25), were routinely submitted to cervical pessary plus progesterone after the diagnosis of short cervix from the 18th to the 27th weeks of gestation (Pessary-Progesterone group, PPG). The primary outcome analyzed was the rate of PBs before 34 weeks.
Results
There were no statistical differences between the NTG and the PPG regarding PB < 34 weeks (18.8%; versus 40.0%; respectively; p = 0.07) and the mean birthweight of the smallest twin (2,037 ± 425 g versus 2,195 ± 665 g; p = 0.327). The Kaplan-Meyer Survival analysis was performed, and there were no differences between the groups before 31.5 weeks. Logistic regression showed that a previous PB (< 37 weeks) presented an odds ratio (OR) of 15.951 (95%; confidence interval [95%;CI]: 1.294-196.557; p = 0.031*) for PB < 34 weeks in the PPG.
Conclusion
In DC-DA twin pregnancies with a short cervix, (which means a higher risk of PB), the treatment with cervical pessary plus progesterone could be considered equivalent in several aspects related to PB in the NTG, despite the big difference between these groups.
Key-words cervical pessarydichorionic-diamniotic twin pregnancyPreterm birthshort cervixvaginal progesteroneSee moreViews420This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleCervical Pessary Plus Progesterone for Twin Pregnancy with Short Cervix Compared to Unselected and Non-Treated Twin Pregnancy: A Historical Equivalence Cohort Study (EPM Twin Pessary Study)
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):621-629
- Marcelo Santucci França ,
- Alan Roberto Hatanaka ,
- Valter Lacerda de Andrade Junior ,
- Julio Elito Junior ,
- David Baptista Silva Pares ,
- Tatiana Emy Nishimoto Kawanami Hamamoto ,
- Stephanno Gomes Pereira Sarmento ,
- Rosiane Mattar ,
- Antonio Fernandes Moron
Views420Abstract
Objective
The present study aims to determine if the use of cervical pessary plus progesterone in short-cervix (≤ 25 mm) dichorionic-diamniotic (DC-DA) twin pregnancies is equivalent to the rate of preterm births (PBs) with no intervention in unselected DC-DA twin pregnancies.
Methods
A historical cohort study was performed between 2010 and 2018, including a total of 57 pregnant women with DC-DA twin pregnancies. The women admitted from 2010 to 2012 (n = 32) received no treatment, and were not selected by cervical length (Non-Treated group, NTG), whereas those admitted from 2013 to 2018 (n = 25), were routinely submitted to cervical pessary plus progesterone after the diagnosis of short cervix from the 18th to the 27th weeks of gestation (Pessary-Progesterone group, PPG). The primary outcome analyzed was the rate of PBs before 34 weeks.
Results
There were no statistical differences between the NTG and the PPG regarding PB < 34 weeks (18.8%; versus 40.0%; respectively; p = 0.07) and the mean birthweight of the smallest twin (2,037 ± 425 g versus 2,195 ± 665 g; p = 0.327). The Kaplan-Meyer Survival analysis was performed, and there were no differences between the groups before 31.5 weeks. Logistic regression showed that a previous PB (< 37 weeks) presented an odds ratio (OR) of 15.951 (95%; confidence interval [95%;CI]: 1.294-196.557; p = 0.031*) for PB < 34 weeks in the PPG.
Conclusion
In DC-DA twin pregnancies with a short cervix, (which means a higher risk of PB), the treatment with cervical pessary plus progesterone could be considered equivalent in several aspects related to PB in the NTG, despite the big difference between these groups.
Key-words cervical pessarydichorionic-diamniotic twin pregnancyPreterm birthshort cervixvaginal progesteroneSee 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. - Marcelo Santucci França
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Original Article12-21-2020
New Benefits of Hydroxychloroquine in Pregnant Women with Systemic Lupus Erythematosus: A Retrospective Study in a Tertiary Centre
- Rahana Abd Rahman ,
- Kyaw Min Tun ,
- Ixora Kamisan Atan ,
- Mohd Shahrir Mohamed Said ,
- Ruslinda Mustafar , [ ... ],
- Ani Amelia Zainuddin
Abstract
Original ArticleNew Benefits of Hydroxychloroquine in Pregnant Women with Systemic Lupus Erythematosus: A Retrospective Study in a Tertiary Centre
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):705-711
- Rahana Abd Rahman ,
- Kyaw Min Tun ,
- Ixora Kamisan Atan ,
- Mohd Shahrir Mohamed Said ,
- Ruslinda Mustafar ,
- Ani Amelia Zainuddin
Views211See moreAbstract
Objective:
To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center.
Methods:
A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy.
Results:
There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016).
Conclusion:
Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.
Views211This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleNew Benefits of Hydroxychloroquine in Pregnant Women with Systemic Lupus Erythematosus: A Retrospective Study in a Tertiary Centre
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):705-711
- Rahana Abd Rahman ,
- Kyaw Min Tun ,
- Ixora Kamisan Atan ,
- Mohd Shahrir Mohamed Said ,
- Ruslinda Mustafar ,
- Ani Amelia Zainuddin
Views211See moreAbstract
Objective:
To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center.
Methods:
A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy.
Results:
There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016).
Conclusion:
Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.
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. - Rahana Abd Rahman
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Original Article12-21-2020
The Relationship between Serum Ischemia-Modified Albumin Levels and Uterine Artery Doppler Parameters in Patients with Primary Dysmenorrhea
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):630-633
Abstract
Original ArticleThe Relationship between Serum Ischemia-Modified Albumin Levels and Uterine Artery Doppler Parameters in Patients with Primary Dysmenorrhea
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):630-633
Views230See moreAbstract
Objective
Primary dysmenorrhea occurs due to abnormal levels of prostanoids, uterine contractions, and uterine blood flow. However, the reasons for pain in primary dysmenorrhea have not yet been clarified. We examined the blood flow alterations in patients with primary dysmenorrhea and determined the relationship between ischemia-modified albumin (IMA) levels, as an ischemia indicator, and primary dysmenorrhea.
Methods
In the present study, 37 patients who had primary dysmenorrhea and were in their luteal and menstrual phase of their menstrual cycles were included. Thirty individuals who had similar demographic characteristics, who were between 18 and 30 years old and did not have gynecologic disease were included as control individuals. Their uterine artery Doppler indices and serum IMA levels were measured.
Results
Menstrual phase plasma IMA levels were significantly higher than luteal phase IMA levels, both in the patient and in the control groups (p < 0.001). Although the menstrual phase IMA levels of patients were significantly higher than those of controls, luteal phase IMA levels were not significantly different between the two groups. Menstrual uterine artery pulsatility index (PI) and resistance index (RI) of primary dysmenorrhea patients were significantly different when compared with luteal uterine artery PI and RI levels. There was a positive correlation between menstrual phase IMA and uterine artery PI and RI in the primary dysmenorrhea.
Conclusion
Ischemia plays an important role in the etiology of the pain, which is frequently observed in patients with primary dysmenorrhea. Ischemia-modified albumin levels are considered as an efficient marker to determine the severity of pain and to indicate ischemia in primary dysmenorrhea.
Views230This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleThe Relationship between Serum Ischemia-Modified Albumin Levels and Uterine Artery Doppler Parameters in Patients with Primary Dysmenorrhea
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(10):630-633
Views230See moreAbstract
Objective
Primary dysmenorrhea occurs due to abnormal levels of prostanoids, uterine contractions, and uterine blood flow. However, the reasons for pain in primary dysmenorrhea have not yet been clarified. We examined the blood flow alterations in patients with primary dysmenorrhea and determined the relationship between ischemia-modified albumin (IMA) levels, as an ischemia indicator, and primary dysmenorrhea.
Methods
In the present study, 37 patients who had primary dysmenorrhea and were in their luteal and menstrual phase of their menstrual cycles were included. Thirty individuals who had similar demographic characteristics, who were between 18 and 30 years old and did not have gynecologic disease were included as control individuals. Their uterine artery Doppler indices and serum IMA levels were measured.
Results
Menstrual phase plasma IMA levels were significantly higher than luteal phase IMA levels, both in the patient and in the control groups (p < 0.001). Although the menstrual phase IMA levels of patients were significantly higher than those of controls, luteal phase IMA levels were not significantly different between the two groups. Menstrual uterine artery pulsatility index (PI) and resistance index (RI) of primary dysmenorrhea patients were significantly different when compared with luteal uterine artery PI and RI levels. There was a positive correlation between menstrual phase IMA and uterine artery PI and RI in the primary dysmenorrhea.
Conclusion
Ischemia plays an important role in the etiology of the pain, which is frequently observed in patients with primary dysmenorrhea. Ischemia-modified albumin levels are considered as an efficient marker to determine the severity of pain and to indicate ischemia in primary dysmenorrhea.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original Article Archives - Page 3 of 201 - Revista Brasileira de Ginecologia e Obstetrícia
