Trabalhos Originais Archives - Page 2 of 51 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):113-117
DOI 10.1590/S0100-72032001000200009
Purpose: to examine the effects of tramadol hydrochloride on rat pregnancy. Methods: five groups of 10 pregnant albino rats each were treated from the 1st up to the 20th day of pregnancy as follows: GI = intact controls; GII = controls which received 0.5 ml of distilled water (drug vehicle) once a day by gavage; GIII, GIV and GV = groups treated respectively with 6.7, 20.1 or 45.6 mg/kg of tramadol hydrochloride once a day by gavage in a final volume of 0.5 mL. Body weight gain was monitored by weighing at the beginning and on the 7th, 14th and 20th day of pregnancy. At term the animals were killed under deep ether anesthesia and the following parameters were evaluated: number of implantations, of resorptions, of viable fetuses and of placentae; presence of major malformations; maternal and fetal mortality and weights of fetuses and placentae. Results: tramadol significantly affected maternal body weight gain, this effect being more apparent in groups IV and V (mean reductions of weight gain of 41 and 56%, respectively). In group III the weight gain was affected more at days 7 and 14 (33% mean gain reductions) than at day 20 (19%). Drug treatment affected significantly and in a dose-dependent fashion the following parameters: individual weight of fetuses (GV = -39.2%), offspring weight (GIV = -51.7%; GV = -44.2%), number of placentae (GIV = -28.4%; GV = -11.6%), individual weight of placentae (GV = -10%) and the total weight of placentae (GIV = -28.4%; GV = -16.8%). Though among the treated animals there was an increase in resorptions and deaths at birth, these events were not significantly different from those found in controls. Conclusions: Tramadol showed definite deleterious effects on albino rat pregnancy, and these effects were exerted not only on the maternal but also the on fetal organisms. Overall, the effects were more pronounced at the 14th than at the 20th day of pregnancy, thus suggesting that the organogenic phase of the fetus is more susceptible than its initial (embryogenic) or final (term) phases. The results call attention to the care which is to be taken when the use of this opioid is considered during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):113-117
DOI 10.1590/S0100-72032001000200009
Purpose: to examine the effects of tramadol hydrochloride on rat pregnancy. Methods: five groups of 10 pregnant albino rats each were treated from the 1st up to the 20th day of pregnancy as follows: GI = intact controls; GII = controls which received 0.5 ml of distilled water (drug vehicle) once a day by gavage; GIII, GIV and GV = groups treated respectively with 6.7, 20.1 or 45.6 mg/kg of tramadol hydrochloride once a day by gavage in a final volume of 0.5 mL. Body weight gain was monitored by weighing at the beginning and on the 7th, 14th and 20th day of pregnancy. At term the animals were killed under deep ether anesthesia and the following parameters were evaluated: number of implantations, of resorptions, of viable fetuses and of placentae; presence of major malformations; maternal and fetal mortality and weights of fetuses and placentae. Results: tramadol significantly affected maternal body weight gain, this effect being more apparent in groups IV and V (mean reductions of weight gain of 41 and 56%, respectively). In group III the weight gain was affected more at days 7 and 14 (33% mean gain reductions) than at day 20 (19%). Drug treatment affected significantly and in a dose-dependent fashion the following parameters: individual weight of fetuses (GV = -39.2%), offspring weight (GIV = -51.7%; GV = -44.2%), number of placentae (GIV = -28.4%; GV = -11.6%), individual weight of placentae (GV = -10%) and the total weight of placentae (GIV = -28.4%; GV = -16.8%). Though among the treated animals there was an increase in resorptions and deaths at birth, these events were not significantly different from those found in controls. Conclusions: Tramadol showed definite deleterious effects on albino rat pregnancy, and these effects were exerted not only on the maternal but also the on fetal organisms. Overall, the effects were more pronounced at the 14th than at the 20th day of pregnancy, thus suggesting that the organogenic phase of the fetus is more susceptible than its initial (embryogenic) or final (term) phases. The results call attention to the care which is to be taken when the use of this opioid is considered during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):69-73
DOI 10.1590/S0100-72032001000200002
Purpose: to analyze the follow-up of regretful sterilized women who sought sterilization reversal at a public service. Method: a retrospective study was carried out with a population of sterilized women who attended the infertility clinic during the period from June 1983 to July 1998. The analysis of the data was descriptive. Results: among the 147 women who sought the infertility clinic, most were 20 to 30 years old and 60% were sterilized at the age of 25 years. During follow-up, 54.4% of the initial patients gave up treatment, 15% were discouraged to continue the investigation and only 31 (21%) underwent tubal anastomosis. Fourteen women became pregnant and nine (6.1%) of them had term gestation. Conclusion: women who request sterilization should be counseled and instructed about the definitive feature of this method in order to reduce regret after sterilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):69-73
DOI 10.1590/S0100-72032001000200002
Purpose: to analyze the follow-up of regretful sterilized women who sought sterilization reversal at a public service. Method: a retrospective study was carried out with a population of sterilized women who attended the infertility clinic during the period from June 1983 to July 1998. The analysis of the data was descriptive. Results: among the 147 women who sought the infertility clinic, most were 20 to 30 years old and 60% were sterilized at the age of 25 years. During follow-up, 54.4% of the initial patients gave up treatment, 15% were discouraged to continue the investigation and only 31 (21%) underwent tubal anastomosis. Fourteen women became pregnant and nine (6.1%) of them had term gestation. Conclusion: women who request sterilization should be counseled and instructed about the definitive feature of this method in order to reduce regret after sterilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):77-82
DOI 10.1590/S0100-72032001000200003
Purpose: to evaluate the nonpharmacologic treatment (reassurance) as a first line therapy for women with cyclical mastalgia, and to observe if a prolonged course of pain alters the outcome. Methods: we conducted a noncontrolled experimental study with a sample of 128 eligible women with a clear history of cyclical mastalgia treated with reassurance. A visual linear analogical scale of the pain was used before and after treatment in order to assess its severity and the mastalgias were classified into degrees I (mild), II (moderate) and III (severe) according to the intensity of pain. We also used a modified Cardiff Breast Score (CBS) to assess the clinical response. The data analysis was performed using the chi² test (Epi-Info 6.04 software). Results: we verified a success rate of 59.4% with reassurance, but there was no significant statistical difference between the groups (p = 0.16) with different degrees of mastalgia. The less satisfactory response to the nonpharmacologic treatment in those pacients with a prolonged course of pain was only apparent, since there was no significant statistical difference (p = 0.14). Conclusion: reassurance should be always tried as the first choice treatment for women with cyclical mastalgia, independently of pain intensity. Prolonged course of pain did not alter the outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):77-82
DOI 10.1590/S0100-72032001000200003
Purpose: to evaluate the nonpharmacologic treatment (reassurance) as a first line therapy for women with cyclical mastalgia, and to observe if a prolonged course of pain alters the outcome. Methods: we conducted a noncontrolled experimental study with a sample of 128 eligible women with a clear history of cyclical mastalgia treated with reassurance. A visual linear analogical scale of the pain was used before and after treatment in order to assess its severity and the mastalgias were classified into degrees I (mild), II (moderate) and III (severe) according to the intensity of pain. We also used a modified Cardiff Breast Score (CBS) to assess the clinical response. The data analysis was performed using the chi² test (Epi-Info 6.04 software). Results: we verified a success rate of 59.4% with reassurance, but there was no significant statistical difference between the groups (p = 0.16) with different degrees of mastalgia. The less satisfactory response to the nonpharmacologic treatment in those pacients with a prolonged course of pain was only apparent, since there was no significant statistical difference (p = 0.14). Conclusion: reassurance should be always tried as the first choice treatment for women with cyclical mastalgia, independently of pain intensity. Prolonged course of pain did not alter the outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):93-97
DOI 10.1590/S0100-72032001000200006
Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water) on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml) IM on the 11th, 12th, 18th and 19th day of pregnancy. Group III - the rats did not receive any drug or vehicle. The animals were weighed on days 0, 7, 14 and on the 20th of pregnancy, and on the last day of weighing, the animals were sacrificed. The number of implantations, resorptions, fetuses, placentas, malformations, maternal and fetal mortality as well as the weight of the fetuses and placentas were obtained and analyzed. Results: our results show that the rats treated with betamethasone gained significantly less weight. Their fetuses had an average weight of 3.2 g compared with 3.75 g in the control group. The results regarding placental weight were 0.36 g vs 0.48 g, respectively. All these differences were statistically significant. Conclusions: betamethasone had a negative effect on the gain of weight of matrices, fetuses and placentas when administered repeatedly and continuousy after the second half of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):93-97
DOI 10.1590/S0100-72032001000200006
Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water) on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml) IM on the 11th, 12th, 18th and 19th day of pregnancy. Group III - the rats did not receive any drug or vehicle. The animals were weighed on days 0, 7, 14 and on the 20th of pregnancy, and on the last day of weighing, the animals were sacrificed. The number of implantations, resorptions, fetuses, placentas, malformations, maternal and fetal mortality as well as the weight of the fetuses and placentas were obtained and analyzed. Results: our results show that the rats treated with betamethasone gained significantly less weight. Their fetuses had an average weight of 3.2 g compared with 3.75 g in the control group. The results regarding placental weight were 0.36 g vs 0.48 g, respectively. All these differences were statistically significant. Conclusions: betamethasone had a negative effect on the gain of weight of matrices, fetuses and placentas when administered repeatedly and continuousy after the second half of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):553-558
DOI 10.1590/S0100-72032001000900002
Purpose: to evaluate the role of routine obstetrical ultrasound scan in suspecting the presence of fetal congenital heart diseases and severe arrhythmias, as well as the factors involved in its accuracy. Methods: the sample was made up of 77 neonates and infants hospitalized at the Institute of Cardiology of Rio Grande do Sul from May to October of 2000, with confirmed postnatal diagnosis of structural heart disease or severe arrhythmia, whose mothers had been submitted to at least one obstetrical ultrasound scan after 18 weeks of gestation. After informed consent, a customized standard questionnaire was used. Categorical variables were compared using chi² test or Fisher's exact test and a logistic regression model was used to determine independent variables possibly involved in the prenatal suspicion of cardiac abnormalities. Results: in 19 patients (24.6%), obstetrical ultrasound was able to rise prenatal suspicion of structural or rhythm abnormalities. Considering only congenital heart diseases, this prevalence was 19.2% (14/73). In 73.7% of these cases, the cardiac disorder was accessible by the four-chamber view alone. Arrhythmias during obstetrical scan were observed in 26.3 of the babies with prenatal suspicion of a heart abnormality, while only 3.4% of the patients without prenatal suspicion showed a rhythm alteration (p=0.009). Significant differences between the groups with and without prenatal suspicion of cardiac abnormalities were observed in relation to parity (p=0.029), delivery by cesarean section (p=0.006), need for intensive care (p=0.046) and school education level of the father (p=0.014). At multivariate analysis, only the presence of a rhythm alteration during ultrasound scan was shown to be an independent variable associated with prenatal suspicion of cardiac abnormalities. Conclusions: routine obstetrical ultrasound has been underused in prenatal screening of congenital heart diseases. Adequate training and making obstetricians and the population a ware of the problem may be instruments for increasing the efficacy of routine obstetrical ultrasound in rising the suspicion of fetal cardiac abnormalities.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):553-558
DOI 10.1590/S0100-72032001000900002
Purpose: to evaluate the role of routine obstetrical ultrasound scan in suspecting the presence of fetal congenital heart diseases and severe arrhythmias, as well as the factors involved in its accuracy. Methods: the sample was made up of 77 neonates and infants hospitalized at the Institute of Cardiology of Rio Grande do Sul from May to October of 2000, with confirmed postnatal diagnosis of structural heart disease or severe arrhythmia, whose mothers had been submitted to at least one obstetrical ultrasound scan after 18 weeks of gestation. After informed consent, a customized standard questionnaire was used. Categorical variables were compared using chi² test or Fisher's exact test and a logistic regression model was used to determine independent variables possibly involved in the prenatal suspicion of cardiac abnormalities. Results: in 19 patients (24.6%), obstetrical ultrasound was able to rise prenatal suspicion of structural or rhythm abnormalities. Considering only congenital heart diseases, this prevalence was 19.2% (14/73). In 73.7% of these cases, the cardiac disorder was accessible by the four-chamber view alone. Arrhythmias during obstetrical scan were observed in 26.3 of the babies with prenatal suspicion of a heart abnormality, while only 3.4% of the patients without prenatal suspicion showed a rhythm alteration (p=0.009). Significant differences between the groups with and without prenatal suspicion of cardiac abnormalities were observed in relation to parity (p=0.029), delivery by cesarean section (p=0.006), need for intensive care (p=0.046) and school education level of the father (p=0.014). At multivariate analysis, only the presence of a rhythm alteration during ultrasound scan was shown to be an independent variable associated with prenatal suspicion of cardiac abnormalities. Conclusions: routine obstetrical ultrasound has been underused in prenatal screening of congenital heart diseases. Adequate training and making obstetricians and the population a ware of the problem may be instruments for increasing the efficacy of routine obstetrical ultrasound in rising the suspicion of fetal cardiac abnormalities.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):561-566
DOI 10.1590/S0100-72032001000900003
Purpose: to evaluate fetuses with facial cleft as to type of lesion, associated malformations and aneuploidies. Method: the following parameters were evaluated: maternal age and previous history, gestational age at diagnosis, lesion side, type of lesion, presence of associated malformations and aneuploidies, mortality rate and postnatal follow-up. Results: forty fetuses had facial cleft, 18 (45%) cases had cleft lip, 19 (47.5%) had cleft lip and palate, and 3 (7.5%) cases presented with cleft palate. Isolated facial cleft was observed in 10 fetuses (25%), all of them unilaterally located. Aneuploidies were identified in 10/30 (33.33%) of the patients with associated malformations. Cleft lip and palate was more often seen in this group (18/30 - 60%), followed by bilateral lesion (8/30 - 26.7%) and median cleft (10/30 - 33.3%). Conclusion: facial clefts are considered excellent signs for the presence of associated malformations and fetal aneuploidies. Fetuses with facial cleft must be referred to specialized centers in order to have specialized ultrasound and genetic analysis which can provide the best prenatal counseling for these cases. Isolated facial cleft was associated with very good prognosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):561-566
DOI 10.1590/S0100-72032001000900003
Purpose: to evaluate fetuses with facial cleft as to type of lesion, associated malformations and aneuploidies. Method: the following parameters were evaluated: maternal age and previous history, gestational age at diagnosis, lesion side, type of lesion, presence of associated malformations and aneuploidies, mortality rate and postnatal follow-up. Results: forty fetuses had facial cleft, 18 (45%) cases had cleft lip, 19 (47.5%) had cleft lip and palate, and 3 (7.5%) cases presented with cleft palate. Isolated facial cleft was observed in 10 fetuses (25%), all of them unilaterally located. Aneuploidies were identified in 10/30 (33.33%) of the patients with associated malformations. Cleft lip and palate was more often seen in this group (18/30 - 60%), followed by bilateral lesion (8/30 - 26.7%) and median cleft (10/30 - 33.3%). Conclusion: facial clefts are considered excellent signs for the presence of associated malformations and fetal aneuploidies. Fetuses with facial cleft must be referred to specialized centers in order to have specialized ultrasound and genetic analysis which can provide the best prenatal counseling for these cases. Isolated facial cleft was associated with very good prognosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):567-571
DOI 10.1590/S0100-72032001000900004
Purpose: to determine normal ranges for fetal heart rate (FHR) between the 10th and 14th week of pregnancy. Methods: a total of 1078 fetuses within a crown-rump length (CRL) from the 10th to the 14th week of pregnancy were evaluated. The fetuses were divided into 4 groups: Group I (10 weeks), Group II (11 weeks), Group III (12 weeks), Group IV (13 weeks). The fetal heart was seen using B-mode/M-mode at a sagital plane and FHR was recorded. FHR was electronically calculated using calipers within 3 consecutive cycles without fetal moveiments. Results: FRH ranged from 136 to 178 bpm among the 1078 studied fetuses. Median values and standard deviations (5 and 95 percentiles) were calculated for each group. The FHR range for each group was: 158 to 184 bpm (Group I); 155 to 175 bpm (Group II); 152 to 172 bpm (Group III) and 149 to 168 bpm (Group IV). Our main finding was a progressive reduction in FHR during the time period under consideration. Discussion: FHR evaluation in the first trimester of gestation is a simple procedure and should be analyzed not only qualitatively but also quantitatively. Published papers have shown a relation ship between FHR and fetal prognosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):567-571
DOI 10.1590/S0100-72032001000900004
Purpose: to determine normal ranges for fetal heart rate (FHR) between the 10th and 14th week of pregnancy. Methods: a total of 1078 fetuses within a crown-rump length (CRL) from the 10th to the 14th week of pregnancy were evaluated. The fetuses were divided into 4 groups: Group I (10 weeks), Group II (11 weeks), Group III (12 weeks), Group IV (13 weeks). The fetal heart was seen using B-mode/M-mode at a sagital plane and FHR was recorded. FHR was electronically calculated using calipers within 3 consecutive cycles without fetal moveiments. Results: FRH ranged from 136 to 178 bpm among the 1078 studied fetuses. Median values and standard deviations (5 and 95 percentiles) were calculated for each group. The FHR range for each group was: 158 to 184 bpm (Group I); 155 to 175 bpm (Group II); 152 to 172 bpm (Group III) and 149 to 168 bpm (Group IV). Our main finding was a progressive reduction in FHR during the time period under consideration. Discussion: FHR evaluation in the first trimester of gestation is a simple procedure and should be analyzed not only qualitatively but also quantitatively. Published papers have shown a relation ship between FHR and fetal prognosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):575-580
DOI 10.1590/S0100-72032001000900005
Purpose: to check alcohol consumption during pregnancy regarding type of drink, amount ingested, awareness of alcohol consumption risk, and tracking its consumption during prenatal care. Methods: interview of 445 women who had just given birth in a maternity hospital from January to May, 1999. The data analysis was performed using Student's t test and Kruskal-Wallis nonparametric test. Results: of the women interviewed, 66.3% did not consume alcohol, 17.8% consumed it throughout pregnancy and 15.9% consumed it until pregnancy was confirmed, which occurred when they were 9.6 weeks pregnant on average; 98.7% of the women consumed it on weekends or at parties, and 1.3% daily. The mean ingestion was 14.74 grams/occasion for those who consumed alcohol throughout pregnancy and 25.83% grams/occasion for those who consumed it until pregnancy was confirmed. There were statistical differences between the mean rates in both groups. The mean intake per occasion was classified as moderate. The most ingested alcoholic beverage was beer (64.0%). Regarding awareness of the risk of alcohol intake, 71.5% believe that it is not good for the fetus health, 15.5% believe that it is not good for their own health. Alcohol consumption tracking was referred to by 48.8% of the women. Conclusion: a great number of women consumed alcoholic drinks at some time during pregnancy, despite being aware of the risks to their fetus. Prenatal care is not used as a favorable occasion for alcohol consumption tracking as well as for discontinuing its intake.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):575-580
DOI 10.1590/S0100-72032001000900005
Purpose: to check alcohol consumption during pregnancy regarding type of drink, amount ingested, awareness of alcohol consumption risk, and tracking its consumption during prenatal care. Methods: interview of 445 women who had just given birth in a maternity hospital from January to May, 1999. The data analysis was performed using Student's t test and Kruskal-Wallis nonparametric test. Results: of the women interviewed, 66.3% did not consume alcohol, 17.8% consumed it throughout pregnancy and 15.9% consumed it until pregnancy was confirmed, which occurred when they were 9.6 weeks pregnant on average; 98.7% of the women consumed it on weekends or at parties, and 1.3% daily. The mean ingestion was 14.74 grams/occasion for those who consumed alcohol throughout pregnancy and 25.83% grams/occasion for those who consumed it until pregnancy was confirmed. There were statistical differences between the mean rates in both groups. The mean intake per occasion was classified as moderate. The most ingested alcoholic beverage was beer (64.0%). Regarding awareness of the risk of alcohol intake, 71.5% believe that it is not good for the fetus health, 15.5% believe that it is not good for their own health. Alcohol consumption tracking was referred to by 48.8% of the women. Conclusion: a great number of women consumed alcoholic drinks at some time during pregnancy, despite being aware of the risks to their fetus. Prenatal care is not used as a favorable occasion for alcohol consumption tracking as well as for discontinuing its intake.