Trabalhos Originais Archives - Page 3 of 51 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):305-309
DOI 10.1590/S0100-72032004000400007
OBJECTIVE: to develop a new preoperative classification of submucous myomas to evaluate the viability and the degree of difficulty of hysteroscopic myomectomy. METHODS: forty-four patients were submitted to hysteroscopic resection of submucous myomas. The possibility of total resection of the myoma, the surgery duration, the fluid deficit, and the incidence of complications were evaluated. The myomas were classified by the Classification of the European Society of Endoscopic Surgery (CESES) and by the classification proposed (CP) by our group, that besides the degree of penetration of the myoma in the myometrium, adds the parameters: extent of the base of the myoma as related to the uterine wall, the size of the myoma in centimeters and its topography at the uterine cavity. For statistical analysis the Fisher test, the Student t test and the analysis of variance were used. Statistic significance was considered when the p-value was smaller than 0.05 in the bicaudal test. RESULTS: in 47 myomas the hysteroscopic surgery was considered complete. There was no significant difference among the three levels (0, 1 and 2) by CESES. By CP, the difference among the number of complete surgeries was significant (p=0.001) between the two levels (groups I and II). The difference between the surgery duration was significant when the two classifications were compared. In relation to the fluid deficit, just CP presented significant differences among the levels (p=0,02). CONCLUSIONS: the proposed classification includes more clues about the difficulties of the hysteroscopic myomectomy than the standard classification. It should be noted that the number of hysteroscopic myomectomies used for that analysis was modest, being interesting to evaluate the performance of the proposed classification in larger series of cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):305-309
DOI 10.1590/S0100-72032004000400007
OBJECTIVE: to develop a new preoperative classification of submucous myomas to evaluate the viability and the degree of difficulty of hysteroscopic myomectomy. METHODS: forty-four patients were submitted to hysteroscopic resection of submucous myomas. The possibility of total resection of the myoma, the surgery duration, the fluid deficit, and the incidence of complications were evaluated. The myomas were classified by the Classification of the European Society of Endoscopic Surgery (CESES) and by the classification proposed (CP) by our group, that besides the degree of penetration of the myoma in the myometrium, adds the parameters: extent of the base of the myoma as related to the uterine wall, the size of the myoma in centimeters and its topography at the uterine cavity. For statistical analysis the Fisher test, the Student t test and the analysis of variance were used. Statistic significance was considered when the p-value was smaller than 0.05 in the bicaudal test. RESULTS: in 47 myomas the hysteroscopic surgery was considered complete. There was no significant difference among the three levels (0, 1 and 2) by CESES. By CP, the difference among the number of complete surgeries was significant (p=0.001) between the two levels (groups I and II). The difference between the surgery duration was significant when the two classifications were compared. In relation to the fluid deficit, just CP presented significant differences among the levels (p=0,02). CONCLUSIONS: the proposed classification includes more clues about the difficulties of the hysteroscopic myomectomy than the standard classification. It should be noted that the number of hysteroscopic myomectomies used for that analysis was modest, being interesting to evaluate the performance of the proposed classification in larger series of cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):317-323
DOI 10.1590/S0100-72032004000400009
OBJECTIVE: to evaluate the epidemiological and parturitional aspects of obstetric patients admitted to intensive care units (ICU), and analyze the frequency of intensive support needed by them. METHODS: observational and descriptive study of all obstetric patients' transfers to ICU from the Hospital Materno Infantil of Goiânia-Go, from January 1999 to December 2001. The analysis has included variables as maternal age, parity, obstetric and non-obstetric indications for ICU admissions, moment of transfer, mode of delivery, maternal death, and the frequency of ICU utilization per 1,000 deliveries (IDR - imminent death ratio). The statistical analysis was performed by the chi2 test or the Fisher exact test and a significant difference was set at a level of 5%. RESULTS: over the 36-month period analyzed, 86 pregnancy-associated ICU admissions were identified (among 4,560 deliveries). Of the 86 patients, 52.33% (n=45) were nulliparae and 63 (73.26%) were between 19 and 35 years old. Hypertensive disorders accounted for 41 (57.75%) of the admissions and hemorrhage for 14 (19.72%). Eclampsia (n=23), HELLP syndrome (n=13) and premature abruptio placentae (n=5) were the most common obstetric indications for ICU admissions. Maternal cardiac disorders accounted for 4 cases of non-obstetric indications. There was a predominance of postpartum transfers (82.35%). Fifty-five (72.37%) patients needed delivery by caesarian section. The average time spent in the UCI by those patients was 5.1 days. Maternal mortality found in this study was 24.29%, hypertensive disorders being responsible for 52.94% (9/17) of all obstetric-associated deaths. There were no significant statistical differences (p=0.81) regarding these obstetric-associated deaths and their causes (hypertensive disorders, hemorrhage or infections) or even regarding maternal deaths and duration of stay (< or > 48 hours) in the ICU (p=0.08). The IDR found was 18.8 per 1,000 deliveries. CONCLUSIONS: the need of intensive care estimated by IDR was 18.8 per 1,000 deliveries, the pregnancy-induced hypertension being responsible for the majority of the indications for maternal transfers.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):317-323
DOI 10.1590/S0100-72032004000400009
OBJECTIVE: to evaluate the epidemiological and parturitional aspects of obstetric patients admitted to intensive care units (ICU), and analyze the frequency of intensive support needed by them. METHODS: observational and descriptive study of all obstetric patients' transfers to ICU from the Hospital Materno Infantil of Goiânia-Go, from January 1999 to December 2001. The analysis has included variables as maternal age, parity, obstetric and non-obstetric indications for ICU admissions, moment of transfer, mode of delivery, maternal death, and the frequency of ICU utilization per 1,000 deliveries (IDR - imminent death ratio). The statistical analysis was performed by the chi2 test or the Fisher exact test and a significant difference was set at a level of 5%. RESULTS: over the 36-month period analyzed, 86 pregnancy-associated ICU admissions were identified (among 4,560 deliveries). Of the 86 patients, 52.33% (n=45) were nulliparae and 63 (73.26%) were between 19 and 35 years old. Hypertensive disorders accounted for 41 (57.75%) of the admissions and hemorrhage for 14 (19.72%). Eclampsia (n=23), HELLP syndrome (n=13) and premature abruptio placentae (n=5) were the most common obstetric indications for ICU admissions. Maternal cardiac disorders accounted for 4 cases of non-obstetric indications. There was a predominance of postpartum transfers (82.35%). Fifty-five (72.37%) patients needed delivery by caesarian section. The average time spent in the UCI by those patients was 5.1 days. Maternal mortality found in this study was 24.29%, hypertensive disorders being responsible for 52.94% (9/17) of all obstetric-associated deaths. There were no significant statistical differences (p=0.81) regarding these obstetric-associated deaths and their causes (hypertensive disorders, hemorrhage or infections) or even regarding maternal deaths and duration of stay (< or > 48 hours) in the ICU (p=0.08). The IDR found was 18.8 per 1,000 deliveries. CONCLUSIONS: the need of intensive care estimated by IDR was 18.8 per 1,000 deliveries, the pregnancy-induced hypertension being responsible for the majority of the indications for maternal transfers.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):213-219
DOI 10.1590/S0100-72032004000300007
OBJECTIVE: to evaluate the effectiveness of the hygroscopic dilator in the colposcopic examination of the endocervical canal in patients with high-grade lesion in the cytopathology and unsatisfactory colposcopy. METHODS: prospective study, including 62 patients with unsatisfactory colposcopic examination and cytology compatible with high-grade intraepithelial lesion. The patients were submitted to dilation of the endocervical canal by means of a hygroscopic dilator. After dilation, the new colposcopic findings were recorded, and then conization was made through loop electrosurgical excision procedure. The incidence of neoplasic involvement of surgical margins was compared between patients with examinations modified toward satisfactory results and those that remained with unsatisfactory colposcopy. In order to compare the incidence of involved margins and the incidence of residual disease, two retrospective control-groups were used: the GinSat group (n = 35): patients with unsatisfactory colposcopy; GSat group (n = 38): patients with satisfactory colposcopy and endocervical atypy. RESULTS: 80.6% of the cases presented satisfactory colposcopic vision after dilation. 80.4% of those presented disease-free resection margins. The incidence of disease-free resection margins in patients with persistent unsatisfactory colposcopy after dilation was 36.3%. Affected surgical margins occurred in 28% of the group that had undergone dilation, 28.5% of the cases in GinSat group, and 31.5% in the Gsat group. Follow-up showed the incidence of residual disease in 7.5% of the patients under dilation, 28.5% in the GinSat group and 28.9% in the GSat group. CONCLUSION: the use of hygroscopic dilation improved visualization of lesions of difficult access to the colposcopic examination, thus permitting reduction in the percentage of residual neoplasic disease in patients with unsatisfactory colposcopy treated with loop electrosurgical excision procedure.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):213-219
DOI 10.1590/S0100-72032004000300007
OBJECTIVE: to evaluate the effectiveness of the hygroscopic dilator in the colposcopic examination of the endocervical canal in patients with high-grade lesion in the cytopathology and unsatisfactory colposcopy. METHODS: prospective study, including 62 patients with unsatisfactory colposcopic examination and cytology compatible with high-grade intraepithelial lesion. The patients were submitted to dilation of the endocervical canal by means of a hygroscopic dilator. After dilation, the new colposcopic findings were recorded, and then conization was made through loop electrosurgical excision procedure. The incidence of neoplasic involvement of surgical margins was compared between patients with examinations modified toward satisfactory results and those that remained with unsatisfactory colposcopy. In order to compare the incidence of involved margins and the incidence of residual disease, two retrospective control-groups were used: the GinSat group (n = 35): patients with unsatisfactory colposcopy; GSat group (n = 38): patients with satisfactory colposcopy and endocervical atypy. RESULTS: 80.6% of the cases presented satisfactory colposcopic vision after dilation. 80.4% of those presented disease-free resection margins. The incidence of disease-free resection margins in patients with persistent unsatisfactory colposcopy after dilation was 36.3%. Affected surgical margins occurred in 28% of the group that had undergone dilation, 28.5% of the cases in GinSat group, and 31.5% in the Gsat group. Follow-up showed the incidence of residual disease in 7.5% of the patients under dilation, 28.5% in the GinSat group and 28.9% in the GSat group. CONCLUSION: the use of hygroscopic dilation improved visualization of lesions of difficult access to the colposcopic examination, thus permitting reduction in the percentage of residual neoplasic disease in patients with unsatisfactory colposcopy treated with loop electrosurgical excision procedure.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):177-184
DOI 10.1590/S0100-72032004000300002
PURPOSE: to assess the use of antenatal corticosteroid (AC) by mothers and its repercussion on the birth conditions of preterm babies at the eight university neonatal units belonging to the Brazilian Network of Neonatal Research. METHODS: an observational prospective cohort study. All 463 pregnant women with a gestational age (GA) of 23 to 34 weeks and their 514 newborn babies were evaluated during the period from August 1 to December 31, 2001. The data were obtained by maternal interview, by the analysis of the medical records and by the follow-up of the newborn infants, and analyzed statistically using chi2, Mann-Whitney and ANOVA tests and multiple logistic regression, with the level of significance set at 0.05. RESULTS: 60.1% (282/463) of the pregnant women (a variation from 12.5 to 87.3% among units) received at least one AC dose. The AC use was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented higher birth weight (1,379±421 vs 1,244±543 g), longer gestational age (30.9±2.0 vs 29.5±3.5 weeks), better Apgar scores at the 1st and 5th minute, and a reduced need for intervention in the delivery room. The use of AC, the GA and a baby small for GA independently improved the birth conditions. CONCLUSIONS: at most centers, AC was administered at frequencies below the desired ones, and in 50% of cases in an inadequate manner. Treatment was applied more to mothers who received appropriate prenatal care and was associated with better birth conditions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):177-184
DOI 10.1590/S0100-72032004000300002
PURPOSE: to assess the use of antenatal corticosteroid (AC) by mothers and its repercussion on the birth conditions of preterm babies at the eight university neonatal units belonging to the Brazilian Network of Neonatal Research. METHODS: an observational prospective cohort study. All 463 pregnant women with a gestational age (GA) of 23 to 34 weeks and their 514 newborn babies were evaluated during the period from August 1 to December 31, 2001. The data were obtained by maternal interview, by the analysis of the medical records and by the follow-up of the newborn infants, and analyzed statistically using chi2, Mann-Whitney and ANOVA tests and multiple logistic regression, with the level of significance set at 0.05. RESULTS: 60.1% (282/463) of the pregnant women (a variation from 12.5 to 87.3% among units) received at least one AC dose. The AC use was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented higher birth weight (1,379±421 vs 1,244±543 g), longer gestational age (30.9±2.0 vs 29.5±3.5 weeks), better Apgar scores at the 1st and 5th minute, and a reduced need for intervention in the delivery room. The use of AC, the GA and a baby small for GA independently improved the birth conditions. CONCLUSIONS: at most centers, AC was administered at frequencies below the desired ones, and in 50% of cases in an inadequate manner. Treatment was applied more to mothers who received appropriate prenatal care and was associated with better birth conditions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):185-192
DOI 10.1590/S0100-72032004000300003
PURPOSE: to investigate the glomerular alterations in patients with severe preeclampsia, as well as to evaluate the evolution of these lesions, relating them to the moment of the renal biopsy. METHODS: seventy-two pregnant women with hypertensive syndrome underwent renal biopsy in the puerperium. Appropriate samples for electron microscopic examination were obtained from 39 patients and grouped as follows: 25 with preeclampsia and 14 with superimposed preeclampsia. Biopsy findings were classified into: normal kidney, endothelial cell edema, mesangial expansion, mesangial interposition, subendothelial fibrinoid deposits, and podocyte fusion. RESULTS: the most frequent alterations found in both groups were subendothelial fibrinoid deposits and podocyte fusion. Endothelial edema was present in 84% of the preeclampsia patients and in 92.9% of the superimposed preeclampsia cases. There was no association between the degree of hypertension and the severity of endothelial edema. A tendency to mesangial interposition was observed in patients who had a biopsy after the seventh day after delivery. Podocyte fusion showed a significant association with 24-hour proteinuria. CONCLUSIONS: the above mentioned glomerular alterations represent a spectrum of complex and dynamic lesions that together represent the ultrastructural characteristics of preeclampsia which should no longer be diagnosed based only on the presence or absence of endothelial edema.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):185-192
DOI 10.1590/S0100-72032004000300003
PURPOSE: to investigate the glomerular alterations in patients with severe preeclampsia, as well as to evaluate the evolution of these lesions, relating them to the moment of the renal biopsy. METHODS: seventy-two pregnant women with hypertensive syndrome underwent renal biopsy in the puerperium. Appropriate samples for electron microscopic examination were obtained from 39 patients and grouped as follows: 25 with preeclampsia and 14 with superimposed preeclampsia. Biopsy findings were classified into: normal kidney, endothelial cell edema, mesangial expansion, mesangial interposition, subendothelial fibrinoid deposits, and podocyte fusion. RESULTS: the most frequent alterations found in both groups were subendothelial fibrinoid deposits and podocyte fusion. Endothelial edema was present in 84% of the preeclampsia patients and in 92.9% of the superimposed preeclampsia cases. There was no association between the degree of hypertension and the severity of endothelial edema. A tendency to mesangial interposition was observed in patients who had a biopsy after the seventh day after delivery. Podocyte fusion showed a significant association with 24-hour proteinuria. CONCLUSIONS: the above mentioned glomerular alterations represent a spectrum of complex and dynamic lesions that together represent the ultrastructural characteristics of preeclampsia which should no longer be diagnosed based only on the presence or absence of endothelial edema.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):193-200
DOI 10.1590/S0100-72032004000300004
PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):193-200
DOI 10.1590/S0100-72032004000300004
PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-sectional study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical length was up to 20 mm in 3.3% of all studied patients and in 27.8% of those who delivered spontaneously before the end of the pregnancy. Absence of the CGA was detected in 2.8% of all patients and in 44.4% of the women who eventually developed spontaneous preterm labor. There was a statistically significant association of absence of CGA with short cervical length (p<0.001). Absence of CGA was strongly associated with spontaneous preterm delivery (relative risk of 28.57, 95% CI 14.40-56.68). CONCLUSION: the absent CGA feature is a new morphological ultrasonographic parameter that is useful in the prediction of spontaneous preterm delivery in single gestations. Our results show that the parameter can be used as an indicator of risk for premature delivery, to be confirmed by future research.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):201-206
DOI 10.1590/S0100-72032004000300005
OBJECTIVE: to evaluate platelet parameters in normal and pre-eclamptic pregnant women. METHODS: a controlled cross-sectional study was carried out. The medical records of the women who had delivered in the Hospital Universitário Júlio Müller-Cuiabá/MT, from January 1, 2001 to July 31, 2002, were reviewed. The pregnant women were pre-selected based on their platelet parameters analyses performed after the 28th week of gestation. Two groups of study were analyzed: PE group (36 pre-eclamptic women) and NP group (58 normal pregnant women). The platelet parameters analyzed by the automated method were: platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and platelet - large cells ratio (P-LCR). For statistical analysis the Student t-test and the chi-square test were used to compare the groups, and to evaluate the degree of dependence among the variables, the coefficient of determination was used (r²). For all these tests, the significance level considered was p < 0.05. RESULTS: the platelet counts did not show difference between the two groups. However, all other platelet indices (MPV, PDW and P-LCR) were significantly higher in the PE group. The severity of the disease was documented in 91.7% of the pre-eclamptic women, despite the fact that none of the patients included had shown thrombocytopenia as a criterion of severity. Negative correlation was detected between the platelet counts and the other platelet parameters analyzed and there was positive correlation between MPV and PDW, MPV and P-LCR, and PDW and P-LCR. Positive correlation was also observed between MPV, PDW and P-LCR, and the maximum systolic and diastolic blood pressures. CONCLUSIONS: pre-eclampsia was associated with these platelet parameters, suggesting alterations of the platelet functions. The clinical applicability of these parameters, as early markers of severity of pre-eclampsia, needs more studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):201-206
DOI 10.1590/S0100-72032004000300005
OBJECTIVE: to evaluate platelet parameters in normal and pre-eclamptic pregnant women. METHODS: a controlled cross-sectional study was carried out. The medical records of the women who had delivered in the Hospital Universitário Júlio Müller-Cuiabá/MT, from January 1, 2001 to July 31, 2002, were reviewed. The pregnant women were pre-selected based on their platelet parameters analyses performed after the 28th week of gestation. Two groups of study were analyzed: PE group (36 pre-eclamptic women) and NP group (58 normal pregnant women). The platelet parameters analyzed by the automated method were: platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and platelet - large cells ratio (P-LCR). For statistical analysis the Student t-test and the chi-square test were used to compare the groups, and to evaluate the degree of dependence among the variables, the coefficient of determination was used (r²). For all these tests, the significance level considered was p < 0.05. RESULTS: the platelet counts did not show difference between the two groups. However, all other platelet indices (MPV, PDW and P-LCR) were significantly higher in the PE group. The severity of the disease was documented in 91.7% of the pre-eclamptic women, despite the fact that none of the patients included had shown thrombocytopenia as a criterion of severity. Negative correlation was detected between the platelet counts and the other platelet parameters analyzed and there was positive correlation between MPV and PDW, MPV and P-LCR, and PDW and P-LCR. Positive correlation was also observed between MPV, PDW and P-LCR, and the maximum systolic and diastolic blood pressures. CONCLUSIONS: pre-eclampsia was associated with these platelet parameters, suggesting alterations of the platelet functions. The clinical applicability of these parameters, as early markers of severity of pre-eclampsia, needs more studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):207-211
DOI 10.1590/S0100-72032004000300006
OBJECTIVE: to evaluate the chronic effects of amprenavir on implantations, reabsorptions, fetuses, placentae, and maternal and fetal mortality in the albino rat. METHODS: five groups of EPM-1 Wistar pregnant rats were used: two controls: Contr1 (control of stress) and Contr2 (drug vehicle control), and 3 experimental groups that were treated once a day throughout gestation with 46mg/kg (Exper1), 138mg/kg (Exper2) and 414mg/kg (Exper3) of oral solution of amprenavir. The drug and the vehicle (propyleneglycol) were administered by gavage. The evaluations included maternal body weight gain, number of implantations, reabsorptions, fetuses, placentae and of intrauterine deaths as well as fetal and placental mean weight and major malformations. Fragments of lungs, kidneys, liver and intestines were collected and prepared for histopathological evaluation. RESULTS: Exper3 group tended to show lesser maternal body weight gain during gestation (P = 0.07), but amprenavir did not affect the intrauterine contents. The cytotoxic effect of the drug was observed with regard to the histopathological analyses of pregnant rat viscerae and to the maternal mortality rate: 50% in Exper1 and Exper2 groups, and 70% in Exper3 group. CONCLUSION: amprenavir exerted adverse side effects on maternal lung, gut, kidney and liver, and significantly increased maternal mortality rates in all administered doses and especially at 414 mg/kg.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):207-211
DOI 10.1590/S0100-72032004000300006
OBJECTIVE: to evaluate the chronic effects of amprenavir on implantations, reabsorptions, fetuses, placentae, and maternal and fetal mortality in the albino rat. METHODS: five groups of EPM-1 Wistar pregnant rats were used: two controls: Contr1 (control of stress) and Contr2 (drug vehicle control), and 3 experimental groups that were treated once a day throughout gestation with 46mg/kg (Exper1), 138mg/kg (Exper2) and 414mg/kg (Exper3) of oral solution of amprenavir. The drug and the vehicle (propyleneglycol) were administered by gavage. The evaluations included maternal body weight gain, number of implantations, reabsorptions, fetuses, placentae and of intrauterine deaths as well as fetal and placental mean weight and major malformations. Fragments of lungs, kidneys, liver and intestines were collected and prepared for histopathological evaluation. RESULTS: Exper3 group tended to show lesser maternal body weight gain during gestation (P = 0.07), but amprenavir did not affect the intrauterine contents. The cytotoxic effect of the drug was observed with regard to the histopathological analyses of pregnant rat viscerae and to the maternal mortality rate: 50% in Exper1 and Exper2 groups, and 70% in Exper3 group. CONCLUSION: amprenavir exerted adverse side effects on maternal lung, gut, kidney and liver, and significantly increased maternal mortality rates in all administered doses and especially at 414 mg/kg.
