Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):358-365
DOI 10.1590/S0100-72032007000700006
PURPOSE: to evaluate fetal maternal complications after chorionic villus sampling (CVS) for prenatal diagnosis of genetic disorders in pregnant women of Salvador (BA), Brazil. METHODS: case-series study of 958 pregnancies with high risk for chromosomal abnormality submitted to CVS transabdominal between the ninth to the 24th week of gestation, using an ultrasound-guided 18G 3½ spinal needle, from 1990 to 2006. The variables for the analysis of immediate complications were uterine cramps, subchorionic hematoma, accidental amniotic cavity punction, pain in the punction area, amniotic fluid leakage, abdominal discomfort, fetal arrhythmias and vaginal bleeding, and of late complication, abdominal pain, vaginal bleeding, amniotic fluid leakage, infection and spontaneous miscarriage. Premature labor, obstetrical complications (abruption placenta and placenta previa) and newborn malformation were also studied. Qui-square, Student’s "t" or Mann-Whitney tests were used for the statistical analysis; the significance level was 5%. RESULTS: maternal mean age was 36.3±4.9 years old. Immediate complications ware found in 182 (19%) cases (uterine cramp in 14%, subchorionic hematoma in 1.8% and accidental amniotic cavity punction in 1.3%). Late complications were found in 32 (3.3%) cases (vaginal bleeding in 1.6%, abdominal pain in 1.4%, amniotic fluid leakage in 0.3% and spontaneous miscarriage in 1.6% cases). There was no case of abruption placentae, placenta previa or fetal malformation. CONCLUSIONS: CVS is a simple and safe procedure. CVS should be performed in high risk pregnant patients who need prenatal diagnosis of fetal chromosomal abnormalities.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7)
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7)
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):331-334
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):335-339
DOI 10.1590/S0100-72032007000700002
PURPOSE: to evaluate the effect of raloxifene on breast cancer angiogenesis of menopausal women. METHODS: sixteen menopausal women with stage II (>3 cm) estrogen receptor positive operable breast cancer were enrolled in this study. Following confirmation of the diagnosis by incisional biopsy, the patients received 60 mg raloxifene daily for 28 days prior to the definitive surgery. Immunohistochemical study was performed on the sample tumors obtained during the biopsy for the diagnosis and evaluation of the status of estrogen receptor and during the definitive surgery. The anti-CD34 monoclonal antibody was used as a marker for endothelial cells. The vascular unit was considered as any endothelial cell or group of cells of a brownish color, clearly separated from adjacent microvessels, tumor cells or other connective tissue, forming or not lumen. Microvessel count was performed in ten fields of each slide using a 40X objective lens (400X magnification). A microscope coupled to a system of capture and analysis of image was used (Imagelab®). Statistical analysis of data was carried out using the paired Student t-test and significance level was established at p<0.05. RESULTS: mean numbers of anti-CD34 antibody-stained microvessels before and after raloxifene treatment were 44.4±3.5 and 22.6±1.6, respectively. A significant reduction in the number of microvessels following raloxifene therapy was observed (p<0.001). CONCLUSIONS: when administered as primary therapy for menopausal women with breast carcinoma, raloxifene significantly reduced tumoral angiogenesis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):340-345
DOI 10.1590/S0100-72032007000700003
PURPOSE: to evaluate the efficacy of in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) in natural cycle (NC). METHODS: retrospective clinical trial that evaluated 70 treatment cycles in 60 couples that were submitted to IVF treatment with ICSI in NC performed in private clinic from 1999 until 2003. It was performed daily ultrasound monitorization or on alternate days, and urinary LH dosage when the follicle reached 16 mm of diameter. It was scheduled egg retrieval when the follicle reached 18 mm of diameter and 36 hours after hCG administration when the LH test was negative. Embryo transfer was performed 48 to 52 hours after ICSI. RESULTS: 70 ICSI cycles in 60 patients were performed and the indications of treatment included: male factor (47.1%), tubal factor (37.1%), associated factors (8.7%), unknown infertility (7.1%). Out of 70 cycles, 18 cycles were cancelled (25.7% of cancellation rate). Out of 52 patients that were submitted to ovarian punction to oocyte retrieval we found mature oocytes in 77% of the cases (40 cycles), in four cases we collected immature oocytes and in eight cases we could not found it. We had 70% of fertilization rate and only one fertilized oocyte did not achieve the cleavage stage. So, the transfers rate per punction and per mature oocyte was 52% and 67.5%, respectively. We had 11.4% of pregnancy rate per cycle, 15.4% per punction and 29.6% per embryo transfer. CONCLUSIONS: FIV/ICSI in NC seem to be a satisfactory option of treatment, with low costs and complications (multiple gestation and Ovarian Hyperstimulation Syndrome), mainly in poor responder patients and in poor populations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):352-357
DOI 10.1590/S0100-72032007000700005
PURPOSE: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. METHODS: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. RESULTS: the glucose levels demonstrated significantly superior average in the diabetic group (113.3±35.3 g/dL) in relation to the normal group (78.2±14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5±6.4 cm) when compared with controls (10.6±2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6±4.4) in relation to controls (14.8±2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6±14.8%) was significantly higher than that in the control group (30.5±7.4%, p<0.0001). CONCLUSIONS: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies.