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You searched for:"Alex Sandro Rolland de Souza"
We found (6) results for your search.Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(11):488-493
DOI 10.1590/S0100-72032012001100002
PURPOSE: To identify the accuracy of urinalysis in the diagnosis of urinary tract infection in pregnant women at high risk. METHODS: a prospective, cross-sectional study was conducted on 164 pregnant women admitted to the high-risk the ward of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) during the period from January to June 2011. Patients who had been taking antibiotics in the last ten days were excluded. All patients were subjected to simple urine tests and urine culture at the beginning of their admission. The agreement between the results of the examinations was evaluated by Kappa indices (K), and accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were also determined. RESULTS: When only the presence of pus cells in urinalysis was used as a diagnostic criterion suggesting bacteriuria, there was a poor agreement when compared to uroculture (K=0.16). Accuracy was 61%, sensitivity 62.5%, and specificity 60.6%. PPV was 27.78% and NPV was 87%. CONCLUSION: The presence of alteration of urinalysis does not necessarily indicate an ongoing urinary tract infection, with urine culture being necessary. However, when urinalysis data are normal, uroculture may be avoided.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(11):488-493
DOI 10.1590/S0100-72032012001100002
PURPOSE: To identify the accuracy of urinalysis in the diagnosis of urinary tract infection in pregnant women at high risk. METHODS: a prospective, cross-sectional study was conducted on 164 pregnant women admitted to the high-risk the ward of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) during the period from January to June 2011. Patients who had been taking antibiotics in the last ten days were excluded. All patients were subjected to simple urine tests and urine culture at the beginning of their admission. The agreement between the results of the examinations was evaluated by Kappa indices (K), and accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were also determined. RESULTS: When only the presence of pus cells in urinalysis was used as a diagnostic criterion suggesting bacteriuria, there was a poor agreement when compared to uroculture (K=0.16). Accuracy was 61%, sensitivity 62.5%, and specificity 60.6%. PPV was 27.78% and NPV was 87%. CONCLUSION: The presence of alteration of urinalysis does not necessarily indicate an ongoing urinary tract infection, with urine culture being necessary. However, when urinalysis data are normal, uroculture may be avoided.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(9):459-468
DOI 10.1590/S0100-72032010000900008
Hypertensive disorders in pregnancy deserve special attention in the setting of global public health. Currently, they represent the third cause of maternal mortality in the world and first in Brazil. From a practical standpoint, pre-eclampsia remains a syndrome that leads to serious repercussions on maternal and fetal mortality and its etiology is not well known. Currently, the best treatment for forms of pre-eclampsia is being discussed at different times in pregnancy and puerperium, with the objective to reduce the high rates of maternal and fetal morbidity and mortality. Considering the pathophysiology of the event, anticipation of delivery is the best treatment for pre-eclampsia. The use of magnesium sulfate is recommended in all cases of severe pre-eclampsia and eclampsia for prevention and treatment of seizures. Likewise, treatment of hypertensive crises is recommended. Hydralazine, nifedipine and labetalol have been the most commonly used drugs for this purpose, but their use depends on the familiarity of the treating physician. Antenatal corticoid therapy is indicated whenever there is an imminent risk of preterm delivery between 24 and 34 weeks. In contrast, there is insufficient evidence to recommend bed rest and routine plasma volume expansion, and there is an urgent need for randomized clinical trials to determine whether maintenance antihypertensive treatment in pregnant women has benefits or risks for mothers and fetuses in all clinical forms of disease, particularly in cases of pure pre-eclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(9):459-468
DOI 10.1590/S0100-72032010000900008
Hypertensive disorders in pregnancy deserve special attention in the setting of global public health. Currently, they represent the third cause of maternal mortality in the world and first in Brazil. From a practical standpoint, pre-eclampsia remains a syndrome that leads to serious repercussions on maternal and fetal mortality and its etiology is not well known. Currently, the best treatment for forms of pre-eclampsia is being discussed at different times in pregnancy and puerperium, with the objective to reduce the high rates of maternal and fetal morbidity and mortality. Considering the pathophysiology of the event, anticipation of delivery is the best treatment for pre-eclampsia. The use of magnesium sulfate is recommended in all cases of severe pre-eclampsia and eclampsia for prevention and treatment of seizures. Likewise, treatment of hypertensive crises is recommended. Hydralazine, nifedipine and labetalol have been the most commonly used drugs for this purpose, but their use depends on the familiarity of the treating physician. Antenatal corticoid therapy is indicated whenever there is an imminent risk of preterm delivery between 24 and 34 weeks. In contrast, there is insufficient evidence to recommend bed rest and routine plasma volume expansion, and there is an urgent need for randomized clinical trials to determine whether maintenance antihypertensive treatment in pregnant women has benefits or risks for mothers and fetuses in all clinical forms of disease, particularly in cases of pure pre-eclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):435-435
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):435-435
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):416-423
DOI 10.1590/S0100-72032006000700007
Conjoined twins have a rare prevalence and special curiosity among physicians and the general population. The reported frequency varies from 1:50,000 to 1:200,000 pregnancies. Its early diagnosis becomes very important when we think about pregnancy management, method of delivery and neonatal care. We describe two cases of conjoined twins diagnosed by ultrasound and magnetic resonance during prenatal care with the aim to better studying the fetus anatomy. The first conjoined twins were cephalopagus sharing head, thorax and abdominal wall and with two pelvis and four arms and four legs. The second were thoracopagus, united by thorax and part of abdomen. Magnetic resonance imaging contribution was not important to diagnose conjoined twins. However, it was useful to describe the shared organs, contributing to define fetal outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):416-423
DOI 10.1590/S0100-72032006000700007
Conjoined twins have a rare prevalence and special curiosity among physicians and the general population. The reported frequency varies from 1:50,000 to 1:200,000 pregnancies. Its early diagnosis becomes very important when we think about pregnancy management, method of delivery and neonatal care. We describe two cases of conjoined twins diagnosed by ultrasound and magnetic resonance during prenatal care with the aim to better studying the fetus anatomy. The first conjoined twins were cephalopagus sharing head, thorax and abdominal wall and with two pelvis and four arms and four legs. The second were thoracopagus, united by thorax and part of abdomen. Magnetic resonance imaging contribution was not important to diagnose conjoined twins. However, it was useful to describe the shared organs, contributing to define fetal outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):244-250
DOI 10.1590/S0100-72032006000400007
Osteogenesis imperfecta is a connective tissue disorder due to quantitative and qualitative anomalies in type 1 collagen, genetically transmitted by a dominant or recessive autosomal gene, leading to bone fragility. We report a case of a 19-year-old G1 PO patient referred to our institution following a screening ultrasound that demonstrated short limb fetal extremities. A level 3 scan was performed which evidenced an irregular cranial shape and compression of the cephalic pole with moderate transducer pressure. Limb shortening, decreased echoes and fractures of long bones were found on our scan evaluation. A vaginal delivery occurred at 35 weeks of gestation. The male newborn, weighing 1.990 grams had 6 and 8 in Apgar scores. The neonate was clearly abnormal, presenting irregular cranial shape, with poor ossification on X-ray, blue sclera, fractures and limb deformities. Postnatal evaluation was satisfactory and the neonate was discharged in good conditions. Prenatal diagnosis is important for an adequate pregnancy follow-up. Postnatal outcome was not related to vaginal delivery, as there were no recent fractures in the newborn.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):244-250
DOI 10.1590/S0100-72032006000400007
Osteogenesis imperfecta is a connective tissue disorder due to quantitative and qualitative anomalies in type 1 collagen, genetically transmitted by a dominant or recessive autosomal gene, leading to bone fragility. We report a case of a 19-year-old G1 PO patient referred to our institution following a screening ultrasound that demonstrated short limb fetal extremities. A level 3 scan was performed which evidenced an irregular cranial shape and compression of the cephalic pole with moderate transducer pressure. Limb shortening, decreased echoes and fractures of long bones were found on our scan evaluation. A vaginal delivery occurred at 35 weeks of gestation. The male newborn, weighing 1.990 grams had 6 and 8 in Apgar scores. The neonate was clearly abnormal, presenting irregular cranial shape, with poor ossification on X-ray, blue sclera, fractures and limb deformities. Postnatal evaluation was satisfactory and the neonate was discharged in good conditions. Prenatal diagnosis is important for an adequate pregnancy follow-up. Postnatal outcome was not related to vaginal delivery, as there were no recent fractures in the newborn.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):750-758
DOI 10.1590/S0100-72032005001200008
Congenital cytomegalovirus infection is an important clinical entity, due to its sonographic symptomatology. In Brazil, in utero diagnosis is not accomplished despite the improvements in diagnostic methods. We report a congenital infection including: splenomegaly and hepatomegaly, hypoplasia of the cerebellar vermis, intracranial calcifications, hyperechoic kidneys, hyperechoic bowel, cardiomegaly, lung hypoplasia, ascites, and pericardial effusion. Fetal magnetic resonance imaging confirmed the sonographic findings. Amniocentesis was performed for cytomegalovirus PCR in amniotic fluid, which confirmed fetal infection. Fetal loss occurred in the 31st week of pregnancy. Necropsy studies confirmed the sonographic findings. The diagnostic methods have been useful to confirm congenital cytomegalovirus infection and to establish fetal outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):750-758
DOI 10.1590/S0100-72032005001200008
Congenital cytomegalovirus infection is an important clinical entity, due to its sonographic symptomatology. In Brazil, in utero diagnosis is not accomplished despite the improvements in diagnostic methods. We report a congenital infection including: splenomegaly and hepatomegaly, hypoplasia of the cerebellar vermis, intracranial calcifications, hyperechoic kidneys, hyperechoic bowel, cardiomegaly, lung hypoplasia, ascites, and pericardial effusion. Fetal magnetic resonance imaging confirmed the sonographic findings. Amniocentesis was performed for cytomegalovirus PCR in amniotic fluid, which confirmed fetal infection. Fetal loss occurred in the 31st week of pregnancy. Necropsy studies confirmed the sonographic findings. The diagnostic methods have been useful to confirm congenital cytomegalovirus infection and to establish fetal outcome.
