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Rev Bras Ginecol Obstet. 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
Rev Bras Ginecol Obstet. 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
Rev Bras Ginecol Obstet. 2004;26(6):449-454
DOI 10.1590/S0100-72032004000600005
OBJECTIVE: to study the effect of a single contraceptive implant of nomegestrol acetate (Uniplant) on the ovarian function, cervical mucus production and sperm penetration, when inserted in women in the preovulatory phase. METHODS: twenty women with regular menstrual cycles were included in an open comparative study. All participants were investigated during one menstrual cycle before (control) and one menstrual cycle after implant insertion. Measurements of estradiol, LH, and progesterone, as well as transvaginal sonography, cervical mucus examination and sperm penetration test, were carried out. Statistical analysis was performed with the paired t-test and the non-parametric test of Wilcoxon. RESULTS: all control cycles were ovulatory and presented normal parameters. Preovulatory estradiol and LH peak decreased significantly from 603.2 ± 78.0 pmo/l and 22.5 ± 6.5 IU/l at pre-insertion to 380.7 ± 51.9 pmol/l and 4.9 ± 1.3 IU/l 48 hours after implant insertion (p < 0.05 and p < 0.01, respectively). Progesterone levels did not vary significantly (control cycle = 49.8 ± 3.3 nmol/l and treated cycle = 43.2 ± 5.2 nmol/l). Cervical mucus and sperm penetration tests were profoundly affected in 10.5% of the users 20 h after implant insertion, in 68.5% after 24 h and in 100% after 48 h. Follicular rupture occurred in the majority of the cycles 48 h after implant insertion. CONCLUSIONS: the use of a single implant of nomegestrol acetate affected estradiol and LH preovulatory peaks and disrupted the process of cervical mucus production and sperm penetration, but it was unable to prevent ovulation when inserted at the preovulatory phase, which reinforces the need to insert the implant during the first five days of the menstrual cycle.
Summary
Rev Bras Ginecol Obstet. 2004;26(6):449-454
DOI 10.1590/S0100-72032004000600005
OBJECTIVE: to study the effect of a single contraceptive implant of nomegestrol acetate (Uniplant) on the ovarian function, cervical mucus production and sperm penetration, when inserted in women in the preovulatory phase. METHODS: twenty women with regular menstrual cycles were included in an open comparative study. All participants were investigated during one menstrual cycle before (control) and one menstrual cycle after implant insertion. Measurements of estradiol, LH, and progesterone, as well as transvaginal sonography, cervical mucus examination and sperm penetration test, were carried out. Statistical analysis was performed with the paired t-test and the non-parametric test of Wilcoxon. RESULTS: all control cycles were ovulatory and presented normal parameters. Preovulatory estradiol and LH peak decreased significantly from 603.2 ± 78.0 pmo/l and 22.5 ± 6.5 IU/l at pre-insertion to 380.7 ± 51.9 pmol/l and 4.9 ± 1.3 IU/l 48 hours after implant insertion (p < 0.05 and p < 0.01, respectively). Progesterone levels did not vary significantly (control cycle = 49.8 ± 3.3 nmol/l and treated cycle = 43.2 ± 5.2 nmol/l). Cervical mucus and sperm penetration tests were profoundly affected in 10.5% of the users 20 h after implant insertion, in 68.5% after 24 h and in 100% after 48 h. Follicular rupture occurred in the majority of the cycles 48 h after implant insertion. CONCLUSIONS: the use of a single implant of nomegestrol acetate affected estradiol and LH preovulatory peaks and disrupted the process of cervical mucus production and sperm penetration, but it was unable to prevent ovulation when inserted at the preovulatory phase, which reinforces the need to insert the implant during the first five days of the menstrual cycle.