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  • Original Article

    Women’s Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(9):540-546

    Summary

    Original Article

    Women’s Obstetric History and Midtrimester Cervical Length Measurements by 2D/3D and Doppler Ultrasound

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(9):540-546

    DOI 10.1055/s-0040-1713010

    Views6

    Abstract

    Objective

    The aim of the present study was to compare the obstetric history and both two- and tri-dimensional ultrasound parameters according to different cervical lengths.

    Methods

    The present cross-sectional study analyzed 248 midtrimester pregnant women according to cervical length and compared the data with the obstetric history and 2D/3D ultrasound parameters. Patients were divided into 3 groups according to cervical length: The Short Cervix group for cervical lengths ≥ 15mm and< 25mm(n= 68), the Very Short Cervix group for cervical lengths< 15mm (n = 18) and the Control group, composed of 162 pregnant women with uterine cervical lengths ≥ 25mm.

    Results

    When analyzing the obstetric history of only non-nulliparous patients, a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth was reported (p = 0.021). Cervical length and volume were positively correlated (Pearson coefficient = 0.587, p < 0.0001). The flow index (FI) parameter of cervical vascularization was significantly different between the Control and Very Short Cervix groups. However, after linear regression, in the presence of volume information, we found no association between the groups and FI. Uterine artery Doppler was also not related to cervical shortening.

    Conclusion

    The present study showed a significant association between the presence of a short cervix in the current pregnancy and at least one previous preterm birth. None of the vascularization indexes correlate with cervical length as an independent parameter. Uterine artery Doppler findings do not correlate with cervical length.

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  • Original Article

    Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):596-601

    Summary

    Original Article

    Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):596-601

    DOI 10.1055/s-0037-1606859

    Views6

    Abstract

    Objective

    To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion.

    Methods

    This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered nonrecovery and categorized as an adverse outcome.

    Results

    The final analysis included ten singleton pregnancies: seven of which were categorized into the recovery group and three of which into the non-recovery group. The baseline characteristics were similar between the groups. All fetuses were hydropic at the time of diagnosis. No significant differences related to sonographic or intrauterine transfusion parameters were identified between the groups; however, the nonrecovery group tended to have an increased number of sonographic markers and lower fetal hemoglobin and platelet levels before the transfusion.

    Conclusion

    We were unable to firmly establish the clinical or sonographic parameters associated with adverse fetal outcomes in patients with parvovirus infection managed with intrauterine transfusions; however, edema, placental thickening and oligohydramnios may indicate greater fetal compromise and, subsequently, adverse outcomes. However, further studies are necessary, mainly due to the small number of cases analyzed in the present study.

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  • Trabalhos Originais

    Changes in amniotic fluid index estimated by ultrasonography in pregnant patients submitted to subtotal immersion in water

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):101-105

    Summary

    Trabalhos Originais

    Changes in amniotic fluid index estimated by ultrasonography in pregnant patients submitted to subtotal immersion in water

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):101-105

    DOI 10.1590/S0100-72032001000200007

    Views1

    Purpose: to study the changes in amniotic fluid index (AFI) measured by ultrasonography, mean arterial pressure (MAP) and pulse rate in normal pregnant women submitted to subtotal body immersion in water for different periods of time, and to standardize the technique. Methods: AFI values were studied as recommended by Phelan et al.¹ in a group of 52 pregnant women with gestational age of 28 weeks or more considered to be clinically normal, before and after exposure to subtotal immersion in water heated to 32 to 34ºC for 30, 45 and 60 min. The patients were seen at the Ultrasonography and Medical Updating School of Ribeirão Preto and in the Department of Gynecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, University of São Paulo. Results: before and after immersion, the average of MAP was 87.8 and 87.1 in the group of 30 min, 76.7 and 66.6 in the group of 45 min and 77.4 and 60.7 in the group of 60 min, with statistical significance. Before and after immersion, the means of pulse rates were 74.9 and 78.7 in the group of 30 min, 83.6 and 85.2 in the group of 45 min and 84.9 and 90.6 in the group of 60 min, with statistical significance. The mean of AFI also showed statistical significance. When submitted to 30-min immersion the means of AFI were 11.7 cm before and 16.8 cm after. In the group of 45 min, the averages were 9.7 cm before and 13.8 cm after immersion. In the group of 60 min, the averages were 9.5 cm before and 13.6 cm after immersion. The time of immersion of 30-min was as effective and ample as 45 or 60 min. Conclusions: subtotal immersion in water is a safe and practical procedure that can mobilize fluids during pregnancy, increasing amniotic fluid volume.

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    Changes in amniotic fluid index estimated by ultrasonography in pregnant patients submitted to subtotal immersion in water

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