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  • Original Article

    Prenatal Diagnosis of Aberrant Right Subclavian Artery: Association with Genetic Abnormalities

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(6):452-456

    Summary

    Original Article

    Prenatal Diagnosis of Aberrant Right Subclavian Artery: Association with Genetic Abnormalities

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(6):452-456

    DOI 10.1055/s-0041-1732461

    Views10

    Abstract

    Objective

    The objective of the present study was to determine the frequency of malformations and chromosomal abnormalities in a population of fetuses with an aberrant right subclavian artery (ARSA).

    Methods

    This is a 6-year retrospective study of fetuses with a prenatal diagnosis of ARSA conducted during the period between September 2013 and June 2019 at a fetal medicine unit. Data were collected from ultrasound, fetal echocardiograms, genetic studies, and neonatal records.

    Results

    An ARSA was diagnosed in 22 fetuses. An ARSA was an isolated finding in 18 out of 22 cases (82%). Associated abnormal sonographic findings were found in 4 cases. All cases underwent invasive testing. In 1 of the cases, a chromosomal abnormality was detected (mos 45,X [13]/46,X,e(X) (p22.1q22.1)). No cases of congenital heart disease were found in any of these fetuses. There were two cases in which the postnatal evaluation revealed amalformation: one case of hypospadias and 1 case of cleft palate.

    Conclusion

    The presence of an isolated ARSA is benign and is not associated with chromosomal abnormalities. The finding of ARSA, however, warrants a detailed fetal ultrasound in order to exclude major fetal abnormalities and other soft markers.

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    Prenatal Diagnosis of Aberrant Right Subclavian Artery: Association with Genetic Abnormalities
  • Original Article

    Laparoscopic Approach in Surgical Staging of Endometrial Cancer

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):306-311

    Summary

    Original Article

    Laparoscopic Approach in Surgical Staging of Endometrial Cancer

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):306-311

    DOI 10.1055/s-0039-1688461

    Views10

    Abstract

    Objective

    To compare laparoscopy with laparotomy for surgical staging of endometrial cancer.

    Methods

    A cohort of women with preoperative diagnosis of endometrial cancer who underwent surgical staging was retrospectively evaluated. The main study end points were: morbidity and mortality, hospital length of stay, perioperative adverse events and recurrence rate. Data analysis was performed with the software SPSS v25 (IBM Corp., Armonk, NY, USA), categorical variables using a Chi-square and Fisher test, and continuous variables using the Student t-test.

    Results

    Atotal of 162 patientswere analyzed. 138 patientsmet the inclusion criteria, 41of whom underwent staging by laparoscopy and 97 by laparotomy. Conversions from laparoscopy to laparotomy happened in 2 patients (4.9%) and were secondary to technical difficulties and poor exposure. Laparoscopy had fewer postoperative adverse events when compared with laparotomy (7.3% vs 23.7%, respectively; p = 0.005), but similar rates of intraoperative complications, despite having a significantly longer operative time (median, 175 vs 130 minutes, respectively; p < 0.001). Hospital stay was significantly lower in laparoscopy versus laparotomy patients (median, 3 vs 7 days, respectively; p < 0.001). No difference in recurrence or mortality rates were observed.

    Conclusion

    Laparoscopic surgical staging for endometrial cancer is feasible and safe. Patients have lower postoperative complication rates and shorter hospital stays when compared with the approach by laparotomy.

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    Laparoscopic Approach in Surgical Staging of Endometrial Cancer
  • Original Article

    Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):740-748

    Summary

    Original Article

    Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):740-748

    DOI 10.1055/s-0038-1675187

    Views21

    Abstract

    Objective

    To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes.

    Methods

    This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics and gynecology of Centro Hospitalar Tondela Viseu between September 2013 and September 2015. Total cohort and subgroup analysis were performed: group A-women with umbilical cord blood gas analysis (UCBGA) performed for non-reassuring fetal cardiotocographic patterns, placental abruption, or shoulder dystocia; and group B-all the others. Assays were made with the software SPSS for Windows, Versions 20.0 and 21.0 (IBM Corp., Armonk, NY, USA).

    Results

    A total of 428 UCBGAs met the inclusion criteria. The group analysis revealed an association between group A and pHua ≤7.00, as well as between BDua ≥12.00 mmol/L and 1st minute Apgar score ≤4 (p = 0.011). After the application of the logistic regression models in the total cohort analysis, pHua ≤7.00 had an impact in the occurrence of acute neonatal hypoxia (odds ratio [OR]: 6.71; 95% confidence interval [CI]: 1.21-37.06; p = 0.029); multiparous women had a higher risk of delivering a newborn with first minute Apgar score ≤4 and acute neonatal hypoxia (OR: 5.38; 95% CI: 1.35-21.43; p = 0.017; and OR: 2.66; 95% CI: 1.03-6.89, p = 0.043, respectively); women who had urologic problems during pregnancy had a higher risk of delivering a newborn with 5th minute Apgar score ≤7 (OR: 15.17; 95% CI: 1.29-177.99; p = 0.030); and shoulder dystocia represented a 15 times higher risk of acute neonatal hypoxia (OR: 14.82; 95% CI: 2.20-99.60; p = 0.006).

    Conclusion

    The pHua and the BDua are predictors of adverse neonatal outcome, and UCBGA is a useful tool for screening newborns at risk. Universal UCBGA should be considered for all deliveries, as it is an accurate screening test for neonatal hypoxia.

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    Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome

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