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  • Original Article

    Factors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section

    Rev Bras Ginecol Obstet. 2000;22(3):175-179

    Summary

    Original Article

    Factors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section

    Rev Bras Ginecol Obstet. 2000;22(3):175-179

    DOI 10.1590/S0100-72032000000300009

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    Purpose: to evaluate the route of delivery in a group of low-income primipara pregnant women with a previous cesarean section, and the factors associated with the repetition of the cesarean section on the second delivery. Patients and Methods: it was a case-control study including 356 women who were assisted at the Maternity of CAISM/UNICAMP during the period between January 1993 and January 1996. The cases were 153 women whose second delivery was through a cesarean section and the controls were 203 women whose second delivery was vaginal. For analysis, means, standard deviation, Student's t-test, Mann-Whitney test, chi² test and odds ratio (OR) with 95% CI for each factor possibly associated with cesarean section on the second delivery were used. Results: the route of the second delivery was vaginal for 57% of the women. Among the several variables studied, those which showed to be significantly associated with a cesarean section on the second delivery were: higher maternal age (for women over 35 years, OR = 16.4), previous abortions (OR = 2.09), induced labor (OR = 3,83), premature rupture of membranes (OR = 2.83), not having an epidural analgesia performed during labor (OR = 5.3), the finding of some alteration in fetal well-being (OR = 2.7) and the delivery occurring during the afternoon (OR = 1.92). Conclusions: these results indicate that the factors associated with the repetition of cesarean section in women with a previous scar of cesarean section in this population are predominantly medical; however, there is still the possibility of proposing interventions directed to decreasing the rates of repeated cesarean sections.

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  • Original Article

    Validity of the normal fetal weight curve estimated by ultrasound for diagnosis of neonatal weight

    Rev Bras Ginecol Obstet. 2003;25(1):35-40

    Summary

    Original Article

    Validity of the normal fetal weight curve estimated by ultrasound for diagnosis of neonatal weight

    Rev Bras Ginecol Obstet. 2003;25(1):35-40

    DOI 10.1590/S0100-72032003000100006

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    PURPOSE: tocompare the ultrasound estimation of fetal weight (EFW) with neonatal weight and to evaluate the performance of the normal EFW curve according to gestational age for the diagnosis of fetal/neonatal weight deviation and associated factors. METHODS: one hundred and eighty-six pregnant women who delivered at the institution from November 1998 to January 2000 and who had one ultra-sonographic evaluation performed until three days prior to delivery with estimation of the amniotic fluid index were included. EFW was calculated and classified in to small for gestational age (SGA), adequate for gestational age (AGA) and large for gestational age (LGA) through the normal EFW curve for this population. Neonatal weight was similarly classified. The variability of the measures and the degree of linear correlation between EFW and neonatal weight, as well as sensitivity, specificity and predictive values for the use of the normal EFW curve in the diagnosis of neonatal weight deviations were calculated. RESULTS: the difference between EFW and neonatal weight ranged from -540 to +594 g, with a mean of +46.9 g, and the two measures presented a linear correlation coefficient of 0.94. The normal EFW curve had a sensitivity of 100% and specificity of 90.5% in detecting SGA neonates and of 94.4 and 92.8%, respectively, in detecting LGA; however, the predictive positive values were low for both conditions. CONCLUSIONS:ultrasound EFW was in agreement with the neonatal weight, with a mean overweight of approximately 47 g, and its normal curve showed a good performance in the screening of SGA and LGA neonates.

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    Validity of the normal fetal weight curve estimated by ultrasound for diagnosis of neonatal weight

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