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  • Original Article

    Mechanical method of induction of labor in high-risk pregnant women with previous cesarean section

    Rev Bras Ginecol Obstet. 2015;37(3):127-132

    Summary

    Original Article

    Mechanical method of induction of labor in high-risk pregnant women with previous cesarean section

    Rev Bras Ginecol Obstet. 2015;37(3):127-132

    DOI 10.1590/SO100-720320150005120

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    PURPOSE:

    To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section.

    METHODS:

    An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours.

    RESULTS:

    Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%).

    CONCLUSIONS:

    The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate.

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  • Original Article

    Evaluation of Immunological Parameters in Pregnant Women: Low Levels of B and NK Cells

    Rev Bras Ginecol Obstet. 2019;41(4):213-219

    Summary

    Original Article

    Evaluation of Immunological Parameters in Pregnant Women: Low Levels of B and NK Cells

    Rev Bras Ginecol Obstet. 2019;41(4):213-219

    DOI 10.1055/s-0039-1683903

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    Abstract

    Objective

    To describe the immunological and hematological reference intervals of low-risk pregnant women.

    Methods

    A cross-sectional retrospective database analysis of a basic and translational study analyzing the hematological evaluation blood counts and immunophenotyping of TCD3 + , TCD4 + , TCD8 + , B, and natural killer (NK) cells of the peripheral blood in 79 low-risk pregnant women and of 30 control women from the state of Pernambuco, Brazil, was performed.

    Results

    No significant differences were detected between the hematological profiles of the 2nd and 3rd trimesters. Nevertheless, the median level of B cells decreased significantly in the 2nd (174 x 103 μL; p < 0.002) and 3rd trimesters (160 x 103 μL; p < 0.001), compared with the control group (296 x 103 μL). Similarly, the median level of NK cells was lower in the 2nd (134 x 103 μL; p < 0.0004) and 3rd trimesters (100 x 103 μL, p < 0.0004), compared with the control group (183 x 103 μL). In contrast, relative TCD4+ and TCD8+ levels increased in the 2nd and 3rd trimesters compared with the controls (TCD4 + : 2nd trimester = 59%; p < 0.001; 3rd trimester = 57%; p < 0.01; control = 50%; and TCD8 + : 2nd trimester = 31%; p < 0.001; 3rd trimester = 36%; p < 0.01; control = 24%).

    Conclusion

    Low-risk pregnant women have ~ 40% less B and NK cells in the peripheral blood, compared with non-pregnant women. These parameters may improve health assistance for mothers and contribute to define reference values for normal pregnancies.

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    Evaluation of Immunological Parameters in Pregnant Women: Low Levels of B and NK Cells
  • Original Article

    Impact of antenatal corticosteroid therapy for the acceleration of fetal lung maturation in neonates at a teaching hospital in Brazil

    Rev Bras Ginecol Obstet. 2002;24(10):655-661

    Summary

    Original Article

    Impact of antenatal corticosteroid therapy for the acceleration of fetal lung maturation in neonates at a teaching hospital in Brazil

    Rev Bras Ginecol Obstet. 2002;24(10):655-661

    DOI 10.1590/S0100-72032002001000004

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    PURPOSE: to evaluate the effects of antenatal corticosteroid treatment on the incidence of respiratory distress syndrome (RDS), neonatal morbidities, and mortality in preterm babies assisted at IMIP, a teaching hospital in Brazil. METHODS: this was an observational, analytical, cohort study which included 155 newborns from women who delivered prematurely. The study was conducted between February and November 2001 and included 78 women in the corticosteroid-treated group and 77 in the nontreated group. The study design included the incidence of RDS, assessment of morbidities related to prematurity and tabulation of neonatal mortality. The risk ratio and its 95% confidence interval were determined for estimation of the relative risk for RDS and neonatal outcome (dependent variables) according to antenatal corticoid therapy administration (independent variable). RESULTS: corticosteroid treatment was administered to 50.3% of the patients (64% of the women received the full treatment course, while 36% of the same group received a partial course of treatment). The incidence of RDS was significantly lower in the corticosteroid treated group (37.2%) compared with the nontreated group (63.6%). There was no observable decrease in the risk for morbidities associated with prematurity. There was a decrease in mortality and in the frequency of supplemental oxygen therapy in the corticosteroid group (37%). On multiple logical regression analysis, there was a 72% reduction in the risk for RDS in the corticosteroid group, and approximately a seven times greater risk for RDS in babies of gestational age below 32 weeks. CONCLUSIONS: a favorable impact of antenatal corticosteroid administration was observed, with significant reduction of the risk for RDS in patients with gestational age between 26 and 35 weeks. Although no effect on the other morbidities was observed, this can be explained by the small size of the sample.

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