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Summary
Rev Bras Ginecol Obstet. 2010;32(1):11-18
DOI 10.1590/S0100-72032010000100003
PURPOSE: to describe adverse perinatal outcomes in patients with fetal blood flow centralization, using the relationship between the pulsatility indexes of the middle cerebral and umbilical arteries (MCAPI/UAPI), and between the resistance indexes of the middle cerebral and umbilical arteries (MCARI/UARI), as well as to compare both diagnostic indexes. METHODS: 151 pregnant women with diagnosis of blood flow centralization, attended to at the maternity hospital of Universidade Estadual de Campinas, whose delivery occurred up to 15 days after the ultrasonographic diagnosis, were included. It was considered as adverse perinatal outcomes: Apgar index lower than 7 at the fifth minute, permanence in neonatal ICU, small fetus for the gestational age, severe fetal suffering, perinatal death, hypoglycemia, polycythemia, necrotizing enterocolitis, brain hemorrhage, lung hemorrhage, anemia, septicemia, hyaline membrane disease, convulsive syndromes, hyperreflexia syndrome and kidney insufficiency. Rates of the perinatal adverse outcomes (PAO) for the brain-placentary ratios have been compared, using Fisher's exact or Pearson's χ2 tests, at 5% significance level. Adverse perinatal outcomes according to the gestational age have been evaluated using the Cochrane-Armitage test for trend. RESULTS: the adverse perinatal outcomes for the group with the two indexes altered were: 62.5% of the newborns needed to be placed in an ICU, 75.2% were small for the gestational age (SGA), 35.3% were under severe fetal suffering, 84.4% had hypoglycemia, 8.3% polycythemia, 4.2% necrotizing enterocolitis, and 2.1% brain hemorrhage. There has been significant association between the MCAPI/UAPI and MCARI/UARI ratios along the gestational age, and the need for neonatal intensive care, small fetuses for the gestational age, septicemia, necrotizing enterocolitis, kidney insufficiency, hyaline membrane disease, and anemia. There has been no significant difference between the two indexes of adverse perinatal outcome.
Summary
Rev Bras Ginecol Obstet. 2010;32(1):11-18
DOI 10.1590/S0100-72032010000100003
PURPOSE: to describe adverse perinatal outcomes in patients with fetal blood flow centralization, using the relationship between the pulsatility indexes of the middle cerebral and umbilical arteries (MCAPI/UAPI), and between the resistance indexes of the middle cerebral and umbilical arteries (MCARI/UARI), as well as to compare both diagnostic indexes. METHODS: 151 pregnant women with diagnosis of blood flow centralization, attended to at the maternity hospital of Universidade Estadual de Campinas, whose delivery occurred up to 15 days after the ultrasonographic diagnosis, were included. It was considered as adverse perinatal outcomes: Apgar index lower than 7 at the fifth minute, permanence in neonatal ICU, small fetus for the gestational age, severe fetal suffering, perinatal death, hypoglycemia, polycythemia, necrotizing enterocolitis, brain hemorrhage, lung hemorrhage, anemia, septicemia, hyaline membrane disease, convulsive syndromes, hyperreflexia syndrome and kidney insufficiency. Rates of the perinatal adverse outcomes (PAO) for the brain-placentary ratios have been compared, using Fisher's exact or Pearson's χ2 tests, at 5% significance level. Adverse perinatal outcomes according to the gestational age have been evaluated using the Cochrane-Armitage test for trend. RESULTS: the adverse perinatal outcomes for the group with the two indexes altered were: 62.5% of the newborns needed to be placed in an ICU, 75.2% were small for the gestational age (SGA), 35.3% were under severe fetal suffering, 84.4% had hypoglycemia, 8.3% polycythemia, 4.2% necrotizing enterocolitis, and 2.1% brain hemorrhage. There has been significant association between the MCAPI/UAPI and MCARI/UARI ratios along the gestational age, and the need for neonatal intensive care, small fetuses for the gestational age, septicemia, necrotizing enterocolitis, kidney insufficiency, hyaline membrane disease, and anemia. There has been no significant difference between the two indexes of adverse perinatal outcome.
Summary
Rev Bras Ginecol Obstet. 2002;24(2):121-127
DOI 10.1590/S0100-72032002000200008
Purpose: to estimate the performance of ultrasound to detect gestations at risk for fetal chromosomal abnormalities. Methods: four hundred and thirty-six patients selected for the study had undergone ultrasound examination and fetal karyotyping, between March 1993 and March 1998. Two hundred and seventy-seven patients had fetal karyotype for fetal malformation detected on ultrasound and 158 for parental anxiety with normal ultrasound examination. Ultrasound sensitivity and specificity were calculated using fetal karyotype as gold standard. The relative risk for each chromosomal abnormality was calculated according to the altered system on ultrasound examination and the risks of the presence of one or more abnormalities on ultrasound, using the Epi-Info 6.0 software package for statistical analysis. Results: the relative risks for chromosomal abnormalities were 89 for face malformations, 53 for abdominal wall and cardiovascular, 49.6 for neck, 44.6 for extremities, 42.4 for lung, 32.7 for gastrointestinal tract, 27.4 for central nervous system and 23.0 for urinary tract malformations. The relative risk for fetal chromosomal anomalies for genital, thorax, spine and muscle and/or skeletal malformations was not appropriate for calculation because they occurred at very low frequencies. An isolated malformation detected by ultrasound is associated with a 7.8 times higher relative risk for chromosomal anomalies than none, and associated morphologic malformations have a 33.8 times higher relative risk for chromosomal abnormalities. Conclusion: ultrasound has good performance to detect gestations at risk for chromosomal abnormalities.
Summary
Rev Bras Ginecol Obstet. 2002;24(2):121-127
DOI 10.1590/S0100-72032002000200008
Purpose: to estimate the performance of ultrasound to detect gestations at risk for fetal chromosomal abnormalities. Methods: four hundred and thirty-six patients selected for the study had undergone ultrasound examination and fetal karyotyping, between March 1993 and March 1998. Two hundred and seventy-seven patients had fetal karyotype for fetal malformation detected on ultrasound and 158 for parental anxiety with normal ultrasound examination. Ultrasound sensitivity and specificity were calculated using fetal karyotype as gold standard. The relative risk for each chromosomal abnormality was calculated according to the altered system on ultrasound examination and the risks of the presence of one or more abnormalities on ultrasound, using the Epi-Info 6.0 software package for statistical analysis. Results: the relative risks for chromosomal abnormalities were 89 for face malformations, 53 for abdominal wall and cardiovascular, 49.6 for neck, 44.6 for extremities, 42.4 for lung, 32.7 for gastrointestinal tract, 27.4 for central nervous system and 23.0 for urinary tract malformations. The relative risk for fetal chromosomal anomalies for genital, thorax, spine and muscle and/or skeletal malformations was not appropriate for calculation because they occurred at very low frequencies. An isolated malformation detected by ultrasound is associated with a 7.8 times higher relative risk for chromosomal anomalies than none, and associated morphologic malformations have a 33.8 times higher relative risk for chromosomal abnormalities. Conclusion: ultrasound has good performance to detect gestations at risk for chromosomal abnormalities.
Summary
Rev Bras Ginecol Obstet. 1999;21(3):161-165
DOI 10.1590/S0100-72031999000300007
Purpose: to evaluate the social, demographic and obstetrical profile of adolescents as compared with adult women hospitalized for abortion complications. Material and methods: this is a descriptive study that evaluated 230 women with abortion complications. Among them, 59 were adolescents hospitalized at the IMIP Maternity (Recife, Brazil) from August 1994 to July 1995. The variables studied were: educational level, marital status, any paid activity, gestation age, number of pregnancies, desire to become pregnant, use of anticonceptive method, kind of relationship, reason for voluntary interruption, clinical classification of abortion and associated complications. The procedure for data analysis was the distribution of variables among adolescents and adults, the differences being evaluated through chi² and chi² for trend. Results: compared with the adult women who aborted, the adolescents showed a lower number of paid activity and multiparity and a higher number of pregnancies resulting from an unstable relationship. Conclusions: the results indicated that biologicallly the adolescents who were hospitalized for abortion have a similar profile to adult women. What differentiates them are the unfavorable social and demographic conditions that they are faced with at their generally unplanned first pregnancies.
Summary
Rev Bras Ginecol Obstet. 1999;21(3):161-165
DOI 10.1590/S0100-72031999000300007
Purpose: to evaluate the social, demographic and obstetrical profile of adolescents as compared with adult women hospitalized for abortion complications. Material and methods: this is a descriptive study that evaluated 230 women with abortion complications. Among them, 59 were adolescents hospitalized at the IMIP Maternity (Recife, Brazil) from August 1994 to July 1995. The variables studied were: educational level, marital status, any paid activity, gestation age, number of pregnancies, desire to become pregnant, use of anticonceptive method, kind of relationship, reason for voluntary interruption, clinical classification of abortion and associated complications. The procedure for data analysis was the distribution of variables among adolescents and adults, the differences being evaluated through chi² and chi² for trend. Results: compared with the adult women who aborted, the adolescents showed a lower number of paid activity and multiparity and a higher number of pregnancies resulting from an unstable relationship. Conclusions: the results indicated that biologicallly the adolescents who were hospitalized for abortion have a similar profile to adult women. What differentiates them are the unfavorable social and demographic conditions that they are faced with at their generally unplanned first pregnancies.
Summary
Rev Bras Ginecol Obstet. 2000;22(3):175-179
DOI 10.1590/S0100-72032000000300009
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.
Summary
Rev Bras Ginecol Obstet. 2000;22(3):175-179
DOI 10.1590/S0100-72032000000300009
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.
Summary
Rev Bras Ginecol Obstet. 2005;27(5):275-282
DOI 10.1590/S0100-72032005000500008
PURPOSE: to evaluate the effectiveness of the "global active stretching" (GAS) method and the routine medical recommendations for lumbar and/or posterior pelvic pain in pregnancy. METHODS: sixty-nine pregnant women who experienced lumbar or posterior pelvic pain were selected and identified through a randomized controlled clinical trial and were randomly divided into two groups. One group practiced GAS-oriented exercises and the other followed the routine medical recommendations. The pregnant women were followed up for eight weeks. The severity of pain was estimated by the visual analog scale and posterior pelvic pain and lumbar back pain were confirmed by provocation tests. RESULTS: after treatment, 61% (p<0.01) of the women of the GAS group reported no pain at the lumbar/or posterior pelvic area compared with 11% (p=0.50) of the group who followed routine medical recommendations. CONCLUSIONS: the GAS method relieved and diminished the intensity of lumbar and/or pelvic pains more effectively than routine medical recommendations.
Summary
Rev Bras Ginecol Obstet. 2005;27(5):275-282
DOI 10.1590/S0100-72032005000500008
PURPOSE: to evaluate the effectiveness of the "global active stretching" (GAS) method and the routine medical recommendations for lumbar and/or posterior pelvic pain in pregnancy. METHODS: sixty-nine pregnant women who experienced lumbar or posterior pelvic pain were selected and identified through a randomized controlled clinical trial and were randomly divided into two groups. One group practiced GAS-oriented exercises and the other followed the routine medical recommendations. The pregnant women were followed up for eight weeks. The severity of pain was estimated by the visual analog scale and posterior pelvic pain and lumbar back pain were confirmed by provocation tests. RESULTS: after treatment, 61% (p<0.01) of the women of the GAS group reported no pain at the lumbar/or posterior pelvic area compared with 11% (p=0.50) of the group who followed routine medical recommendations. CONCLUSIONS: the GAS method relieved and diminished the intensity of lumbar and/or pelvic pains more effectively than routine medical recommendations.
Summary
Rev Bras Ginecol Obstet. 2011;33(10):286-291
DOI 10.1590/S0100-72032011001000003
PURPOSES: To determine the rate of low birth weight and some of the risk factors associated with this event among adolescents. METHODS: A cross-sectional study conducted between October 1994 and December 2009 at a maternity in Campinas, in Brazil, using information generated from the computerized obstetric form. After selection of adolescents who delivered at this hospital, two groups were created, with and without low birth weight, respectively. Relative risk and 95% confidence interval for all independent variables (risk factors) and the Χ2 test for some perinatal results were performed. The level of significance was set at 5%. RESULTS: During the study period, 24,000 births occurred at CAISM. Of these, 2,404 occurred among 2,357 teenagers (10.02%) and the frequency of low birth weight was 15.1%. Adolescent pregnancy recurred in 294 (8.2%). Age less than 15 years-old, anemia, smoking, and hypertension were not significantly associated with low birth weight. Antecedent of miscarriage and association with systemic lupus erythematosus increased the risk of low birth weight. Cesarean section and an Apgar score below seven were more prevalent among adolescents with low birth weight, and 85% of all adolescents had less than six prenatal visits. CONCLUSIONS: The prevalence of low birth weight is higher among adolescents than among adult women, and there was a large number of adolescents with less than six prenatal visits . The antecedent of miscarriage and the presence of systemic lupus erythematosus were risk factors associated with the occurrence of low birth weight among adolescents.
Summary
Rev Bras Ginecol Obstet. 2011;33(10):286-291
DOI 10.1590/S0100-72032011001000003
PURPOSES: To determine the rate of low birth weight and some of the risk factors associated with this event among adolescents. METHODS: A cross-sectional study conducted between October 1994 and December 2009 at a maternity in Campinas, in Brazil, using information generated from the computerized obstetric form. After selection of adolescents who delivered at this hospital, two groups were created, with and without low birth weight, respectively. Relative risk and 95% confidence interval for all independent variables (risk factors) and the Χ2 test for some perinatal results were performed. The level of significance was set at 5%. RESULTS: During the study period, 24,000 births occurred at CAISM. Of these, 2,404 occurred among 2,357 teenagers (10.02%) and the frequency of low birth weight was 15.1%. Adolescent pregnancy recurred in 294 (8.2%). Age less than 15 years-old, anemia, smoking, and hypertension were not significantly associated with low birth weight. Antecedent of miscarriage and association with systemic lupus erythematosus increased the risk of low birth weight. Cesarean section and an Apgar score below seven were more prevalent among adolescents with low birth weight, and 85% of all adolescents had less than six prenatal visits. CONCLUSIONS: The prevalence of low birth weight is higher among adolescents than among adult women, and there was a large number of adolescents with less than six prenatal visits . The antecedent of miscarriage and the presence of systemic lupus erythematosus were risk factors associated with the occurrence of low birth weight among adolescents.
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