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Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS03
, , , , , , , • The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS03
, , , , , , , • The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):153-160
DOI 10.1590/S0100-72032002000300002
Purpose: to study the fetal hemodynamic profile in high-risk pregnancy and correlate it with perinatal results. Methods: transverse prospective study of 108 patients of the Obstetric Clinic of the Hospital das Clínicas, São Paulo University School of Medicine. The patients were evaluated at the Fetal Surveillance Unit, and Doppler examinations of umbilical, aorta, middle cerebral artery, inferior vena cava and ductus venosus were performed. The criteria for inclusion were patients whose delivery was in the next 24 hours after evaluation. Twin pregnancies and fetal malformations were excluded. Results: the hemodynamic implications in the fetal circulation were demonstrated by changes in the Doppler ultrasonographic results in the umbilical artery, aorta, middle cerebral artery, ductus venosus and in the inferior vena cava. The Doppler examinations were abnormal in the umbilical artery (25.9%), fetal aorta (24%), middle cerebral artery (34.2%), ductus venosus (18.2%) and inferior vena cava (46,6%). Segments of the fetal circulation which best correlated with the perinatal results were the umbilical artery and the ductus venosus. The abnormal results in the umbilical artery were significantly associated with 1st minute Apgar score <7 in 42.8% and need of neonatal intensive care unit in 50% of the cases. The abnormal results in the ductus venosus Doppler ultrasonography showed statistical association with 1st minute Apgar score <7 (52.6%), 5th min Apgar <7 (15.7%), acidemia at birth (60%), need of neonatal intensive care unit (52.6%) and neonatal death (21.1%). The predictive values of the ductus venosus Doppler for fetal acidemia were: sensitivity of 39.1; specificity of 90.4; positive predictive value of 60.0 and negative predictive value of 80.2. Conclusion: the Doppler ultrasonography allowed us to evaluate the fetal hemodynamics in the most varied situations and the study of the venous duct is an important examination in the evaluation of fetal hemodynamic response to hypoxia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):153-160
DOI 10.1590/S0100-72032002000300002
Purpose: to study the fetal hemodynamic profile in high-risk pregnancy and correlate it with perinatal results. Methods: transverse prospective study of 108 patients of the Obstetric Clinic of the Hospital das Clínicas, São Paulo University School of Medicine. The patients were evaluated at the Fetal Surveillance Unit, and Doppler examinations of umbilical, aorta, middle cerebral artery, inferior vena cava and ductus venosus were performed. The criteria for inclusion were patients whose delivery was in the next 24 hours after evaluation. Twin pregnancies and fetal malformations were excluded. Results: the hemodynamic implications in the fetal circulation were demonstrated by changes in the Doppler ultrasonographic results in the umbilical artery, aorta, middle cerebral artery, ductus venosus and in the inferior vena cava. The Doppler examinations were abnormal in the umbilical artery (25.9%), fetal aorta (24%), middle cerebral artery (34.2%), ductus venosus (18.2%) and inferior vena cava (46,6%). Segments of the fetal circulation which best correlated with the perinatal results were the umbilical artery and the ductus venosus. The abnormal results in the umbilical artery were significantly associated with 1st minute Apgar score <7 in 42.8% and need of neonatal intensive care unit in 50% of the cases. The abnormal results in the ductus venosus Doppler ultrasonography showed statistical association with 1st minute Apgar score <7 (52.6%), 5th min Apgar <7 (15.7%), acidemia at birth (60%), need of neonatal intensive care unit (52.6%) and neonatal death (21.1%). The predictive values of the ductus venosus Doppler for fetal acidemia were: sensitivity of 39.1; specificity of 90.4; positive predictive value of 60.0 and negative predictive value of 80.2. Conclusion: the Doppler ultrasonography allowed us to evaluate the fetal hemodynamics in the most varied situations and the study of the venous duct is an important examination in the evaluation of fetal hemodynamic response to hypoxia.