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You searched for:"José Gonçalves Franco Júnior"
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Rev Bras Ginecol Obstet. 2012;34(3):122-127
DOI 10.1590/S0100-72032012000300006
PURPOSE: To compare the diagnostic accuracy of sonohysterography (HSN) and conventional transvaginal ultrasound (USG) in assessing the uterine cavity of infertile women candidate to assisted reproduction techniques (ART). METHODS: Comparative cross-sectional study with 120 infertile women candidate to ART, assisted at Centro de Reprodução Assistida (CRA) of Hospital Regional da Asa Sul (HRAS), Brasília - DF, from August 2009 to November 2010. Sonohysterography was performed with saline solution infusion in a close system. The sonohysterography finding was compared to previous USG results. The uterine cavity was considered abnormal when the endometrium was found to be thicker than expected during the menstrual cycle and when an endometrial polyp, a submucous myoma and an abnormal shape of the uterine cavity were observed. The statistical analysis was done using absolute frequencies, percentage values and the χ², with the level of significance set at 5%. RESULTS: HSN revealed that 92 (76.7%) infertile women candidate to ART had a normal uterine cavity, while 28 (23.3%) had the following abnormalities: 15 polyps (12.5%), 9 cases of abnormal shape of the uterine cavity (7.5%), 6 submucous myomas (5%), 4 cases of inadequate endometrial thickness for the menstrual cycle phase (3.3%), and 2 cases of uterine septum (1.7%); 5 women presented more than one abnormality (4.2%). While USG showed alteration in the cavity only in 5 (4.2%) women, the sonohysterography confirmed 4 out of the 5 abnormalities shown by USG and detected an abnormal uterine cavity in 24 other women, who had not been detected by USG. This means that sonohysterography was able to detect more abnormalities in the uterine cavity than USG, with a statistically significant difference (p=0.002). CONCLUSION: The sonohysterography was more accurate than USG in the assessment of the uterine cavity of this cohort of infertile women candidate to ART. The sonohysterography can be easily incorporated into the investigation of these women and contribute to reducing embryo implantation failures.
Summary
Rev Bras Ginecol Obstet. 2012;34(3):122-127
DOI 10.1590/S0100-72032012000300006
PURPOSE: To compare the diagnostic accuracy of sonohysterography (HSN) and conventional transvaginal ultrasound (USG) in assessing the uterine cavity of infertile women candidate to assisted reproduction techniques (ART). METHODS: Comparative cross-sectional study with 120 infertile women candidate to ART, assisted at Centro de Reprodução Assistida (CRA) of Hospital Regional da Asa Sul (HRAS), Brasília - DF, from August 2009 to November 2010. Sonohysterography was performed with saline solution infusion in a close system. The sonohysterography finding was compared to previous USG results. The uterine cavity was considered abnormal when the endometrium was found to be thicker than expected during the menstrual cycle and when an endometrial polyp, a submucous myoma and an abnormal shape of the uterine cavity were observed. The statistical analysis was done using absolute frequencies, percentage values and the χ², with the level of significance set at 5%. RESULTS: HSN revealed that 92 (76.7%) infertile women candidate to ART had a normal uterine cavity, while 28 (23.3%) had the following abnormalities: 15 polyps (12.5%), 9 cases of abnormal shape of the uterine cavity (7.5%), 6 submucous myomas (5%), 4 cases of inadequate endometrial thickness for the menstrual cycle phase (3.3%), and 2 cases of uterine septum (1.7%); 5 women presented more than one abnormality (4.2%). While USG showed alteration in the cavity only in 5 (4.2%) women, the sonohysterography confirmed 4 out of the 5 abnormalities shown by USG and detected an abnormal uterine cavity in 24 other women, who had not been detected by USG. This means that sonohysterography was able to detect more abnormalities in the uterine cavity than USG, with a statistically significant difference (p=0.002). CONCLUSION: The sonohysterography was more accurate than USG in the assessment of the uterine cavity of this cohort of infertile women candidate to ART. The sonohysterography can be easily incorporated into the investigation of these women and contribute to reducing embryo implantation failures.
Summary
Rev Bras Ginecol Obstet. 1999;21(1):18-24
DOI 10.1590/S0100-72031999000100004
Purpose: it has been demonstrated that delays in gestational sac development, in crown-rump length and low embryonic heart rate could be indicators of poor pregnancy outcome. The purpose was to evaluate the use of these three parameters together, which we named Biophysical Triple Test (BTT). Method: thirty-five singleton pregnancies following IVF treatment with intracytoplasmatic sperm injection (ICSI) were studied. All ultrasonographic scans were performed by the same examiner, 4-5 weeks after embryo transference (6-7 week gestation), using a Diasonics equipment, model Synergy, with a 7.0-MHz transvaginal transducer. The gestational sac (GS) was measured at the longest transverse diameter; the crown-rump length (CRL) was measured at the sagittal plan and the embryonic heart rate (EHR) was calculated from frozen B and M-mode and Doppler. The statistical test used was Fisher's test. Results: the following parameters were considered abnormal: GS < 15.4 mm, CRL < 3.9 mm, EHR < 100 bpm. The parameters were calculated from the means less one standard deviation for the ongoing pregnancies. The patients with a positive BTT, i.e., with a high risk of miscarriage, were those with at least 2 altered parameters. In 35 pregnancies, a positive BTT was found in 5, all of those who miscarrided and 2 of those who had no miscarriage. The difference between the two groups was highly significant (p = 0.0015; t-Fisher). The sensitivity of the method was is 100%, with a specificity of 93.75 %, which resulted in a 96.87% efficacy. Conclusion: the BTT is an ultrasonographic noninvasive method that presents high efficacy as an indicator of poor pregnancy outcome.
Summary
Rev Bras Ginecol Obstet. 1999;21(1):18-24
DOI 10.1590/S0100-72031999000100004
Purpose: it has been demonstrated that delays in gestational sac development, in crown-rump length and low embryonic heart rate could be indicators of poor pregnancy outcome. The purpose was to evaluate the use of these three parameters together, which we named Biophysical Triple Test (BTT). Method: thirty-five singleton pregnancies following IVF treatment with intracytoplasmatic sperm injection (ICSI) were studied. All ultrasonographic scans were performed by the same examiner, 4-5 weeks after embryo transference (6-7 week gestation), using a Diasonics equipment, model Synergy, with a 7.0-MHz transvaginal transducer. The gestational sac (GS) was measured at the longest transverse diameter; the crown-rump length (CRL) was measured at the sagittal plan and the embryonic heart rate (EHR) was calculated from frozen B and M-mode and Doppler. The statistical test used was Fisher's test. Results: the following parameters were considered abnormal: GS < 15.4 mm, CRL < 3.9 mm, EHR < 100 bpm. The parameters were calculated from the means less one standard deviation for the ongoing pregnancies. The patients with a positive BTT, i.e., with a high risk of miscarriage, were those with at least 2 altered parameters. In 35 pregnancies, a positive BTT was found in 5, all of those who miscarrided and 2 of those who had no miscarriage. The difference between the two groups was highly significant (p = 0.0015; t-Fisher). The sensitivity of the method was is 100%, with a specificity of 93.75 %, which resulted in a 96.87% efficacy. Conclusion: the BTT is an ultrasonographic noninvasive method that presents high efficacy as an indicator of poor pregnancy outcome.
Summary
Rev Bras Ginecol Obstet. 2006;28(3):190-194
DOI 10.1590/S0100-72032006000300009
PURPOSE: to verify the viability of early diagnosis of fetal gender in maternal plasma by the real-time polymerase chain reaction (real-time PCR) starting at the 5th week of pregnancy. METHODS: peripheral blood was collected from pregnant women with single fetus starting at the 5th week of gestation. After centrifugation, 0.4 mL plasma was separated for fetal DNA extraction. The DNA was analyzed in duplicate by real-time PCR for two genomic regions, one of the Y chromosome and the other common to both sexes, through the TaqMan® method, which uses a pair of primers and a fluorescent probe. Patients who aborted were excluded. RESULTS: a total of 79 determinations of fetal DNA in maternal plasma were performed in 52 pregnant women. The results of the determinations were compared to fetal gender after delivery. Accuracy according to gestational age was 92.6% (25 of 27 cases) at 5 weeks with 87% sensitivity, and 95.6% (22 of 23 cases) at 6 weeks with 92% sensitivity. Starting at the 7th week of pregnancy, accuracy was 100% (29 of 29 cases). Specificity was 100% regardless of gestational age. CONCLUSION: real-time PCR for the detection of fetal gender in maternal plasma starting at the 5th week of gestation has good sensitivity and excellent specificity. There was agreement of the results in 100% of the cases in which male gender was diagnosed, regardless of gestational age, and from the 7th week of gestation for female gender diagnosis.
Summary
Rev Bras Ginecol Obstet. 2006;28(3):190-194
DOI 10.1590/S0100-72032006000300009
PURPOSE: to verify the viability of early diagnosis of fetal gender in maternal plasma by the real-time polymerase chain reaction (real-time PCR) starting at the 5th week of pregnancy. METHODS: peripheral blood was collected from pregnant women with single fetus starting at the 5th week of gestation. After centrifugation, 0.4 mL plasma was separated for fetal DNA extraction. The DNA was analyzed in duplicate by real-time PCR for two genomic regions, one of the Y chromosome and the other common to both sexes, through the TaqMan® method, which uses a pair of primers and a fluorescent probe. Patients who aborted were excluded. RESULTS: a total of 79 determinations of fetal DNA in maternal plasma were performed in 52 pregnant women. The results of the determinations were compared to fetal gender after delivery. Accuracy according to gestational age was 92.6% (25 of 27 cases) at 5 weeks with 87% sensitivity, and 95.6% (22 of 23 cases) at 6 weeks with 92% sensitivity. Starting at the 7th week of pregnancy, accuracy was 100% (29 of 29 cases). Specificity was 100% regardless of gestational age. CONCLUSION: real-time PCR for the detection of fetal gender in maternal plasma starting at the 5th week of gestation has good sensitivity and excellent specificity. There was agreement of the results in 100% of the cases in which male gender was diagnosed, regardless of gestational age, and from the 7th week of gestation for female gender diagnosis.