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  • Original Article

    Agreement Analysis between Sonographic Estimates and Birth Weight, by the WHO and Intergrowth-21st Tables, in Newborns of Diabetic Mothers

    Rev Bras Ginecol Obstet. 2021;43(1):20-27

    Summary

    Original Article

    Agreement Analysis between Sonographic Estimates and Birth Weight, by the WHO and Intergrowth-21st Tables, in Newborns of Diabetic Mothers

    Rev Bras Ginecol Obstet. 2021;43(1):20-27

    DOI 10.1055/s-0040-1719146

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    Abstract

    Objective

    To analyze the agreement, in relation to the 90th percentile, of ultrasound measurements of abdominal circumference (AC) and estimated fetal weight (EFW), between the World Health Organization (WHO) and the International Fetal and Newborn Growth Consortium for the 21st Century (intergrowth-21st) tables, as well as regarding birth weight in fetuses/newborns of diabetic mothers.

    Methods

    Retrospective study with data from medical records of 171 diabetic pregnant women, single pregnancies, followed between January 2017 and June 2018. Abdominal circumference and EFW data at admission (from 22 weeks) and predelivery (up to 3 weeks) were analyzed. These measures were classified in relation to the 90th percentile. The Kappa coefficient was used to analyze the agreement of these ultrasound variables between the WHO and intergrowth-21st tables, as well as, by reference table, these measurements and birth weight.

    Results

    The WHO study reported 21.6% large-for-gestational-age (LGA) newborns while the intergrowth-21st reported 32.2%. Both tables had strong concordances in the assessment of initial AC, final AC, and initial EFW (Kappa = 0.66, 0.72 and 0.63, respectively) and almost perfect concordance in relation to final EFW (Kappa = 0.91). Regarding birth weight, the best concordances were found for initial AC (WHO: Kappa = 0.35; intergrowth-21st: Kappa= 0.42) and with the final EFW (WHO: Kappa = 0.33; intergrowth- 21st: Kappa = 0.35).

    Conclusion

    The initial AC and final EFW were the parameters of best agreement regarding birth weight classification. The WHO and intergrowth-21st tables showed high agreement in the classification of ultrasound measurements in relation to the 90th

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    Agreement Analysis between Sonographic Estimates and Birth Weight, by the WHO and Intergrowth-21st Tables, in Newborns of Diabetic Mothers
  • Case Report

    Portopulmonary Hypertension and Pregnancy

    Rev Bras Ginecol Obstet. 2002;24(4):271-276

    Summary

    Case Report

    Portopulmonary Hypertension and Pregnancy

    Rev Bras Ginecol Obstet. 2002;24(4):271-276

    DOI 10.1590/S0100-72032002000400009

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    The severity of the association of pulmonary hypertension with pregnancy is well known. Pulmonary arterial hypertension constitutes one of the highest risk conditions for maternal mortality in late pregnancy and postpartum. Patients with portal hypertension of varying etiology may develop pulmonary arterial hypertension (portopulmonary hypertension) and most cases present cirrhosis as the underlying disease; however, a few cases of noncirrhotic etiology have been described. Clinical and pathological findings in two cases of portopulmonary hypertension and pregnancy are presented here. The two patients (30 and 24 years old) developed severe right heart failure and shock just after the delivery and the disease progressed rapidly to death. Autopsy demonstrated fibrosis in hepatic portal tracts, as has been described in cases of idiopathic portal hypertension. Also, pulmonary hypertension classified as plexogenic was reported.

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    Portopulmonary Hypertension and Pregnancy

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