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Rev Bras Ginecol Obstet. 2000;22(5):257-263
DOI 10.1590/S0100-72032000000500002
Purpose: to evaluate the evolution of gestation, metabolic control and perinatal outcome of pregestational diabetic patients and to perform a comparative study of the results of patients with insulin-dependent diabetes (type I) and non-insulin-dependent diabetes (type II). Methods: retrospective analysis of 57 pregestational diabetic woman charts who began a prenatal follow-up in the Service of Maternofetal Medicine of the Maternidade-Escola Assis Chateaubriand of the Universidade Federal do Ceará, in the period from January 1995 to December 1998. The 57 pregnant women included in the study were divided into groups: the first, composed of 28 patients with insulin-dependent diabetes (type I), and the second with 29 pregnant women with non-insulin-dependent diabetes (type II), controlled with diet or with oral hypoglycemics before pregnancy. Results: there was no statistically significant difference between the two groups in relation to the need of hospitalization for glycemia control (39.2% x 27.5%) and maternal complications, such as: chronic arterial hypertension (14.2% x 27.5%), pregnancy-induced hypertension (14.2% x 17.2%), premature rupture of membranes (3.5% x 10.3%), urinary tract infection (10.7% x 6.8%), and preterm labor (3.5% x 6.8%). However, episodes of maternal hypoglycemia were more frequent among insulin-dependent patients (35.7% x 3.4%). The perinatal results were similar. We observed a great number of congenital anomalies and increased perinatal morbidity and mortality. Conclusion: there was no difference in the incidence of obstetric and clinical complications between insulin-dependent and non-insulin-dependent patients, except for maternal hypoglycemia.
Summary
Rev Bras Ginecol Obstet. 2000;22(5):257-263
DOI 10.1590/S0100-72032000000500002
Purpose: to evaluate the evolution of gestation, metabolic control and perinatal outcome of pregestational diabetic patients and to perform a comparative study of the results of patients with insulin-dependent diabetes (type I) and non-insulin-dependent diabetes (type II). Methods: retrospective analysis of 57 pregestational diabetic woman charts who began a prenatal follow-up in the Service of Maternofetal Medicine of the Maternidade-Escola Assis Chateaubriand of the Universidade Federal do Ceará, in the period from January 1995 to December 1998. The 57 pregnant women included in the study were divided into groups: the first, composed of 28 patients with insulin-dependent diabetes (type I), and the second with 29 pregnant women with non-insulin-dependent diabetes (type II), controlled with diet or with oral hypoglycemics before pregnancy. Results: there was no statistically significant difference between the two groups in relation to the need of hospitalization for glycemia control (39.2% x 27.5%) and maternal complications, such as: chronic arterial hypertension (14.2% x 27.5%), pregnancy-induced hypertension (14.2% x 17.2%), premature rupture of membranes (3.5% x 10.3%), urinary tract infection (10.7% x 6.8%), and preterm labor (3.5% x 6.8%). However, episodes of maternal hypoglycemia were more frequent among insulin-dependent patients (35.7% x 3.4%). The perinatal results were similar. We observed a great number of congenital anomalies and increased perinatal morbidity and mortality. Conclusion: there was no difference in the incidence of obstetric and clinical complications between insulin-dependent and non-insulin-dependent patients, except for maternal hypoglycemia.
Summary
Rev Bras Ginecol Obstet. 2001;23(6):383-390
DOI 10.1590/S0100-72032001000600007
Purpose: to evaluate the ultrasonographic parameters associated with perinatal mortality increase in cases of fetal hydrocephalus. Method: 45 cases of fetal hydrocephalus were followed-up between January 1996 and December 1999. Fetal hydrocephalus was diagnosed when the ratio of lateral ventricles and the corresponding cerebral hemispheres was above 0.35 or when the measurement of the atrium of the lateral ventricles was above 10 mm. In all examinations the type of hydrocephalus, severity, symmetry, evolution and time of diagnosis were defined. The patients were submitted to morphologic ultrasound in the search of other anatomical abnormalities. The amniotic fluid index and fetal deaths were registered. The main ultrasonographic findings were correlated with perinatal mortality. For statistical analysis, chi² test and exact Fisher test were used. The value of p<0,05 was considered to be significant. Results: a total of 20 deaths were observed (44.4%), 6 occurred intra-uterus and 14 in the neonatal period. The diagnosis of hydrocephalus was established at a mean gestational age of 29 weeks. There was no association between perinatal mortality and alterations in the amniotic fluid volume, time of diagnosis, symmetry and type of hydrocephalus and the presence of other intra- or extracranial anomalies. On the other hand, the severity of the disease was associated significantly with perinatal death (p<0.0001). Conclusion: among all the analyzed ultrasonographic parameters, only the severity of hydrocephalus presented statistical association with perinatal death.
Summary
Rev Bras Ginecol Obstet. 2001;23(6):383-390
DOI 10.1590/S0100-72032001000600007
Purpose: to evaluate the ultrasonographic parameters associated with perinatal mortality increase in cases of fetal hydrocephalus. Method: 45 cases of fetal hydrocephalus were followed-up between January 1996 and December 1999. Fetal hydrocephalus was diagnosed when the ratio of lateral ventricles and the corresponding cerebral hemispheres was above 0.35 or when the measurement of the atrium of the lateral ventricles was above 10 mm. In all examinations the type of hydrocephalus, severity, symmetry, evolution and time of diagnosis were defined. The patients were submitted to morphologic ultrasound in the search of other anatomical abnormalities. The amniotic fluid index and fetal deaths were registered. The main ultrasonographic findings were correlated with perinatal mortality. For statistical analysis, chi² test and exact Fisher test were used. The value of p<0,05 was considered to be significant. Results: a total of 20 deaths were observed (44.4%), 6 occurred intra-uterus and 14 in the neonatal period. The diagnosis of hydrocephalus was established at a mean gestational age of 29 weeks. There was no association between perinatal mortality and alterations in the amniotic fluid volume, time of diagnosis, symmetry and type of hydrocephalus and the presence of other intra- or extracranial anomalies. On the other hand, the severity of the disease was associated significantly with perinatal death (p<0.0001). Conclusion: among all the analyzed ultrasonographic parameters, only the severity of hydrocephalus presented statistical association with perinatal death.
Summary
Rev Bras Ginecol Obstet. 2006;28(8):446-452
DOI 10.1590/S0100-72032006000800002
PURPOSE: to describe the obstetric outcomes in pregnant adolescents at a tertiary hospital and to compare the maternal and labor outcomes between precocious and late adolescents. METHODS: in a transversal analytical study, 2058 cases were evaluated, considering 322 (15.65%) from the precocious group and 1736 (84.35%) from the late group that delivered at the "Maternidade Escola Assis Chateaubriand/UFC" from January 1, 2000 to December 31, 2000. The clinical complications in the prenatal period, kind of delivery, indications for cesarean section, birth gestational age at birth, birth weight, comparison of birth weight and gestational age, Apgar score at the first and fifth minute, presence of malformations, and neonatal death were analyzed. The exact Fisher and the chi2 tests were used to compare both groups. The prevalence ratio was calculated. RESULTS: from of total of deliveries, 25.95% belonged to adolescents. The average age was 17.19 years. Prenatal visits were made by 88% of the patients, but 60% had an insufficient number of visits. The most frequent clinical situations were preeclampsia (14.72%), anemia (12.97%) and urinary tract infections (6.37%), with no statistical difference between the groups. Thirty-one and three percent of the births were by cesarean section, preeclampsia being the main indication in the two age groups (25 and 23%, respectively). The frequency of an Apgar score less than 7 at the first minute was 19,9% in the precocious adolescent group and 14,2% in the late adolescent group (x²=6,96, p=0.008). There was no statistical difference regarding prematurity rate (20.2 vs 16.1%), low-birth weight infants (12.4 vs 10.4%), low Apgar score at the fifth minute (5.3 vs 3.3%), congenital malformations (3.1 vs 2.7%), and neonatal death (5.3 vs 3.3%). CONCLUSIONS: the precocious and late pregnant adolescents presented similar pregnancy evolution and obstetric outcomes, except for the differences of the first minute Apgar scores.
Summary
Rev Bras Ginecol Obstet. 2006;28(8):446-452
DOI 10.1590/S0100-72032006000800002
PURPOSE: to describe the obstetric outcomes in pregnant adolescents at a tertiary hospital and to compare the maternal and labor outcomes between precocious and late adolescents. METHODS: in a transversal analytical study, 2058 cases were evaluated, considering 322 (15.65%) from the precocious group and 1736 (84.35%) from the late group that delivered at the "Maternidade Escola Assis Chateaubriand/UFC" from January 1, 2000 to December 31, 2000. The clinical complications in the prenatal period, kind of delivery, indications for cesarean section, birth gestational age at birth, birth weight, comparison of birth weight and gestational age, Apgar score at the first and fifth minute, presence of malformations, and neonatal death were analyzed. The exact Fisher and the chi2 tests were used to compare both groups. The prevalence ratio was calculated. RESULTS: from of total of deliveries, 25.95% belonged to adolescents. The average age was 17.19 years. Prenatal visits were made by 88% of the patients, but 60% had an insufficient number of visits. The most frequent clinical situations were preeclampsia (14.72%), anemia (12.97%) and urinary tract infections (6.37%), with no statistical difference between the groups. Thirty-one and three percent of the births were by cesarean section, preeclampsia being the main indication in the two age groups (25 and 23%, respectively). The frequency of an Apgar score less than 7 at the first minute was 19,9% in the precocious adolescent group and 14,2% in the late adolescent group (x²=6,96, p=0.008). There was no statistical difference regarding prematurity rate (20.2 vs 16.1%), low-birth weight infants (12.4 vs 10.4%), low Apgar score at the fifth minute (5.3 vs 3.3%), congenital malformations (3.1 vs 2.7%), and neonatal death (5.3 vs 3.3%). CONCLUSIONS: the precocious and late pregnant adolescents presented similar pregnancy evolution and obstetric outcomes, except for the differences of the first minute Apgar scores.