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  • Review Article

    Pregestational Diabetes and Congenital Heart Defects

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):953-961

    Summary

    Review Article

    Pregestational Diabetes and Congenital Heart Defects

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):953-961

    DOI 10.1055/s-0042-1755458

    Views47

    Abstract

    Studies have consistently shown a significant increase in the risk of congenital heart defects in the offspring of diabetic mothers compared with those of nondiabetic pregnancies. Evidence points that all types of pregestational diabetes have the capacity of generating cardiac malformations in a more accentuated manner than in gestational diabetes, and there seems to be an increased risk for all congenital heart defects phenotypes in the presence of maternal diabetes. Currently, the application of some therapies is under study in an attempt to reduce the risks inherent to diabetic pregnancies; however, it has not yet been possible to fully prove their effectiveness. The present review aims to better understand the mechanisms that govern the association between pregestational diabetes and congenital heart defects and how maternal diabetes interferes with fetal cardiac development, as there is still a long way to go in the investigation of this complex process.

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    Pregestational Diabetes and Congenital Heart Defects
  • Review

    Doppler Ultrasound of the Umbilical Artery: Clinical Application

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):519-531

    Summary

    Review

    Doppler Ultrasound of the Umbilical Artery: Clinical Application

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):519-531

    DOI 10.1055/s-0042-1743097

    Views31

    Abstract

    Objective

    To provide a survey of relevant literature on umbilical artery Doppler ultrasound use in clinical practice, technical considerations and limitations, and future perspectives.

    Methods

    Literature searches were conducted in PubMed and Medline, restricted to articles written in English. Additionally, the references of all analyzed studies were searched to obtain necessary information.

    Results

    The use of this technique as a routine surveillance method is only recommended for high-risk pregnancies with impaired placentation. Meta-analyses of randomized trials have established that obstetric management guided by umbilical artery Doppler findings can improve perinatal mortality and morbidity. The values of the indices of Umbilical artery Doppler decrease with advancing gestational age; however, a lack of consensus on reference ranges prevails.

    Conclusion

    Important clinical decisions are based on the information obtained with umbilical artery Doppler ultrasound. Future efforts in research are imperative to overcome the current limitations of the technique.

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    Doppler Ultrasound of the Umbilical Artery: Clinical Application
  • Case Report

    Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(2):92-95

    Summary

    Case Report

    Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(2):92-95

    DOI 10.1055/s-0037-1613690

    Views23

    Abstract

    Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies. Both women recovered, and the postpartum evaluation revealed a normal uterus with an adequate blood supply, suggesting potential fertility, as described in the literature regarding this kind of therapeutic approach.

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    Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony

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