Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
You searched for:"Nuno Aires Mota de Mendonça Montenegro"
We found (2) results for your search.Summary
Rev Bras Ginecol Obstet. 2008;30(3):149-159
DOI 10.1590/S0100-72032008000300008
It is advisable to do the non-invasive diagnosis of ectopic pregnancy precociously, before there is the tube rupture, combining for that the transvaginal ultrasonography with the dosage of the b-fraction of the chorionic gonadotrophin. A range of treatment options may be used. Either a surgical intervention or a clinical treatment may be taken into consideration. Laparotomy is indicated in cases of hemodynamic instability. Laparoscopy is the preferential route for the treatment of tube pregnancy. Salpingectomy should be performed in patients having the desired number of children, while salpingostomy should be indicated in patients willing to have more children, when the b-hCG titers are under 5,000 mUI/mL and the surgical conditions are favorable. The use of methotrexate (MTX) is a consecrated clinical procedure and should be indicated as the first option of treatment. The main criteria for MTX indication are hemodynamic stability, b-hCG <5,000 mUI/mL, anexial mass <3,5 cm, and no alive embryo. It is preferable a single intramuscular dose of 50 mg/m², because it is easier, more practical and with less side effects. Protocol with multiple doses should be restricted for the cases with atypical localization (interstitial, cervical, caesarean section scar and ovarian) with values of b-hCG >5,000 mUI/mL and no alive embryo. Indication for local treatment with an injection of MTX (1 mg/kg) guided by transvaginal ultrasonography should occur in cases of alive embryos, but with an atypical localization. An expectant conduct should be indicated in cases of decrease in the b-hCG titers within 48 hous before the treatment, and when the initial titers are under 1,500 mUI/mL. There are controversies between salpingectomy and salpingostomy, concerning the reproductive future. Till we reach an agreement in the literature, the advice to patients who are looking forward to a future gestation, is to choose either surgical or clinical conservative conducts.
Summary
Rev Bras Ginecol Obstet. 2008;30(3):149-159
DOI 10.1590/S0100-72032008000300008
It is advisable to do the non-invasive diagnosis of ectopic pregnancy precociously, before there is the tube rupture, combining for that the transvaginal ultrasonography with the dosage of the b-fraction of the chorionic gonadotrophin. A range of treatment options may be used. Either a surgical intervention or a clinical treatment may be taken into consideration. Laparotomy is indicated in cases of hemodynamic instability. Laparoscopy is the preferential route for the treatment of tube pregnancy. Salpingectomy should be performed in patients having the desired number of children, while salpingostomy should be indicated in patients willing to have more children, when the b-hCG titers are under 5,000 mUI/mL and the surgical conditions are favorable. The use of methotrexate (MTX) is a consecrated clinical procedure and should be indicated as the first option of treatment. The main criteria for MTX indication are hemodynamic stability, b-hCG <5,000 mUI/mL, anexial mass <3,5 cm, and no alive embryo. It is preferable a single intramuscular dose of 50 mg/m², because it is easier, more practical and with less side effects. Protocol with multiple doses should be restricted for the cases with atypical localization (interstitial, cervical, caesarean section scar and ovarian) with values of b-hCG >5,000 mUI/mL and no alive embryo. Indication for local treatment with an injection of MTX (1 mg/kg) guided by transvaginal ultrasonography should occur in cases of alive embryos, but with an atypical localization. An expectant conduct should be indicated in cases of decrease in the b-hCG titers within 48 hous before the treatment, and when the initial titers are under 1,500 mUI/mL. There are controversies between salpingectomy and salpingostomy, concerning the reproductive future. Till we reach an agreement in the literature, the advice to patients who are looking forward to a future gestation, is to choose either surgical or clinical conservative conducts.
Summary
Rev Bras Ginecol Obstet. 2015;37(10):467-472
DOI 10.1590/SO100-720320150005440
The administration of a single-course antenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks with risk of premature birth. The maximum effect is achieved when antenatal corticosteroids are administered between 24h and 7 days before delivery. The objective of this study was to evaluate the occurrence of birth within seven days of corticosteroid therapy in major obstetric situations with risk of preterm birth
Retrospective cohort study including 209 pregnant women hospitalized in risk of preterm delivery, submitted to corticosteroid therapy for fetal lung maturation. The study was carried out between January 2012 and March 2014 at a university hospital. Main outcome measure was the number of women who delivered within 7 da ys after antenatal corticosteroid administration. Two groups were defined according to the reason for starting corticosteroids: threatened preterm labour (Group APPT) and other indications for corticosteroid therapy (Group RPPT). A Kaplan-Meier survival analysis was performed and a p value <0.05 was considered statistically significant.
46.4% (n=97) of pregnant women gave birth in the seven days following corticosteroid administration. Delivery within 7 days occurred more frequently on group 2 in comparison to group 1 (57.3 versus42.4%; p=0.001). There is a statistically significant difference between the survival curve for groups 1 and 2, with a hazard ratio for delivery within 7 days 1.71 times higher for group 2 (95%CI 1.23-2.37; p<0.001)
It can be concluded that the probability of an event (birth within 7 days after corticosteroids) is smaller in the group of pregnant women admitted in the context of threatened preterm labor than for other indications. The use of corticosteroids in pregnant women admitted for suspected preterm labor should be subject to rigorous clinical evaluation
Summary
Rev Bras Ginecol Obstet. 2015;37(10):467-472
DOI 10.1590/SO100-720320150005440
The administration of a single-course antenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks with risk of premature birth. The maximum effect is achieved when antenatal corticosteroids are administered between 24h and 7 days before delivery. The objective of this study was to evaluate the occurrence of birth within seven days of corticosteroid therapy in major obstetric situations with risk of preterm birth
Retrospective cohort study including 209 pregnant women hospitalized in risk of preterm delivery, submitted to corticosteroid therapy for fetal lung maturation. The study was carried out between January 2012 and March 2014 at a university hospital. Main outcome measure was the number of women who delivered within 7 da ys after antenatal corticosteroid administration. Two groups were defined according to the reason for starting corticosteroids: threatened preterm labour (Group APPT) and other indications for corticosteroid therapy (Group RPPT). A Kaplan-Meier survival analysis was performed and a p value <0.05 was considered statistically significant.
46.4% (n=97) of pregnant women gave birth in the seven days following corticosteroid administration. Delivery within 7 days occurred more frequently on group 2 in comparison to group 1 (57.3 versus42.4%; p=0.001). There is a statistically significant difference between the survival curve for groups 1 and 2, with a hazard ratio for delivery within 7 days 1.71 times higher for group 2 (95%CI 1.23-2.37; p<0.001)
It can be concluded that the probability of an event (birth within 7 days after corticosteroids) is smaller in the group of pregnant women admitted in the context of threatened preterm labor than for other indications. The use of corticosteroids in pregnant women admitted for suspected preterm labor should be subject to rigorous clinical evaluation
