You searched for:"Rosiane Mattar"
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Summary
Rev Bras Ginecol Obstet. 2015;37(3):101-104
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Rev Bras Ginecol Obstet. 2003;25(2):103-107
DOI 10.1590/S0100-72032003000200005
PURPOSE: to study the causes and associated factors of fetal death. METHODS: epidemiological descriptive study, composed of 190 cases of fetal loss amongst 11,825 pregnant women that gave birth at the two only hospitals (Casa de Saúde Divino Espírito Santo and Hospital Nossa Senhora Auxiliadora) of Caratinga City, in the State of Minas Gerais, Brazil, in the period from January 1, 1995 to April 30, 2000. The variables were the number of pregnancies, the timing of the pregnant women at the time of hospitalization, the occurrence of fetal death in relation to delivery and the cause of fetal death. Since there were no comparative groups, tables, percentages and arithmetical means were applied, following the guidelines of the Course of Statistics, of the "Universidade Federal de São Paulo". RESULTS: among the 189 pregnant women with fetal death, 77 were primigravidal and 76 had already been pregnant 2 to 5 times. The gestational age in 113 women was from 20 to 37 weeks. In relation to parturition, the fetal loss occurred during the antepartum period in 164 of 190 dead fetuses. The most frequently noticed death causes were: abruptio placentae in 35 cases, fetal anomaly in 12 cases, and hypertension syndrome in 8 cases. Nervertheless, there was no explanation for the etiology of 117 cases of fetal death. CONCLUSION: stillbirth has frequently been observed among the primigravidae (40.74%), in preterm period (59.79%), and in the antepartum period (86.31%). Among fetal death causes, the most frequent was a abruptio placentae (18.42%), and in 61.57% of the cases the fetal death could not be explained.
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Rev Bras Ginecol Obstet. 2023;45(2):104-108
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Rev Bras Ginecol Obstet. 2022;44(12):1083-1089
To compare the efficacy of quadratus lumborum (QL) block and intrathecal morphine (M) for postcesarean delivery analgesia.
Thirty-one pregnant women with ≥ 37 weeks of gestation submitted to elective cesarean section were included in the study. They were randomly allocated to either the QL group (12.5 mg 0.5% bupivacaine for spinal anesthesia and 0.3 ml/kg 0.2% bupivacaine for QL block) or the M group (12.5 mg bupivacaine 0.5% and 100 mcg of morphine in spinal anesthesia). The visual analog scale of pain, consumption of morphine and tramadol for pain relief in 48 hours, and side effects were recorded.
Median pain score and/or pain variation were higher in the morphine group than in the QL group (p = 0.02). There was no significant difference in the consumption of morphine or tramadol between groups over time. Side effects such as pruritus, nausea, and vomiting were observed only in the morphine group.
Quadratus lumborum block and intrathecal morphine are effective for analgesia after cesarean section. Patients undergoing QL block had lower postoperative pain scores without the undesirable side effects of opioids such as nausea, vomiting, and pruritus.
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Rev Bras Ginecol Obstet. 2023;45(3):109-112
Summary
Rev Bras Ginecol Obstet. 2023;45(1):11-20
Systemic lupus erythematosus (SLE) may cause irreversible organ damage. Pregnancy with SLE may have severe life-threatening risks. The present study aimed to determine the prevalence of severe maternal morbidity (SMM) in patients with SLE and analyze the parameters that contributed to cases of greater severity.
This is a cross-sectional retrospective study from analysis of data retrieved from medical records of pregnant women with SLE treated at a University Hospital in Brazil. The pregnant women were divided in a control group without complications, a group with potentially life-threatening conditions (PLTC), and a group with maternal near miss (MNM).
The maternal near miss rate was 112.9 per 1,000 live births. The majority of PLTC (83.9%) and MNM (92.9%) cases had preterm deliveries with statistically significant increased risk compared with the control group (p = 0.0042; odds ratio [OR]: 12.05; 95% confidence interval [CI]: 1.5–96.6 for the MNM group and p = 0.0001; OR: 4.84; 95%CI: 2.2–10.8 for the PLTC group). Severe maternal morbidity increases the risk of longer hospitalization (p < 0.0001; OR: 18.8; 95%CI: 7.0–50.6 and p < 0.0001; OR: 158.17; 95%CI: 17.6–1424,2 for the PLTC and MNM groups, respectively), newborns with low birthweight (p = 0.0006; OR: 3.67; 95%CI: 1.7–7.9 and p = 0.0009; OR: 17.68; 95%CI: 2–153.6) for the PLTC and MNM groups, respectively] as well as renal diseases (PLTC [8.9%; 33/56; p = 0.0069] and MNM [78.6%; 11/14; p = 0.0026]). Maternal near miss cases presented increased risk for neonatal death (p = 0.0128; OR: 38.4; 95%CI: 3.3–440.3]), and stillbirth and miscarriage (p = 0.0011; OR: 7.68; 95%CI: 2.2–26.3]).
Systemic lupus erythematosus was significantly associated with severe maternal morbidity, longer hospitalizations, and increased risk of poor obstetric and neonatal outcomes.