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Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(8):475-479
DOI 10.1590/S0100-72031999000800008
SUMMARY Purpose: to evaluate the role of prenatal diagnosis of gastroschisis in the quality of assistance to and in the evolution of neonates with gastroschisis. Methods: a retrospective survey of 25 charts of neonates with gastroschisis treated at the State University of Campinas, between January 1989 and June 1998. Results: comparing the groups with prenatal (PN) and neonatal (NN) diagnosis, no differences regarding incidence of prematurity, birth weight and relations hip between weight and gestational age were observed. The median time from birth to surgery was 5 h. Such interval was shorter in the PN than the NN group (2.25 h versus 13 h; p<0.05). Primary closure of the defect was achieved in 17 neonates (68%) of both groups. Although this difference was not statistically significant, survival was higher among infants of the PN group (85.7% versus 45.5%). Conclusions: prenatal diagnosis of gastroschisis contributes favorably to improve perinatal assistance, resulting in reduced mortality of these children.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(8):475-479
DOI 10.1590/S0100-72031999000800008
SUMMARY Purpose: to evaluate the role of prenatal diagnosis of gastroschisis in the quality of assistance to and in the evolution of neonates with gastroschisis. Methods: a retrospective survey of 25 charts of neonates with gastroschisis treated at the State University of Campinas, between January 1989 and June 1998. Results: comparing the groups with prenatal (PN) and neonatal (NN) diagnosis, no differences regarding incidence of prematurity, birth weight and relations hip between weight and gestational age were observed. The median time from birth to surgery was 5 h. Such interval was shorter in the PN than the NN group (2.25 h versus 13 h; p<0.05). Primary closure of the defect was achieved in 17 neonates (68%) of both groups. Although this difference was not statistically significant, survival was higher among infants of the PN group (85.7% versus 45.5%). Conclusions: prenatal diagnosis of gastroschisis contributes favorably to improve perinatal assistance, resulting in reduced mortality of these children.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):177-184
DOI 10.1590/S0100-72032004000300002
PURPOSE: to assess the use of antenatal corticosteroid (AC) by mothers and its repercussion on the birth conditions of preterm babies at the eight university neonatal units belonging to the Brazilian Network of Neonatal Research. METHODS: an observational prospective cohort study. All 463 pregnant women with a gestational age (GA) of 23 to 34 weeks and their 514 newborn babies were evaluated during the period from August 1 to December 31, 2001. The data were obtained by maternal interview, by the analysis of the medical records and by the follow-up of the newborn infants, and analyzed statistically using chi2, Mann-Whitney and ANOVA tests and multiple logistic regression, with the level of significance set at 0.05. RESULTS: 60.1% (282/463) of the pregnant women (a variation from 12.5 to 87.3% among units) received at least one AC dose. The AC use was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented higher birth weight (1,379±421 vs 1,244±543 g), longer gestational age (30.9±2.0 vs 29.5±3.5 weeks), better Apgar scores at the 1st and 5th minute, and a reduced need for intervention in the delivery room. The use of AC, the GA and a baby small for GA independently improved the birth conditions. CONCLUSIONS: at most centers, AC was administered at frequencies below the desired ones, and in 50% of cases in an inadequate manner. Treatment was applied more to mothers who received appropriate prenatal care and was associated with better birth conditions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):177-184
DOI 10.1590/S0100-72032004000300002
PURPOSE: to assess the use of antenatal corticosteroid (AC) by mothers and its repercussion on the birth conditions of preterm babies at the eight university neonatal units belonging to the Brazilian Network of Neonatal Research. METHODS: an observational prospective cohort study. All 463 pregnant women with a gestational age (GA) of 23 to 34 weeks and their 514 newborn babies were evaluated during the period from August 1 to December 31, 2001. The data were obtained by maternal interview, by the analysis of the medical records and by the follow-up of the newborn infants, and analyzed statistically using chi2, Mann-Whitney and ANOVA tests and multiple logistic regression, with the level of significance set at 0.05. RESULTS: 60.1% (282/463) of the pregnant women (a variation from 12.5 to 87.3% among units) received at least one AC dose. The AC use was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented higher birth weight (1,379±421 vs 1,244±543 g), longer gestational age (30.9±2.0 vs 29.5±3.5 weeks), better Apgar scores at the 1st and 5th minute, and a reduced need for intervention in the delivery room. The use of AC, the GA and a baby small for GA independently improved the birth conditions. CONCLUSIONS: at most centers, AC was administered at frequencies below the desired ones, and in 50% of cases in an inadequate manner. Treatment was applied more to mothers who received appropriate prenatal care and was associated with better birth conditions.