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You searched for:"Simone Angélica Leite de Carvalho Silva"
We found (4) results for your search.Summary
Rev Bras Ginecol Obstet. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Summary
Rev Bras Ginecol Obstet. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Summary
Rev Bras Ginecol Obstet. 2004;26(3):256-256
Summary
Rev Bras Ginecol Obstet. 2004;26(3):256-256
Summary
Rev Bras Ginecol Obstet. 2002;24(9):579-584
DOI 10.1590/S0100-72032002000900003
Purpose: to evaluate the sensitivity, specificity, positive and negative predictive values of a clinical and an ecographic method for adenomyosis diagnosis. Methods: a transversal study of validation of the diagnostic method was done, including 95 women in menacme submitted to hysterectomy for various causes. Adenomyosis was diagnosed through a clinical method in women aged 40 years or older, with 2 or more deliveries, increased menstrual bleeding associated with dysmenorrhea. The ecographic diagnosis was established if at least one myometrial ill defined area of abnormal ecotexture was found, which could be hypoechoic, hyperchoic, heterogeneous or cystic. Gold standard was histopathology, defined as the finding of endometrial glands or stroma more than 2.5 cm above the endomiometrial junction. Results: the clinical method had 68.2% sensitivity, 78.1% specificity, 48.4% positive predictive value and 89.1% negative predictive value. For the echographic method this figures were, respectively, 45.5%, 84.9%, 47.6% and 83.8%. Likelihood ratio was 3.11 for the clinical and 3.03 for the echographic method. Considering only those simultaneously positive cases by both methods, sensitivity was below 30% and specificity was near 100%. Considering all positive cases by one or the other method or concomitanty by both, the sensitivity reached 86% and specificity was 60%. Conclusion: the echographic method was not better than the clinical for the diagnosis of adenomyosis.
Summary
Rev Bras Ginecol Obstet. 2002;24(9):579-584
DOI 10.1590/S0100-72032002000900003
Purpose: to evaluate the sensitivity, specificity, positive and negative predictive values of a clinical and an ecographic method for adenomyosis diagnosis. Methods: a transversal study of validation of the diagnostic method was done, including 95 women in menacme submitted to hysterectomy for various causes. Adenomyosis was diagnosed through a clinical method in women aged 40 years or older, with 2 or more deliveries, increased menstrual bleeding associated with dysmenorrhea. The ecographic diagnosis was established if at least one myometrial ill defined area of abnormal ecotexture was found, which could be hypoechoic, hyperchoic, heterogeneous or cystic. Gold standard was histopathology, defined as the finding of endometrial glands or stroma more than 2.5 cm above the endomiometrial junction. Results: the clinical method had 68.2% sensitivity, 78.1% specificity, 48.4% positive predictive value and 89.1% negative predictive value. For the echographic method this figures were, respectively, 45.5%, 84.9%, 47.6% and 83.8%. Likelihood ratio was 3.11 for the clinical and 3.03 for the echographic method. Considering only those simultaneously positive cases by both methods, sensitivity was below 30% and specificity was near 100%. Considering all positive cases by one or the other method or concomitanty by both, the sensitivity reached 86% and specificity was 60%. Conclusion: the echographic method was not better than the clinical for the diagnosis of adenomyosis.
Summary
Rev Bras Ginecol Obstet. 2003;25(10):739-744
DOI 10.1590/S0100-72032003001000007
PURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.
Summary
Rev Bras Ginecol Obstet. 2003;25(10):739-744
DOI 10.1590/S0100-72032003001000007
PURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.