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Rev Bras Ginecol Obstet. 2011;33(3):118-122
DOI 10.1590/S0100-72032011000300003
PURPOSE: to determine the efficacy and safety of dinoprostone and misoprostol for the induction of vaginal childbirth, with or without the use of oxytocin in nulliparous women. METHODS: in this retrospective observational study, 238 patients were subjected to the induction of delivery from January 2008 to February 2010 with the use of misoprostol 25 mcg by the vaginal route or a pessary containing 10 mg of dinoprostone. A total of 184 patients were selected, with the following characteristics: nulliparous, gestational age of 37-42 weeks, singleton pregnancies, cephalic presentation, intact membranes, and Bishop score < 3. Obstetric and neonatal data were analyzed and compared between groups. The Student t-test, chi-square test and Fisher's exact test were used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the rate of vaginal childbirth did not differ significantly in patients who used misoprostol and dinoprostone (43.2% versus 50%; p = 0.35, respectively). The ripening of cervix was higher in the group treated with misoprostol (87.3% versus 75.6%, p=0.04). The use of oxytocin was necessary in 58.8% of the misoprostol group and 57.3% in the dinoprostone group after the ripening of cervix. Failed induction was the primary indication of caesarean section delivery in both groups, with no significant difference between them. Fetal and maternal adverse events, such as tachysystole and Apgar scores were similar. CONCLUSION: dinoprostone and misoprostol are both effective for vaginal childbirth induction, although they need to be combined with oxytocin. They showed a similar safety profile, with misoprostol being more efficient regarding cervical ripening.
Summary
Rev Bras Ginecol Obstet. 2011;33(3):118-122
DOI 10.1590/S0100-72032011000300003
PURPOSE: to determine the efficacy and safety of dinoprostone and misoprostol for the induction of vaginal childbirth, with or without the use of oxytocin in nulliparous women. METHODS: in this retrospective observational study, 238 patients were subjected to the induction of delivery from January 2008 to February 2010 with the use of misoprostol 25 mcg by the vaginal route or a pessary containing 10 mg of dinoprostone. A total of 184 patients were selected, with the following characteristics: nulliparous, gestational age of 37-42 weeks, singleton pregnancies, cephalic presentation, intact membranes, and Bishop score < 3. Obstetric and neonatal data were analyzed and compared between groups. The Student t-test, chi-square test and Fisher's exact test were used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the rate of vaginal childbirth did not differ significantly in patients who used misoprostol and dinoprostone (43.2% versus 50%; p = 0.35, respectively). The ripening of cervix was higher in the group treated with misoprostol (87.3% versus 75.6%, p=0.04). The use of oxytocin was necessary in 58.8% of the misoprostol group and 57.3% in the dinoprostone group after the ripening of cervix. Failed induction was the primary indication of caesarean section delivery in both groups, with no significant difference between them. Fetal and maternal adverse events, such as tachysystole and Apgar scores were similar. CONCLUSION: dinoprostone and misoprostol are both effective for vaginal childbirth induction, although they need to be combined with oxytocin. They showed a similar safety profile, with misoprostol being more efficient regarding cervical ripening.
Summary
Rev Bras Ginecol Obstet. 2016;38(4):183-188
The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs.
A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group.
We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p < 0.001). Low birth weight (2,620 g versus 3,333 g on average, p < 0.001) and maternal syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs.
The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs.
Summary
Rev Bras Ginecol Obstet. 2016;38(4):183-188
The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs.
A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group.
We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p < 0.001). Low birth weight (2,620 g versus 3,333 g on average, p < 0.001) and maternal syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs.
The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs.
Summary
Rev Bras Ginecol Obstet. 2011;33(6):271-275
DOI 10.1590/S0100-72032011000600002
PURPOSE: to investigate the association between gene polymorphism of the progesterone receptor (PROGINS) and the risk of premature birth. METHODS: In this case-control study, 57 women with previous premature delivery (Case Group) and 57 patients with delivery at term in the current pregnancy and no history of preterm delivery (Control Group) were selected. A 10 mL amount of peripheral blood was collected by venipuncture and genomic DNA was extracted followed by the polymerase chain reaction (PCR) under specific conditions for this polymorphism and 2% agarose gel electrophoresis. The bands were visualized with an ultraviolet light transilluminator. Genotype and allele PROGINS frequencies were compared between the two groups by the χ2 test, with the level of significance set at value p<0.05. The Odds Ratio (OR) was also used, with 95% confidence intervals. RESULTS: PROGINS genotypic frequencies were 75.4% T1/T1, 22.8% T1/T2 and 1.8% T2/T2 in the Group with Preterm Delivery and 80.7% T1/T1, 19.3% T1/T2 and 0% T2/T2 in the term Delivery Group. There were no differences between groups when genotype and allele frequencies were analyzed: p=0.4 (OR=0.7) and p=0.4 (OR=0.7). CONCLUSIONS: the present study suggests that the presence of PROGINS polymorphism in our population does not constitute a risk factor for premature birth.
Summary
Rev Bras Ginecol Obstet. 2011;33(6):271-275
DOI 10.1590/S0100-72032011000600002
PURPOSE: to investigate the association between gene polymorphism of the progesterone receptor (PROGINS) and the risk of premature birth. METHODS: In this case-control study, 57 women with previous premature delivery (Case Group) and 57 patients with delivery at term in the current pregnancy and no history of preterm delivery (Control Group) were selected. A 10 mL amount of peripheral blood was collected by venipuncture and genomic DNA was extracted followed by the polymerase chain reaction (PCR) under specific conditions for this polymorphism and 2% agarose gel electrophoresis. The bands were visualized with an ultraviolet light transilluminator. Genotype and allele PROGINS frequencies were compared between the two groups by the χ2 test, with the level of significance set at value p<0.05. The Odds Ratio (OR) was also used, with 95% confidence intervals. RESULTS: PROGINS genotypic frequencies were 75.4% T1/T1, 22.8% T1/T2 and 1.8% T2/T2 in the Group with Preterm Delivery and 80.7% T1/T1, 19.3% T1/T2 and 0% T2/T2 in the term Delivery Group. There were no differences between groups when genotype and allele frequencies were analyzed: p=0.4 (OR=0.7) and p=0.4 (OR=0.7). CONCLUSIONS: the present study suggests that the presence of PROGINS polymorphism in our population does not constitute a risk factor for premature birth.
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Rev Bras Ginecol Obstet. 2022;44(5):452-457
, , , To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.
The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.
There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.
Summary
Rev Bras Ginecol Obstet. 2022;44(5):452-457
, , , To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.
The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.
There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.
Summary
Rev Bras Ginecol Obstet. 2000;22(10):633-639
DOI 10.1590/S0100-72032000001000006
Purpose: to evaluate the risk of preterm delivery using the fetal fibronectin test and the measurement of the cervix by transvaginal ultrasonography in pregnant women with previous preterm delivery. Methods: one hundred and seven women were enrolled in the study at 24th, 28thand 32ndweek to detect the presence of fetal fibronectin by immediate-reading membrane test and to perform vaginal ultrasonography to measure the length of the cervix between the internal and external cervical os. The cervix was considered to be short when the cervical length was at or below the cutoff set by the receiver-operating characteristic (ROC) curve for prediction of preterm delivery. Sonographic cervical length and fetal fibronectin were compared to assess the risk of preterm birth before 34 and 37 weeks. Results: the spontaneous preterm delivery rate was 37.4% (40/107). The analysis made by the ROC curve indicated 30 mm as the best cutoff to maximize sensitivity and specificity at 24 and 28 weeks and 25 mm at 32 weeks of gestation. The positive test of fetal fibronectin had a significant relative risk (RR: 1.77; 95% confidence interval (IC): 1.10-2.84) to predict delivery before 37 weeks, when compared with a negative test, only at 28 weeks. The presence of short cervix at 24, 28 and 32 weeks showed a significative RR for birth before 37 weeks. The highest RR occurred with a short cervix at 24 weeks (RR: 4.42; 95% CI: 1.25-15.56). Conclusion: we concluded that the measurement of uterine cervix by vaginal ultrasonography is better than the fetal fibronectin test for evaluating the risk of preterm delivery in women with previous preterm delivery.
Summary
Rev Bras Ginecol Obstet. 2000;22(10):633-639
DOI 10.1590/S0100-72032000001000006
Purpose: to evaluate the risk of preterm delivery using the fetal fibronectin test and the measurement of the cervix by transvaginal ultrasonography in pregnant women with previous preterm delivery. Methods: one hundred and seven women were enrolled in the study at 24th, 28thand 32ndweek to detect the presence of fetal fibronectin by immediate-reading membrane test and to perform vaginal ultrasonography to measure the length of the cervix between the internal and external cervical os. The cervix was considered to be short when the cervical length was at or below the cutoff set by the receiver-operating characteristic (ROC) curve for prediction of preterm delivery. Sonographic cervical length and fetal fibronectin were compared to assess the risk of preterm birth before 34 and 37 weeks. Results: the spontaneous preterm delivery rate was 37.4% (40/107). The analysis made by the ROC curve indicated 30 mm as the best cutoff to maximize sensitivity and specificity at 24 and 28 weeks and 25 mm at 32 weeks of gestation. The positive test of fetal fibronectin had a significant relative risk (RR: 1.77; 95% confidence interval (IC): 1.10-2.84) to predict delivery before 37 weeks, when compared with a negative test, only at 28 weeks. The presence of short cervix at 24, 28 and 32 weeks showed a significative RR for birth before 37 weeks. The highest RR occurred with a short cervix at 24 weeks (RR: 4.42; 95% CI: 1.25-15.56). Conclusion: we concluded that the measurement of uterine cervix by vaginal ultrasonography is better than the fetal fibronectin test for evaluating the risk of preterm delivery in women with previous preterm delivery.
