This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes the behavior of ...these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia.
Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group.
Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p<0.05.
The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR.
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The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
Introduction This project is part of a line of research aimed at identifying possible laboratory and anthropometric markers in the mediate postpartum period, compared to healthy women. It observes ...the behavior of these effectors in the maternal organism, collaborating with the prediction and prevention of preeclampsia. Objective Identify in the mediate postpartum period, lipotoxicity markers and anthropometric profile in postpartum women with preeclampsia compared with control group. Methods Cross-sectional study developed at the Guilherme Álvaro Hospital – Santos/Brazil. It was collected blood samples and anthropometric data of 132 women (56 cases and 76 controls) in the mediate postpartum during January 2015 to May 2016. Laboratory markers were analyzed to possibly associate with preeclampsia. Case group: patients with preeclampsia according to the criteria of NHBPEP – National High Blood Pressure Education Program (2000). Control group: women after vaginal delivery with term newborn, without hypertension and/or other comorbidities. Variables analyzed: maternal age, gestational age, body mass index (BMI), neck, arm and abdominal circumferences and newborn weight. Laboratory variables: total cholesterol and High Density Lipoprotein (HDL) fraction, triglycerides, serum creatinine, uric acid, alanine aminotransferase (ALT), total protein, albumin, C-reactive protein (CRP), fasting glucose and HOMA-IR index. Exclusion criteria for both groups: previously diagnosed diabetes mellitus, collagen diseases, smoking, twin pregnancy and fetal malformations. For the numerical variables of the research it was used the Student’s t test and for the statistical analysis the Fisher’s exact test. The significance level was p < 0.05. Results The results allow us to affirm that the groups differ from each other in the variables: maternal age, gestational age, newborn weight, BMI, abdominal, arm and neck circumferences, albumin, CRP, ALT, uric acid, glucose, and HOMA-IR. Conclusion The present study shows that women with preeclampsia have higher body mass index, larger body circumferences, they are older and have an increased insulin resistance than normal ones. Analyzing the study group individually, we can observe that those patients have premature babies and lower birth weight more often. It is also notice increased levels in the study group compared to the control group in non-specific inflammatory (CRP), hepatic (ALT) and renal (uric acid) markers. Albumin was higher in the control group.
Objectives Describe the epidemiological profile of pregnant diagnosed with pre-eclampsia (PE) as well as the outcome of obstetric and neonatal. Methods Cohort study conducted by collecting data from ...45 pregnant women diagnosed with PE that gave birth during the years 2012 and 2013 at Guilherme Álvaro Hospital, Santos–SP, Brazil. The survey was conducted from the hospital records of these women and their newborns since their admission until delivery. The diagnosis of PE followed the recommendations do National High Blood Pressure Education program-2000. Results The descriptive analysis from the study group has an average age of 28 years (18–35 years old), preferably residents from Santos, white race and first pregnancy. Laboratory features presented were hemoglobin 10.9 ⩾ 1.7 mg/dL and hematocrit 32.7 ⩾ 5.4%. Regarding proteinuria, 80% of diagnoses were determined by 24-h sample and 20% by dipstick. As obstetric results obtained in 6.7% vaginal delivery, cesarean section in 93.3%, hypertensive crisis in the puerperium in 28.9%, use of hydralazine in 42.2%, a PE was classified as mild preeclampsia in 48.9%, severe in 28.9% and 22.2% superimposed. The premature newborns were 66.7%, regular birth weight in 55.6% and Apgar ⩾ 7 at first and fifth minute 72.7% and 90.9%, respectively. Conclusions Considering the high rate of Caesarean section, the productive age group of the lives of women most affected and prematurity can identify the potential of hypertensive disorders causing adverse social and perinatal outcomes. Puerperal complications represented primarily by hypertensive crises, stresses the need for skilled care and also during this period of pregnancy/cycle puerperal. These results may signal the need to adopt common strategies to prevent or reduce the damage from these disorders contributing to the improvement of the indicators pursued in obstetric care. Disclosures B. Moreno: None. J. Gregorio: None. M. dos Reis: None. M. Estorniol: None. A. de Lima: None. A. Menegazzo: None. C. de Siqueira: None. I. Trotti: None. E. de Souza: None. F. Sousa: None. J. Garcia: None. R. Guidoni: None.
Describe the epidemiological profile of pregnant diagnosed with pre-eclampsia (PE) as well as the outcome of obstetric and neonatal.
Cohort study conducted by collecting data from 45 pregnant women ...diagnosed with PE that gave birth during the years 2012 and 2013 at Guilherme Álvaro Hospital, Santos–SP, Brazil. The survey was conducted from the hospital records of these women and their newborns since their admission until delivery. The diagnosis of PE followed the recommendations do National High Blood Pressure Education program-2000.
The descriptive analysis from the study group has an average age of 28 years (18–35years old), preferably residents from Santos, white race and first pregnancy. Laboratory features presented were hemoglobin 10.9⩾1.7mg/dL and hematocrit 32.7⩾5.4%. Regarding proteinuria, 80% of diagnoses were determined by 24-h sample and 20% by dipstick. As obstetric results obtained in 6.7% vaginal delivery, cesarean section in 93.3%, hypertensive crisis in the puerperium in 28.9%, use of hydralazine in 42.2%, a PE was classified as mild preeclampsia in 48.9%, severe in 28.9% and 22.2% superimposed. The premature newborns were 66.7%, regular birth weight in 55.6% and Apgar⩾7 at first and fifth minute 72.7% and 90.9%, respectively.
Considering the high rate of Caesarean section, the productive age group of the lives of women most affected and prematurity can identify the potential of hypertensive disorders causing adverse social and perinatal outcomes. Puerperal complications represented primarily by hypertensive crises, stresses the need for skilled care and also during this period of pregnancy/cycle puerperal. These results may signal the need to adopt common strategies to prevent or reduce the damage from these disorders contributing to the improvement of the indicators pursued in obstetric care.
B. Moreno: None. J. Gregorio: None. M. dos Reis: None. M. Estorniol: None. A. de Lima: None. A. Menegazzo: None. C. de Siqueira: None. I. Trotti: None. E. de Souza: None. F. Sousa: None. J. Garcia: None. R. Guidoni: None.
Este estudo buscou analisar a assistência pré-natal oferecida às gestantes inscritas no Programa de Pré-Natal na Unidade Básica de Saúde do Rádio Clube (UBS-RC) do município de Santos, SP. Os ...objetivos foram: caracterizar as gestantes da UBS-RC do município de Santos, segundo dados sócio-demográficos e obstétricos; descrever a estrutura do serviço e analisar o processo de assistência pré-natal prestados às gestantes usuárias da UBS-RC. Trata-se de um estudo descritivo retrospectivo com coleta de dados feitos por meio de entrevista com o responsável pela unidade e de consulta aos dados de 366 prontuários de gestantes matriculadas no ano de 2009. A coleta dos dados foi realizada entre os meses de julho a novembro de 2010. A análise da estrutura e do processo foi baseada nos critérios estabelecidos pelo Ministério da Saúde (MS) em 2006 a partir das recomendações do Programa de Humanização do Pré-natal e Nascimento (PHPN). Os resultados mostram que as gestantes eram jovens, média da idade 24,9 anos, 59,6% casadas ou com união estável, 50,3% não branca, 50,3% com ensino médio, 32,2% primigestas. A estrutura do serviço atende aos requisitos para o desenvolvimento das ações preconizadas para a atenção pré-natal. Observou-se que 81,7% da amostra iniciaram o pré-natal até 120 dias da gestação; 64,8% fizeram o número mínimo de seis consultas; 44,0% tiveram pelo menos uma consulta no primeiro trimestre, duas no segundo trimestre, e três no terceiro trimestre; 38,5% tiveram o mínimo de seis consultas pré-natal e a consulta de puerpério; 6,6% tiveram o mínimo de seis consultas pré-natal e os exames básicos; 4,1% tiveram mínimo de seis consultas pré-natal, consulta de puerpério e exames básicos; 3,0% tiveram mínimo de seis consultas pré-natal, consulta de puerpério, exames básicos e imunização antitetânica; 75,0% da amostra eram ou foram imunizadas com a vacina antitetânica. Considerando apenas retorno ao puerpério 61,7% das mulheres o fizeram. Segundo o Índice de Kessner, modificado por Takeda o pré-natal foi Adequado para 56,6% da amostra. Os dados relativos aos indicadores de processo mostram que, à medida que há um somatório das ações recomendadas pelo PHPN há uma queda importante na proporção de realização. É necessária uma mobilização de gestores e profissionais envolvidos na assistência pré-natal para que ocorra melhora dos indicadores da atenção à saúde materna e perinatal.
This study aimed to analyse the prenatal care offered to pregnant women enrolled in the Prenatal Program in Basic Health Unit of the Radio Club (UBS-RC) in the city of Santos (SP). The objectives were to characterize the women of the UBS-RC of Santos city, according to sociodemographic and obstetric data, to describe the structure of the service and to analyze the process of prenatal care provided to pregnant women from UBS-RC. This is a descriptive and retrospective study, data were collected during an interview with the person in charge for the unity and from medical records of 366 pregnant women enrolled in 2009. Data collection was carried out from July to November 2010. The analysis of the structure and of the process was based on criteria established by the Ministry of Health (MOH) in 2006, following the recommendations of the Humanization of Prenatal and Childbirth Program(PHPN). The results show that the women were young, mean age 24.9 years, 59.6% married or with stable union, 50.3% skin colour non white, 50.3% with secondary level of education, 32.2% were primiparous. The structure of the service meets the requirements for the development of recommended actions for prenatal care. It was observed that 81.7% of the women initiated prenatal care within 120 days of gestation, 64.8% did the minimum number of 6 appointments, 44.0% had at least one appointment in the first trimester, 2 in the second trimester and 3 in the third trimester, 38.5% had at least 6 prenatal appointments and the postpartum appointment, 6.6% had at least 6 prenatal appointments and the basic exams, 4.1% had minimum of 6 prenatal appointments, postpartum appointment and the basic exams, 3.0% had at least 6 prenatal appointments and the postpartum appointment, basic exams and tetanus immunization, 75.0% of the sample were or have been immunized against tetanus. Considering only postpartum return after delivery, 61.7% of women did it so. According to the Kessner Index, modified by Takeda, the prenatal care was adequate for 56.6% of the sample. Data regarding process indicators has shown that, while there is an addition of the actions recommended by PHPN, there is a significant decrease in the proportion of accomplishment of the actions. The mobilization of managers and professionals involved in prenatal care is needed to improve the indicators of maternal and perinatal health care.
Preeclampsia (PE) causes morbidity and mortality in several women in the productive phase, including definitive sequels. Recognizing the socio-demographic profile of pregnant women may justify the ...allocation of resources to promote an effective care for this population.
To describe the socio-demographic profile of pregnant women diagnosed with preeclampsia.
Retrospective study of medical records of 98 patients. Place: Hospital Guilherme Álvaro Santos/ Brazil, (from May 2017 to April 2018). Variables analyzed: Previous history of systemic arterial hypertension (SAH) and preeclampsia, first-degree relative with SAH, recreational drug use, cohabitation with the partner, pre-eclampsia, employment status, years of schooling, average number of pregnancies and body mass index (BMI). For all the information in the sample, a description of the data was made through numerical means and descriptive measures of variables with the intention of searching for clues about the behavior of the phenomena studied. The study has ethical approval.
We identified that 53.1% had previous SAH; 29% reported a history of preeclampsia; 83% had first-degree relative with SAH; 19% used recreational drugs; 32% lived with partner; 38% were unemployed. How many means: the time of schooling was of 10,23 years; that of pregnancies of 2.27 previous; and the BMI of 31.93 (obesity).
These data suggest that it is necessary to create strategies for reproductive planning access for this population because several women were in the third gestation and advised of the risks identified in their own history as relatives with SAH. Avoiding additional complications due to drug use, especially among obese women, hypertensive and with a history of pre-eclampsia and that these guidelines need to be reinforced also by low education. These aspects can be recognized by the anamnesis itself, which can optimize resources and optimize financial resources.
Current diagnostic criteria for pre-eclampsia include organic dysfunctions. Recognizing predictive signs of complications in the initial clinical evaluation could optimize resources guiding care ...strategies.
To describe the status of pre-eclampsia patients in the initial evaluation by clinical and laboratorial parameters.
Retrospective study approved by Ethics Committee. Location: Guilherme Álvaro Hospital, Santos, São Paulo/Brazil; (May 2017 - April 2018). Inclusion: 85 patients. with pre-ecampsia, according to NHBPEP (2000) criteria. Analized Variables: Gestational age and severe admission complications, pressure values, symptomatology (visual, headache, epigastralgia) and medication use. For the sample’s information, numerical means and descriptive measures were used.
The means of gestational age was 31.7 weeks, systolic and diastolic blood pressures 137.51 and 83.34 mmHg respectively and weight 91.67 kg. 18,8% of urine dipsticks tests were negative or trace. The symptomathic evaluation, 11.8% was visuals (scotoma), 21.2% headache and 12.9% epigastric pain. For medication, 23.5% used Acetylsalicylic acid (ASA), 89.4% methyldopa and 28.2% corticosteroid. About 1.2% of the patients presented placental abruption, 1.2% eclampsia and 5.9% thrombocytopenia as severe complications at admission. No fetal or maternal death occurred in the current analyzed population.
Early clinical evaluation may demonstrate the potential risk of prematurity associated with pre-eclampsia, once the mean of gestacional week was 31 weeks. A considerable fraction of the analyzed women presented obesity and serious clinicals expressions of pre-eclampsia, although approximately 20% was not recognized by the initial proteinuria test screening. An expressive amount of the patients used ASA, without a characterization about the use. Most patients used at least one hypotensive agent, which could be an exaggerated expectation for these drugs. Although just a few patients presented serious complications these risks should not be neglected, mainly the thrombocytopenia. We also observed that some clinical-laboratory data can guide actions since the admission of the pregnant woman.
The onset of preeclampsia is related to diet. The nutritional status is determined mainly by nutrient intake, if taken in excess or shortage causes disturbance.
To analyze daily food intake in ...pregnancies with and without preeclampsia.
A transversal study, case-control, developed at the Guilherme Álvaro Hospital located at Santos/Brazil. Data on the food intake were collected from January 2015 to May 2016, from 157 women (72 cases and 85 controls) in the mediate postpartum. The case group was composed by women with preeclampsia (PE) according to the criteria of NHBPEP (2000) and the control group (C) was enrolled by women without hypertension and/or other comorbidities after vaginal delivery with newborn to term. Exclusion criteria for both groups: diabetes mellitus previously diagnosed as well as collagen diseases, smoking, twin pregnancy and fetal malformations. After recruitment and acceptance to participate in the study, the patients signed an informed consent. To assess food consumption was applied a food frequency questionnaire, including four account options for frequency of consumption: daily, weekly, monthly and never. For this current analysis only the data for daily consumption was considered; the data were expressed as percentages of patients in each group analyzed.
The table shows the profile of the daily food intake among the groups C and PE. Although the values found were similar between both groups, there was lower intake of protein foods (meat, eggs, viscera), as well as fruits, tubers and roots among PE group when compared do the control group. It was also noted in the PE group the lower daily consumption of natural juices. Display omitted
Applying a simple questionnaire to assess food frequency, showed that patients in the PE group had lower intake of proteic food. The PE group showed higher consumption canned food and coffee and lower ingestion of natural juice.This could lead to impairment of nutritional status.
Introduction The onset of preeclampsia is related to diet. The nutritional status is determined mainly by nutrient intake, if taken in excess or shortage causes disturbance. Objectives To analyze ...daily food intake in pregnancies with and without preeclampsia. Methods A transversal study, case-control, developed at the Guilherme Álvaro Hospital located at Santos/Brazil. Data on the food intake were collected from January 2015 to May 2016, from 157 women (72 cases and 85 controls) in the mediate postpartum. The case group was composed by women with preeclampsia (PE) according to the criteria of NHBPEP (2000) and the control group (C) was enrolled by women without hypertension and/or other comorbidities after vaginal delivery with newborn to term. Exclusion criteria for both groups: diabetes mellitus previously diagnosed as well as collagen diseases, smoking, twin pregnancy and fetal malformations. After recruitment and acceptance to participate in the study, the patients signed an informed consent. To assess food consumption was applied a food frequency questionnaire, including four account options for frequency of consumption: daily, weekly, monthly and never. For this current analysis only the data for daily consumption was considered; the data were expressed as percentages of patients in each group analyzed. Results The table shows the profile of the daily food intake among the groups C and PE. Although the values found were similar between both groups, there was lower intake of protein foods (meat, eggs, viscera), as well as fruits, tubers and roots among PE group when compared do the control group. It was also noted in the PE group the lower daily consumption of natural juices. Conclusions Applying a simple questionnaire to assess food frequency, showed that patients in the PE group had lower intake of proteic food. The PE group showed higher consumption canned food and coffee and lower ingestion of natural juice.This could lead to impairment of nutritional status.
Introduction Preeclampsia (PE) affects 5–8% of pregnant women, it is a multi-systemic damage which obesity is a predisposing factor and may be recognized by anthropometric measurements. The increased ...adiposity results in tissue necrosis and release of fatty acids, promoting metabolic changes known as lipotoxicity that causes endothelial damage. This immune disorder causes: vascular reactivity, vasospasm, alterations in capillary permeability and coagulation system. Resulting in anatomical/functional damage such as brain, cardio-pulmonary, renal, hepatic, hematological and utero-placental. This research project is part of a line of research that will assess the long-term values of the selected indicators in the remote postpartum period, thus seeking to observe the behavior of these effectors in the mother’s body. Objective To evaluate possible laboratory and anthropometric markers in selected mothers with PE in the immediate postpartum compared to women without this complication. Methods Case-control study developed at the Hospital Guilherme Álvaro, Santos/Brazil. Blood samples and anthropometric data from 15 mothers were collected in the period from January to May/2015 in the immediate postpartum and analyzed selected laboratory and nutritional markers, possibly related to PE. Case group: women with PE according to the NHBPEP (2000). Control group: women with vaginal birth and newborn full-term, without hypertension and other comorbidities. Variables analyzed: maternal age, gestational age at birth, body mass index (BMI), neck, arm and abdominal circumferences, total cholesterol, HDL (high density lipoprotein), LDL (low-density lipoprotein), VLDL (very low- density lipoprotein), triglycerides, fasting glucose and insulin levels to calculate HOMA-IR index, C-reactive protein. Exclusion terms: collagen disease, smoking, twin pregnancy and fetal malformations. Results The total of 15 blood samples (09 – study group and 06 – control group). Conclusion This study showed that potential markers lipotoxicity and anthropometric data can relate to the PE, possibly indicating probable risk factors, contributing to the understanding of certain clinical expressions and possibly correlate with prognostic factors. More studies are needed to expand the preliminary information of the present study.
