Rhabdomyosarcoma (RMS) is a rare solid tumor in childhood and adolescence. The higher incidence is predominant during the first two decades of life. According to the Intergroup RMS Study Group, the ...embryonal RMS (ERMS), botryoidal variant, constitutes a histological subtype characterized as a "grape-like" lesion of 2.0 cm to 9.5 cm. The treatment involves chemotherapy, surgery, and/or radiotherapy. We present the case of a 14-year-old female patient diagnosed with ERMS, botryoidal variant, which originated in the uterine cervix with vaginal externalization. The initial therapeutic approach comprised an initial prolapsed mass excision followed by Wertheim-Meigs surgery due to the tumor extension. No consensual protocol to ERMS treatment is found in the medical literature; however, a combined approach seems to offer a better result. The postoperative time period was uneventful and the patient followed an adjuvant therapy with vincristine, d-actinomycin, and cyclophosphamide. A comprehensive evaluation of the therapeutic options preserving the reproductive function-unfortunately not always possible-is part of a multi-disciplined care team concerning the pediatric patients.
The use of such markers in predicting preeclampsia, such as PlGF, can serve in predicting the syndrome, and precocious identification can anticipate management and decrease the risks.
To evaluate ...among pregnant women, both those who developed pre-eclampsia as those who did not developed hypertensive disorder complications, the role of placental growth factor (PlGF) as predictor of the syndrome in question, pre-eclampsia.
From the MEDLINE database, articles were extracted using the following keywords: (placental growth factor OR PLGF) AND pre-eclampsia/diagnosis by selecting, from a total of 193 retrieved in the search, papers published from 2014 to produce a systematic review. Were excluded narrative and systematic reviews, and in addition, the selected study models included cohort and case-control, which analyzed PlGF alone, sFlt-1/PlGF ratio, PlGF associated with other biomarkers of PE, Doppler Velocimetry uterine artery added to the PlGF and other biomarkers, getting a total of 25 articles after three independent reviewers to analyze the search results and confront their findings.
Although there is no agreement in all literature about the PlGF levels during pregnancy, the studies evaluated showed a standardization of variations in the marker values during gestation, which are reduced in the preeclampsia group compared to controls, and further reduced in early and severe preeclampsia. On average, pregnancies that resulted in the disease did not show values above 208pg/ml, unlike the pregnancies in the control group who always obtained values above 300pg/ml, usually in the second quarter. Recalling that, in the latter group, it kept growing with the evolution of pregnancy. The association of PlGF to Doppler velocimetry of the uterine artery, or other biomarkers or both leads to an increase in the accuracy of the tests. But we can see that the evaluation of sFlt-1 ratio/PlGF is the parameter that brings greater sensitivity and specificity in predicting preeclampsia.
According to gestational age, PlGF levels have a pattern of variability that differs in healthy women compared to that present the syndrome in question. The latter has lower PlGF values than the control group, and the difference is even greater when you have early or severe PE.
None declared.
Introduction Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide. Objective Evaluate maternal ...and perinatal outcomes at 37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities. Method A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05. Results 88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide.
Evaluate maternal and perinatal outcomes at ...37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities.
A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05.
88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Fraturas da coluna vertebral associadas à lesão medular raramente acometem pacientes gestantes. Os autores apresentam o caso de uma mulher de 20 anos de idade, com gestação de 20 semanas, que sofreu ...fratura-luxação da coluna torácica (T4-T5) e foi submetida a descompressão, redução e artrodese posterior com parafusos pediculares. Apesar de apresentar lesão medular completa, a gestação evoluiu sem intercorrências e resultou no nascimento, por parto normal, de uma criança saudável a termo. Algumas particularidades, como o cuidado com o uso de radiação ionizante, via de acesso cirúrgico e de parto, corticoterapia e complicações gestacionais em pacientes nessas condições são discutidas neste artigo. Somente uma equipe multidisciplinar, formada por médicos de diferentes especialidades (cirurgiões de coluna, obstetras e fisiatras), enfermeiras e fisioterapeutas é capaz de assistir a essas pacientes de modo satisfatório.Spinal fractures associated with spinal cord injury rarely affect pregnant patients. The authors present the case of a 20-year-old woman in her 20th week of pregnancy, who suffered fracture-dislocation of the thoracic spine (T4-T5) and underwent decompression, reduction and posterior fusion with pedicle screws. Despite the complete spinal cord injury presented, the pregnancy progressed uneventfully and resulted in birth via normal delivery of a healthy newborn at term. Some particular features of this case, like the care needed in using ionizing radiation, the surgical approach and delivery, use of steroids and pregnancy complications in such patients are discussed here. Only a multidisciplinary team composed by physicians from different specialties (spinal surgeons, obstetricians and physiatrists), nurses and physiotherapists is capable of assisting pregnant patients with spinal cord injuries satisfactorily.
Fraturas da coluna vertebral associadas à lesão medular raramente acometem pacientes gestantes. Os autores apresentam o caso de uma mulher de 20 anos de idade, com gestação de 20 semanas, que sofreu ...fratura-luxação da coluna torácica (T4-T5) e foi submetida a descompressão, redução e artrodese posterior com parafusos pediculares. Apesar de apresentar lesão medular completa, a gestação evoluiu sem intercorrências e resultou no nascimento, por parto normal, de uma criança saudável a termo. Algumas particularidades, como o cuidado com o uso de radiação ionizante, via de acesso cirúrgico e de parto, corticoterapia e complicações gestacionais em pacientes nessas condições são discutidas neste artigo. Somente uma equipe multidisciplinar, formada por médicos de diferentes especialidades (cirurgiões de coluna, obstetras e fisiatras), enfermeiras e fisioterapeutas é capaz de assistir a essas pacientes de modo satisfatório.
Spinal fractures associated with spinal cord injury rarely affect pregnant patients. The authors present the case of a 20-year-old woman in her 20th week of pregnancy, who suffered ...fracture-dislocation of the thoracic spine (T4-T5) and underwent decompression, reduction and posterior fusion with pedicle screws. Despite the complete spinal cord injury presented, the pregnancy progressed uneventfully and resulted in birth via normal delivery of a healthy newborn at term. Some particular features of this case, like the care needed in using ionizing radiation, the surgical approach and delivery, use of steroids and pregnancy complications in such patients are discussed here. Only a multidisciplinary team composed by physicians from different specialties (spinal surgeons, obstetricians and physiatrists), nurses and physiotherapists is capable of assisting pregnant patients with spinal cord injuries satisfactorily.
Know the additional risks associated with hypertensive disorders in pregnancy, such as the use of licit and illicit substances, may contribute to the adoption of strategies that minimize adverse ...outcomes.
Estabilish the prevelence of the use of harmful substances such as alcohol, tobacco and ilicit drugs in pregnant women in relation to healthy pregnant women.
A transversal study has been conducted in the prenatal and maternity of the Hospital Guilherme Álvaro from April to June 2016. 61 patients were selected, 34 from the study group and 27 from de control group. Among the patients in the study group, are included pregnant or postpartum women with hypertensive disorders, according NHBPEP 2000. In the control group, are included only pregnant or postpartum women without previous comorbidity, which gave birth to one healthy live newborn, vaginal delivery.
It was applied two questionnaires, ASSIST, screening test of involvement with alcohol, tobacco and illicit substances, developed by WHO, useful for health professionals to identify the use and dependence on psychoactive substances, evaluated through a score, the answer ranges from 0 to 4 points, and the sum can range from 0 to 20, it is considered casual use 0 to 3, 4 suggestive of abuse 4–15 and suggestive of addiction 16–20. And another that evaluates epidemiological woman information, current and obstetric pregnancy as well as age, color, living city, number of consultations prenatal, site of consultations, among others.
The data were passed to the Excel program and analyzed quantitatively, to compare Study and Control groups on the ASSIST score related to each psychoactive drug, we used the Student’s T Test for unrelated samples. It was considered significant samples where p<0.05.
The obtained results, shown below, do not allow to say that the groups differ, although the sample size and the low frequency of drug use in the groups studied compromise the accuracy of information.
In percentage, 80.32% of all pregnant women have proved any drugs. Among the groups, the Study 70.83% have used drugs and in the control group 81.48% have used drugs.
Psychoactive drugs most used by pregnant women are: alcohol 77,0% and tobacco 42,6%.
In the correlation between the use of each type of drug with additional information about pregnancy and previous pregnancies
– The use of tobacco, the less prenatal consultations, higher the score, in the Study group
– The use of marijuana, the number of children who died (fetal or neonatal previous) was higher in the Study group
– The use of cocaine, the number of children who died (fetal or neonatal previous) was higher in the Study group
– The use of sedatives, the number of prenatal consultations, the highest score in the Study group
SUBSTANCE Study % Control % Total % P Tobacco Alcohol Marijuana Cocaine Amphetamine Inalants Sedatives Hallucinogens Opiates.
Display omitted
Distribution ASSIST score among these drugs was more abuse and addiction to alcohol and tobacco in the Control group compared to the Study group. Although we saw that the Hypertensive group made greater use of cocaine, amphetamine and opioids than those of the Control group.
The other comparisons were not significant and the larger sample can clear the results.
Introduction Know the additional risks associated with hypertensive disorders in pregnancy, such as the use of licit and illicit substances, may contribute to the adoption of strategies that minimize ...adverse outcomes. Objective Estabilish the prevelence of the use of harmful substances such as alcohol, tobacco and ilicit drugs in pregnant women in relation to healthy pregnant women. Methodology A transversal study has been conducted in the prenatal and maternity of the Hospital Guilherme Álvaro from April to June 2016. 61 patients were selected, 34 from the study group and 27 from de control group. Among the patients in the study group, are included pregnant or postpartum women with hypertensive disorders, according NHBPEP 2000. In the control group, are included only pregnant or postpartum women without previous comorbidity, which gave birth to one healthy live newborn, vaginal delivery. It was applied two questionnaires, ASSIST, screening test of involvement with alcohol, tobacco and illicit substances, developed by WHO, useful for health professionals to identify the use and dependence on psychoactive substances, evaluated through a score, the answer ranges from 0 to 4 points, and the sum can range from 0 to 20, it is considered casual use 0 to 3, 4 suggestive of abuse 4–15 and suggestive of addiction 16–20. And another that evaluates epidemiological woman information, current and obstetric pregnancy as well as age, color, living city, number of consultations prenatal, site of consultations, among others. The data were passed to the Excel program and analyzed quantitatively, to compare Study and Control groups on the ASSIST score related to each psychoactive drug, we used the Student’s T Test for unrelated samples. It was considered significant samples where p < 0.05. Results The obtained results, shown below, do not allow to say that the groups differ, although the sample size and the low frequency of drug use in the groups studied compromise the accuracy of information. In percentage, 80.32% of all pregnant women have proved any drugs. Among the groups, the Study 70.83% have used drugs and in the control group 81.48% have used drugs. Psychoactive drugs most used by pregnant women are: alcohol 77,0% and tobacco 42,6%. In the correlation between the use of each type of drug with additional information about pregnancy and previous pregnancies – The use of tobacco, the less prenatal consultations, higher the score, in the Study group – The use of marijuana, the number of children who died (fetal or neonatal previous) was higher in the Study group – The use of cocaine, the number of children who died (fetal or neonatal previous) was higher in the Study group – The use of sedatives, the number of prenatal consultations, the highest score in the Study group SUBSTANCE Study % Control % Total % P Tobacco Alcohol Marijuana Cocaine Amphetamine Inalants Sedatives Hallucinogens Opiates. Conclusion Distribution ASSIST score among these drugs was more abuse and addiction to alcohol and tobacco in the Control group compared to the Study group. Although we saw that the Hypertensive group made greater use of cocaine, amphetamine and opioids than those of the Control group. The other comparisons were not significant and the larger sample can clear the results.
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