OBJETIVO: comparar, macro e microscopicamente, cicatrizes uterinas pós-cesáreas, nas quais foram feitas suturas com pontos separados, contínuos e contínuos ancorados. MÉTODOS: utilizamos três coelhas ...prenhes, realizando parto cesáreo no 26º dia de prenhez, com três incisões em cada corno uterino. As histerorrafias foram realizadas com fio Vicryl® 00, com suturas distintas (pontos separados, sutura contínua e contínua ancorada). No 60º dia pós-parto, realizamos histerectomia total abdominal e anexectomia bilateral, para avaliação das cicatrizes cirúrgicas. Na macroscopia, avaliamos o grau de retração cicatricial (longitudinal e transversal), o depósito de fibrina, presença de aderências e integridade dos fios de sutura. Na microscopia, utilizamos coloração de hematoxilina-eosina, para contagem de vasos sangüíneos e fibroblastos, e a coloração do tricômio de Masson, para quantificação do colágeno. Para a análise comparativa das cicatrizes, utilizamos os testes de Friedman e exato de Fisher, adotando nível de significância de 5%. RESULTADOS: foram obtidas 18 cicatrizes, seis para cada tipo de sutura. Obtivemos as seguintes médias 0,5/0,4/0,5 (p=0,069) para os graus de retração longitudinal e 0,3/0,4/0,3 (p=0,143) para os graus de retração transversal, respectivamente para as suturas com pontos separados, contínuo e contínuo ancorado. Todas as suturas apresentaram depósito de fibrina regular, ausência de aderência e reabsorção integral dos fios. Na microscopia, apuramos a média de vasos sangüíneos (158,5/139,3/172,1; p=0,293), de fibroblastos (351,6/345,8/354,3; p=0,311) e da porcentagem de tecido colágeno (44,0/45,5/48,5; p=0,422), respectivamente para as suturas com pontos separados, contínuo e contínuo ancorado. CONCLUSÕES: a técnica de histerorrafia na cesárea de coelhas (pontos simples, sutura contínua e contínua ancorada) não determinou diferenças estatísticas significantes em relação aos parâmetros macroscópicos e microscópicos avaliados.
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.
The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia.
Investigate the intake and calcium supplementation in pregnant.
...The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2, was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p< 0.05 was considered significant. Spearman correlations were used to measure associations among variables.
We studied 72 pregnant, mean±standard deviation age of 30,7±6,8years, gestational age of 26,5±8,2 and BMI=32,7±6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4±372,5mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4±119,5mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% (n=7).The calcium intake from the group calcium supplementation (1000mg elemental calcium/day) said use was higher (median 1691,4mg/day; p<0,001) than the not used supplement (626,2mg/day) and not exceed UL.
Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
Introduction The WHO recommends calcium supplementation in pregnant with low calcium intake as part of the care for the prevention of preeclampsia. Objective Investigate the intake and calcium ...supplementation in pregnant. Methods The study was performed involving pregnant women seen for their prenatal care at the Guilherme Alvaro Hospital, Santos, Brazil. Calcium intake was estimated through Food Frequency Questionnaire (FFQ) proposed by Fisberg et al. (2005) adapted. The Body Mass Index (BMI), calculated as kg/m2 , was classified according Atalah et al. (1997). Data were compared using Mann–Whitney U or Kruskal–Wallis test (post hoc Dunn), p < 0.05 was considered significant. Spearman correlations were used to measure associations among variables. Results We studied 72 pregnant, mean ± standard deviation age of 30,7 ± 6,8 years, gestational age of 26,5 ± 8,2 and BMI = 32,7 ± 6,9kg/m2 that characterizes 47,3% the sample as obesity pattern and 29,1% as overweight. Mean daily calcium intake from food records was low (723,4 ± 372,5 mg/day), 84,7% had lower average consumption that the WHO recommendation. The relationship between BMI classification and calcium intake mean not differed. It was found that milk was the most common (72,7%) among pregnant women with adequate dietary calcium intake (15,3%; 1353,4 ± 119,5 mg/day). Calcium supplementation with or without vitamin D was reported by 9,7% ( n = 7).The calcium intake from the group calcium supplementation (1000 mg elemental calcium/day) said use was higher (median 1691,4 mg/day; p < 0,001) than the not used supplement (626,2 mg/day) and not exceed UL. Conclusion Calcium supplementation was needed to the adequacy of calcium intake in this group of pregnant women, it is could contributes with reduced preeclampsia development.
A systematic delivery approach in pregnant women diagnosed with preeclampsia could avoid risks to both mother and newborn. A study about these outcomes could guide this practice.
Evaluate ...epidemiological characteristics and compare maternal and neonatal outcomes in gestations with and without preeclampsia.
Prospective study with 40 women was developed in Guilherme Álvaro Hospital- Santos/São Paulo/Brazil (December/2015–May/2016). Study group: 20 women with preeclampsia according to NHBPEP – National High Blood Pressure Education Program (2000), >37weeks. Control group: 20 pregnant women with single and live fetus, >38weeks, without comorbidities. Exclusion criteria for study group: twin pregnancy, fetal anomalies and gestational age under 37weeks. Control group exclusion criteria: twin pregnancy, gestational age under 38weeks, cesarean/ forceps/ induced vaginal delivery and comorbidities. Maternal variables: age, gestational age at delivery, previous pregnancy history, body mass index (BMI), comorbidities, length of hospital stay, intensive care unit admission, previous preeclampsia and delivery route. Neonatal variables: birth weight, adequacy weight for gestational age, Apgar score, meconium fluid at delivery, intensive care unit admission, acute respiratory distress syndrome, cardiopulmonary arrest, jaundice, oxygen therapy and intrahospital mortality. The statistical comparisons were made using Fisher’s exact test and Tukey multiple comparisons method. Data analysis was performed by calculating odds ratio adoption hypothesis and the rejection level of 0,05.
Comparison between preeclampsia and normal pregnancies in maternal and neonatal outcomes (*=p<0,05): Display omitted
Preeclampsia is more often associated with maternal and neonatal adverse outcomes when compared to the healthy pregnancies. Women diagnosed with preeclampsia appears to be older, have higher body mass index, longer hospital stay (including intensive care unit) and have previous preeclampsia more often than those without this comorbidity. There is a lack of significance in comparing neonatal outcomes between the systematic delivery approach at 37weeks and the control groups.
Introduction Clinical forms of early and late preeclampsia have different physiopathological mechanisms. Their influence in the most adverse outcomes is related with as earlier the delivery occurs. ...Objectives Compare maternal and neonatal outcomes of preeclampsia according to gestational age and identify some maternal characteristics related in each group. Methods Retrospective study with 71 women, through medical records review, was developed in Guilherme Álvaro Hospital-Santos/São Paulo/Brazil (July/2015-April/2016). This study involved pregnant women diagnosed with preeclampsia according to NHBPEP – National High Blood Pressure Education Program (2000), with single and live fetus, regardless of gestational age. Patients were divided into three groups according to delivery gestational age: 20 for early group (<34 weeks), 17 for intermediate group (between 34 and 36 6/7 weeks) and 34 for late group (>37 weeks). Exclusion criteria: twin pregnancy and fetal anomalies. Maternal variables: age, gestational age at admission, previous pregnancy history, length of hospital stay, body mass index (BMI), chronic hypertension and diabetes mellitus. Neonatal variables: weight, adequacy of weight for gestational age, height, length of hospital stay, intensive care unit (ICU) admission, Apgar score and respiratory and non-respiratory complications. The study was approved by Guilherme Álvaro Hospital’s ethics and research committee. Statistical comparisons for categorical variables were made using Fisher’s exact test, and Tukey multiple comparisons method for numerical variables. The significance level was p < 0.05. Results A comparison between the three groups of preeclampsia according to maternal and neonatal outcomes (∗ = p < 0.05): Conclusions Preeclampsia delivery before 34 weeks is more often associated with maternal and neonatal adverse outcomes if compared to deliveries after this gestational age. Patients from early preeclampsia group stay longer in hospital and they are usually non-diabetic. Their newborns present lower weight, smaller height, lower Apgar scores at birth, longer hospital stay (including in ICU) and acute respiratory distress syndrome development. There is a lack of significance in associating maternal age, BMI and chronic hypertension with maternal and neonatal adverse outcomes.
Introduction A systematic delivery approach in pregnant women diagnosed with preeclampsia could avoid risks to both mother and newborn. A study about these outcomes could guide this practice. ...Objectives Evaluate epidemiological characteristics and compare maternal and neonatal outcomes in gestations with and without preeclampsia. Methods Prospective study with 40 women was developed in Guilherme Álvaro Hospital- Santos/São Paulo/Brazil (December/2015–May/2016). Study group: 20 women with preeclampsia according to NHBPEP – National High Blood Pressure Education Program (2000), > 37 weeks. Control group: 20 pregnant women with single and live fetus, > 38 weeks, without comorbidities. Exclusion criteria for study group: twin pregnancy, fetal anomalies and gestational age under 37 weeks. Control group exclusion criteria: twin pregnancy, gestational age under 38 weeks, cesarean/ forceps/ induced vaginal delivery and comorbidities. Maternal variables: age, gestational age at delivery, previous pregnancy history, body mass index (BMI), comorbidities, length of hospital stay, intensive care unit admission, previous preeclampsia and delivery route. Neonatal variables: birth weight, adequacy weight for gestational age, Apgar score, meconium fluid at delivery, intensive care unit admission, acute respiratory distress syndrome, cardiopulmonary arrest, jaundice, oxygen therapy and intrahospital mortality. The statistical comparisons were made using Fisher’s exact test and Tukey multiple comparisons method. Data analysis was performed by calculating odds ratio adoption hypothesis and the rejection level of 0,05. Results Comparison between preeclampsia and normal pregnancies in maternal and neonatal outcomes (* = p < 0 , 05 ): Conclusions Preeclampsia is more often associated with maternal and neonatal adverse outcomes when compared to the healthy pregnancies. Women diagnosed with preeclampsia appears to be older, have higher body mass index, longer hospital stay (including intensive care unit) and have previous preeclampsia more often than those without this comorbidity. There is a lack of significance in comparing neonatal outcomes between the systematic delivery approach at 37 weeks and the control groups.
Clinical forms of early and late preeclampsia have different physiopathological mechanisms. Their influence in the most adverse outcomes is related with as earlier the delivery occurs.
Compare ...maternal and neonatal outcomes of preeclampsia according to gestational age and identify some maternal characteristics related in each group.
Retrospective study with 71 women, through medical records review, was developed in Guilherme Álvaro Hospital-Santos/São Paulo/Brazil (July/2015-April/2016). This study involved pregnant women diagnosed with preeclampsia according to NHBPEP – National High Blood Pressure Education Program (2000), with single and live fetus, regardless of gestational age. Patients were divided into three groups according to delivery gestational age: 20 for early group (<34weeks), 17 for intermediate group (between 34 and 36 6/7weeks) and 34 for late group (>37weeks). Exclusion criteria: twin pregnancy and fetal anomalies. Maternal variables: age, gestational age at admission, previous pregnancy history, length of hospital stay, body mass index (BMI), chronic hypertension and diabetes mellitus. Neonatal variables: weight, adequacy of weight for gestational age, height, length of hospital stay, intensive care unit (ICU) admission, Apgar score and respiratory and non-respiratory complications. The study was approved by Guilherme Álvaro Hospital’s ethics and research committee. Statistical comparisons for categorical variables were made using Fisher’s exact test, and Tukey multiple comparisons method for numerical variables. The significance level was p<0.05.
A comparison between the three groups of preeclampsia according to maternal and neonatal outcomes (∗=p<0.05):
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Preeclampsia delivery before 34weeks is more often associated with maternal and neonatal adverse outcomes if compared to deliveries after this gestational age. Patients from early preeclampsia group stay longer in hospital and they are usually non-diabetic. Their newborns present lower weight, smaller height, lower Apgar scores at birth, longer hospital stay (including in ICU) and acute respiratory distress syndrome development. There is a lack of significance in associating maternal age, BMI and chronic hypertension with maternal and neonatal adverse outcomes.
Introduction Preeclampsia is associated with complications especially in severe forms. Recognize this condition can direct to adoption of different behaviors. Objectives Evaluate epidemiological ...characteristics and compare maternal and neonatal outcomes of mild and severe preeclampsia in pregnancies that results in delivery after 37 weeks of gestation. Methods Prospective study with 40 women was developed in Guilherme Álvaro Hospital-Santos/Brazil, during December/2015 and May/2016. Study group: 20 women with preeclampsia (13 mild and 7 severe), according to NHBPEP – National High Blood Pressure Education Program (2000) criteria and gestational age > 37 weeks. Control group: 20 pregnant women with single and live fetus, > 38 weeks, without comorbidities. Exclusion criteria for study group: twin pregnancy, fetal anomalies and gestational age under 37 weeks. Control group exclusion criteria: twin pregnancy, gestational age under 38 weeks, cesarean/forceps/induced vaginal delivery and comorbidities. Maternal variables: age, gestational age at delivery, previous pregnancy history, body mass index (BMI), comorbidities, length of hospital stay and intensive care unit (ICU) admission, previous preeclampsia and delivery route. Neonatal variables: birth weight, adequacy weight for gestational age, Apgar score, meconium fluid at delivery, intensive care unit admission, acute respiratory distress syndrome, cardiopulmonary arrest, jaundice, oxygen therapy and intrahospital mortality. The statistical comparisons were made using Fisher’s exact test and Tukey multiple comparisons method. The significance level was p < 0,05. Results Comparison between the three groups in maternal and neonatal outcomes (* = p < 0,05): Conclusions The present study showed that the mild preeclampsia group has better results than the severe group in some variables. This first group had no need of mother ICU admission, their BMI is higher and was the group with more previous preeclampsia. The severe preeclampsia group has a significant level of arterial hypertension, stayed longer in the hospital and their newborn had presented more general complications. Data shows more favorable maternal and neonatal outcomes in the control group.
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