D o m in g o s S ilva 'OSeja por sua relativa raridade, de vez que só estão registrados n a lite ratu ra m é dica 85 casos: seja por suas ca ra c te rísti cas clínicas, que a diferenciam das outras parablastom icoses, ou ainda, pelas in te r m ináveis discussões qu an to à posição do agente responsável n a Sistem ática Mieológica, pode-se afirm ar, sem receio de co n testação, que os vários aspectos desta m i cose continuam sujeitos a sérias divergên cias, entre os num erosos pesquisadores que têm tra ta d o do assunto.Por esta razão, .julgamos oportuno t r a çar u m perfil da Micose de Lobo, ab o r dando alguns ângulos que nes parecem controvertidos EPIDEM IOLOGIA ci> A micose tem sido en co n trad a so m en te na região neotrópica.Por longo tem po considerada exclusiva da região am azônica, fei, pouco a pouco, sendo id en tificada em outras áreas das Américas do Sul e C entral:Caso 10 -em Costa Rica -por Rornero & Trejos (20).Caso 15 -no P a n a m á -por H errera (12).Caso 19 -n a Venezuela -por Cam po A achen (6 >.Caso 26 -na Venezuela -por Convit & Escuder (7).Caso 27 -na Colômbia -por H enao Pelayo (11). Rev. Soc. Bras. Med. Trop.

aObjective A maternal death is defined by WHO as 'the death of a woman while pregnant or within 42 days of termination of pregnancy. . .'. The origin of the 42 days is no longer clear. In developing countries, the burden imposed by pregnancy and birth on a woman's body may extend beyond 42 days as pregnancyrelated anaemia can persist for longer and vaginal haemorrhaging and risk of infections are not necessarily over after six weeks. We therefore examined duration of excess mortality after delivery in rural Guinea-Bissau. Design In a prospective cohort study, we followed 15,844 women of childbearing age with biannual visits over a period of six years, resulting in a total of 60,192 person-years-at-risk. To establish cause and timing in relation to termination of pregnancy, verbal autopsy was carried out for all deaths. Mortality rates were calculated for short time intervals after each delivery or miscarriage. Results During the observation period we registered 14,257 pregnancies and 350 deaths. One hundred and ninety-four deaths followed termination of a registered pregnancy and thus were eligible for the analysis. Eighty-two deaths occurred during the first 42 days after delivery/miscarriage. A further 16 women died in the period from 43 to 91 days after parturition, 16 between 92 and 182 days and 18 between 183 and 365 days after delivery. Compared with baseline mortality 7 -12 months after delivery, women who had recently delivered had 15.9 times higher mortality (95% CI 9.8-27.4). From days 43 to 91 the mortality was still significantly elevated ). Conclusion Where living conditions are harsh, pregnancy and delivery affect the health of the woman for more than 42 days. Using the WHO definition may result in an under-estimation of the pregnancy-related part of the reproductive age mortality. Extending the definition of maternal death to include all deaths within three months of delivery may increase current estimates of maternal mortality by 10 -15%.

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