Early treatment with oseltamivir may prevent serious complications associated with H1N1 infection in pregnant women but it does not affect perinatal outcome.

Background: In this study, we aimed to verify the frequency of urinary tract infection (UTI) in pregnant women, the main etiologic agents and their antibiotic susceptibilities. Moreover, to confirm UTI as a risk factor for maternal and fetal complications. Methodology: Data collection was performed using medical records from pregnant women suffering from UTIs (the Study Group) and pregnant women without UTIs (the Control Group). Both groups of patients visited the Department of High Risk Pregnancy,

Background: In recent years, so-called "non-ablative rejuvenation" has been carried out with the use of lasers or intense pulsed light (IPL) to stimulate collagen production by dermal fibroblasts. Intradermal infusion of CO 2 stimulates fibroblasts and the synthesis of collagen and elastin, contributing to the retraction of the skin and tissue rejuvenation. Objectives: To evaluate the effects of IPL and the intradermal infusion of CO 2 on fibroblast proliferation and collagen in the skin of female rats. Methods: Sixteen adult female Wistar rats were divided into two groups of eight animals. Group 1 underwent IPL and group 2 underwent intradermal CO 2 infusion. There was a total of 8 weeks of treatment. We conducted a punch in each animal before any procedure (T0), another punch in the middle of treatment at 4 weeks post-procedure (T1) and a punch at the end of treatment at 8 weeks post-procedure (T2). The cells involved in inflammation, fibrosis and vascularization of the injured tissue by histopathology were analyzed. Results: There was statistically significant fibroblast proliferation and collagen proliferation noted when analyzing all 16 animals together and also when considering the two study groups separately. In both groups, the greatest proliferation of fibroblasts coincided with periods of increased collagen production. Conclusion: Both IPL and intradermal CO 2 infusion stimulated fibroblast and collagen proliferation in the skin of the rats studied.

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undertaken to determine the risk of sepsis or severe sepsis associated with obesity (body mass index Z30) during the intrapartum and immediate postpartum periods.Data from women in the intrapartum, and postpartum periods with ICD-9 codes for sepsis or severe sepsis were obtained from the Aberdeen Maternal and Neonatal Databank from 1986 to 2009. Four controls per case without a diagnosis of sepsis were selected from the database and frequency matched based on year of delivery. Dependent variables were uncomplicated sepsis or severe/near-miss sepsis. Independent variables were demographic, medical, and delivery characteristics. The final results were reported as unadjusted and adjusted odds ratios with 95% confidence intervals.The study population included 89 cases of uncomplicated sepsis, 14 cases of severe sepsis, and 412 controls. Most cases occurred postpartum and before hospital discharge (98.9% for uncomplicated sepsis and 92.9% for severe sepsis). The mean age of women with uncomplicated sepsis, severe sepsis, and controls was 28.2, 27.4, and 31.3 years, respectively. More women with sepsis were multiparous or had had a prior miscarriage. Percentages of those with anemia were 67.4%, 92.9%, and 37.6% for women with sepsis, severe sepsis, and controls, respectively. The rate of obesity was significantly greater among patients with sepsis, but the obesity rate among those with severe sepsis was similar to that of controls. Compared with controls, women with severe sepsis had greater rates of prelabor rupture of membranes and induced labor. Women with uncomplicated and severe sepsis had cesarean section rates of 48.3% and 64.3%, respectively, compared to a rate of 25.3% in controls. Women with severe sepsis more often required manual removal of the placenta (21.4% vs. 4.7% in controls) and lost Z500 mL blood (72.4% vs. 23.9% of controls) during delivery. Women with sepsis also had higher rates of severe preeclampsia, preterm birth, and infants admitted to the neonatal intensive care unit. During the entire study period, the proportion of spontaneous vaginal deliveries decreased and that of operative vaginal deliveries and cesarean sections increased significantly. Sepsis case rates remained the highest for women undergoing a cesarean section throughout the study period. Of note, there was a decreasing trend in sepsis rates from 1986 to 2003 but from that point until the end of the study in 2009, the sepsis rates increased for all modes of delivery. Among women with sepsis who had a cesarean delivery, 38.5% received antibiotics during pregnancy or delivery compared with 70.2% of control women who had a cesarean section. After adjusting for changes over time, factors significantly associated with both uncomplicated sepsis and severe sepsis were: younger age, anemia, labor induction, operative vaginal delivery, and cesarean section. Preterm birth was associated with uncomplicated sepsis only, whereas induced labor was associated with severe sepsis. Obesity was significantly associated with uncomplicated sepsis but...

Women with serum markers for inherited or acquired thrombophilia showed a high relative risk to develop pre-eclampsia.

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ResumoOBJETIVO: Avaliar se a intervenção com heparina de baixo peso molecular (HBPM) -enoxaparina sódica -foi eficaz na melhora dos desfechos perinatais de mulheres com trombofillias com base em sistema de pontuação. MÉTODOS: Estudo prospectivo, não randomizado, não controlado, realizado em um Ambulatório de Gestação de Alto Risco, durante o período de novembro de 2009 a novembro de 2011. Foram incluídas gestantes com diagnóstico e intervenção terapêutica para trombofilias adquiridas e/ou hereditárias na gestação atual. Os dados obstétricos e perinatais das gestantes anteriores à intervenção foram comparados com os desfechos subsequentes à intervenção, sendo analisados estatisticamente através do teste do χ 2 , com correção de Yates, considerando significativos quando p<0,05. A dosagem inicial de HBPM foi norteada por sistema de pontuação, baseado no histórico clínico e gestacional das pacientes, além de exames de rastreamento de trombofilias adquiridas e/ou hereditárias. RESULTADOS: Foram incluídas 84 mulheres grávidas com 175 gestações anteriores ao diagnóstico, das quais 20,0% resultaram em morte fetal ou perinatal, 40,0% resultaram em abortamento, 17,7% desenvolveram pré-eclâmpsia ou eclâmpsia, 10,3% foram partos a termo e 29,7% partos pré-termo. Nas 84 gestações após a intervenção, 6,0% resultaram em morte fetal ou perinatal, 1,2% em abortamento, 4,8% desenvolveram pré-eclâmpsia/eclâmpsia, 22,6% em parto prematuro e 70,2% parto a termo. Observou-se redução significativa na taxa de óbito fetal ou perinatal (p<0,05) e abortos (p<0,0001), e aumento significativo (p<0,05) no número de nascidos vivos após a intervenção. CONCLUSÃO: A intervenção baseada na enoxaparina utilizando um sistema de pontuação em gestantes com trombofilia mostrou-se eficaz na melhora do desfecho perinatal. Abstract PURPOSES:To assess whether an enoxaparin-based intervention using a score system was effective in improving perinatal outcome in women with thrombophilia. METHODS: Study Design: Prospective, not randomized, uncontrolled, performed at a Clinic of High-Risk Pregnancy from November 2009 to November 2011. We included women with a diagnosis and therapeutic intervention for thrombophilia acquired and/or inherited in the current pregnancy. The obstetric and perinatal outcomes of pregnant women before the intervention were compared with outcomes after the intervention, and statistically analyzed using the χ 2 test with Yates correction, considered significant when p<0.05. The initial dose of low-molecular-weight Heparin (LMWH) was guided by a scoring system based on the clinical and gestational history of the patients and screening tests for acquired and/or inherited thrombophilia. RESULTS: We included 84 pregnant women with 175 pregnancies before diagnosis, 20.0% of which resulted in fetal ou perinatal death, 40.0% resulted in abortion, 17.7% developed preeclampsia/eclampsia, 10.3% resulted in full-term births, and 29.7% in premature births. In the 84 pregnancies after intervention, 6.0% resulted in fetal ou perinatal death, 1.2% in ...