Intralobar pulmonary sequestration is a rare bronchopulmonary malformation consisting of a non-functioning lung mass that receives its arterial blood supply from systemic circulation and that does not adequately communicate with the tracheobronchial tree through a normal bronchus. These sequestrations account for 1.1-1.8% of all lung resections. Herein we present two clinical cases with a prenatal diagnosis of pulmonary sequestration using ultrasound and magnetic resonance imaging. Pulmonary images indicated a progressive decrease in the size and echogenicity of the lung mass with fetal growth, resulting in asymptomatic neonates with normal chest radiographs. We emphasize the importance of combining imaging examinations with follow-up by a multidisciplinary team working in a center specialized in maternal-fetal medicine. For the successive monitoring of the size of the lung tissue mass, we propose the calculation of the following two biometric ratios that are not yet described in the literature: mass area/head circumference and mass volume/estimated fetal weight. The second ratio was similar in both cases, a result which suggests its potential for use in estimating the probability of the spontaneous regression of intralobar pulmonary sequestration.
Aim: To assess the accuracy of delivery date predictions made using fetal adrenal artery Doppler velocimetry in pregnant women with spontaneous preterm birth (PB) and to compare these predictions with cervical length (CL) measurements.Material and methods: A prospective study was performed with 51 pregnant women whose gestational lengths were between 24 and 36 weeks. The main outcome was the time between the Doppler velocimetry examination and delivery, categorized as delivery within 7 days or 7 days later after the examination. A receiver operating characteristics curve was performed to define the cutoffs among deliveries within 7 days for fetal adrenal artery Doppler velocimetry parameters and CL measurements.Results: The incidence of delivery within 7 days was 37.3%, with a statistically significant difference for the pulsatility index (PI; p=0.045) and resistance index (RI; p=0.030) of the fetal adrenal artery. The best cutoff values of PI and RI for predicting deliveries within 7 days were 1.65 and 0.78, respectively. The sensitivity and specificity of PI, RI, and CL (20 mm) were 73.7% (95% CI: 51.9–95.5) and 56.3% (95% CI: 38.1–74.4); 68.4% (95% CI: 45.4–91.4) and 62.5% (95% CI: 44.8–80.2); and 76.5% (95% CI: 54.0–99.0) and 78.1% (95%: CI 71.1–97.7), respectively.Conclusion: Fetal adrenal artery Doppler velocimetry can predict delivery within 7 days among pregnant women in cases of spontaneous PB and this prediction is similar to the predictions made using CL measurements.
Objectives: To describe the prevalence of the implementation of obstetric interventions for labor and birth in normal-risk women in reference to maternity Stork Network. Methodology: cross-sectional study was performed from April 2014 to January 2015, with 421 participants in the Maternity School Assis Chateaubriand - UFC, admitted during spontaneous or induced labor with a live fetus and single pregnancy term and their fetuses weighing between 2,500 and 4.499g. The data collection instrument was divided into blocks with sociodemographic and clinical characteristics, obstetric, data care during labor, delivery and birth, maternal morbidity, maternal outcome and obstetric practices in categories A and B from WHO and perinatal outcomes. The values are presented as mean ± standard deviation. Results: The age ranged from 13 to 44; the average gestational age at admission was 38.9 ± 1.1 weeks; 52.2% with only one child; 8.6% had a previous cesarean section. There was 96.2% of pre-natal coverage with an average of 6.4 consultations. 76.2% had vaginal delivery. Obstetric practices in category A were more prevalent oxytocin in the third stage (97.1%), partograph (95%), non-invasive methods for pain relief (87.2%), companion (84.6%). While in section B were more of a vaginal examination at 2 hours (50.4%) and intravenous infusion (44.9%) and oxytocin in the expansion phase (28.8%). The present study had as limitations the loss of some data, which depended on the filling of third parties, which are characteristic of searches in medical records, or any documentary archive because it is a collection of secondary data. Conclusions: It was possible to identify that the "Good labor assistance practices" has been developed in a good proportion considered; however some practices that should be discouraged are still performed relatively frequently.
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