A doença periodontal (DP) durante a gestação, em conjunto com outras variáveis sócio-economico-demográficas e de assistência à saúde, tem sido citada como um importante fator de risco para o parto prematuro (PP) e recém-nascido de baixo peso (BP). O objetivo deste estudo foi avaliar a doença periodontal de gestantes e verificar a associação desta condição e do Programa Saúde da Família (PSF) com a prevalência de PP e BP. Trata-se de estudo de coorte conduzido em dois municípios brasileiros, sendo um deles com PSF implantado. Foram realizados exames bucais durante a gestação e acompanhamento das pacientes até nascimento da criança. Os resultados foram verificados por meio de análises estatísticas bivariadas (α=0,05). Foram examinadas todas as gestantes (n=119) cadastradas no serviços públicos de saúde de ambos os municípios. Doença periodontal, representada pela presença de bolsas rasas e profundas, foi observadaem 20% das gestantes, enquanto a perda de inserção periodontal superior a 4 mm foi verificada em 23,5%. Crianças prematuras e de baixo peso foram observadas em 15,8% e 10,5% da população, respectivamente. Não foi encontrada associação estatística entre DP materna e PP (p=1,000) e BP (p=1,000). A ausência do PSF não foi associada com uma maior prevalência do PP (p=1,000) nem BP (p=0,394). Desse modo, a doença periodontal materna não foi considerada um fator de risco para o nascimento de bebês prematuros e com baixo peso na população avaliada, assim como a ausência do PSF não influenciou na ocorrência da prematuridade.
Poster abstracts anemia (hemoglobin 3.9 g/dl), thrombocytopenia (platelet count 21,000/mm3) and consumptive coagulopathy. With DIC and multiorgan failure, the baby was died 6 days after birth despite massive transfusion and ventilator care. Fetal MR and prenatal ultrasound imaging can be used to reveal the location, size and structural components, especially vascular components of a lesion, as well as extensiveness to the surrounding organ. It can also provide more information for differential diagnosis of vascular or soft tissue tumors.
All fetuses underwent serial monitoring sessions including especially computerized cardiotocographic (cCTG) short term variability (STV) analysis, Doppler assessment of middle cerebral artery (MCA) and ductus venosus (DV) at least twice weekly. Timing of delivery was independently decided by the clinical staff based on a short term STV or cCTG anomalies. All growth-restricted fetuses were free from structural and chromosomal abnormalities. Individual data were normalized by converting the results in Z-scores. Results: When the mean values of the last session were compared with those obtained from previous recordings, we found that MCA RI shows significant changes only more than 2 weeks before cCTG anomalies. Also, for DV PVI the values in the last recording were not different from values obtained in the last 5 days, but significantly increased compared with earlier recordings. It appears that the STV has a constant and significant decrease with gestational age during last three weeks, being under 2 SD only for the last session. Conclusions: IUGR fetuses show a specific temporal sequence in antenatal tests. Doppler velocimetry alterations are the first to appear abnormal at the level of UA and then of MCA, followed by DV anomalies. The last test alterations to appear are represented by STV on cCTG analysis. For the clinician, the combination of venous Doppler and cCTG, on a daily monitoring in last week can provide an optimal fetal assessment. P37.03 Clinical, sonographic and psychosomatic aspects of delayed-interval delivery in twin pregnancy
Poster abstractswhich is a local tertiary referral center. Gestational age at referral was defined as time of diagnosis. The cases in which the malformation was already known for more than one week and fetuses with further malformations were excluded. The number of fetuses, mean gestational age at diagnosis, the rate of fetuses with diagnosis before 17 weeks of gestation (wks) and 25 wks and reason for referral were compared between three groups: 1994-1996 (group I), 1997-1999 (group II) und 2000-2003. Results: In 77 fetuses between 14 and 36 wks a spina bifida was detected. The number (n) and mean gestational age at diagnosis was n = 12 at 23.0 + 6.5 wks in group I, in group II n = 24 at 23.8 + 6.3 wks and in group III n = 41 at 22.2 + 5.9 wks. The rate of diagnosis before 17 wks was 0%, 12.5% and 17.0% and before 25 wks 66.0%, 62.5% and 73.2%, respectively. The reason for referral was the suspicion of a fetal malformation in 52.0% in group II and 70.7% in group III. Conclusions: Our results show a slow decrease in gestational age of the prenatal diagnosis of spina bifida and an increasing rate of fetuses referred for malformations to the tertiary centre during a decade. However, in a quarter of all affected fetuses the diagnosis is still made after 24 weeks of gestation. If the benefit of fetal surgery to prevent secondary damage will be proved, an early diagnosis of spina bifida will be important for these individuals. Cleido-cranial dysplasia (CCD) is characterized by a triad of calvarial dysostosis, hypoplasia or absence of clavicles, and supernumerary permanent teeth. The delayed calvarial ossification necessitates a planned Cesarean section in order to prevent a possible severe brain damage during birth. Therefore, early recognition of CCD is of major clinical importance. In the present case report, the patient was a 30-year-old gravida 2 para 1 with RUNX2-negative CCD. Family history comprised three generations of clinically diagnosed CCD; including the father of the patient and her first child born in 2000. An ultrasound examination was performed using a GE Voluson 730 Expert scanner at week 13 + 6. The severely delayed ossification of the vertebral spine was easily seen as echo poor, nearly black vertebral bodies, both on longitudinal as well as on transverse sections. In the calvaria, only the frontal bone showed signs of calcification, confirming severe delay in calvarial ossification. The clavicles were barely seen, lacking the typical S-shape. Except for short femurs, all other anatomic structures were normal for gestational age. Serial ultrasound examinations during pregnancy confirmed the diagnosis, but as ossification progressed the above mentioned manifestations became less distinct. A Cesarean section was performed in week 38. The infant had the same clinical signs of CCD as his affected family members. In conclusion, this case demonstrates that early ultrasound around thirteen weeks should be performed in pregnancies at risk of CCD since delayed mineralisation of the vertebral spine is an ea...
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