Diabetes e gravidez: aspectos clínicos e perinatais

Filho, Francisco Mauad; Dias, Cleusa Cascaes; Meirelles, Roberto Salles; Cunha, Sérgio Pereira da; Nogueira, Antônio Alberto; Duarte, Geraldo

doi:10.1590/s0100-72031998000400004

Cited by 2 publications

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References 9 publications

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“…Preterm premature rupture of membranes (PPROM) is a condition affecting 2–3% of pregnant women [ 1 ], and accounts for about a third (32.6%) and one fifth (18.2%) of preterm births in the US [ 2 ] and Brazil [ 3 ]. PPROM is considered the most common intercurrence in prematurity [ 4 ]. Treatment protocols vary greatly from one location to another [ 5 ] but are generally based on postponing childbirth with expectant management to reduce the inherent risk of prematurity.…”

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confidence: 99%

Clinical characteristics, complications, and predictive model of histological chorioamnionitis in women with preterm premature rupture of membranes

et al. 2023

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We aimed to analyze the impact of histological chorioamnionitis (HCA) in the presence of preterm premature rupture of the membranes (PPROM) on obstetric and neonatal outcomes, and its possible predictability. A retrospective cohort analysis of PPROM cases (20–37 weeks) was conducted comparing the patients with and without HCA, seeking a predictive model of HCA using logistic regression. A total of 295 cases of PPROM were selected, of which 72 (24.4%) had HCA. The group with HCA had a shorter latency period and a greater number of clinical and laboratory criteria in the evolution. The group with HCA had a worse comparative result and presented: lower gestational age at delivery, lower average birth weight, lower Apgar scores, longer neonatal hospitalization, worse maternal clinical conditions and, higher rates of stillbirth, low birth weight (LBW), very low birth weight (VLBW), complications in pregnancy and childbirth, and cesarean delivery due to fetal distress or chorioamnionitis. A predictive model for HCA was developed, with the following independent variables: abdominal pain (odds ratio [OR] = 11.61), uterine activity (noticeable contractions on physical exam) (OR = 5.97), fever (OR = 5.77), latency > 3 days (OR = 2.13), and C-reactive protein (OR = 1.01). With this model, an adequate receiver operating characteristic curve was found, with an area under the curve of 0.726, and some HCA probability curves were constructed for different clinical situations. In this novel study, we present a non-invasive predictive model, with clinical and laboratory variables, which may help in decision-making in a patient with PPROM.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics, complications, and predictive model of histological chorioamnionitis in women with preterm premature rupture of membranes

et al. 2023

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“…Não obstante, a polidramnia pode chegar a não ser clinicamente significativa até que o volume do líquido amniótico alcance 3000 a 4000 ml. A prevalência da polidramnia relatada por estudos ultra-sonográficos varia entre 0,4 e 1,5% (Yamamoto & Miyadahira, 1993;Mauad Filho et al, 1996b;Mauad Filho et al, 1996c). Sabe-se que, tanto a oligodramnia, quanto a polidramnia, são importantes marcadores de patologia clínica, estando associadas ao incremento nas taxas de morbi-mortalidade perinatais (Manning et al, 1981;Mercer et al, 1984;Magann et al, 1995;Bar-Hava et al, 1995;Divon et al, 1995;Chauhan et al, 1996;Chua et al, 1996;.…”

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Quantificação dos volumes do líquido amniótico e do embrião obtidos pela ultra-sonografia bidimensional e tridimensional no primeio trimestre da gestação

Spara¹

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SPARA, P. Quantitation of amniotic fluid and embryo volumes by twodimensional and three-dimensional ultrasonography in the first trimester of pregnancy. 2005. 133p. Tese de Doutorado -Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2005.The objective of this study was to determine amniotic fluid and embryo volumes by two-dimensional and three-dimensional ultrasonography in normal pregnant women from the 8th to the 11th week of gestation. We made a prospective longitudinal study on 25 normal fetuses. Inclusion criteria were singleton fetuses and normal clinical and laboratory evaluation, and exclusion criteria were pregnant women with maternal diseases and/or diseases typical of pregnancy, smokers, and alcohol or drug users.All patients signed an informed consent form. The tests were performed by two observers using an ultrasonography apparatus model SA-9900 (MEDISON), a volumetric endovaginal transducer, a 5-6.5 Hz broad band and 120 o of visual field.Each pregnant woman was evaluated in the 8 th , 9 th , 10 th and 11 th week of gestation.The two-dimensional study consisted of the determination of volumetric measurements by a mathematical calculation based on the ellipsoid shape, with determination of total amniotic sac volume and embryo volume. In the threedimensional study the amniotic fluid volume was determined by the VOCAL technique. In both methods, the amniotic fluid volume was obtained by subtracting the volumetric measurement of the embryo from the measurement of the amniotic sac volume. Data were analyzed statistically by analysis of variance (ANOVA), by correlation and by regression analysis, with the level of significance set at p< 0.05 in all analyses. The amniotic fluid volume (V AF ) determined by two-dimensional ultrasonography increased from 5.45 to 39.52 cm 3 from the 8 th to the 11 th week (ANOVA -p< 0.05). There was a strong positive correlation between gestational age and V AF (p< 0.001, r 2 = 88.3%). In the three-dimensional study, V AF increased from 5.75 to 42.96 cm 3 from the 8 th to the 11 th week (ANOVA -p< 0.05). The correlation between gestational age and V AF was strong and positive (p< 0.001, r 2 = 98.1%). In conclusion, the volume of the amniotic fluid and of the embryo increased progressively from the 8th to the 11th week of gestation both when evaluated by two-dimensional and three-dimensional ultrasonography. The estimate of V AF obtained by three-dimensional ultrasonography was lower than that obtained by twodimensional ultrasonography in the 9th and 10th week of gestation and higher in the 11th week of gestation. The embryo volume obtained by the three-dimensional technique was larger than that obtained by the two-dimensional technique in all gestational weeks evaluated.

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Diabetes e gravidez: aspectos clínicos e perinatais

Abstract: Diabetes mellitus define um grupo de alterações genética e clinicamente heterogêneas que têm em comum a intolerância aos

Cited by 2 publications

References 9 publications

Clinical characteristics, complications, and predictive model of histological chorioamnionitis in women with preterm premature rupture of membranes

Clinical characteristics, complications, and predictive model of histological chorioamnionitis in women with preterm premature rupture of membranes

Quantificação dos volumes do líquido amniótico e do embrião obtidos pela ultra-sonografia bidimensional e tridimensional no primeio trimestre da gestação

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