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Prenatal diagnosis and natural history of fetuses presenting with pleural effusion

RUANO, Rodrigo; RAMALHO, Alan Saito; CARDOSO, Ana Karina Silva; MOISE JR., Kenneth; ZUGAIB, Marcelo
Fonte: WILEY-BLACKWELL Publicador: WILEY-BLACKWELL
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
35.99%
Objective To describe the natural history of fetuses presenting with pleural effusion. Methods Between January 2005 and December 2009 all fetuses diagnosed with pleural effusion were followed up. Fetuses were divided into three groups: I, isolated pleural effusion; II, associated structural anomalies but normal karyotype; and III, chromosomal anomalies. Univariate and multivariate analyses were performed to determine the association between prenatal ultrasound findings and perinatal death. Results Fifty-six fetuses were included in the study. Associated structural or chromosomal anomalies occurred in 75.0% (42/56) of cases. Bilateral pleural effusion and fetal hydrops were associated with each other (p < 0.01) and with perinatal death (p < 0.05). Multivariate analysis indicated that only the presence of associated abnormalities was a statistical determinant of perinatal death (OR, 3.56; 95% CI, 1.48-5.64; p < 0.01). Conclusion Fetal pleural effusion is often associated with other abnormalities, and this association has poor perinatal outcome. Copyright (C) 2011 John Wiley & Sons, Ltd.; National Council for Scientific and Technological Development of Brazil (Conselho Nacional de Desenvolvimento de Pesquisa e Tecnologia do Brasil, CNPq)

Systemic lupus erythematosus and pregnancy: clinical evolution, maternal and perinatal outcomes and placental findings

Surita,Fernanda Garanhani de Castro; Parpinelli,Mary Ângela; Yonehara,Ema; Krupa,Fabiana; Cecatti,José Guilherme
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2007 EN
Relevância na Pesquisa
45.95%
CONTEXT AND OBJECTIVE: Systemic lupus erythematosus is a chronic disease that is more frequent in women of reproductive age. The relationship between lupus and pregnancy is problematic: maternal and fetal outcomes are worse than in the general population, and the management of flare-ups is difficult during this period. The aim here was to compare the outcomes of 76 pregnancies in 67 women with lupus, according to the occurrence or absence of flare-ups. DESIGN AND SETTING: An observational cohort clinical study evaluating the evolution of pregnant women with lupus who were receiving care at the prenatal outpatient clinic, Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas (CAISM/Unicamp), between 1995 and 2002. METHODS: Data were collected on a precoded form. The women were divided into two groups according to the occurrence or absence of flare-ups, as defined by the systemic lupus erythematosus disease activity index (SLEDAI). The presence or absence of flare-ups and renal involvement was considered to be the independent variable and the other results were dependent variables. RESULTS: Flare-ups occurred in 85.3% of cases, and were most significant when there was renal involvement. This was related to greater numbers of women with preeclampsia and poor perinatal outcome. Intrauterine growth restriction was more common in the women with active disease. Placental weight was significantly lower in the women with renal involvement. CONCLUSIONS: Flare-ups and renal involvement in lupus patients during pregnancy are associated with increased maternal and perinatal complications.

Adrenocortical responsiveness is blunted in twin relative to singleton ovine fetuses

Gardner, DS; Jamall, E; Fletcher, AJW; Fowden, AL; Giussani, DA
Fonte: Blackwell Science Inc Publicador: Blackwell Science Inc
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
35.95%
Twin fetuses experience much higher rates of perinatal mortality/morbidity than age- and weight-matched singletons. Across species, the prepartum increase in fetal plasma cortisol is responsible for maturing a number of systems in preparation for birth and the immediate postnatal period. In sheep, it is known that basal adrenocortical function is delayed in twins relative to singletons. Thus, it could be argued that relative immaturity in twins may explain their increased susceptibility to stress in the perinatal period and their relatively poor perinatal outcome. However, whether adrenocortical responsiveness to stress is also diminished in the twin fetus and whether the fetal cardiovascular, metabolic and endocrine defences to acute stress are comparatively weak in the twin fetus is unknown. This study investigated the effect of twinning on adrenocortical responsiveness to either the physiological stress of acute hypoxaemia or to an exogenous ACTH test, and on the fetal cardiovascular, metabolic and endocrine responses to acute hypoxaemic stress. Twenty Welsh Mountain sheep fetuses were chronically instrumented (1–2% halothane) at 121 ± 3 days of gestation (term is ca 145 days) with amniotic and vascular catheters and with a transit-time flow probe around a femoral artery. The animals were divided into two groups based upon fetal number (singletons...

Individual accumulation of heterogeneous risks explains perinatal inequalities within deprived neighbourhoods

Timmermans, Sarah; Bonsel, Gouke J.; Steegers-Theunissen, Régine P. M.; Mackenbach, Johan P.; Steyerberg, Ewout W.; Raat, Hein; Verbrugh, Henri A.; Tiemeier, Henning W.; Hofman, Albert; Birnie, Erwin; Looman, Caspar W. N.; Jaddoe, Vincent W. V.; Steegers
Fonte: Springer Netherlands Publicador: Springer Netherlands
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.07%
Dutch’ figures on perinatal mortality and morbidity are poor compared to EU-standards. Considerable within-country differences have been reported too, with decreased perinatal health in deprived urban areas. We investigated associations between perinatal risk factors and adverse perinatal outcomes in 7,359 pregnant women participating in population-based prospective cohort study, to establish the independent role, if any, for living within a deprived urban neighbourhood. Main outcome measures included perinatal death, intrauterine growth restriction (IUGR), prematurity, congenital malformations, Apgar at 5 min < 7, and pre-eclampsia. Information regarding individual risk factors was obtained from questionnaires, physical examinations, ultrasounds, biological samples, and medical records. The dichotomous Dutch deprivation indicator was additionally used to test for unexplained deprived urban area effects. Pregnancies from a deprived neighbourhood had an increased risk for perinatal death (RR 1.8, 95% CI [1.1; 3.1]). IUGR, prematurity, Apgar at 5 min < 7, and pre-eclampsia also showed higher prevalences (P < 0.05). Residing within a deprived neighbourhood was associated with increased prevalence of all measured risk factors. Regression analysis showed that the observed neighbourhood related differences in perinatal outcomes could be attributed to the increased risk factor prevalence only...

Giant placental chorioangioma: a rare cause of fetal hydrops

Barros, Andreia; Freitas, Ana Cristina; Cabral, António Jorge; Camacho, Maria Carmo; Costa, Edite; Leitão, Henrique; Nunes, José Luis
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 17/05/2011 EN
Relevância na Pesquisa
35.89%
Giant choriangiomas are rare placental tumours, associated with a high prevalence of pregnancy complications and a poor perinatal outcome. Neonatal consequences include severe microangiopathic haemolytic anaemia, thrombocytopaenia and hydrops. The associated high perinatal death rate (30–40%) has led to a number of prenatal therapeutic interventions with limited success in most cases. The authors present a case of non-immune fetal hydrops caused by a giant chorioangioma, diagnosed at 27 weeks of gestational age. Despite tocolytic therapy, the baby was born prematurely (28 weeks of gestational age) and required transfusion of blood derivatives, intensive phototherapy and exchange transfusion. She had an uncomplicated recovery and was discharged home in the second month of life. The authors emphasise the need to consider chorioangioma as a cause of non-immune fetal hydrops and microangiopathic haemolytic anaemia.

Perinatal Outcome in Unbooked Teenage Pregnancies in the University of Calabar Teaching Hospital, Calabar, Nigeria

Iklaki, C. U.; Inaku, J. U.; Ekabua, J. E.; Ekanem, E. I.; Udo, A. E.
Fonte: International Scholarly Research Network Publicador: International Scholarly Research Network
Tipo: Artigo de Revista Científica
Publicado em 04/03/2012 EN
Relevância na Pesquisa
56.16%
Background. Teenage pregnancy being a high risk condition requires skilled attention for good outcome. Objectives. To determine the influence of antenatal care on perinatal outcome in teenage pregnancies in Calabar. Materials and Methods. A review of patient records in Calabar was conducted between 1st January, 2006 and 31st December, 2010, to determine perinatal outcome in teenage pregnancy. Results. Teenage pregnancy accounted for 644 (6.5%) of the total deliveries with 245 (38.0%) booked while 399 (62.0%) were unbooked. Teenage mothers contributed significantly to the proportion of women who were delivered without prior antenatal care (χ2 = 6.360; P < 0.05). The mean duration of labour in booked teenagers was 10.85 ± 4.2 hours, while unbooked teenagers was 23.31 ± 3.6 hours (t-value = 77.1039; P < 0.05). There was statistically more caesarean sections among unbooked teenage pregnancies than booked (χ2 = 36.75; P < 0.05). Stillbirth was statistically significant (χ2 = 27.096; P < 0.05) among unbooked teenagers than booked. However, early neonatal death was not significantly different between booked and unbooked teenage pregnancies(χ2 = 0.512; P < 0.05). Conclusion. Unbooked teenage pregnancies were significantly associated with increased operative intervention and poor perinatal outcome.

Maternal and Fetal Acid-Base Chemistry: A Major Determinant of Perinatal Outcome

Omo-Aghoja, L
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
35.98%
Very small changes in pH may significantly affect the function of various fetal organ systems, such as the central nervous system, and the cardiovascular system with associated fetal distress and poor Apgar score. Review of existing data on maternal-fetal acid-base balance in pregnancy highlight the factors that are associated with derangements of the acid-base status and the impact of the derangements on fetal outcome. Extensive search of electronic databases and manual search of journals for relevant literature on maternal and fetal acid chemistry, clinical studies and case studies were undertaken. There is a substantial reduction in the partial pressure of carbon dioxide (pCO2) in pregnancy. Adequate buffering prevents significant changes in maternal arterial pH. Normal fetal metabolism results in the production of acids which are buffered to maintain extracellular pH within a critical range. Fetal hypoxia can occur when maternal oxygenation is compromised, maternal perfusion of the placenta is reduced, or delivery of oxygenated blood from the placenta to the fetus is impeded. When adequate fetal oxygenation does not occur, metabolisms proceed along with an anaerobic pathway with production of organic acids, such as lactic acid. Accumulation of lactic acid can deplete the buffer system and result in metabolic acidosis with associated low fetal pH...

Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

Mahajan, Hemant; Sharma, Bhuwan
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em 26/03/2014 EN
Relevância na Pesquisa
35.92%
Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas.

Electroencephalogram and Magnetic Resonance Imaging Comparison as a Predicting Factor for Neurodevelopmental Outcome in Hypoxic Ischemic Encephalopathy Infant Treated with Hypothermia

Del Balzo, Francesca; Maiolo, Stella; Papoff, Paola; Giannini, Luigi; Moretti, Corrado; Properzi, Enrico; Spalice, Alberto
Fonte: PAGEPress Publications, Pavia, Italy Publicador: PAGEPress Publications, Pavia, Italy
Tipo: Artigo de Revista Científica
Publicado em 01/10/2014 EN
Relevância na Pesquisa
36.02%
Hypoxic-ischemic encephalopathy (HIE) is an important cause of acute neurological damage in newborns at (or near) term. Several trials in recent years have shown that moderate hypothermia by total body cooling or selective head is an effective intervention to reduce mortality and major disability in infants survived a perinatal hypoxic-ischemic attack. Follow-up in these patients is very important to establish neurodevelopmental outcome, and specific markers can lead us to detect predicting sign for good or poor outcome. We reported a few cases of newborn with HIE treated with hypothermia, in whom the comparison between electroencephalogram (EEG) and magnetic resonance imaging (MRI) represents the first marker for neurodevelopment outcome prediction. The continuous EEG monitoring showed a depressed EEG activity with diffuse burst depression in 7 patients. No epileptic abnormalities were registered. In 10 out of 20 patients no abnormalities of the background activity and no epileptic abnormalities were observed. We found that a depressed EEG activity during the first 72 h of life and a diffused alteration of basal ganglia at MRI were correlated with a poor neurodevelopmental outcome at 18 months of follow-up.

The Human Resources for Health Crisis in Zambia : An Outcome of Health Worker Entry, Exit, and Performance within the National Health Labor Market

Herbst, Christopher H.; Vledder, Monique; Campbell, Karen; Sjöblom, Mirja; Soucat, Agnes
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
35.92%
This report compiles recent evidence on the Zambian health labor market and provides some baseline information on human resources for health (HRH) to help the government address its HRH challenges. Rather than focusing on making policy recommendations, the report is designed to be a source book to benefit and fuel discussions related to HRH in Zambia. Most of the data presented in the report covers the period 2005-08. The report analyzes the national health labor market to better understand the available evidence related to the stock, distribution, and performance of HRH in Zambia (that is, the HRH outcomes). It aims to explain those HRH outcomes by mapping, assessing, and analyzing pre-service education and labor market dynamics, that is, the flow of health workers into, within, and out of the health labor market, as well as the core factors influencing these dynamics. Finally, this report examines the issue of access and equity of HRH. It finds that even if health workers are available, in either urban or rural areas...

Substance use during pregnancy: risk factors and obstetric and perinatal outcomes in South Australia

Kennare, R.; Heard, A.; Chan, A.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
Relevância na Pesquisa
46.16%
Objective: To determine the prevalence of self-reported substance use during pregnancy in South Australia, the characteristics of substance users, their obstetric outcomes and the perinatal outcomes of their babies. Methods: Multivariable logistic regression with STATA statistical software was undertaken using the South Australianperinatal data collection 1998–2002. An audit was conducted on every fifth case coded as substance use to identify the actual substances used. Results: Substance use was reported by women in 707 of 89 080 confinements (0.8%). Marijuana (38.9%), methadone (29.9%), amphetamines (14.6%) and heroin (12.5%) were most commonly reported, with polydrug use among 18.8% of the women audited. Substance users were more likely than non-users to be smokers, to have a psychiatric condition, to be single, indigenous, of lower socio-economic status and living in the metropolitan area. The outcome models had poor predictive powers. Substance use was associated with increased risks for placental abruption (OR 2.53) and antepartum haemorrhage from other causes (OR 1.41). The exposed babies had increased risks for preterm birth (OR 2.63), small for gestational age (OR 1.79), congenital abnormalities (1.52), nursery stays longer than 7 days (OR 4.07)...

Effectiveness of continuous glucose monitoring during diabetic pregnancy (GlucoMOMS trial); a randomised controlled trial

Voormolen, D.; DeVries, J.; Franx, A.; Mol, B.; Evers, I.
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
35.96%
Background: Hyperglycemia in pregnancy is associated with poor perinatal outcome. Even if pregnant women with diabetes are monitored according to current guidelines, they do much worse than their normoglycaemic counterparts, marked by increased risks of pre-eclampsia, macrosomia, and caesarean section amongst others. Continuous Glucose Monitoring (CGM) is a new method providing detailed information on daily fluctuations, used to optimize glucose control. Whether this tool improves pregnancy outcome remains unclear. In the present protocol, we aim to assess the effect of CGM use in diabetic pregnancies on pregnancy outcome. Methods/design: The GlucoMOMS trial is a multicenter open label randomized clinical trial with a decision and cost-effectiveness study alongside. Pregnant women aged 18 and over with either diabetes mellitus type 1 or 2 on insulin therapy or with gestational diabetes requiring insulin therapy before 30 weeks of gestation will be asked to participate. Consenting women will be randomly allocated to either usual care or complementary CGM. All women will determine their glycaemic control by self-monitoring of blood glucose levels and HbA1c. In addition, women allocated to CGM will use it for 5–7 days every six weeks. Based on their CGM profiles they receive dietary advice and insulin therapy adjustments if necessary. The primary outcome measure is rate of macrosomia...

Determinants of adverse perinatal outcome in high-risk women with abnormal uterine artery Doppler images

Toal, M.; Keating, S.; Machin, G.; Dodd, J.; Adamson, S.L.; Windrim, R.C.; Kingdom, J.C.P.
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
56.08%
Objective: The purpose of this study was to evaluate the prognostic role of placental ultrasound imaging at 19-23 weeks of gestation in clinically high-risk women with abnormal uterine artery Doppler (UTAD). Study Design: Placentas of 60 women with abnormal UTAD were examined at 19-23 weeks of gestation for shape and texture abnormalities. Findings were correlated with clinical outcomes (preterm delivery at <32 weeks of gestation; birth weight <10th percentile [small for gestational age]; preeclampsia/hemolysis, elevated liver enzymes, low platelets; early-onset intrauterine growth restriction with abnormal umbilical artery Doppler; and intrauterine fetal death) and maternal serum screening data. Placental disease was reviewed by 2 perinatal pathologists. Results: Women with abnormal placental shape at 19-23 weeks of gestation (n = 28) had higher odds of intrauterine fetal death (odds ratio, 4.5; 95% CI, 1.3-15.6), delivery at <32 weeks of gestation (odds ratio, 4.7; 95% CI, 1.6-14.1]), and intrauterine growth restriction (odds ratio, 4.7; 95% CI, 1.4-15.1]) than did the women with a normal placental shape. Thirty-two of 41 placentas (74%) weighed <10th percentile, and 36 of 43 placentas (83%) had ischemic-thrombotic pathologic condition. There was no association between abnormal placental shape at 19-23 weeks of gestation and placental weight...

Perinatal outcomes following maternal asthma and cigarette smoking during pregnancy

Hodyl, N.A.; Stark, M.J.; Scheil, W.; Grzeskowiak, L.E.; Clifton, V.L.
Fonte: European Respiratory Society Publicador: European Respiratory Society
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
35.99%
Does cigarette smoking in pregnancy explain the increased risk of adverse perinatal outcomes that occur with maternal asthma or does it compound the effect? Using population based birth records, a retrospective analysis was conducted of all singleton pregnancies in South Australia over 10 years (1999–2008; n=172 305), examining maternal asthma, cigarette smoking and quantity of smoking to estimate odds ratios. Compared with nonasthmatic females who did not smoke during pregnancy, both asthmatic females who smoked and those who did not smoke during pregnancy had a significantly increased risk of gestational diabetes, antepartum haemorrhage, polyhydramnios, premature rupture of membranes, emergency Caesarean section, and the child being small for gestational age and having congenital abnormalities. These associations suggest that asthma, independently of maternal smoking, increases the risk of these adverse perinatal outcomes. Maternal smoking was itself associated with an increased risk of a number of poor neonatal outcomes, with a dose–response relationship observed. Notably, maternal asthma combined with cigarette smoking significantly increased the risk of preterm birth and urinary tract infections to a greater degree than with either exposure alone. Maternal asthma and cigarette smoking during pregnancy are both independently associated with adverse perinatal outcomes and...

Cervical pessaries for prevention of preterm birth in women with a multiple pregnancy (ProTWIN): a multicentre, open-label randomised controlled trial

Liem, S.; Schuit, E.; Hegeman, M.; Bais, J.; de Boer, K.; Bloemenkamp, K.; Brons, J.; Duvekot, H.; Nij Bijvanck, B.; Franssen, M.; Gaugler, I.; de Graaf, I.; Oudijk, M.; Papatsonis, D.; Pernet, P.; Porath, M.; Scheepers, L.; Sikkema, M.; Sporken, J.; Viss
Fonte: Lancet Publicador: Lancet
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.35%
Background: In women with a multiple pregnancy, spontaneous preterm delivery is the leading cause of perinatal morbidity and mortality. Interventions to reduce preterm birth in these women have not been successful. We assessed whether a cervical pessary could effectively prevent poor perinatal outcomes. Methods: We undertook a multicentre, open-label randomised controlled trial in 40 hospitals in the Netherlands. We randomly assigned women with a multiple pregnancy between 12 and 20 weeks' gestation (1:1) to pessary or control groups, using a web-based application with a computer-generated list with random block sizes of two to four, stratified by hospital. Participants and investigators were aware of group allocation. For women in the pessary group, a midwife or obstetrician inserted a cervical pessary between 16 and 20 weeks' gestation. Women in the control group did not receive the pessary, but otherwise received similar obstetrical care to those in the pessary group. The primary outcome was a composite of poor perinatal outcome: stillbirth, periventricular leucomalacia, severe respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular haemorrhage, necrotising enterocolitis, proven sepsis, and neonatal death. Analyses were by modified intention to treat. This trial is registered in the Dutch trial registry...

Is Gestational Diabetes a Clinical Entity?

Hunter, David J. S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1984 EN
Relevância na Pesquisa
35.95%
`Gestational diabetes' is defined as abnormal glucose tolerance appearing for the first time in pregnancy. However, it is difficult to establish an important relationship between this diagnosis and poor perinatal outcome. There is little evidence, therefore, that screening for the condition with a glucose tolerance test (GTT) will provide significant improvement in obstetrical results. It is likely that maternal age and weight can predict women at risk of perinatal loss with equal or greater effectiveness. Focus on GTTs may lead the clinician to neglect more important factors associated with perinatal loss. Attention to the currently accepted risk factors of maternal age, stature, and post-obstetric history, together with careful assessment of fetal growth, should be the approach to care in patients at risk from gestational diabetes.

Diagnosis of Severe Fetal Anemia Based on Perinatal Outcomes: A Comparative Analysis of the Current Reference Values

Reis, Zilma Silveira Nogueira; Osanan, Gabriel Costa; Coelho, Tiago Lanfernini Ricardo; Rezende, Cezar Alencar De Lima; Leite, Henrique Vitor; Cabral, Antônio Carlos Vieira
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.95%
Objectives. To compare current criteria for severe fetal anemia diagnosis. Methodology. A cohort study analyzed 105 alloimmunized fetuses that underwent cordocentesis due to risk of anemia. Concordance among the diagnostic criteria for severe fetal anemia, hemoglobin deficit >7 g/dL, hemoglobin deficit ≥5 g/dL, and hemoglobin concentration <0.55 MoM, was analyzed using Cohen's Kappa index. Perinatal mortality, fetal hydrops, and fetal acidosis were used to discuss discordances. Results. There was fair concordance among the three criteria analyzed: 0.80 (Kappa index, IC 95%: 0.67 to 0.93) when comparing hemoglobin deficit >7.0 g/dL and hemoglobin concentration <0.55 MoM criteria, 0.63 (Kappa index, IC 95%: 0.47 to 0.69) when comparing hemoglobin deficit ≥5.0 g/dL and hemoglobin deficit >7.0 g/dL reference, and 0.77 (Kappa index, IC 95%: 0.64 to 0.90) when comparing hemoglobin deficit≥5.0 g/dL and hemoglobin concentration <0.55 MoM standards. Eighteen cases were classified differently depending on the criteria used. The cut-off point of hemoglobin deficit ≥5 g/dL was the best criterion to discriminate fetuses with poor perinatal outcome in our study. Conclusions. Relevant discordances in classification of severe fetal anemia were pointed out. Some criteria may underestimate the real gravity of fetal anemia.

Patología obstétrica y resultado perinatal en la población inmigrante atendida en el hospital del mar de Barcelona

Castillo Vico, Maria Teresa
Fonte: [Barcelona] : Universitat Autònoma de Barcelona, Publicador: [Barcelona] : Universitat Autònoma de Barcelona,
Tipo: Tesis i dissertacions electròniques; info:eu-repo/semantics/doctoralThesis; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em //2015 CAT
Relevância na Pesquisa
46.21%
La inmigración es hoy en día un fenómeno importante para la mayor parte de los países del mundo occidental, ya sea desde un punto de vista económico como social y cultural. En la actualidad, las razones económicas constituyen una de las causas más comunes de migración. De este modo, las personas buscan un nuevo lugar más propicio para su desarrollo, en el que puedan adquirir un mejor nivel de vida. Este tipo de migración suele darse desde países en vías de desarrollo hacia lugares más prósperos o con mayores posibilidades teóricas de desarrollo personal.En los últimos veinte años han llegado a España personas que provienen de diferentes partes del mundo. Estas personas se han instalado, principalmente en las comunidades de Cataluña, Madrid , Andalucía y Valencia, debido a las oportunidades de incorporación al mercado laboral que existen, especialmente, en sectores en los que debido al nivel salarial, a los horarios, a la temporalidad de los contratos o incluso a la peligrosidad y siniestralidad laboral, resulta difícil de conseguir mano de obra autóctona. En Barcelona, los distritos de Sant Martí y de Ciutat Vella son áreas de referencia del Hospital del Mar, y en ellos se concentra casi el 4% del total de la población extranjera inmigrante de la ciudad...

Saúde perinatal em Pelotas, RS, Brasil: fatores sociais e biológicos; Perinatal health in Pelotas, Rio Grande do Sul, Brazil: social and biological factors

Barros, Fernando C.; Victora, Cesar G.; Granzoto, José Aparecido; Vaughan, J. Patrick; Lemos Júnior, Ari Vieira
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/08/1984 POR
Relevância na Pesquisa
46.08%
Todos os nascimentos ocorridos em hospitais na cidade de Pelotas, RS, Brasil, durante 1982, foram estudados através de entrevistas hospitalares e de visitas domiciliares de uma amostra dos recém-nascidos e revisão mensal de atestados de óbito. A mortalidade perinatal para recém-nascidos de partos únicos foi de 31,9/1.000 nascidos totais, sendo a mortalidade fetal de 16,2/1.000 e a mortalidade neonatal precoce de 15,9/1.000. A incidência de baixo peso ao nascer (peso abaixo de 2.500g) foi de 8,1% para partos únicos.; All hospital births occurring during 1982 in Pelotas, Southern Brazil (pop. 260,000) were studied. This a highly representative perinatal population, since in this city less than 1% of the deliveries occur at home. The study was performed through: hospital interviews with mothers and evaluation of the newborn; home visits of a random sample of 15% of the births after the seventh day of life; and monthly checking of birth and death certificates. Overall, the perinatal mortality rate (PNMR) for singletons was 31.9/1,000 births, fetal mortality rate (FMR) being 16.2/1,000 and early neonatal mortality rate (ENMR) 15.9/1,000. The incidence of low birth weight (LBW) babies was 8.1%. Main causes of death were immaturity...

Advanced abdominal pregnancy: a case report of good maternal and perinatal outcome

Sr,EM Brewster; Braithwaite,EA; Brewster Jr,EM
Fonte: West Indian Medical Journal Publicador: West Indian Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2011 EN
Relevância na Pesquisa
56.04%
Advanced abdominal pregnancy is understood to mean any extrauterine pregnancy found within the peritoneal cavity that is greater than 20 weeks gestation. Its management is one of laparotomy with varying complications including poor perinatal outcome and increased maternal morbidity and mortality. There is no accepted consensus for the complete removal of the placenta at laparotomy. This paper reports the management of a unique case of advanced abdominal pregnancy that was diagnosed by ultrasound at 20 weeks gestation and treated conservatively until delivery of a viable female neonate at 33 weeks and 4 days by elective laparotomy. At the time of laparotomy, the placenta was removed completely with good maternal outcome. This, to the best of our knowledge, is the first case in the West Indian literature documenting complete removal of the placenta at the time of laparotomy with good maternal outcome.