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Id: biblio-1284548
Autor: Cieto, Júlia Ferreira; Santos, Laleska Andres Costa; Gozzo, Thais de Oliveira.
Título: Câncer durante a gravidez: análise dos casos com ênfase nos resultados obstétricos e neonatais / Cáncer durante el embarazo: análisis de casos con énfasis sobre resultados obstétricos y neonatales / Cancer during pregnancy: analysis of cases with emphasis on obstetric and neonatal results
Fonte: Rev. enferm. Cent.-Oeste Min;11:4096, 20210000.
Idioma: pt.
Resumo: Objetivos: Conhecer as interferências do câncer no processo gestacional e seu desfecho, identificar as neoplasias mais frequentemente diagnosticadas em mulheres no período reprodutivo. Métodos: Foram coletadas, informações dos prontuários de mulheres que vivenciaram o câncer, durante a gestação, no período de 2011 a 2018, acompanhadas em um hospital de referência. Resultados: Os cânceres mais prevalentes, durante a gestação foram: mama, colo do útero, leucemia e linfoma, 64,29% das grávidas estavam no segundo trimestre. A faixa etária foi de 27 a 44 anos, 80% receberam quimioterapia, 73,68% apresentaram complicações na gestação/puerpério, 42,11% das mulheres foram a óbito. Observaram-se 70,59% recém-nascidos pré-termo, 56,25% baixo peso, ocorrência de dois abortos espontâneos e um natimorto. Conclusão: Neoplasias associadas à gravidez têm aumentando em incidência e, contribuindo para a mortalidade indireta na gravidez e no pós-parto. Desca-se a abordagem multidisciplinar, centrada no bem-estar maternofetal, além de incluir a mulher e a família no processo(AU)

Objectives: To know how cancer interferes with pregnancy , to identify the most frequently diagnosed neoplasms in women in the reproductive period. Methods: Information was collected from the medical records of women who experienced cancer during pregnancy, from 2011 to 2018, and were treated at a reference hospital. Results: The most prevalent cancers during pregnancy were breast, cervix, leukemia and lymphoma. 64.29% of pregnant women were in the second trimester. The age range was between 27 and 44 years. 80% of these weomen received chemotherapy, 73.68% had complications during pregnancy / postpartum, and 42.11% died. There were 70.59% preterm newborns, 56.25% underweight, two spontaneous abortions and one stillbirth. Conclusion: The incidence of neoplasms associated with pregnancy have increased and contributed to indirect mortality in pregnancy and postpartum. The multidisciplinary approach is centeredon mother-fetus well-being, in addition to including women and family in the process(AU)

Objetivos: Conocer las interferencias del cáncer en el proceso gestacional y su desenlace, identificar las neoplasias más frecuentemente diagnosticadas en mujeres en período reproductivo. Métodos: Se recopiló información de las historias clínicas de mujeres que experimentaron cáncer durante el embarazo, de 2011 a 2018, acompañadas en un hospital de referencia. Resultados: Los cánceres más prevalentes durante el embarazo fueron: mama, cérvix, leucemia y linfoma, el 64,29% de las gestantes estaban en el segundo trimestre. El rango de edad fue de 27 a 44 años, el 80% recibió quimioterapia, el 73,68% presentó complicaciones durante el embarazo/puerperio, fallecieron el 42,11% de las mujeres. Hubo 70,59% de recién nacidos prematuros, 56,25% de bajo peso, dos abortos espontáneos y un mortinato. Conclusión: Las neoplasias asociadas al embarazo han aumentado en incidencia, contribuyendo a la mortalidad indirecta en el embarazo y posparto. El enfóque se centra en el punto de vista multidisciplinario, dirigido al bienestar materno-fetal, además de incluir a la mujer y la familia en el proceso(AU)
Descritores: Complicações Neoplásicas na Gravidez
Recém-Nascido
Resultado da Gravidez
Limites: Humanos
Feminino
Gravidez
Responsável: BR1259.1 - DIBIB - Divisão de Biblioteca


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Id: biblio-1003726
Autor: Chiriboga-Vivanco, Richard; Gonzaga-Aguilar, Daniel.
Título: Útero didelfo, bicollis con embarazo gemelar: revisión de la literatura a propósito de un caso / Didelphic uterus, bicollis with twin pregnancy: review of the literature on a case-by-case basis
Fonte: Rev. chil. obstet. ginecol. (En línea);84(1):75-81, feb. 2019. tab, graf, ilus.
Idioma: es.
Resumo: RESUMEN El útero didelfo forma parte de las anomalías müllerianas, este se produce tras a una falla en la fusión de los conductos müllerianos, resultando dos cavidades uterinas divergentes y dos cérvix que se fusionan en el segmento inferior uterino. En la mayoría de los casos esta malformación se asocia a septo vaginal longitudinal o septo unilateral con formación de una hemivagina. Todo esto debido a deficiencias en el proceso de organogénesis de los conductos müllerianos. Esta revisión relata el caso de una paciente con útero didelfo, quién obtuvo un embarazo gemelar en un hemiútero, sin métodos de apoyo para alcanzar el embarazo, del cual se obtuvieron dos productos sanos tras cesárea de emergencia por amenaza de parto gemelar prematuro en la semana 34,5 de gestación. Los embarazos gemelares en úteros didelfos se estiman en 1 por cada millón de habitantes, pero a la actualidad solo se encuentran reportados alrededor de 20 casos.

ABSTRACT The uterus didelphys is part of the müllerian anomalies, this occurs after a failure in the fusion of the müllerian ducts, resulting in two divergent uterine cavities and two cervix that fuse in the lower uterine segment. In most cases, this malformation is associated with a longitudinal vaginal septum or unilateral septum with the formation of a hemivagina. All this due to deficiencies in the process of organogenesis of the müllerian ducts. This review reports the case of a patient with a uterus didelphis, who obtained a twin pregnancy in a hemi-uterus, without support methods to achieve pregnancy, from which two healthy products were obtained after emergency cesarean by threat of premature twin delivery in the week 34,5 of gestation. Twin pregnancies in uterus didelphys are estimated at 1 per million inhabitants, but currently only about 20 cases are reported.
Descritores: Útero/anormalidades
Gravidez de Gêmeos
-Vagina/anormalidades
Resultado da Gravidez
Ductos Paramesonéfricos/anormalidades
Limites: Humanos
Feminino
Gravidez
Recém-Nascido
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL126.2 - Biblioteca Médica Dr. Profesor Hernán Alessandri R.


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Id: biblio-844418
Autor: Villarroel, Julia; Álvarez, Ana M; Salvador, Francisco; Chávez, Ana; Wu, Elba; Contardo, Verónica.
Título: Mujeres jóvenes con infección por VIH adquirida por transmisión vertical: expectativas de tener hijos no infectados / Young women with HIV infection acquired by vertical transmission: expectations of having uninfected children
Fonte: Rev. chil. infectol;33(6):650-655, dic. 2016. tab.
Idioma: es.
Resumo: Introduction: Pediatric antiretroviral therapy (ART), changed the prognosis of the disease, allowing young women infected by vertical transmission (TV) to be pregnant without risk for their fetus of acquiring this infection. Aim: To describe the clinical-immune status in pregnant women that acquired HV by vertical transmission, treatments received, monitoring of pregnancy and newborn characteristics. Material and Methods: A protocol was performed, evaluating clinical and immunological parameters during pregnancy, ART used, protocol preventing vertical transmission (PPTV), and follow up of children to 18 months of age. Results: Of 358 HIV-positive patients vertically infected, five women became pregnant, between 14 and 24 years old. Pregnancies were controlled in clinical/immune-stage N2 C3. They had received two to five therapies. Full PPTV was performed in all binomials. Pre-natal undetectable viral loads ranged from 4,700 ARN copies/mL. Five living children were born by Caesarean section, four of them with 37 weeks of completed gestation and one of them with 34 weeks of gestation. All received zidovudine (AZT) for 6 weeks. CD4 at 72 hours of life ranged from 48% to 74.6%. All children were born uninfected with HIV. Only two had mild anemia. Conclusions: Expectations of HIV mothers vertically infected to have healthy children are similar to those infected by horizontal transmission, using PPTV

Introducción: La terapia anti-retroviral en pediatría (TARV), cambió el pronóstico de la enfermedad, permitiendo embarazarse a mujeres jóvenes infectadas por transmisión vertical (TV). Objetivos: Conocer las características clínico-inmunológicas de las mujeres embarazadas, tratamientos recibidos, condición al embarazo y seguimiento de sus recién nacidos. Material y Método: Se efectuó un protocolo, evaluando etapas clínico-inmunológicas en el embarazo, TARV usadas, protocolo de prevención de transmisión vertical (PPTV) y seguimiento de los niños hasta 18 meses. Resultados: De 358 pacientes con infección por VIH adquirida por TV, cinco mujeres se embarazaron, con edades entre 14 a 24 años, embarazos que fueron controlados por el equipo de salud, encontrándose en etapa clínico-inmunológica N2 a C3. Habían recibido dos a cinco esquemas de TARV. Se efectuó PPTV completo en todos los binomios. Las cargas virales previas al parto fluctuaron entre indetectable y 4.700 copias ARN/ml. Nacieron por cesárea cinco niños vivos, cuatro de término y uno con 34 semanas de gestación. Todos recibieron zidovudina (AZT) durante seis semanas. Los CD4 a las 72 h de vida fluctuaron entre 48 y 74,6%. Ninguno de los niños adquirió la infección por VIH en forma vertical. Sólo dos presentaron anemia leve. Conclusiones: Las expectativas de madres con infección por VIH de adquisición vertical de tener hijos sanos son semejantes a las infectadas por transmisión horizontal, al usar PPTV.
Descritores: Complicações Infecciosas na Gravidez/virologia
Infecções por HIV/transmissão
Transmissão Vertical de Doenças Infecciosas/prevenção & controle
Fármacos Anti-HIV/uso terapêutico
-Complicações Infecciosas na Gravidez/tratamento farmacológico
Resultado da Gravidez
Infecções por HIV/imunologia
Infecções por HIV/prevenção & controle
Seguimentos
Contagem de Linfócito CD4
Carga Viral
Quimioterapia Combinada
Genótipo
Limites: Humanos
Masculino
Gravidez
Recém-Nascido
Adolescente
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-961407
Autor: León, Pilar; Lería, Josefina; Cardemil, Daniela; Díaz, Angélica; Hernández, Miguelina; Chubretovic, Magdalena; González, Josefa; Cabrera, María Elena.
Título: Aplasia medular adquirida y embarazo. caso clínico / Acquired aplastic anemia during pregnancy. report of one case
Fonte: Rev. méd. Chile;146(3):399-402, mar. 2018. graf.
Idioma: es.
Resumo: Aplastic anemia (AA) or acquired aplastic anemia is an uncommon and potentially fatal disease. It is defined as reduction of at least two peripheral blood series, associated with persistent bone marrow hypocellularity. It's association with pregnancy is even more uncommon, and it may result in high mortality for the mother and the child. We report an adolescent female with aplastic anemia, which worsened during pregnancy. Her hemoglobin was 5.2 g/dl, her leukocytes were 1,833/ul and her platelets were 19,000/ul. She was initially treated with cyclosporine and horse antithymocyte globulin without hematologic improvement. At 36 weeks of pregnancy methylprednisolone and platelet transfusions were used and a cesarean section was performed. Six month later she continues to require red blood cell and platelet transfusions.
Descritores: Complicações Hematológicas na Gravidez/terapia
Anemia Aplástica/terapia
-Índice de Gravidade de Doença
Resultado da Gravidez
Limites: Humanos
Masculino
Feminino
Gravidez
Recém-Nascido
Adolescente
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-990870
Autor: Lara-Contreras, Alma Concepción; Cervantes-Becerra, Roxana Gisela; Villarreal-Ríos, Enrique; Vargas-Daza, Emma Rosa; Galicia-Rodríguez, Liliana; Martínez-González, Lidia.
Título: Prevalencia de los factores asociados a la no coincidencia del método de planificación familiar electo en la atención prenatal y el aplicado post-evento obstétrico / Prevalence of the factors associated with the non-coincidence of the method of elected family planning in prenatal care and applied post-event obstetric
Fonte: Rev. chil. obstet. ginecol. (En línea);83(6):553-559, 2018. tab.
Idioma: es.
Resumo: RESUMEN Marco teórico: La atención prenatal tiene varios objetivos y entre ellos está el fomentar y sentar bases para una decisión adecuada sobre planificación familiar con base en las condiciones clínicas de la mujer. Es frecuente encontrar en la atención de puerperio que la paciente no haya recibido un método de planificación familiar por distintos factores. Objetivo: Identificar la prevalencia de los factores asociados a la no coincidencia del método de planificación familiar electo en la atención prenatal y el aplicado post-evento obstétrico. Metodología: Diseño transversal descriptivo en pacientes en puerperio inmediato cuyo método de planificación familiar solicitado en consentimiento informado firmado en la atención prenatal no coincidió con el aplicado post-evento obstétrico. Se midieron factores intrínsecos y extrínsecos Resultados: El factor intrínseco más importante fue el cambio de decisión personal 59.0% (IC 95%; 53.10-64.90) y el factor extrínseco la falta de insumos en el 31.20% (IC 95%; 25.60-36.80). Cuando se realizó la evaluación conjunta la prevalencia del cambio de decisión personal se modificó a 35.20% (IC 95%; 29.4-41.0) y la falta de insumos a 12.6% (IC95%; 8.6-16.6) Conclusión: Los factores intrínsecos y extrínsecos asociados a la no coincidencia del método de planificación familiar con mayor prevalencia son el cambio de decisión por la paciente y la falta de insumos respectivamente.

ABSTRACT Background: Prenatal care has several objectives and among them is to promote and lay the groundwork for an adequate decision on family planning based on the clinical conditions of women. It is common to find in puerperium care that the patient has not received a family planning method due to different factors. Objective: To identify the prevalence of the factors associated with the non-coincidence of the method of family planning elected in prenatal care and the post-obstetric event applied. Methods: Descriptive cross-sectional design in patients in the immediate puerperium whose family planning method requested in signed informed consent in prenatal care did not coincide with the applied post-obstetric event. Intrinsic and extrinsic factors were measured Results: The most important intrinsic factor was the change of personal decision 59.0% (95% CI, 53.10-64.90) and the extrinsic factor the lack of inputs in 31.20% (95% CI, 25.60-36.80). When the joint evaluation was carried out, the prevalence of the personal decision change was modified to 35.20% (95% CI, 29.4-41.0) and the lack of inputs to 12.6% (95% CI, 8.6-16.6). Conclusion: The intrinsic and extrinsic factors associated with the non-coincidence of the family planning method with the highest prevalence are the change of decision by the patient and the lack of inputs, respectively.
Descritores: Cuidado Pré-Natal
Parto
Serviços de Planejamento Familiar
-Garantia da Qualidade dos Cuidados de Saúde
Resultado da Gravidez
Estudos Transversais
Limites: Humanos
Feminino
Gravidez
Responsável: CL126.2 - Biblioteca Médica Dr. Profesor Hernán Alessandri R.


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Id: biblio-1045583
Autor: YuanI, P; Wang, Q; Huang, R; Cao, F; Zhu, Z; Sun, D; Zhou, H; Yu, B.
Título: Clinical evaluation with self-sequential longitudinal reference intervals: pregnancy outcome and neonatal thyroid stimulating hormone level associated with maternal thyroid diseases / Evaluación clínica con intervalos de referencia longitudinal auto-secuencial: evolución clínica del embarazo y niveles de la hormona estimulante de la tiroides en neonatos asociados con enfermedades tiroideas maternas
Fonte: West Indian med. j;62(1):28-34, Jan. 2013. ilus, tab.
Idioma: en.
Resumo: OBJECTIVE: We attempted to evaluate maternal thyroid function in a new self-sequential longitudinal reference interval (SLRI) which we established recently. By this method, we analysed the correlation between pregnancy outcome, neonatal thyroid stimulating hormone (TSH) level and maternal thyroid diseases. METHODS: A total of 1744 pregnant women participated in the study and 1747 babies were born from those women (three bore twins). The levels of TSH, free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab) of mothers were quantified by electrochemistry immunoassay (ECL). The levels of neonatal blood TSH were detected by time-resolved fluorescence immunoassay (TRFIA). All data were collected and statistically analysed by SPSS 13.0 software. RESULTS: With our new SLRI method, we found that 0.11%~3.84% pregnant women would get thyroid diseases. Subclinical hypothyroidism was the most common maternal thyroid disorder. Being positive for thyroid peroxidase antibodies was a significant risk factor of subclinical hypothyroidism during pregnancy. The median, P2.5~P97.5, and interquartile range (IQR) of neonatal TSH (N-TSH) of 1747 babies were 2.72 mIU/L, 0.10~8.01 mIU/L and 2.62 mIU/L, respectively; 28.6% of pregnant women with thyroid diseases developed pregnancy complications. The prevalence was significantly higher than in the normal thyroid function group (p< 0.001). The levels of N-TSH were low correlated with maternal TSH levels (p < 0.05), but there were no significant correlations between N-TSH and maternal FT4 and maternal TPO-Ab (p > 0.05). CONCLUSIONS: Thyroid disorders, especially subclinical hypothyroidism, are common in pregnant women. These disorders are associated with pregnancy and fetal outcome. Routine maternal thyroid function screening is important and should be recommended.

OBJETIVO: Intentamos evaluar la función tiroidea materna en un nuevo intervalo de referencia longitudinal auto-secuencial (SLRI) que establecimos recientemente. Por este método, analizamos la correlación entre el resultado del embarazo, el nivel de la hormona estimulante de la tiroides (TSH) en neonatos, y las enfermedades tiroideas maternas MÉTODOS: Un total de 1744 mujeres embarazadas participó en el estudio y 1747 bebés nacieron de esas mujeres (tres de ellas tuvieron gemelos). Los niveles de TSH, la tiroxina libre (FT4), y los anticuerpos de la peroxidasa tiroidea (TPO-Ab) de las madres, fueron cuantificados mediante inmunoensayo electroquímico (ECL). Los niveles de TSH en la sangre de los neonatos, fueron determinados mediante inmunoensayo por fluorescencia resuelto en el tiempo (TRFIA). Todos los datos fueron recogidos y analizados estadísticamente usando el software SPSS 13.0 RESULTADOS: Con nuestro nuevo método SLRI, encontramos que 0.11%~3.84% de las mujeres embarazadas contraerán enfermedades tiroideas. El hipotiroidismo subclínico fue el trastorno de la tiroides materna más común. Ser positivo a los anticuerpos de la peroxidasa tiroidea fue un factor de riesgo significativo del hipotiroidismo subclínico durante el embarazo. La mediana, P2.5~P97.5, y el rango intercuartil (IQR) de la TSH (N-TSH) neonatal de los 1747 bebés fueron 2.72 mIU/L, 0.10~8.01 mIU/L y 2.62 mIU/L respectivamente. El 28.6% de las mujeres embarazadas que tenían enfermedades tiroideas, desarrollaron complicaciones del embarazo. La prevalencia fue significativamente más alta que en el grupo con función tiroidea normal (p < 0.001). Los niveles de N-TSH fueron bajos en correlación con los niveles de TSH maternos (p < 0.05), pero no hubo ninguna correlación significativa entre la N-TSH y la FT4 materna, y la TPO-Ab materna (p > 0.05). CONCLUSIÓNS: Los trastornos tiroideos, especialmente el hipotiroidismo, son comunes en las mujeres embarazadas.Estos trastornos se hallan asociados con el resultado del embarazo y el resultado fetal. El tamizaje de rutina de la función tiroidea materna es importante y debe recomendarse.
Descritores: Peroxidases/sangue
Complicações na Gravidez/diagnóstico
Doenças da Glândula Tireoide/diagnóstico
Tireotropina/sangue
-Complicações na Gravidez/sangue
Complicações na Gravidez/epidemiologia
Trimestres da Gravidez/sangue
Valores de Referência
Doenças da Glândula Tireoide/sangue
Doenças da Glândula Tireoide/epidemiologia
Testes de Função Tireóidea/métodos
Resultado da Gravidez
China/epidemiologia
Triagem Neonatal
Limites: Humanos
Feminino
Recém-Nascido
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-978118
Autor: Mauricio, Besio R; Matías, Fica F; Mónica, Theodor D.
Título: Cerclaje Cérvico-Ístmico transabdominal: experiencia de 30 años / Cervical-Isthmic transabdominal cerclage: experience of 30 years
Fonte: Rev. chil. obstet. ginecol. (En línea);83(5):444-451, nov. 2018. tab.
Idioma: es.
Resumo: RESUMEN Introducción: se define incompetencia cervical como la incapacidad del cuello uterino de retener una gestación en el segundo trimestre, en ausencia de contracciones uterinas. El cerclaje cervical es la intervención que ha demostrado utilidad en el tratamiento de la incompetencia cervical. La principal vía utilizada para cerclaje es la vaginal, sin embargo existe un grupo de pacientes en el que ésta no es posible y debe realizarse un abordaje transabdominal. Este trabajo muestra los resultados y experiencia de 30 años en la instalación de cerclaje por vía abdominal abierta. Se realiza una revisión de la literatura y se discuten sus indicaciones, resultados y complicaciones. Además se analiza la técnica quirúrgica, especialmente las variantes de ella y el momento de realizar la intervención. Métodos: se revisaron datos de 20 pacientes a las que se realizó cerclaje transabdominal, desde el año 1985 hasta la fecha. En todas las cirugías participó el autor principal de este artículo. Resultados: las intervenciones se realizaron entre las 8 y 18 semanas de gestación. Las causas principales fueron la imposibilidad de realizar un cerclaje por vía vaginal, debido a ausencia de cuello por conizaciones amplias o repetidas y amputaciones cervicales o fracaso de cerclajes por vía vaginal previos. Las 20 pacientes tuvieron 23 embarazos, 20 partos (16 mayores de 37 s. y 4 mayores de 34 s.) y 3 abortos. Se obtuvo un 87% de sobrevida fetal. Conclusiones: la utilización de esta técnica es útil en pacientes con imposibilidad de cerclaje por vía vaginal o en fracasos de cerclajes vaginales previos. La literatura revisada no muestra diferencias estadísticamente significativas entre los procedimientos realizados previos o durante la gestación, ni tampoco si se realiza mediante laparoscopía o cirugía abierta.

SUMMARY Introduction: cervical incompetence is defined as the inability of the cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. Cervical cerclage is the intervention that has proven its usefulness in the treatment of cervical incompetence. The main route used for cerclage is vaginal, however there is a group of patients in which this is not possible and a transabdominal approach must be performed. This work shows the results and experience of 30 years in the installation of cerclage by abdominal open route. A review of the literature is made and its indications, results and complications are discussed. In addition, the surgical technique is analyzed, especially it's variants and the moment of performing the intervention. Methods: data from 20 patients who underwent a transabdominal cerclage from 1985 to date were reviewed. In all the surgeries, the main author of this article participated. Results: the interventions were performed between 8 and 18 weeks of gestation. The main causes were the impossibility of performing a cerclage by vaginal route due to absence of the cervix by extensive or repeated conizations and cervical amputations or failure of previous cerclage by vaginal route. The 20 patients had 23 pregnancies, 20 deliveries (16 over 37 w. and 4 over 34 w.) and 3 abortions. 87% of fetal survival was obtained. Conclusions: the use of this technique is useful in patients with inability to cerclage vaginally or in failures of previous vaginal cerclages. The literature reviewed does not show statistically significant differences between the procedures performed before or during pregnancy, nor whether it is performed by laparoscopy or open surgery.
Descritores: Vagina
Incompetência do Colo do Útero
Cerclagem Cervical/métodos
-Complicações Pós-Operatórias
Resultado da Gravidez
Cesárea
Cerclagem Cervical/estatística & dados numéricos
Nascimento Prematuro
Limites: Humanos
Feminino
Gravidez
Recém-Nascido
Adulto
Tipo de Publ: Revisão
Responsável: CL126.2 - Biblioteca Médica Dr. Profesor Hernán Alessandri R.


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Id: biblio-961456
Autor: Henríquez-Villaseca, María Paz; Catalán-Barahona, Alejandra; Lattus-Olmos, José; Vargas-Valdebenito, Karina; Silva-Ruz, Solange.
Título: Hematoma subcapsular hepático roto en síndrome HELLP / Ruptured subscapular liver hematoma in context of HELLP syndrome
Fonte: Rev. méd. Chile;146(6):753-761, jun. 2018. tab, graf.
Idioma: es.
Resumo: Background: Ruptured subscapular liver hematoma in context of HELLP syndrome is a rare complication with high mortality. Clinical presentation is nonspecific: epigastric pain, right upper quadrant pain and shoulder pain, should however provide high index of suspicion. Termination of pregnancy is the only definitive treatment with a beneficial effect on the mother and the fetus. According to the hemodynamic status of the patient, treatment can be conservative through hepatic artery embolization, or surgical management, via contained packing of the bleeding area. Aim: To report seven cases of ruptured subscapular liver hematomas treated in a period of 13 years. Material and Methods: Review of medical records of patients discharged with the diagnosis from 2002 to 2015. Results: We identified seven women aged 30 to 44 years, for a total of 86,858 live births. At presentation, mean gestational age was 36 weeks. Five patients reported epigastric pain and three shoulder pain. All patients met the criteria for HELPP syndrome. All patients were operated on, and packing of the bleeding zone was carried out in six. One patient died. Two newborns died. Conclusions: The features of these patients may help in the management of this uncommon but severe condition.
Descritores: Síndrome HELLP/diagnóstico
Hematoma/cirurgia
Hematoma/etiologia
Hepatopatias/cirurgia
Hepatopatias/etiologia
-Pré-Eclâmpsia
Ruptura Espontânea/cirurgia
Ruptura Espontânea/etiologia
Fatores de Tempo
Índice de Gravidade de Doença
Resultado da Gravidez
Registros Médicos
Estudos Retrospectivos
Idade Gestacional
Resultado do Tratamento
Tempo de Internação
Limites: Humanos
Feminino
Gravidez
Adulto
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-903242
Autor: Mascarello, Keila Cristina; Horta, Bernardo Lessa; Silveira, Mariângela Freitas.
Título: Maternal complications and cesarean section without indication: systematic review and meta-analysis / Complicações maternas e cesárea sem indicação: revisão sistemática e meta-análise
Fonte: Rev. saúde pública (Online);51:105, 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT OBJECTIVE The objective of this study was to determine the risks of severe acute maternal complications associated with cesarean section without medical indication. METHODS A systematic review was carried out with meta-analysis. The literature search was performed systematically, in multiple stages, in the PubMed, Lilacs, and Web of Science databases using the following descriptors: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). The protocol of the study was registered at PROSPERO as CRD42016032933. A total of 1,328 articles were found; after selection, eight publications that met the study objective and inclusion criteria were selected, with information on 1,051,543 individuals. RESULTS The results obtained in the meta-analyses indicate that women with cesarean section have a higher chance of maternal death (OR = 3.10, 95%CI 1.92-5.00) and postpartum infection (OR = 2.83, 95%CI, 1.585.06), but they have a lower chance of hemorrhage (OR = 0.52, 95%CI 0.48-0.57). For the blood transfusion outcome, the group effect was not associated with the type of delivery (95%CI 0.88-2.81). CONCLUSIONS The quality of evidence was considered low for hemorrhage and blood transfusion and moderate for postpartum infection and maternal death. Thus, cesarean sections should be performed with caution and safety, especially when its benefits outweigh the risks of a surgical procedure.

RESUMO OBJETIVO Determinar os riscos de complicações maternas agudas graves associadas ao parto cesárea sem indicação médica. MÉTODOS Foi conduzida uma revisão sistemática com meta-análise. A busca na literatura ocorreu de forma sistemática, em múltiplas etapas, nas bases de dados PubMed, Lilacs e Web of Science, utilizando os descritores: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). O protocolo de estudo foi registrado na PROSPERO sob o número CRD42016032933. Foram encontrados 1.328 artigos, permanecendo, após seleção, oito publicações que atendiam ao objetivo do estudo e critérios de inclusão, com informações de 1.051.543 indivíduos. RESULTADOS Os resultados obtidos nas meta-análises indicam que mulheres de parto cesárea tem maior chance de morte materna (OR = 3,10; IC95% 1,92-5,00) e infecção pós-parto (OR = 2,83; IC95% 1,58-5,06), mas possuem menor chance de hemorragia (OR = 0,52; IC95% 0,48-0,57). Para o desfecho transfusão de sangue, o efeito agrupado não foi associado à via de parto (IC95% 0,88-2,81). CONCLUSÕES A qualidade da evidência foi considerada baixa para os desfechos hemorragia e transfusão de sangue e moderada para infecção pós-parto e morte materna. Assim, as cesáreas devem ser realizadas com prudência e segurança, principalmente quando seus benefícios superam os riscos de um procedimento cirúrgico.
Descritores: Transtornos Puerperais/epidemiologia
Cesárea/efeitos adversos
Mortalidade Materna
Parto Normal/estatística & dados numéricos
-Transtornos Puerperais/mortalidade
Transfusão de Sangue
Resultado da Gravidez/epidemiologia
Cesárea/estatística & dados numéricos
Fatores de Risco
Período Pós-Parto
Hemorragia Pós-Parto/etiologia
Hemorragia Pós-Parto/mortalidade
Limites: Humanos
Feminino
Gravidez
Tipo de Publ: Revisão
Metanálise
Revisão Sistemática
Responsável: BR1.1 - BIREME


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Id: biblio-903199
Autor: Alonso, Bruna Dias; Silva, Flora Maria Barbosa da; Latorre, Maria do Rosário Dias de Oliveira; Diniz, Carmen Simone Grilo; Bick, Debra.
Título: Caesarean birth rates in public and privately funded hospitals: a cross-sectional study
Fonte: Rev. saúde pública (Online);51:101, 2017. tab, graf.
Idioma: en.
Projeto: CAPES.
Resumo: ABSTRACT OBJECTIVE To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women's maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
Descritores: Resultado da Gravidez/epidemiologia
Cesárea/estatística & dados numéricos
Hospitais Privados/estatística & dados numéricos
Saúde da Mulher/estatística & dados numéricos
Hospitais Públicos/estatística & dados numéricos
-Fatores Socioeconômicos
Brasil/epidemiologia
Estudos Transversais
Idade Materna
Pessoa de Meia-Idade
Limites: Humanos
Feminino
Gravidez
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME



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