Base de dados : MEDLINE
Pesquisa : E05.318.308.985.550.362 [Categoria DeCS]
Referências encontradas : 331 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 34 ir para página                         

  1 / 331 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28708899
[Au] Autor:Goodman DM; Ramaswamy R; Jeuland M; Srofenyoh EK; Engmann CM; Olufolabi AJ; Owen MD
[Ad] Endereço:Hubert-Yeargan Center for Global Health, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America.
[Ti] Título:The cost effectiveness of a quality improvement program to reduce maternal and fetal mortality in a regional referral hospital in Accra, Ghana.
[So] Source:PLoS One;12(7):e0180929, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the cost-effectiveness of a quality improvement intervention aimed at reducing maternal and fetal mortality in Accra, Ghana. DESIGN: Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. METHODS: Data were collected on the cost and outcomes of a 5-year Kybele-Ghana Health Service Quality Improvement (QI) intervention conducted at Ridge Regional Hospital, a tertiary referral center in Accra, Ghana, focused on systems, personnel, and communication. Maternal deaths prevented were estimated comparing observed rates with counterfactual projections of maternal mortality and case-fatality rates for hypertensive disorders of pregnancy and obstetric hemorrhage. Stillbirths prevented were estimated based on counterfactual estimates of stillbirth rates. Cost-effectiveness was then calculated using estimated disability-adjusted life years averted and subjected to Monte Carlo and one-way sensitivity analyses to test the importance of assumptions inherent in the calculations. MAIN OUTCOME MEASURE: Incremental Cost-effectiveness ratio (ICER), which represents the cost per disability-adjusted life-year (DALY) averted by the intervention compared to a model counterfactual. RESULTS: From 2007-2011, 39,234 deliveries were affected by the QI intervention implemented at Ridge Regional Hospital. The total budget for the program was $2,363,100. Based on program estimates, 236 (±5) maternal deaths and 129 (±13) intrapartum stillbirths were averted (14,876 DALYs), implying an ICER of $158 ($129-$195) USD. This value is well below the highly cost-effective threshold of $1268 USD. Sensitivity analysis considered DALY calculation methods, and yearly prevalence of risk factors and case fatality rates. In each of these analyses, the program remained highly cost-effective with an ICER ranging from $97-$218. CONCLUSION: QI interventions to reduce maternal and fetal mortality in low resource settings can be highly cost effective. Cost-effectiveness analysis is feasible and should regularly be conducted to encourage fiscal responsibility in the pursuit of improved maternal and child health.
[Mh] Termos MeSH primário: Análise Custo-Benefício
Melhoria de Qualidade/economia
Centros de Atenção Terciária/economia
[Mh] Termos MeSH secundário: Adulto
Feminino
Mortalidade Fetal
Gana
Hemorragia/etiologia
Seres Humanos
Hipertensão Induzida pela Gravidez/mortalidade
Hipertensão Induzida pela Gravidez/patologia
Trabalho de Parto
Mortalidade Materna
Método de Monte Carlo
Gravidez
Avaliação de Programas e Projetos de Saúde/economia
Estudos Retrospectivos
Fatores de Risco
Natimorto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180929


  2 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28328132
[Au] Autor:Cavadino A; Morris JK
[Ad] Endereço:Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
[Ti] Título:Revised estimates of the risk of fetal loss following a prenatal diagnosis of trisomy 13 or trisomy 18.
[So] Source:Am J Med Genet A;173(4):953-958, 2017 Apr.
[Is] ISSN:1552-4833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13) both have high natural fetal loss rates. The aim of this study was to provide estimates of these fetal loss rates by single gestational week of age using data from the National Down Syndrome Cytogenetic Register. Data from all pregnancies with Edwards or Patau syndrome that were prenatally detected in England and Wales from 2004 to 2014 was analyzed using Kaplan-Meier survival estimates. Pregnancies were entered into the analysis at the time of gestation at diagnosis, and were considered "under observation" until the gestation at outcome. There were 4088 prenatal diagnoses of trisomy 18 and 1471 of trisomy 13 in the analysis. For trisomy 18, 30% (95%CI: 25-34%) of viable fetuses at 12 weeks will result in a live birth and at 39 weeks gestation 67% (60-73%) will result in a live birth. For trisomy 13 the survival is 50% (41-58%) at 12 weeks and 84% (73-90%) at 39 weeks. There was no significant difference in survival between males and females when diagnosed at 12 weeks for trisomy 18 (P-value = 0.27) or trisomy 13 (P-value = 0.47). This paper provides the most precise gestational age-specific estimates currently available for the risk of fetal loss in trisomy 13 and trisomy 18 pregnancies in a general population.
[Mh] Termos MeSH primário: Aborto Espontâneo/diagnóstico
Aborto Espontâneo/epidemiologia
Transtornos Cromossômicos/diagnóstico
Transtornos Cromossômicos/epidemiologia
Mortalidade Fetal/tendências
Trissomia/diagnóstico
[Mh] Termos MeSH secundário: Aborto Eugênico/estatística & dados numéricos
Aborto Espontâneo/genética
Adolescente
Adulto
Transtornos Cromossômicos/genética
Transtornos Cromossômicos/patologia
Cromossomos Humanos Par 13/genética
Cromossomos Humanos Par 18
Inglaterra/epidemiologia
Feminino
Feto
Idade Gestacional
Seres Humanos
Nascimento Vivo/epidemiologia
Nascimento Vivo/genética
Masculino
Gravidez
Diagnóstico Pré-Natal
Risco
Natimorto/epidemiologia
Natimorto/genética
Análise de Sobrevida
Trissomia/genética
Trissomia/patologia
Síndrome da Trissomia do Cromossomo 13
Síndrome da Trissomía do Cromossomo 18
País de Gales/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1002/ajmg.a.38123


  3 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28266126
[Au] Autor:Takahashi K; Sasaki A; Wada S; Wada Y; Tsukamoto K; Kosaki R; Ito Y; Sago H
[Ad] Endereço:Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development (NCCHD), Tokyo, Japan.
[Ti] Título:The outcomes of 31 cases of trisomy 13 diagnosed in utero with various management options.
[So] Source:Am J Med Genet A;173(4):966-971, 2017 Apr.
[Is] ISSN:1552-4833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There are few reports on the prognosis of prenatally diagnosed trisomy 13 in relation to postnatal management. The aim of this study was to report on the prenatal and postnatal outcomes and postnatal management of trisomy 13 fetuses that were prenatally diagnosed at our center between 2003 and 2015. The data were retrospectively reviewed from medical records. Of the 31 cases of trisomy 13, 12 patients were diagnosed before 22 weeks of gestation, and 19 were diagnosed at or after 22 weeks of gestation. Nine families opted for termination of the pregnancy, 14 fetuses died, and 8 were born alive. Aggressive treatment was requested in two of the live births, with one patient achieving long-term survival (7 years). The other died during infancy (Day 61). One out of four who received palliative treatment is alive at two years of age with only nutrition supplementation. These three patients who achieved neonatal survival had few structural anomalies. Fetal death and early neonatal death are common in trisomy 13; however, fetuses that receive medical treatment for cases without major ultrasound abnormalities may achieve neonatal survival. Therefore, it is useful to provide comprehensive information, including precise ultrasound findings and treatment options, to parents with trisomy 13 fetuses during genetic counseling.
[Mh] Termos MeSH primário: Aborto Espontâneo/diagnóstico
Transtornos Cromossômicos/diagnóstico
Transtornos Cromossômicos/terapia
Aconselhamento Genético/ética
Trissomia/diagnóstico
[Mh] Termos MeSH secundário: Aborto Eugênico/estatística & dados numéricos
Aborto Espontâneo/genética
Adulto
Transtornos Cromossômicos/genética
Transtornos Cromossômicos/mortalidade
Cromossomos Humanos Par 13/genética
Gerenciamento Clínico
Feminino
Mortalidade Fetal
Feto
Idade Gestacional
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Cariotipagem
Nascimento Vivo/genética
Masculino
Gravidez
Diagnóstico Pré-Natal
Natimorto/genética
Análise de Sobrevida
Resultado do Tratamento
Trissomia/genética
Síndrome da Trissomia do Cromossomo 13
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.1002/ajmg.a.38132


  4 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28166604
[Au] Autor:Lazarin GA; Haque IS; Evans EA; Goldberg JD
[Ad] Endereço:Counsyl, South San Francisco, CA, USA.
[Ti] Título:Smith-Lemli-Opitz syndrome carrier frequency and estimates of in utero mortality rates.
[So] Source:Prenat Diagn;37(4):350-355, 2017 Apr.
[Is] ISSN:1097-0223
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To tabulate individual allele frequencies and total carrier frequency for Smith-Lemli-Opitz syndrome (SLOS) and compare expected versus observed birth incidences. METHODS: A total of 262 399 individuals with no known indication or increased probability of SLOS carrier status, primarily US based, were screened for SLOS mutations as part of an expanded carrier screening panel. Results were retrospectively analyzed to estimate carrier frequencies in multiple ethnic groups. SLOS birth incidences obtained from existing literature were then compared with these data to estimate the effect of SLOS on fetal survival. RESULTS: Smith-Lemli-Opitz syndrome carrier frequency is highest in Ashkenazi Jews (1 in 43) and Northern Europeans (1 in 54). Comparing predicted birth incidence with that observed in published literature suggests that approximately 42% to 88% of affected conceptuses experience prenatal demise. CONCLUSION: Smith-Lemli-Opitz syndrome is relatively frequent in certain populations and, because of its impact on prenatal and postnatal morbidity and mortality, merits consideration for routine screening. © 2017 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
[Mh] Termos MeSH primário: Triagem de Portadores Genéticos
Síndrome de Smith-Lemli-Opitz/diagnóstico
Síndrome de Smith-Lemli-Opitz/genética
Síndrome de Smith-Lemli-Opitz/mortalidade
[Mh] Termos MeSH secundário: Feminino
Mortalidade Fetal
Frequência do Gene
Triagem de Portadores Genéticos/métodos
Testes Genéticos
Sequenciamento de Nucleotídeos em Larga Escala
Seres Humanos
Mutação
Polimorfismo de Nucleotídeo Único
Gravidez
Diagnóstico Pré-Natal/métodos
Diagnóstico Pré-Natal/estatística & dados numéricos
Estudos Retrospectivos
Análise de Sequência de DNA
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1002/pd.5018


  5 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28165177
[Au] Autor:Perry H; Healy C; Wellesley D; Hall NJ; Drewett M; Burge DM; Howe DT
[Ad] Endereço:Wessex Fetal Medicine Unit, Princess Anne Hospital, Southampton, Hampshire, UK.
[Ti] Título:Intrauterine death rate in gastroschisis following the introduction of an antenatal surveillance program: Retrospective observational study.
[So] Source:J Obstet Gynaecol Res;43(3):492-497, 2017 Mar.
[Is] ISSN:1447-0756
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate whether an antenatal surveillance protocol including ultrasound and cardiotocograph monitoring reduces intrauterine death (IUD) in cases of gastroschisis. Secondary outcomes included neonatal death rate, mode of delivery and rate of intervention before planned time of delivery. METHODS: This was a retrospective observational study of all women with antenatally diagnosed gastroschisis who were managed according to the surveillance program between 2002 and 2015 in a tertiary fetal medicine and pediatric surgical center covering the Wessex region of England. We reviewed and analyzed data from the Wessex Antenatally Detected Anomalies (WANDA) database as well as prospectively managed maternity, ultrasound and neonatal databases over the given time period. Case notes were reviewed when delivery was expedited. RESULTS: The IUD rate was 2.2%, a 58% reduction since the introduction of the surveillance protocol. Delivery was expedited in 35.4% of cases, and in 86% of these, delivery was by cesarean section. In women being induced as planned at 38 weeks, the vaginal delivery rate was 88%, and for those in spontaneous labor before 38 weeks it was 75%. CONCLUSIONS: An antenatal surveillance program appears to reduce the IUD in gastroschisis. In one-third of cases, delivery was indicated before the planned date of delivery. When expedited delivery was indicated, the chance of cesarean section was high.
[Mh] Termos MeSH primário: Morte Fetal/prevenção & controle
Mortalidade Fetal
Gastrosquise/complicações
Gastrosquise/diagnóstico
Morte Perinatal/prevenção & controle
Diagnóstico Pré-Natal/métodos
[Mh] Termos MeSH secundário: Cardiotocografia
Parto Obstétrico
Feminino
Seres Humanos
Recém-Nascido
Gravidez
Estudos Retrospectivos
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1111/jog.13245


  6 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:26978521
[Au] Autor:Alimena S; Nold C; Herson V; Fang YM
[Ad] Endereço:a University of Connecticut School of Medicine , Farmington , CT , USA.
[Ti] Título:Rates of intrauterine fetal demise and neonatal morbidity at term: determining optimal timing of delivery.
[So] Source:J Matern Fetal Neonatal Med;30(2):181-185, 2017 Jan.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine rates of unexplained intrauterine fetal demise (IUFD) and neonatal morbidity in uncomplicated term pregnancies to identify the optimal gestational age for delivery. METHODS: A retrospective case control study was performed with singleton pregnancies delivered between 37 0/7 weeks and 42 6/7 weeks. Exclusion criteria were "complicated pregnancies": emergency deliveries, maternal hypertension, diabetes, infection, fetal disease/malformations and placental abnormalities. RESULTS: Nineteen thousand two hundred and sixty-four maternal/infant pairs were examined. The overall rate of NICU admission was 2.7% and the rate of unexplained IUFD was 2.02 per 1000 births. The lowest rate of IUFD was found at 39 weeks (1.40 per 1000 births). Odds ratios adjusted for maternal smoking, ethnicity, age and mode of delivery showed 2.74 (95% CI 0.35-21.83) risk of IUFD at 42 versus 39 weeks, 2.09 (1.47-2.98) risk of NICU admission at 37 versus 38 weeks, 2.54 (1.62-3.97) risk of respiratory morbidity at 37 versus 38 weeks and 3.38 (1.84-6.18) risk of transient tachypnea of the newborn or respiratory distress syndrome at 37 versus 38 weeks. CONCLUSIONS: Neonatal respiratory morbidity was lowest for deliveries at 38-39 weeks. IUFD was 2.74 times more likely at 42 weeks versus 39 weeks. Our findings support current guidelines advising clinicians when to deliver term pregnancies.
[Mh] Termos MeSH primário: Mortalidade Fetal/tendências
Idade Gestacional
Mortalidade Infantil/tendências
Morte Perinatal
Mortalidade Perinatal
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Parto Obstétrico
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Razão de Chances
Gravidez
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160316
[St] Status:MEDLINE


  7 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Cunha, Antonio José Ledo Alves da
Texto completo
[PMID]:27939461
[Au] Autor:Rezende KB; Bornia RG; Esteves AP; Cunha AJ; Amim Junior J
[Ad] Endereço:Maternidade Escola da Universidade Federal do Rio de Janeiro, Professional Masters Program in Perinatal Health, Brazil. Electronic address: karina@me.ufrj.br.
[Ti] Título:Preeclampsia: Prevalence and perinatal repercussions in a University Hospital in Rio de Janeiro, Brazil.
[So] Source:Pregnancy Hypertens;6(4):253-255, 2016 Oct.
[Is] ISSN:2210-7797
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Preeclampsia (PE) prevalence studies in Brazil are both scarce and not divided in accordance with gestational age at delivery. We accessed PE prevalence according to delivery before 34, 37 and 42weeks in a cross-sectional study including 4464 single deliveries. PE was diagnosed in 301 cases (6.74%); Prevalence of PE was 0.78%; 1.92% and 6.74% according to deliveries before 34, 37 and 42weeks. PE was associated with fetal death, prematurity and small for gestational age newborns.
[Mh] Termos MeSH primário: Mortalidade Fetal
Idade Gestacional
Recém-Nascido Pequeno para a Idade Gestacional
Pré-Eclâmpsia/epidemiologia
Nascimento Prematuro/epidemiologia
[Mh] Termos MeSH secundário: Brasil/epidemiologia
Estudos Transversais
Feminino
Hospitais Universitários
Seres Humanos
Gravidez
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


  8 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Chile
[PMID]:27905648
[Au] Autor:Ovalle A; Fuentes A; Chacón V; Espinoza C; González R; Ramos M; Geraldo J; Osses L; Kakarieka E
[Ti] Título:[A new fetal death classification system].
[Ti] Título:Método de clasificación de mortinatos según condición obstétrica relevante de la muerte fetal, en un hospital público de Chile (Método CORM)..
[So] Source:Rev Med Chil;144(8):1020-1028, 2016 Aug.
[Is] ISSN:0717-6163
[Cp] País de publicação:Chile
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: Stillbirth is the mayor contributor to perinatal mortality. AIM: To report a system for classification of fetal deaths. MATERIAL AND METHODS: Retrospective cohort study of 29,916 births with 258 fetal deaths that occurred in a public hospital. Data were obtained from audit reports of stillbirths. The method for classification “obstetric condition relevant to the death” was applied, based on obstetric and placental pathological findings analyzed exclusively by a single obstetrician and a single pathologist. RESULTS: Ninety two percent of obstetric conditions causing fetal death were identified. The most commonly reported were ascending bacterial infection in 26%, congenital anomalies in 19%, arterial hypertension in 12% and placental pathology in 12%. Fetal growth restriction was identified in 50% of stillbirths. Ninety percent were secondary to a primary obstetric condition and 10% had an unexplained cause. Placental abruption as the final cause of fetal death was identified in 60% of cases with arterial hypertension, 43% of cases with placental pathology and 37% of ascending infections. Fetal deaths occurred during pregnancy in 82% of cases and during labor in 17%. Intrapartum asphyxia occurred in 0.8% of stillbirths and presented in term pregnancies. CONCLUSIONS: The “obstetric condition relevant to the death” method for classification of fetal death is effective to identify the originating obstetric cause of stillbirth and reduces the impact of fetal growth restriction and intrapartum asphyxia as the leading causes of death.
[Mh] Termos MeSH primário: Morte Fetal
Mortalidade Fetal
Hospitais Públicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Infecções Bacterianas/epidemiologia
Causas de Morte
Chile/epidemiologia
Anormalidades Congênitas/epidemiologia
Feminino
Seres Humanos
Hipertensão/epidemiologia
Recém-Nascido
Nascimento Vivo
Idade Materna
Doenças Placentárias/classificação
Gravidez
Natimorto/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE


  9 / 331 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27891808
[Au] Autor:Macfarlane AJ; Blondel B; Mohangoo AD; Cuttini M; Nijhuis J; Novak Z; Ólafsdóttir HS; Zeitlin J; Euro-Peristat Scientific Committee
[Ad] Endereço:Centre for Maternal and Child Health Research, City University London, London, UK.
[Ti] Título:Authors' reply re: Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study.
[So] Source:BJOG;123(13):2231, 2016 12.
[Is] ISSN:1471-0528
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Coleta de Dados
Mortalidade Fetal
[Mh] Termos MeSH secundário: Europa (Continente)
Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE
[do] DOI:10.1111/1471-0528.14140


  10 / 331 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
[PMID]:27796940
[Au] Autor:Solanke D; Rathi C; Pandey V; Patil M; Phadke A; Sawant P
[Ad] Endereço:Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400 022, India. dattatraybs@gmail.com.
[Ti] Título:Etiology, clinical profile, and outcome of liver disease in pregnancy with predictors of maternal mortality: A prospective study from Western India.
[So] Source:Indian J Gastroenterol;35(6):450-458, 2016 Nov.
[Is] ISSN:0975-0711
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of this study is to study the etiology, clinical profile, and prognostic factors related to maternal and fetal health in pregnant patients with liver disease in Western India. METHODS: This study included 103 consecutive pregnant patients with liver dysfunction from August 2013 to July 2015, who underwent regular biochemical tests, viral markers, ultrasound of abdomen, etc. and were followed up for 6 weeks postpartum or until death. RESULTS: Pregnancy-specific causes of liver dysfunction were found in 39 % (40/103) patients. Liver diseases were most frequent in third trimester 69.9 % (72/103). Etiologies in third trimester were viral hepatitis 36.1 % (26/72), pregnancy induced hypertension (PIH) 30.5 % (22/72), intrahepatic cholestasis of pregnancy 11.1 % (8/72), acute fatty liver of pregnancy (2/72), etc. Hepatitis E was the commonest agent among viral hepatitis 71.8 % (28/39). Causes of maternal mortality (n = 25) were hepatitis E 40 % (10/25), PIH 32 % (8/25), and tropical diseases 20 % (5/25). Fetal mortality (n = 31) was 38.7 % (12/31) in hepatitis E. Maternal mortality was significantly associated with presence of jaundice, fever, abdominal pain, oliguria, anemia, leukocytosis, and coagulopathy. Model for end-stage liver disease (MELD) score >21 predicted maternal mortality with 80 % sensitivity and 91 % specificity (area under the receiver operating characteristic curve = 0.878 and p < 0.001). CONCLUSIONS: Liver disease was most common in the third trimester of pregnancy. Hepatitis E was the most common cause of liver disease in pregnant women in western India with significant maternal mortality, predicted by high MELD score.
[Mh] Termos MeSH primário: Doença Hepática Terminal
Complicações na Gravidez
[Mh] Termos MeSH secundário: Adulto
Doença Hepática Terminal/etiologia
Doença Hepática Terminal/mortalidade
Doença Hepática Terminal/fisiopatologia
Feminino
Mortalidade Fetal
Hepatite E/complicações
Hepatite E/epidemiologia
Seres Humanos
Hipertensão Induzida pela Gravidez/epidemiologia
Índia/epidemiologia
Mortalidade Materna
Valor Preditivo dos Testes
Gravidez
Complicações na Gravidez/etiologia
Complicações na Gravidez/mortalidade
Complicações na Gravidez/fisiopatologia
Resultado da Gravidez
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE



página 1 de 34 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde