Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 174
Filter
1.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022501, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367816

ABSTRACT

RESUMO Introdução: A ruptura prematura de membranas (RUPREME) ocorre em 3-5% das gestações e está relacionada a graves complica- ções maternas e fetais, especialmente se ocorrer abaixo das 24 semanas de idade gestacional (IG). Descrição: Trata-se de relato de caso com ruptura prematura de membranas com 18 semanas de IG e desfecho gestacional favorável. Discussão: Nascimento com 33 semanas de IG, alta hospitalar do após 34 dias na Unidade de Internação Neonatal sem sequelas significativas. PALAVRAS-CHAVE: Oligoidrâmnios, ruptura prematura das membranas fetais, viabilidade fetal.


ABSTRACT Introduction: Premature rupture of membranes (PROM) occurs in 3-5% of pregnancies and is related to serious maternal and fetal complications, especially if it occurs below 24 weeks of gestational age (GA). Description: This is a case report with premature rupture of membranes at 18 weeks of GA and favorable gestational outcome. Discussion: Birth at 33 weeks of GA, discharge from hospital after 34 days in the Neonatal Inpatient Unit without significant sequelae. KEYWORDS: Oligohydramnios, premature rupture of fetal membranes, fetal viability, premature birth


Subject(s)
Humans , Fetal Membranes, Premature Rupture , Oligohydramnios , Fetal Viability
2.
Rev. ecuat. pediatr ; 20(2): 43-46, diciembre 2019.
Article in Spanish | LILACS | ID: biblio-1116487

ABSTRACT

Los Inhibidores de la enzima convertidora de angiotensina II (IECAs) y antagonistas de los receptores de angiotensina II (ARA II) son drogas usadas comúnmente en el manejo de hipertensión arterial, sin embargo, su uso en el embarazo está asociado con toxicidad fetal.1, 2 La acción de la angiotensina II requiere su unión a dos receptores; AT1, involucrado en el control de la tensión arterial y AT2, probablemente encargado del crecimiento fetal. 2 La angiotensina II es esencial en la hemodinamia sistémica y la filtración glomerular fetal y neonatal. La disminución de la perfusión placentaria por efecto hipotensor en el bloqueo del sistema renina angiotensina aldosterona materno puede determinar hipotensión fetal sistémica, disminución de la filtración glomerular, oligoamnios e insuficiencia renal, anormalidades tubulares, hipoplasia craneal y alto riesgo de muerte perinatal. 2 Reportamos el caso de prematuro de 30 semanas con oligohidramnios severo y exposición materna a olmesartan. Al nacimiento presentó dificultad respiratoria; imposibilidad de mantener una adecuada tensión arterial a pesar de los esfuerzos para conseguir mejorar su tono vascular; anuria sin respuesta a diuréticos; alteraciones craneales; alteraciones metabólicas severas con consecuencias fatales. El tratamiento de hipertensión materna con inhibidores de la enzima convertidora de angiotensina II y los antagonistas de los receptores de angiotensina II está asociada con toxicidad fetal por lo que su uso debe ser evitado durante el embarazo.


Angiotensin II converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARBs) are drugs for general use in the management of arterial hypertension, however their use in gestational hypertension is related to the Fetal toxicity. 1, 2 The action of angiotensin II requires its binding to two receptors; AT1, involved in the control of blood pressure and AT2, probably responsible for fetal growth.2 Angiotensin II is essential in systemic hemodynamics and fetal and neonatal glomerular filtration. The decrease in placental perfusion due to hypotensive effect in the blockade of the maternal rennin angiotensin aldosterone system can determine systemic fetal hypotension, decreased glomerular filtration, oligohydramnios and renal insufficiency, tubular abnormalities, cranial hypoplasia and high risk of perinatal death. 2 We report the case of prematurity of 30 weeks with a history of severe oligohydramnios and maternal exposure to olmesartan. At birth the patient presented in particular respiratory distress; inability to maintain adequate blood pressure despite efforts to improve your vascular tone; anuria without response to diuretics; cranial alterations; metabolic alterations with fatal consequences. The treatment of maternal hypertension with inhibitors of the angiotensin II convective enzyme and angiotensin II receptor antagonists is associated with fetal toxicity and should therefore be avoided during pregnancy


Subject(s)
Angiotensin-Converting Enzyme Inhibitors , Oligohydramnios , Premature Birth , Renal Insufficiency , Angiotensin II , Maternal Exposure , Hypertension, Pregnancy-Induced , Fetal Development , Toxicity , Hypotension
3.
Rev. cient. Esc. Univ. Cienc. Salud ; 6(2): 40-48, jun.-dic. 2019. tab
Article in Spanish | LILACS | ID: biblio-1117910

ABSTRACT

La morbilidad materna y perinatal asociada a la ruptura prematura de membranas constituye un problema social y de salud importante, por lo que es primordial estimar su frecuencia y magnitud. Este artículo condensa las intervenciones de enfermería en paciente con ruptura prematura de membranas aplicando el proceso de atención de enfermería (PAE) orientado en la teoría de Dorothea Orem, la cual basa el autocuidado de acuerdo al nivel de dependencia para aplicar una intervención de enfermería obstétrica. La metodología utilizada es el estudio de caso que describe una patología y manejo de un problema el cual se intervino logrando la salud de la madre y su hijo. Participó una gestante de 19 años, con 29 semanas y 5 días de gestación, al valorarla ofreció información sobre su estado actual y antecedentes. Se realizó diagnóstico mediante prueba de helecho y reflejó ruptura prematura de membrana (RPM) que la llevó al oligoamnios, manifestando altura de fondo uterino (AFU) de 19 cm y amenaza de parto pretérmino (APP). El oligoamnios pone en riesgo el crecimiento adecuado del feto, por no ser un embarazo viable para recurrir a un parto. Se realizarón cuidados de enfermería dependientes, procurando un reposo absoluto; e interdependientes manteniendo un equilibrio hídrico, alimentación adecuada, tratando el estreñimiento, prevención de infección y manejo de la ansiedad que puede repercutir en el sueño y comodidad. La asiduidad de los cuidados de enfermería logra una respuesta positiva, al prologar la etapa de gestación hasta una maduración fetal viable para la vida...(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Fetal Membranes, Premature Rupture/nursing , Oligohydramnios , Maternal Mortality/trends , Nursing/methods
5.
Article in Korean | WPRIM | ID: wpr-758557

ABSTRACT

Amniotic fluid is an indicator of normal placental function and is essential for normal fetal lung maturation. Amniotic fluid index (AFI) is the most preferred method of amniotic fluid measurement in pregnancy although single deepest pocket (SDP) is also used. To measure AFI, the examiner divides the uterus into four equal quadrants. AFI is the sum of deepest pocket from each quadrant. The normal AFI ranges between 5~24 cm while any value above 24 cm is considered as hydramnios and that below 5 cm is indicated as oligohydramnios. An adequate volume of amniotic fluid is critical to allow normal fetal movement and growth, while also cushioning the fetus and umbilical cord. Regardless of the etiology, oligohydramnios may inhibit these processes and may lead to fetal deformation, umbilical cord compression, and death in some instances. Oligohydramnios can be due to underproduction, loss, or sometimes, isolated. Isolated oligohydramnios has been found to be responsive maternal hydration and is neither a malformation of the urinary system in the fetus, nor a rupture of amnion and due to genetic cause. The author would like to introduce a way to increase amniotic fluid volume in isolated oligohydramnios which is expect to improve the perinatal outcomes.


Subject(s)
Amnion , Amniotic Fluid , Female , Fetal Movement , Fetus , Lung , Methods , Oligohydramnios , Polyhydramnios , Pregnancy , Rupture , Umbilical Cord , Uterus
6.
Article in English | WPRIM | ID: wpr-762867

ABSTRACT

BACKGROUND: Congenital muscular torticollis (CMT) is characterized by persistent head tilt toward the affected side. No consensus exists regarding the cause of this disorder. In this study, we analyzed various clinical factors in patients with CMT who were treated with surgical release. This analysis enabled us to identify potential causative factors of CMT and to establish a basis for surgical interventions. METHODS: In total, 584 patients who underwent surgical intervention for CMT from October 2007 to December 2016 were included in this study. Their demographic characteristics, birth-related factors, and clinical features were analyzed. RESULTS: Data from 525 patients were analyzed in this study after exclusion of those with insufficient information. Before birth, 31 patients (5.9%) were diagnosed with oligohydramnios, and 87 (16.6%) had a breech presentation. Seven (1.3%) cases of clavicle fracture and two (0.4%) cases of cephalohematoma were noted at birth. Before surgery, 397 patients (75.6%) underwent physiotherapy and 128 patients (24.4%) did not. The duration of physiotherapy ranged from 1 to 50 months (average, 6 months). CONCLUSIONS: Our study shows that 16.6% of the CMT patients presented in the breech position, which is a much higher rate than that observed in the general population (3%–4%). We hypothesize that being in the breech position as a fetus appears to exert a significant influence on shortening and fibrosis of the sternocleidomastoid muscle.


Subject(s)
Breech Presentation , Clavicle , Consensus , Female , Fetus , Fibrosis , Head , Humans , Oligohydramnios , Parturition , Pregnancy , Retrospective Studies , Torticollis
7.
Rev. chil. obstet. ginecol. (En línea) ; 82(3): 252-258, jun. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-899902

ABSTRACT

El desprendimiento crónico de placenta se caracteriza por la aparición de un sangrado venoso crónico intra o retroplacentario que produce la separación paulatina de la misma. Es poco frecuente y se puede presentar en pacientes sin factores de riesgo. La imagen ecográfica plantea diagnóstico diferencial con la corioamnionitis. El pronóstico fetal es malo especialmente si se asocia con oligoamnios. Se presentan cuatro casos caracterizados por imagen ecográfica característica, retraso del crecimiento fetal, alteración del Doppler, y confirmación anatomopatológica.


Chronic placental abruption is due to intra or retroplacental insidious bleeding that causes progressive separation from the uterine wall. It is a rare condition and can occur in low risk patients. Chronic abruption imaging poses differential diagnosis with infectious TORCH chorioamnionitis. Fetal prognosis is ominous especially in the presence of oligohydramnios. We present four cases with a common ultrasound appearance, fetal growth restriction, Doppler abnormalities and pathological confirmation.


Subject(s)
Humans , Female , Pregnancy , Adult , Oligohydramnios/diagnostic imaging , Abruptio Placentae/diagnostic imaging , Fetal Growth Retardation/diagnostic imaging , Pregnancy Outcome , Ultrasonography, Prenatal
8.
Article in Korean | WPRIM | ID: wpr-56573

ABSTRACT

PURPOSE: We report 3 cases of patients with retinal hemorrhage among 27 newborns with intrauterine growth retardation. CASE SUMMARY: Twenty-seven newborns with intrauterine growth retardation were examined using the indirect ophthalmoscope for confirming retinal hemorrhage which was observed in 3 patients. The mean gestational age and birth weight (g) of the 3 patients were 37⁺⁶ weeks and 2,086.7 g, respectively. Among the 3 newborns, 1 patient's mother had oligohydramnios. Two patients were delivered vaginally and 1 by cesarean section. All 3 patients had no birth trauma and the retinal hemorrhage was resolved within 2 weeks after the first eye examination. CONCLUSIONS: We observed 3 cases with retinal hemorrhage in neonates with intrauterine growth retardation which improved within 2 weeks.


Subject(s)
Birth Weight , Cesarean Section , Female , Fetal Growth Retardation , Gestational Age , Humans , Incidence , Infant, Newborn , Korea , Mothers , Oligohydramnios , Ophthalmoscopes , Parturition , Pregnancy , Retinal Hemorrhage , Retinaldehyde
9.
Rev. Assoc. Med. Bras. (1992) ; 62(3): 269-275, May-June 2016. tab
Article in English | LILACS | ID: lil-784317

ABSTRACT

SUMMARY Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.


RESUMO Objetivo: determinar a associação do índice de líquido amniótico (ILA) com os resultados perinatais na rotura prematura das membranas pré-termo (RPMPT). Método: realizou-se um estudo de coorte retrospectivo, de 2008 a 2012. Foram incluídas 86 gestantes, com diagnóstico de RPMPT e idade gestacional entre a 24ª e 35ª semanas. Foram excluídas gestantes que apresentavam síndromes hipertensivas, diabetes, fetos com malformações fetais e infecção na admissão. Para determinar a associação entre ILA e desfechos perinatais, foram utilizados os testes qui-quadrado e exato de Fisher, quando pertinentes, além da razão de risco (RR) e seu intervalo de confiança a 95% (IC95%). A correlação entre ILA e desfechos perinatais foi determinada por regressão linear simples, e a evolução do ILA durante a gestação foi analisada pelo teste Z. Resultados: quando comparados os recém-nascidos que apresentavam ultrassonografia com ILA<5 cm e ILA>5 cm, observou-se maior frequência de mortalidade perinatal nos casos de ILA<5 cm. Quando o oligo-hidrâmnio, porém, era diagnosticado como grave (ILA<3 cm), observava-se maior frequência de escore de Apgar <7 no 1º minuto, sepse neonatal e mortalidade neonatal precoce em relação aos que apresentavam ILA>3 cm. Observou-se uma correlação positiva entre ILA e idade gestacional no parto, peso ao nascer e escore de Apgar no 1º e 5º minutos, além de diminuição do volume do líquido amniótico com o avançar da idade gestacional. Conclusão: a presença de oligo-hidrâmnio grave após a RPMPT contribuiu para uma maior frequência de complicações e mortalidade perinatal.


Subject(s)
Humans , Male , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Fetal Membranes, Premature Rupture/physiopathology , Pregnancy Outcome , Oligohydramnios/physiopathology , Apgar Score , Pregnancy Complications , Time Factors , Birth Weight , Severity of Illness Index , Retrospective Studies , Risk Factors , Gestational Age , Perinatal Mortality , Amniotic Fluid/physiology
10.
Article in English | WPRIM | ID: wpr-11118

ABSTRACT

OBJECTIVES: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. METHODS: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). RESULTS: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW. CONCLUSIONS: Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.


Subject(s)
Bacteriuria , Developing Countries , Diabetes, Gestational , Female , Humans , Hypertension, Pregnancy-Induced , Infant, Low Birth Weight , Infant, Newborn , Mass Screening , Obstetrics , Oligohydramnios , Periodontitis , Pregnancy , Pregnancy Outcome , Pregnant Women , Premature Birth , Prospective Studies , Risk Factors , Vaginosis, Bacterial
11.
Med. UIS ; 28(2): 239-246, may.-ago. 2015. tab
Article in Spanish | LILACS | ID: lil-761900

ABSTRACT

Introducción: el síndrome de transfusión feto fetal es una complicación mayor presente en el 10 a 15% de los embarazos monocorialesbiamnióticos, se conoce que parte de su fisiopatología corresponde a la presencia de anastomosis placentarias entre los dos fetos que conllevan a presentar una clínica aguda y de urgente intervención en presencia de anemia, restricción de crecimiento intrauterino, oliguria y oligohidramnios en el gemelo donante, mientras que el receptor se torna pletórico, poliúrico, presentando cardiomegalia, falla cardiaca congestiva y polihidramnios. Objetivo: presentar una revisión de tema acerca del síndrome de transfusión feto fetal, características clínicas, complicaciones y su tratamiento. Metodología: se utilizaron bases de datos como Pubmed y ScienceDirect para la búsqueda de la información, encontrándose 186 artículos de los cuales 41 fueron seleccionados según los criterios de inclusión. Resultados: se encontraron 41 artículos con información actualizada, se revisó su fisiopatología, clasificación y tratamiento, destacando el papel del sistema renina angiotensina aldosterona, la presencia de anastomosis placentarias, la implicación de los niveles de vasopresina y su actual tratamiento. Conclusiones: el síndrome de trasfusión feto fetal es una de las más severas complicaciones de las gestaciones monocoriales-biamnióticas con una alta tasa de morbimortalidad fetal y perinatal. Su patología es causada por desbalance de flujos entre las anastomosis placentarias, alteraciones en el eje renina angiotensina aldosterona, cambios en los niveles de vasopresina, entre otros factores. El tratamiento actual es la terapia de ablación láser de las anastomosis placentarias, con una sobrevida del 70% y una disminución de secuelas neurológicas. Se reitera la importancia de conocer esta patología para realizar un diagnóstico asertivo y un tratamiento inmediato, invitándose a investigarla.


Introduction: twin twin transfusion syndrome is one further complication in the 10-15% of all monochorionic-biamniotic pregnancies, it is known that part of its pathophysiology corresponds to the presence of placental anastomosis between two fetuses that lead to present an acute clinic and urgent intervention for anemia, restriction of intrauterine growth, oliguria and olgohydramnios in the donor twin, while the receiver becomes plethoric, polyuric, cardiomegaly, congestive heart failure and polyhydramnios appear. Objective: present a review about twin-twin transfusion syndrome, clinical features, complications and its treatment. Methodology: databases such as Pubmed and ScienceDirect were used to search for the information. Results: we found 41 articles with updated information, reviewing its pathophysiology, classification and treatment, highlighting the role of the renin angiotensin aldosterone system, the presence of placental anastomosis, the involvement of vasopressin levels and its present treatment. Conclusions: twin-twin transfusion syndrome is one of the most severe complications of the monochorionic-biamniotic pregnancies with a high rate of fetal and perinatal morbidity and mortality. It’s pathology is caused due to imbalance of flows between placental anastomoses, alterations in the axis renin angiotensin aldosterone, changes in the levels of vasopressin, among other factors. The current treatment is the therapy of laser ablation of placental anastomoses with a survival of 70% and a decrease of neurologic sequelae. We reiterate the importance of understanding this disease to make an assertive diagnosis and immediate treatment, inviting you to investigate it.


Subject(s)
Oligohydramnios , Polyhydramnios , Pregnancy, Twin
12.
Article in English | WPRIM | ID: wpr-133639

ABSTRACT

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.


Subject(s)
Anti-Bacterial Agents , Child , Consensus , Diagnosis , Diagnostic Imaging , Female , Gestational Age , Humans , Hydronephrosis , Infant , Male , Oligohydramnios , Pregnancy , Prenatal Diagnosis , Radioisotope Renography , Ultrasonography , Ureter , Urinary Bladder Neck Obstruction , Urinary Tract , Urinary Tract Infections
13.
Article in English | WPRIM | ID: wpr-133638

ABSTRACT

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.


Subject(s)
Anti-Bacterial Agents , Child , Consensus , Diagnosis , Diagnostic Imaging , Female , Gestational Age , Humans , Hydronephrosis , Infant , Male , Oligohydramnios , Pregnancy , Prenatal Diagnosis , Radioisotope Renography , Ultrasonography , Ureter , Urinary Bladder Neck Obstruction , Urinary Tract , Urinary Tract Infections
14.
Article in English | WPRIM | ID: wpr-118870

ABSTRACT

PURPOSE: The aim of this study was to determine the incidence, risk factors, and long-term outcome of nephrocalcinosis in very low birth weight (VLBW) infants. METHODS: A retrospective chart review was performed in VLBW infants between 2006 and 2012 in the neonatal intensive care unit. RESULTS: The incidence of nephrocalcinosis in VLBW infants was 10.2%. By univariate analysis, oligohydramnios and use of antenatal steroids were more frequent in the nephrocalcinosis group. In the nephrocalcinosis group, the gestational age and birth weight were lower and there were more number of female infants. Also, the initial blood pH, the lowest systolic blood pressure, and urine output on the first day of life were lower and bronchopulmonary dysplasia, sepsis, and urinary tract infection were more prevalent in the nephrocalcinosis group. The use of dexamethasone or ibuprofen and the lowest levels of phosphorus, protein and albumin were significantly lower in the nephrocalcinosis group. By binary logistic regression analysis, the use of antenatal steroids, female sex, 5-minute Apgar score, duration of oxygen therapy and total parenteral nutrition, and the lowest albumin level were found to be significant risk factors for nephrocalcinosis. Overall, the resolution rate was 64.1% and 88.6% within 12 months and 18 months, respectively. CONCLUSION: The incidence of nephrocalcinosis in VLBW infants showed increasing trend. The risk factors of nephrocalcinosis were parameters for sick VLBW infants. Although the prognosis of nephrocalcinosis was relatively good, we should pay close attention to the development of complication.


Subject(s)
Apgar Score , Birth Weight , Blood Pressure , Bronchopulmonary Dysplasia , Dexamethasone , Female , Gestational Age , Humans , Hydrogen-Ion Concentration , Ibuprofen , Incidence , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Intensive Care, Neonatal , Logistic Models , Nephrocalcinosis , Oligohydramnios , Oxygen , Parenteral Nutrition, Total , Phosphorus , Pregnancy , Prognosis , Retrospective Studies , Risk Factors , Sepsis , Steroids , Urinary Tract Infections
15.
Article in Korean | WPRIM | ID: wpr-55284

ABSTRACT

PURPOSE: This study was conducted to explore relationships of postpartum depression with socio-demographic and clinical characteristics of preterm infants and mothers. METHODS: Participants were the mothers of 80 premature infants admitted to neonatal intensive care units. Postpartum depression was measured using the Edinburg Postnatal Depression Scale (EPDS). Clinical characteristics were examined through the medical records. The physiological state for the infants was evaluated using the revised Neurobiologic Risk Score (NBRS). Data were analyzed using the t-test, ANOVA, and Pearson correlation coefficients. RESULTS: Average for EPDS was 9.75+/-5.06, and 30% of the participants were at high risk for postpartum depression. There were significant differences in postpartum depression according to mother's education level (F=3.493, p=.035), economic state (F=5.828, p=.004), multiple pregnancy (t=2.141, p=.037), chorioamnionitis (t=2.349, p=.021), oligohydramnios (t=-2.226, p=.029), broncho-pulmonary dysplasia (t=2.085, p=.040), germinal matrix hemorrhage (t=2.259, p=.027), and revised NBRS (t=-2.772, p=.007). There was a significant positive correlation between postpartum depression and number of health problem of infants (r=.252, p=.024) and revised NBRS (r=.316, p=.004). CONCLUSION: As 30% of the mothers with preterm infants were at high risk for postpartum depression, they require attention. When providing interventions, socioeconomic status as well as the physiological state of premature infants should be considered.


Subject(s)
Chorioamnionitis , Depression, Postpartum , Education , Female , Hemorrhage , Humans , Infant , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal , Medical Records , Mothers , Oligohydramnios , Pregnancy , Pregnancy, Multiple , Social Class
16.
Homeopatia Méx ; 83(688): 25-28, ene.-feb. 2014. ilus
Article in Spanish | LILACS | ID: lil-731453

ABSTRACT

Este artículo relata un caso clínico urgente de oligohidramnios (OH) severo, en una paciente primigesta que se encontraba en la semana 21 de gestación, y con un pronóstico de terminación de la misma en las siguientes 48 a 72 horas. La intervención con una prescripción compleja permitió la reversión pronta y total del OH hasta permitir la conclusión a término de un producto sano. Dada la carencia de bibliografía en esta patología, se describe la justificación de la conducta terapéutica.


This paper talks about a mild-severe, urgent case of oligohydramios (OH) in a 21 years woman on her first pregnancy, with a fatal prognosis during the next 48- 72 hours. Homeopathic intervention with a complex prescription produced a rapid and total reversion of OH, leading a term birth of a healthy boy. Due to lacking of homeopathic bibliography on this condition, it is presented rational of therapeutic conduct.


Subject(s)
Humans , Female , Pregnancy , Young Adult , Bryonia/therapeutic use , Homeopathy , Naja tripudians/therapeutic use , Oligohydramnios/therapy , Pregnancy Complications , Tarentula hispanica/therapeutic use
17.
Lima; s.n; 2014. 56 p. tab.
Thesis in Spanish | LIPECS, LILACS, LIPECS | ID: lil-758221

ABSTRACT

Determinar los Factores y Resultados perinatales más frecuentes asociados a Oligohidramnios en gestantes atendidas en el Hospital Nacional Docente Madre Niño San Bartolomé durante el periodo Junio 2010 a Mayo 2011. Material y Métodos: El siguiente estudio es descriptivo no experimental de corte transversal, retrospectivo. Nuestra población de estudio son todas las pacientes gestantes atendidas en el servicio de obstetricia de alto riesgo (Hospitalización B) del Hospital Nacional Docente Madre Niño-San Bartolomé durante el periodo de 1ro de junio del 2010 al 31 de mayo del 2011. Las mismas que están sujetas a los criterios de inclusión y exclusión empleado en el estudio. Una vez obtenidos los datos estos fueron ingresados y analizados usando el paquete SPSS versión 20, para encontrar la relación entre las variables cualitativas, se aplicó la prueba de asociación Odds ratio con sus intervalos de confianza al 95 por ciento, además se analizó a través del Chi cuadrado, significativo con un p<0.05. Además se empleo el procesador de textos Microsoft Office 2013. Resultados: Del total de pacientes se evidenció que el tipo de Oligohidramnios de mayor prevalencia es el moderado con un 53.3 por ciento donde queda demostrado que el factor materno asociado de mayor impacto es el RPM (24.3 por ciento), sin embargo le sigue con poca diferencia el RCIU (22.4 por ciento). Así mismo se observa que el 37.8 por ciento de las gestantes que presentaron nivel de Oligohidramnios severo sufrió RPM, mientras, para los niveles de Oligohidramnios leve y moderado los porcentajes de RPM fueron de 23.1 por ciento y 14.0 por ciento respectivamente; el 27.0 por ciento de las gestantes que presentaron nivel de Oligohidramnios severo sufrió RCIU, mientras que para los niveles de Oligohidramnios leve y moderado los porcentajes de RCIU fueron de 15.4 por ciento y 21.1 por ciento respectivamente; el 38.5 por ciento de las gestantes que presentaron nivel de Oligohidramnios leve sufrió...


Subject(s)
Humans , Male , Adult , Female , Young Adult , Pregnancy, High-Risk , Oligohydramnios , Retrospective Studies , Cross-Sectional Studies
18.
Article in Korean | WPRIM | ID: wpr-76051

ABSTRACT

Early injury to the lung circulation leads to the rapid development of pulmonary hypertension (PH) after premature birth. PH in bronchopulmonary dysplasia (BPD) results from increased vascular tone and abnormal vasoreactivity, hypertensive remodeling, and decreased vascular growth. The development of PH is sometimes a serious complication of BPD that can significantly impact the morbidity and mortality rates of preterm infants. Despite a gradual reduction in pulmonary arterial pressure postnatally, approximately a quarter of BPD infants have echocardiographic evidence of PH later. The pathogenesis of PH in BPD is very complex and multifactorial, often resulting from interactions between genetic and environmental or acquired factors (both prenatal and postnatal). Antenatal risk factors such as intrauterine growth retardation, maternal preeclampsia, and oligohydramnios suggest compelling evidence for the fetal origins of PH. Despite the potential importance of PH in preterm infants, the pathophysiology and the risk factors of PH in infants with BPD are still poorly understood. I have reviewed recent progress in research concerning the pathophysiology including the risk factors of PH in infants with BPD.


Subject(s)
Arterial Pressure , Bronchopulmonary Dysplasia , Echocardiography , Female , Fetal Growth Retardation , Humans , Hydrogen-Ion Concentration , Hypertension, Pulmonary , Infant , Infant, Newborn , Infant, Premature , Lung , Mortality , Oligohydramnios , Pre-Eclampsia , Pregnancy , Premature Birth , Risk Factors
19.
Rev. bras. ginecol. obstet ; 35(8): 342-348, Aug. 2013. tab
Article in Portuguese | LILACS | ID: lil-688693

ABSTRACT

OBJETIVO: Determinar os desfechos maternos e perinatais em gestantes com o líquido amniótico diminuído segundo o índice de líquido amniótico (ILA). MÉTODOS: Realizou-se estudo de coorte com 176 pacientes admitidas na enfermaria de alto risco do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP. O líquido amniótico foi mensurado pelo índice de líquido amniótico , sendo classificado como diminuído, quando entre 5,1 e 7,9 cm; oligohidrâmnio moderado, entre 3,1 e 5,0 cm; e grave, quando menor ou igual a 3,0 cm. Para se determinar a diferença entre os três grupos das variáveis categóricas estudadas, foram utilizados o teste de chi-quadrado e exato de Fisher, quando pertinentes, e, para as variáveis numéricas, utilizou-se o teste de Mann Whitney, em um nível de significância de 5%. RESULTADOS: As malformações fetais ocorreram mais frequentes quando o oligohidrâmnio foi grave, enquanto as síndromes hipertensivas foram associadas ao oligohidrâmnio moderado. Observou-se semelhança entre os três grupos em relação à rotura prematura das membranas e outras causas. O líquido amniótico reduzido foi encontrado com maior frequência quando a idade gestacional do diagnóstico foi ≥32ª semana. Em relação aos desfechos perinatais, a incidência de índice de Apgar <7 no 1ºe 5ºminuto do óbito perinatal, da icterícia neonatal e da hipoplasia pulmonar foi mais elevada na presença do oligohidrâmnio moderado a grave. CONCLUSÕES: As causas e os desfechos maternos e perinatais em gestantes com líquido amniótico reduzido varia em relação a sua classificação pelo ILA, estando o oligohidrâmnio grave associado aos desfechos perinatais adversos e às malformações fetais.


PURPOSE: To determine maternal and perinatal outcomes in pregnant women with low amniotic fluid, according to the amniotic fluid index (AFI). METHODS: A cohort study conducted on 176 patients admitted to the high risk ward of Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), in Recife, Pernambuco, Brazil. Amniotic fluid was measured by the amniotic fluid index, and classified as low when between 5.1 and 7.9 cm, moderate oligohydramnios between 3.1 and 5.0 cm, and severe oligohydramnios when less than or equal to 3.0 cm. To determine the difference between the three groups of categorical variables studied the chi-square and Fisher exact tests were used, when applicable, and for the numerical variables the Mann-Whitney test was applied, with the level of significance set at 5%. RESULTS: Fetal malformation more frequently occurred when oligohydramnios was severe. Hypertensive disorders, however, were associated with moderate oligohydramnios. There was similarity between the three groups in relation to premature rupture of membranes and other causes. Low amniotic fluid was more frequently diagnosed when tested at the gestational age of 32 weeks or earlier. Regarding the perinatal outcomes, the incidence of Apgar score <7 in the 1st and 5th minutes, perinatal death, neonatal jaundice and pulmonary hypoplasia was higher when oligohydramnios was moderate to severe. CONCLUSIONS: Maternal and perinatal causes and outcomes in pregnant women with low amniotic fluid vary with respect to their AFI, severe oligohydramnios being associated with fetal malformation and other adverse perinatal outcomes.


Subject(s)
Adult , Female , Humans , Pregnancy , Oligohydramnios , Pregnancy Outcome , Cohort Studies , Retrospective Studies , Severity of Illness Index
20.
Rev. bras. ginecol. obstet ; 35(2): 49-54, fev. 2013. graf, tab
Article in Portuguese | LILACS | ID: lil-666187

ABSTRACT

OBJETIVO: Avaliar o desempenho de uma curva de altura uterina (AU) quanto à capacidade de rastrear desvios do volume de líquido amniótico, utilizando uma curva brasileira de índice de líquido amniótico (ILA) como padrão-ouro. MÉTODOS: O presente estudo representa um corte transversal no qual foram incluídas 753 gestantes em acompanhamento pré-natal na rede pública de João Pessoa (PB) no período de março a outubro de 2006 e que tiveram um exame de ultrassonografia (US) de rotina agendado para depois da 26ª semana de idade gestacional. Foram excluídos os casos com diagnóstico de gestação gemelar, óbito fetal intrauterino e malformações fetais maiores. Além de informações sociodemográficas, foram coletados também os valores da AU medida de forma padronizada, os valores do peso fetal estimado, do ILA e a idade gestacional pelo exame de US. A capacidade da curva de AU em predizer os desvios do volume de líquido amniótico foi avaliada tendo uma curva brasileira de ILA em função da idade gestacional como padrão-ouro. Para isso, foram estimados a sensibilidade, especificidade e valores preditivos positivo e negativo para diferentes pontos de corte. RESULTADOS: A medida da AU identificou 10,5% das mulheres como AU baixa e possivelmente associada ao oligoâmnio, e 25,2% como AU alta e possivelmente associada ao polidrâmnio. Utilizando uma curva brasileira de referência para ILA, a AU foi capaz de predizer pobremente a ocorrência de oligoâmnio (sensibilidade variando entre 37 a 28%) e de forma razoável a ocorrência de polidrâmnio (sensibilidade variando entre 88 a 69%). CONCLUSÃO: A medida da altura uterina mostrou um desempenho ruim para predizer oligoâmnio e um desempenho razoável para predizer polidrâmnio. Sua utilização para essa finalidade só se justifica, portanto, em situações nas quais o exame ultrassonográfico não esteja fácil e rotineiramente disponível, a fim de ajudar na priorização dos casos que deveriam ter esse exame realizado.


PURPOSE: To evaluate the performance of a Brazilian reference curve of fundal height (FH) regarding its capacity of screening the deviations of volume of amniotic fluid using a Brazilian reference curve of amniotic fluid index (AFI) as gold standard. METHODS: This was a cross-sectional study evaluating 753 pregnant women receiving prenatal care at the public health services of João Pessoa (PB), from March to October 2006, who had a routine ultrasound exam scheduled for after 26 weeks of gestational age. Cases with diagnoses of twin pregnancy, intrauterine fetal death and major fetal malformations were excluded. Besides socio-demographic information, data regarding fundal height measured in a standard way, estimated fetal weight, AFI and gestational age at the time of the ultrasound exam were also collected. The capacity of the FH curve to predict deviations of the amniotic fluid volume was assessed using the Brazilian curve of AFI according to gestational age as the gold standard. For this purpose, sensitivity, specificity, positive and negative predictive values were estimated for different cut-off points. RESULTS: The measurement of FH identified 10.5% of women as having low FH possibly associated with oligohydramnios and 25.2% as having high FH possibly associated with polyhydramnios. Using a Brazilian reference curve of AFI, the FH was able to poorly predict the occurrence of oligohydramnios (sensitivity ranging from 37 to 28%) and to reasonably predict the occurrence of polyhydramnios (sensitivity ranging from 88 to 69%). CONCLUSIONS: The measurement of fundal height showed a poor performance for predicting oligohydramnios and a reasonable performance for predicting polyhydramnios. Its use for this purpose is then only supported in settings where the ultrasound exam is not easily or routinely available in order to help define priorities for cases that should have this exam performed.


Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Pregnancy , Young Adult , Cervical Length Measurement , Oligohydramnios/diagnosis , Polyhydramnios/diagnosis , Brazil , Cross-Sectional Studies , Reference Values
SELECTION OF CITATIONS
SEARCH DETAIL