The anti-clockwise spiralization of the linea nigra sign / O sinal do espiralamento anti-horário da linea nigra

ABSTRACT Objective: To describe the morphology of the supra- and infraumbilical linea nigra in puerperal women. Methods: The study was conducted from September 2017 to April 2018, and included 157 puerperal women admitted for childbirth care at the Obstetrics Department of a public maternity hospital of the city of São Paulo (SP), Brazil. The abdomen of subjects was photographed on the first or second day postpartum, with the patient lying symmetrically in dorsal decubitus at a standardized distance. Contrast was slightly adjusted and the morphological pattern of supra and infraumbilical linea nigra in the proximity of the umbilical scar was characterized. The images were independently analyzed by two researchers and only the matching results from both observers were used. Results: Of the 157 observed cases, 139 (88.5%) images provided concordant results between the two researchers. Excluding 41 cases of absence or poor definition of the linea nigra, 98 images were analyzed. Supra- and infraumbilical linea nigra were analyzed separately and classified according to three directions (left, center and right of the umbilical scar). The combination of the supra- and infraumbilical images resulted in the formation of nine distinct patterns, being the most prevalent, in primiparous (72.2%) and multiparous women (50.0%), and the authors named as "anticlockwise spiralization of the linea nigra". Conclusion: The analysis of supra- and infraumbilical linea nigra in puerperal women showed a predominance of what the authors named "anti-clockwise spiralization of the linea nigra sign".

RESUMO Objetivo: Descrever a morfologia da linea nigra supra e infraumbilical em puérperas. Métodos: O estudo foi realizado no período de setembro de 2017 a abril de 2018 e incluiu 157 puérperas admitidas para o parto no Serviço de Obstetrícia de uma maternidade pública da cidade de São Paulo (SP). O abdome das pacientes foi fotografado no primeiro ou segundo dia pós-parto, com a paciente deitada simetricamente em decúbito dorsal a uma distância padronizada. O contraste foi ligeiramente ajustado, e o padrão morfológico da linea nigra supra e infraumbilical na proximidade da cicatriz umbilical foi caracterizado. As imagens foram analisadas independentemente por dois pesquisadores, e apenas os resultados concordantes dos dois observadores foram utilizados. Resultados: Dos 157 casos observados, 139 (88,5%) imagens apresentaram resultados concordantes entre os dois pesquisadores. Excluindo 41 casos de ausência ou má definição da linea nigra, 98 imagens foram analisadas. As linea nigra supra e infraumbilicais foram analisadas separadamente e classificadas de acordo com três direções (esquerda, centro e direita da cicatriz umbilical). A combinação das imagens supra e infraumbilicais resultou na formação de nove padrões distintos, sendo os mais prevalentes nas primíparas (72,2%) e multíparas (50,0%), o que os autores denominaram "espiralamento anti-horário da linea nigra". Conclusão: A análise das linea nigra supra e infraumbilical em puérperas mostrou predominância do que os autores denominaram "sinal do espiralamento anti-horário da linea nigra".

The clinical study of linea nigra in pregnancy / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to evaluate the relationship between linea nigra and the sex of fetus, neonatal weight, parity, route of delivery, and neonatal disease. METHODS: 41 pregnant women (20 primiparas and 21 multiparas) between 25 and 35 years were included between January and December 2004. We examined the time of appearance and disappearance of linea nigra and morphological differences between linea nigras above the navel and below the navel. Also, we observed the difference of linea nigra according to fetal sex, neonatal weight, parity, interval of childbirth, route of delivery, and the use of whitening cream by answering. RESULTS: The linea nigra was observed in 39 persons (95.1%), and the change of width preceded the change of color among 83.3%. During the third gestational period, the linea nigra became darker the most obvious among 62.5%. Most disappeared rapidly within 3 to 6 months after childbirth among 46.1% of primiparas, meanwhile within 3 months among 60% of multiparas. The linea nigra below the navel became more darker (90%) and wider (79%) than above. However, the linea nigra above the navel disappeared faster. In cases of male babies (63.7%), linea nigra was more darker and wider. The illness of newborns, use of whitening cream, route of delivery and the interval between the first and subsequent childbirth were not found to affect the change of linea nigra. CONCLUSIONS: We thought that this study could be useful to understand the morphogenesis of linear nigra in Korean pregnant women.