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1.
Acta Med Port ; 23(3): 505-10, 2010.
Article in Portuguese | MEDLINE | ID: mdl-20654271

ABSTRACT

Vein of Galen aneurysm is a rare congenital anomaly, originated from a defect in fusion of internal cerebral veins. Due to low resistance, it produces high debit cardiac insufficiency. It constitutes 1% of all intracranial vascular malformations. Prognosis depends on patient's age when the manifestation occurs and aneurysm size. The two reported cases are about fetal prenatal diagnosis of vein of Galen aneurysm, confirmed by ultrasonography, which evolved for caesarian delivery at term gestation. Magnetic resonance was carried out after birth, confirming prenatal diagnosis. The first patient had spontaneous thrombosis of the aneurysm while the second was submitted to embolization. Both of them had hospital discharge with ambulatory accompaniment. The prenatal ultrasonography diagnosis is fundamental to determine aneurysm size, defining the best treatment, when this procedure is indicated, and the more adequate obstetric and perinatal assistance.


Subject(s)
Cerebral Veins , Intracranial Aneurysm/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , Pregnancy
2.
Rev Bras Ginecol Obstet ; 31(2): 82-8, 2009 Feb.
Article in Portuguese | MEDLINE | ID: mdl-19407913

ABSTRACT

PURPOSE: To evaluate the effect of magnesium sulphate on the pulsatility index (PI) of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia. METHODS: A cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate) was compared between the groups (bilateral incision and unilateral/absent incision) using the Mann-Whitney test. RESULTS: There was a significant increase in the maternal heart rate (MHR) and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral/umbilical relationship, before and after magnesium sulphate in each group. No difference between the groups was found, before and after magnesium sulphate, for any of the studied outcomes. CONCLUSIONS: After the intravenous administration of 6 g of magnesium sulphate to patients with severe pre-eclampsia, a decrease in blood pressure and in the PI of the uterine, umbilical and fetal middle cerebral arteries occurs, besides the increase in the MHR, not influenced by the presence of bilateral protodiastolic notch in the uterine arteries.


Subject(s)
Anticonvulsants/pharmacology , Diastole , Magnesium Sulfate/pharmacology , Middle Cerebral Artery/drug effects , Middle Cerebral Artery/physiopathology , Pre-Eclampsia/physiopathology , Umbilical Arteries/drug effects , Umbilical Arteries/physiopathology , Uterus/blood supply , Uterus/drug effects , Adult , Cohort Studies , Female , Humans , Pregnancy , Pulse , Severity of Illness Index
3.
Rev. bras. ginecol. obstet ; 31(2): 82-88, fev. 2009. tab
Article in Portuguese | LILACS | ID: lil-512038

ABSTRACT

OBJETIVO: avaliar o efeito do sulfato de magnésio sobre o índice de pulsatilidade (IP) das artérias uterinas, umbilicais e cerebral média fetal, de acordo com a persistência ou não da incisura protodiastólica bilateral das artérias uterinas na pré-eclâmpsia grave. MÉTODOS: foi desenvolvido um estudo do tipo coorte, incluindo 40 gestantes com pré-eclâmpsia grave, das quais 23 apresentavam incisura protodiastólica bilateral e 17, incisura ausente/unilateral. As pacientes foram submetidas a doplervelocimetria antes e depois de 20 minutos da administração intravenosa de 6 g do sulfato de magnésio. O exame foi realizado com a paciente em posição semi-Fowler, obtendo-se os sonogramas durante a inatividade fetal, em períodos de apneia e ausência de contrações uterinas. Todos os exames foram realizados por dois pesquisadores, considerando a média como resultado final. A comparação dos IP antes e depois do sulfato de magnésio em cada grupo foi realizada pelo teste de Wilcoxon. A diferença das duas medidas (antes e depois do sulfato de magnésio) foi comparada entre os grupos (incisura bilateral e incisura ausente/unilateral) utilizando-se o teste de Mann-Whitney. RESULTADOS: houve um aumento significativo da frequência cardíaca materna e uma diminuição da pressão arterial materna e da mediana dos IP das duas artérias uterinas e da artéria cerebral média fetal depois da utilização do sulfato de magnésio em ambos os grupos. Houve redução significativa do IP da artéria uterina esquerda e da artéria umbilical apenas no grupo com incisura protodiastólica unilateral/ausente. No entanto, não foram encontradas diferenças significativas em relação ao IP da artéria uterina direita e relação umbilical/cerebral antes e depois do sulfato de magnésio em cada grupo. Não se encontrou diferença entre os grupos, antes e depois do sulfato de magnésio, para nenhum dos desfechos estudados. CONCLUSÕES: após a administração intravenosa de 6 g do sulfato de magnésio nas...


PURPOSE: to evaluate the effect of magnesium sulphate on the pulsatility index (PI) of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia. METHODS: a cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate) was compared between the groups (bilateral incision and unilateral/absent incision) using the Mann-Whitney test. RESULTS: there was a significant increase in the maternal heart rate (MHR) and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral/umbilical relationship, before and after magnesium sulphate in each group. No difference between the groups was found, before and after magnesium sulphate, for any of the studied outcomes. CONCLUSIONS: after the intravenous administration of 6 g of magnesium sulphate to patients with severe pre-eclampsia...


Subject(s)
Adult , Female , Humans , Pregnancy , Anticonvulsants/pharmacology , Diastole , Magnesium Sulfate/pharmacology , Middle Cerebral Artery/drug effects , Middle Cerebral Artery/physiopathology , Pre-Eclampsia/physiopathology , Umbilical Arteries/drug effects , Umbilical Arteries/physiopathology , Uterus/blood supply , Uterus/drug effects , Cohort Studies , Pulse , Severity of Illness Index
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