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To describe the ultrasonographic characteristics of congenital porto-systemic venous shunts (CPSS) diagnosed during pregnancy, their outcomes, and their evolution.Two independent researchers selected 493 review articles and case reports through the analysis of titles, abstracts, and full text. The PubMed and LILACS databases were searched. Through the application of filters according to the PRISMA protocol, only six articles were used in the research. The following information was collected, when available: gestational age at diagnosis, gender, birth weight, type of shunt, associated anomalies/complications and treatment/progression.The data were obtained from 27 cases, with 22 (82%) fetuses diagnosed with intra-hepatic CPSS and 5 (18%) with extra-hepatic CPSS. The median time of intrauterine diagnosis was 33 weeks. In 12 (57.1%) of the 21 pregnancies evaluated, delivery was preterm. The estimated fetal weight ranged from 1150 to 3760 g, with 4 (25%) cases at3rd, 3 (18.75%) cases at10th, 8 (50%) cases at50th, and 1 (6.25%) case at97th percentile for gestational age. The most frequent obstetric complication was fetal growth restriction, which occurred in nine (60%) cases. As for postnatal treatment, 19 (70.4%) cases were conservatively treated, and 8 (29.6%) cases required surgical intervention.The diagnosis of CPSS still represents a challenge during prenatal care. Its early identification aims to provide guidance to pregnant women and their families, as well as follow-up and anticipation of possible complications, in addition to the evaluation of the mode of delivery and postnatal follow-up, directing the short- and long-term prognosis.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes. METHODS: This retrospective cohort included pregnant women with premature rupture of membranes (between 24 and 33+6 weeks) who used or did not use prophylactic antibiotics. Pearson's chi-square (χ²) test, Student's t-test, and binary logistic regression were used for statistical analysis. RESULTS: A significant effect was observed in patients with premature rupture of membranes using prophylactic antibiotics regarding amniotic fluid index (p=0.007), deepest vertical pocket (p=0.049), duration of antibiotic therapy (p≤0.001), C-reactive protein level upon admission (p≤0.001), leukocyte count upon admission (p=0.007), and length of stay in neonatal intensive care (p=0.047). A significant association was observed between the abovementioned patients and surfactant use during the neonatal period (p=0.04). A higher prevalence of surfactant use was noted in these patients (20.0 vs. 8.7%; p=0.04). CONCLUSION: No association was found between antibiotic prophylaxis and the presence of adverse perinatal outcomes in pregnant women with premature rupture of membranes between 24 and 33+6 weeks of gestation.

To present a prenatal diagnosis of diastrophic dysplasia in the second trimester of pregnancy using two- (2D) and three-dimensional (3D) ultrasonography. The mother was primigravida and aged 12 years. She underwent the first 2D obstetric ultrasound examination at 27 weeks, showing bilaterally upper and lower limb micromelia, thumb and hallux in bilateral abduction, bilateral talipes equinovarus; hyperlordosis of the lumbar spine, cervical, lumbar, and sacral scoliosis; cervical hyperkyphosis with the misalignment of cervical vertebrae, and straight clavicles. 3D ultrasonography in conventional and HDlive rendering modes confirmed the changes observed in 2D ultrasonography and allowed improved understanding by the parents. At birth, the newborn presented transient respiratory distress and neonatal sepsis. At the time of writing, the child is aged 31 months and under follow-up by the pediatrics department. 3D ultrasound allowed the parents to understand the fetal malformations better, and they received adequate counseling.

Objetivo: mapear as evidências acerca do tratamento de gestantes com confirmação diagnóstica de infecção pelo SARS-CoV-2. Método: revisão de escopo, conforme o Institute Joanna Briggs e o PRISMA-ScR, com buscas em quatro bases de dados; extração, análise e síntese por quatro pesquisadores independentes de forma descritiva. Resultados: das 553 publicações, selecionaram-se 28 artigos para análise, todos no idioma inglês. Observou-se que uma pequena parcela das gestantes utilizou oxigenoterapia e um número inferior necessitou de ventilação mecânica e monitorização em CTI. Os medicamentos mais utilizados no tratamento foram: antibióticos, antivirais e a corticoterapia. Considerações finais: não se encontraram protocolos ou padronização de medicamentos no tratamento da gestante com COVID-19. nsiderações finais: Não encontrou-se protocolos ou padronização de medicamentos no tratamento da gestante com COVID-19.

Aim The study aim was to map clinical characteristics and the evolution of pregnancies in pregnant women with confirmed diagnosis of SARS‐CoV‐2 infection. Methods Searching four databases, studies were investigated that described the evolution of pregnancies in women diagnosed with SARS‐CoV‐2 infection through laboratory tests. A scoping review was undertaken, including 35 articles published in English. Two pairs of independent researchers synthesized the data. Results Most studies were case studies or case series and had a low risk of bias. A predominance of cases was found in women over the age of 30 years who got infected in the third term of pregnancy and who had comorbidities. The prematurity index varied with the heterogeneity of the samples, and the cases of abortion occurred in combination with severe forms of infection. Caesarean section deliveries predominated, indicated mainly by respiratory decompensation caused by infection. Most women were discharged. Conclusion Based on the reviewed studies, the profile and evolution of pregnant women infected with COVID‐19 could be evaluated., Summary statement What is already known about this topic? In 2020, the COVID‐19 pandemic was decreed, currently accounting for more than 105 million cases and more than two million deaths.Physiological changes of pregnancy predispose pregnant women to COVID‐19 infection.The characteristics of pregnancy associated with COVID‐19 infection turn obstetric care into a constant challenge. What this paper adds? The review presents the profile of pregnant women infected by SARS‐CoV‐2, with laboratory confirmation using the diagnostic reference standard (PCR).This review presents the profile of pregnant women infected with SARS‐CoV‐2 and the outcomes of the infection and pregnancy. The implications of this paper: Based on the knowledge of the profile, public policies can be planned to prevent and manage infection among pregnant and postpartum women.Further studies are suggested, mainly follow‐up studies of cohorts with pregnant women infected with SARS‐CoV‐2 to expand knowledge about the profile and obstetric outcomes.

Objetivo: Avaliar a associação entre uso profilático de antibióticos e rotura prematura de membranas (RPM) e resultados perinatais adversos. Métodos: Trata-se de uma coorte retrospectiva de mulheres grávidas com rotura prematura de membranas, que fizeram ou não uso profilático de antibióticos entre 24 e 33 semanas e 6 dias. Para a análise estatística, foram utilizados teste χ2, teste t de Student e regressão logística binária. Resultados: Houve efeito significativo do grupo com RPM em uso profilático de antibióticos sobre a medida do índice de líquido amniótico (ILA) (p=0,007), a medida do maior bolsão vertical (MBV) (p=0,049), o tempo de uso de antibiótico (p≤0,001), a proteína C reativa na internação (p≤0,001), o número de leucócitos na internação (p=0,007) e o tempo de internação em unidade terapia intensiva (UTI) neonatal (p=0,047). Observou-se associação significativa entre o grupo com RPM em uso profilático de antibióticos e o uso de surfactante durante o período neonatal (p=0,04). As pacientes que utilizaram antibióticos profiláticos apresentaram maior prevalência de uso de surfactante (20,0 vs. 8,7%, p=0,04). Conclusão: Não se observou associação entre uso profilático de antibióticos com presença de resultados perinatais adversos em gestantes com RPM entre 24 e 33 semanas e 6 dias.

Resumo Objetivos identificar a prevalência de adesão e não adesão à consulta puerperal, assim como facilitadores e barreiras, entre puérperas assistidas em um hospital de ensino. Método estudo de coorte prospectivo, realizado com 121 puérperas, no período de agosto a dezembro de 2019, nas dependências de um hospital de ensino do interior de Minas Gerais. Resultados a prevalência de adesão à consulta puerperal foi de 34,7%. Observou-se, como facilitador, o acolhimento da equipe durante o pré-natal e/ou parto. Citaram-se como barreiras: esquecimento; intercorrências com o RN e/ou puerperais; dificuldade de transporte e distância entre o serviço e a residência. Foram associados à adesão: puérperas com maior escolaridade, que realizaram todo ou parte do pré-natal na instituição, que tiveram a gestação classificada como alto risco, que apresentaram doenças prévias durante a gestação, primigestas e as que tiveram parto cesáreo. Conclusões e implicações para a prática os dados apresentados possibilitaram delinear um perfil das puérperas que aderiram ou não à consulta puerperal, desvelando fatores facilitadores e barreiras, assim como fatores associados à maior adesão. Faz-se necessário repensar a assistência ao puerpério, uma vez que a consulta é uma estratégia de prevenção de morte materna. Resumen Objetivos identificar la prevalencia de adherencia y no adherencia a la consulta puerperal, así como facilitadores y barreras, entre las mujeres puerperales atendidas en un hospital universitario. Método estudio de cohorte prospectivo, realizado con 121 madres, de agosto a diciembre de 2019, en las instalaciones de un hospital universitario en el interior de Minas Gerais. Resultados La prevalencia de adherencia a la consulta puerperal fue del 34,7%. La bienvenida del equipo durante el prenatal y/o parto se observó como un facilitador. Se mencionaron las siguientes barreras: olvido, complicaciones con el recién nacido y/o puerperal, dificultad en el transporte y la distancia entre el servicio y la residencia. Los siguientes se asociaron con la adherencia: mujeres puerperales con educación superior, que realizaron todo o parte de la atención prenatal en la institución, que tuvieron un embarazo clasificado como de alto riesgo, que tuvieron enfermedades previas durante el embarazo, primigestas y quienes tuvieron un parto por cesárea. Conclusiones e implicaciones para la práctica Los datos presentados permitieron esbozar un perfil de las mujeres puerperales que se adhirieron o no a la consulta puerperal, revelando factores y barreras facilitadoras, así como factores asociados con una mayor adherencia. Es necesario repensar la asistencia al puerperio, ya que la consulta es una estrategia para prevenir la muerte materna. Abstract Objectives to identify the prevalence of adherence and non-adherence to postpartum consultation, as well as facilitators and barriers, among postpartum women assisted in a teaching hospital. Method a prospective cohort study, conducted with 121 postpartum women, from August to December 2019, assisted in a teaching hospital in the inland of Minas Gerais. Results the prevalence of adherence to postpartum consultation was 34.7%. The reception of the health team during the prenatal and/or birth was observed as a facilitator. The mentioned barriers were the following: forgetfulness, complications with themselves and/or the newborn, transportation difficulty and distance between the service and residence. The factors associated with adherence were the following: postpartum women with higher education, who performed all or part of the prenatal care at the institution, who had pregnancy classified as high risk, who had previous diseases during pregnancy, primigravidae, and who had cesarean delivery. Conclusions and implications for the practice the submitted data made it possible to delineate a profile of the postpartum women who adhered or not to the postpartum return, identifying facilitators and barriers as well as factors associated with greater adherence. It is necessary to rethink assistance to the postpartum period, since consultation is the one of the strategies to prevent maternal death.

To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes. Comparar o tipo de manejo (ativo versus expectante) para ruptura prematura de membranas (PPROM, na sigla em inglês) entre 34 e 36 semanas e 6 dias de gestação e os resultados perinatais adversos relacionados, em 2 hospitais terciários do sudeste brasileiro. MéTODOS: No presente estudo de coorte retrospectivo, os dados foram obtidos através da revisão dos prontuários de gestantes internadas em dois centros terciários com protocolos diferentes para o seguimento da PPROM. As gestantes foram divididas em dois grupos com base no manejo da PPROM: grupo I (ativo) e grupo II (expectante). Para análise estatística, foram utilizados o teste t de Student, qui-quadrado e regressão logística binária. Das 118 gestantes incluídas, 78 foram submetidas a tratamento ativo (grupo I) e 40 a seguimento expectante (grupo II). Comparado ao grupo II, o grupo I apresentou índice de líquido amniótico médio significativamente menor (5,5 versus 11,3 cm

Objective: Analyze available evidence related to SARS-CoV-2 infection and vertical transmission. Methods: Scoping review, according to the Joanna Briggs Institute and PRISMA-ScR. Searches were conducted in five electronic databases to find publications about coronavirus infection and vertical transmission. Data were extracted, analyzed and synthesized by three independent researchers using a descriptive approach. Results: The search resulted in 76 publications. After selective steps, 15 articles – retrospective descriptive or case studies – were analyzed, all in English. In order to track the infection, specimens were collected from neonates through nasal swabs and C-reactive protein from breast milk, cord blood, amniotic fluid, placenta and vaginal secretion was analyzed. A small percentage of neonates tested positive for COVID-19, but these cases were not attributed to vertical transmission. Conclusion: Vertical transmission could not be demonstrated. Research protocol registered with the Open Science Framework (https://osf.io/fawmv).

Estudo quantitativo, de delineamento transversal, realizado com 103 puérperas que teve por objetivo analisar e mensurar a qualidade de vida de puérperas, identificar a prevalência de sinais indicativos de depressão pós-parto e associar escores de qualidade de vida com sintomas depressivos. Aplicou-se instrumentos sobre condições sociodemográficas, de saúde e obstétricas, “Índice de Qualidade de Vida” e o Inventário de Beck para Depressão. O escore de qualidade de vida total obteve média de 24,77. Os domínios com menor e maior escore foram Socioeconômico e, Família. A média de pontos obtida no Inventário de Beck foi de 9,42, porém 82,5% não possuíam sinais indicativos de depressão. Observou-se que presença de sinais indicativos alterou todos os escores de qualidade de vida e seus domínios. Concluiu-se que as puérperas obtiveram altos escores de qualidade de vida, contudo, sinais indicativos de depressão influenciaram negativamente a qualidade de vida em todos os seus domínios.

Introdução: Leiomioma uterino é um tumor benigno do tecido miometrial acometendo mulheres em idade reprodutiva. Sua prevalência aumenta com a idade e tem pico de incidência aos 40 anos. O termo “leiomioma metastático” refere-se a um tumor de tecido conectivo denso e células musculares lisas miometriais localizado fora do útero. Pode metastatizar para diversos órgãos, sendo o pulmão seu principal foco. Objetivo: Reportar o caso de paciente, 33 anos, G3P1C1A1, com gestação de 11 semanas e 2 dias, associada a duas massas pélvicas e diagnóstico prévio de leiomiossarcoma pélvico há cinco anos, conduzido com exérese da lesão e seis sessões de quimioterapia adjuvante. Materiais e Métodos: Descrição de leiomioma metastático na gestação e revisão de caso na literatura. Resultados e Conclusão: Paciente submetida à ultrassonografia, que evidenciou massa em fundo de saco posterior, heterogênea, hipoecoica, com limites imprecisos, ecogenicidade de partes moles e dimensões 6,7×2,4×4,0 cm, e massa em parede póstero-lateral esquerda do corpo uterino medindo 18,7×19,3 mm, com nódulos agrupados adjacentes a este medindo 72,2×35,7 mm. Massas diagnosticadas como nódulos ligamentares compatíveis com miomas, predominantes à esquerda e alteração focal do miométrio em parede posterior. Em razão do diagnóstico prévio de sarcoma tratado, foi submetida à ressonância nuclear magnética de tórax normal e de abdome, que demonstrou lesão expansiva, retroperitoneal, heterogênea, em compartimento inframesocólico, paraórtica, anterior ao ventre do músculo psoas esquerdo, em intimidade com polo inferior do rim ipsilateral. Paciente optou por manter a gestação, acompanhada pelas equipes de Oncoginecologia e Medicina Fetal. Pré-natal sem complicações obstétricas, submetida à corticoterapia com 31 semanas e programada interrupção da gestação via alta com 33 semanas e 2 dias. Deu origem a recém-nascido único, vivo, com peso de 1515 g, Apgar 7/8, e que necessitava de intubação orotraqueal e acompanhamento em unidade de terapia intensiva neonatal. Cavidade abdominal revisada, evidenciando massa anexial esquerda de aproximadamente 20 cm em maior diâmetro, aderida ao ligamento largo, ovário e tuba uterina esquerdos, e massa em região paraórtica e pararrenal esquerda com aproximadamente 10 cm em maior diâmetro, com íntima relação com o ureter. Ressecção cuidadosa das massas associada à salpingooforectomia à esquerda. Estudo histopatológico evidenciou leiomiomas com área de degeneração hidrópica e hialina, sem atipias nucleares, atividade mitótica ou necrose típica de leiomiossarcoma. A imuno-histoquímica confirmou o diagnóstico, com positividade do receptor de progesterona, levantando a possibilidade de associação entre a gestação e o crescimento da massa. O caso descrito foi de manejo difícil em virtude do desejo de gestar e do diagnóstico prévio de leiomiossarcoma. Sendo assim, é de importância científica em razão do pequeno número de casos de leiomioma metastático, ainda mais associado à metástase retroperitoneal e em gestante.

Objectives: To estimate the prevalence of nipple traumas and to correlate this occurrence with socio-demographic and obstetric factors in a sample of assisted post-partum patients in a teaching hospital. Method: Cross-sectional, quantitative study of 320 post-partum patients assisted in the maternity from October 2015 to October 2016. Results: The prevalence of nipple trauma in the sample was 35.3%, and only previous experience with breastfeeding has behaved as a protective factor for trauma. No statistical associations were found with other variables. Conclusions and implications for practice: The data presented allowed us to delineate a profile of the post-partum patients assisted in a teaching hospital, as well as the characterization of the occurrence of nipple traumas. From this profile, guidelines can be established on the subject, both in the institution where the study was carried out and in other institutions, since from the literature, the need for this orientation in different contexts and institutions is identified. Resumen Objetivos: Estimar la prevalencia de traumas mamilares y correlacionar su ocurrencia con factores sociodemográficos y obstétricos en muestra de puérperas asistidas en un hospital de enseñanza. Método: Estudio cuantitativo y transversal, realizado con 320 puérperas asistidas en un Alojamiento Conjunto, en el período de octubre de 2015 a marzo de 2016. Resultados: La prevalencia de trauma mamilar en la muestra fue de 35,3%, y solo la experiencia previa con la lactancia actuó como un factor de protección para el trauma. No se encontraron asociaciones estadísticas con otras variables. Conclusiones e implicaciones para la práctica: Los datos presentados permiten delinear un perfil de puerperas asistidas en un hospital de enseñanza, así como la caracterización de la ocurrencia de traumas mamilares. A partir de este perfil se podrán establecer orientaciones sobre el tema tanto en la institución en que se realizó el estudio, como en otras instituciones, ya que a partir de la literatura se pudo identificar la necesidad de esta orientación en diferentes contextos e instituciones. Resumo Objetivos: Estimar a prevalência de traumas mamilares e correlacionar a sua ocorrência com fatores sociodemográficos e obstétricos em amostra de puérperas assistidas em um hospital de ensino. Método: Estudo quantitativo, transversal realizado com 320 puérperas assistidas no Alojamento Conjunto, no período de outubro de 2015 a março de 2016. Resultados: A prevalência de trauma mamilar na amostra foi de 35,3% e apenas a experiência prévia com aleitamento comportou-se como fator de proteção para o trauma. Não foram encontradas associações estatísticas com outras variáveis. Conclusões e implicações para a prática: Os dados apresentados possibilitaram delinear um perfil das puerpéras assistidas em um hospital de ensino, assim como a caracterização da ocorrência dos traumas mamilares. A partir deste perfil poderão ser instituídas orientações sobre o tema tanto na instituição que foi realizado o estudo, quanto em outras instituições, já que a partir da literatura, identifica-se a necessidade desta orientação em diferentes contextos e instituições.

Introduction: Preeclampsia is defined by the development of hypertension associated with proteinuria after the 20th week of gestation in previously normotensive women. IL17A is a potent inducer of tissue inflammation and polymorphisms in the IL17A gene can modulate gene expression and affect the functioning of Th17 cells, strengthening susceptibility to preeclampsia. Objective: To investigate the polymorphisms rs4711998 A>G, rs8193036 C>T and rs2275913 A>G in the IL17A gene in women with preeclampsia. Methods: This is a control case study, composed of 263 women, 89 with preeclampsia and 174 of the control group. The polymorphisms investigated by real time polymerase chain reaction (PCR) allele discrimination technique. The risk of IL17A polymorphisms contributing to preeclampsia was assessed by the inheritance model through logistic regression. Statistical power presented 99.5% for association detection. Statistical significance was defined as p < 0.05. Results: Genotype frequencies as well as multiple logistic regression analysis were not statistically significant for the rs4711998 A>G, rs8193036 C>T and rs2275913 A>G polymorphisms of the IL17A gene. No association was found between any haplotypes of the polymorphisms investigated and the risk of developing PE. Conclusion: There is no association between the allele frequencies, genotype, inheritance models and haplotypes of the rs4711998 A>G, rs8193036 C>T and rs2275913 A>G polymorphisms of the IL17A gene and PE.

Objective: The present study assessed epidemiological and obstetrical data from pregnant women with syphilis at the Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (UFTM, in the Portuguese acronym), describing this disease during pregnancy and its vertical transmission for future healthcare actions. Methods: Records from pregnant women who had been admitted to the Obstetrics Department of the Hospital de Clínicas of the UFTM and were diagnosed with syphilis between 2007 and 2016 were reviewed. A standardized form was used to collect epidemiological, obstetric data and outcomes of congenital infection. The present research has been authorized by the Ethics Committee of the institution. Results: There were 268 women diagnosed with syphilis, with an average age of 23.6 years old. The majority of the patients were from Uberaba. Inadequate prenatal care was observed in 37.9% of the pregnant women. Only 34.2% of the patients completed the treatment according to the guidelines issued by the Ministry of Health of Brazil, and 19.8% of the partners of the patients underwent adequate syphilis treatment; 37 (13.8%) couples (patients and partners) underwent correct treatment. Regarding the obstetric outcomes, 4 (1.5%) patients had a miscarriage and 8 (3.4%) had fetal losses (from the fetal loss group, 7 had no adequate treatment); 61 (25.9%) patients had premature births - this prematurity has been significantly correlated to inadequate or incomplete treatment in 49 (27.9%) patients, compared with 12 (13.0%) patients with premature births and adequate treatment (p = 0.006). The average live newborn weight was 2,840 g; 25.3% had a birth weight < 2,500 g; 74.2% had congenital syphilis, a data with heavy correlation to inadequate or incomplete prenatal care, prematurity, and low birth weight. Conclusion: Public awareness policies on adequate prenatal care, intensification of serological screening, and early treatment of syphilis are needed, considering the rise of cases diagnosed during gestation and its potentially preventable deleterious consequences related to congenital transmission. Resumo Objetivo: O presente estudo avaliou dados epidemiológicos e obstétricos de gestantes com sífilis no Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (UFTM), objetivando o conhecimento desta infecção no ciclo gravídico e a transmissão vertical para futuras ações em saúde pública. Métodos: Foram revisados registros de gestantes admitidas no Departamento de Ginecologia e Obstetrícia do Hospital de Clínicas da UFTM, diagnosticadas com sífilis entre 2007 e 2016. Para a coleta de dados, utilizou-se um formulário padronizado enfocando aspectos epidemiológicos, obstétricos e infecção congênita. A presente pesquisa foi autorizada pelo Comitê de Ética da instituição. Resultados: Obteve-se 268 gestantes diagnosticadas com sífilis, com idade media de 23,6 anos, sendo a maioria de Uberaba. A assistência pré-natal foi inadequada em 37,9% dos casos. O tratamento para sífilis, de acordo com as diretrizes do Ministério da Saúde do Brasil, foi realizado por 34,2% das gestantes e por 19,8% dos parceiros. Quanto aos desfechos obstétricos, observou-se que 4 (1,5%) pacientes evoluíram com abortamento e 8 (3,4%) com óbito fetal, das quais 7 não realizaram tratamento. Observou-se parto prematuro em 61 (25,9%) gestantes, e a prematuridade foi significativamente associada ao tratamento ausente/incompleto, com 49 (27,9%) casos, comparada a 12 (13,0%) casos nos quais o tratamento foi adequado (p = 0,006). Quanto aos recém-nascidos, o peso médio foi de 2.840 g, e 25,3% apresentaram peso < 2.500 g. Diagnosticou-se infecção congênita em 74,2%, dos casos, associada significativamente ao pré-natal inadequado, ao tratamento ausente/ incompleto, à prematuridade e ao baixo peso ao nascer. Conclusão: Políticas públicas de conscientização sobre pré-natal adequado, intensificação de rastreamento sorológico e tratamento precoce da sífilis são necessárias, haja vista a ascensão dos casos diagnosticados na gestação e suas consequências deletérias potencialmente evitáveis relacionadas à transmissão congênita.

This is a cross-sectional and retrospective study based on the analysis of all medical records of puerperal women assisted at a teaching hospital in the state of Minas Gerais, from January 1 to December 31, 2016. This study aims to estimate the success rate in vaginal delivery after a previous cesarean section, and the factors associated with their outcome. 1,157 medical records were reviewed and, after selection, 215 records of puerperal women submitted to vaginal delivery after a previous cesarean section were analyzed. The rate of vaginal delivery after previous cesarean section was 55.8%. The factors associated with the outcome were mainly absence of complications and/or pathologies during pregnancy, full-term pregnancies, and having had at least one previous vaginal birth. There is a need for studies on the subject, given the recent recommendations, factors to be cleared and still contradictory results regarding vaginal delivery after previous cesarean section.

Objectives: to verify the contribution of polymorphisms rs1800469 and rs1800468 of the TGF-β1 gene and the risk factors for the pre-eclampsia development. Methods: this is a case-control study with 257 women from the Uberaba region of Minas Gerais were selected, 88 of them were in the pre-eclampsia group and 169 in the control group. Genotyping was performed by allelic discrimination using the real-time PCR technique. The odds ratio and the 95% confidence interval were used to evaluate the probability of the polymorphisms studied contributing for the pre-eclampsia development. The logistic regression analysis was performed to evaluate the relation among family recurrence, smoking, primiparity and the presence of polymorphic alleles and susceptibility of preeclampsia. Results: no association was found between polymorphisms rs1800469 and rs1800468 of the TGF-β1 gene and pre-eclampsia. The logistic regression analysis was statistically significant for family recurrence, showing that women with a family history of pre-eclampsia and primiparity are at an increased risk of developing the disease. Conclusions: no association was found between polymorphisms rs1800469 and rs1800468 of the TGF-β1 and pre-eclampsia gene. Factors such as family history and primiparity were associated to the risk of developing pre-eclampsia. Resumo Objetivos: verificar a contribuição dos polimorfismos rs1800469 e rs1800468 do gene TGF-β1 e de fatores de risco para o desenvolvimento de PE. Métodos: trata-se de um estudo caso-controle, onde foram selecionadas 257 mulheres, da região de Uberaba, Minas Gerais, sendo 88 do grupo PE e 169 controles. A genotipagem foi realizada por discriminação alélica através da técnica de PCR em tempo real. Odds ratio e o intervalo de confiança de 95% foram usados para avaliar a probabilidade dos polimorfismos estudados contribuírem com o desenvolvimento de PE. A análise de regressão logística foi realizada para avaliar a relação entre recorrência familiar, tabagismo, primiparidade e presença dos alelos polimórficos e a suscetibilidade a PE. Resultados: não foi observada associação entre os polimorfismos rs1800469 e rs1800468 do gene TGF-β1 e PE. A análise de regressão logística foi estatisticamente significativa para recorrência familiar, mostrando que mulheres com histórico familiar de PE e mulheres primigestas possuem risco aumentado de desenvolver a doença. Conclusões: não foi encontrada associação entre os polimorfismos rs1800469 e rs1800468 do gene TGF-β1 e PE. Fatores como histórico familiar e primiparidade foram associados com o risco de desenvolvimento de PE.

This study aimed to evaluate the serum concentration of factors associated with placental angiogenesis in pre-eclamptic and normotensive pregnant women.This was a prospective, cross-sectional, case-control study in which the pro-angiogenic factors PlGF, VEGF and IL-10, and the anti-angiogenic factors IL-6, IL-17 and TNF-α of 55 pregnant women (31 with pre-eclampsia-PE and 24 normotensive), with gestational age ≥20 weeks, were measured in maternal blood through the enzyme-linked immunosorbent assay (ELISA). The Mann-Whitney and Kruskal-Wallis tests were used for comparison between groups.Serum PIGF was reduced in the group of pregnant women with PE when compared with the normotensive women (493.2 ± 55.1 pg/mL vs. 4.4 ± 26.5 pg/mL; p 0.001). There was no significant difference in PlGF levels in the pre-eclamptic pregnant women in relation to gestational age or proteinuria levels (p 0.05). The serum levels of VEGF, IL-17, IL-10 and TNF-α were lower in the pregnant women with PE when compared with their normotensive peers, while the IL-6 levels were higher; however, this difference was not statistically significant (p 0.05).Serum PlGF levels were reduced in the pregnant women with PE and were unrelated to disease severity. Serum levels of VEGF, IL-17, IL-10 and TNF-α were reduced in the pre-eclamptic pregnant women when compared with their normotensive peers, without statistically significant differences.

Pre-eclampsia (PE) is a pregnancy-specific multisystemic syndrome characterized by high blood pressure and presence of protein in the urine. The pathogenesis of pre-eclampsia is poorly understood and many factors such as environment, genetic, and immunology may be involved in PE pathophysiology. Among the genetic factors, there is an association between pre-eclampsia and polymorphisms in some genes of different population samples, as vascular endothelial growth factor and interleukin 1 alpha. The vascular endothelial growth factor gene is highly polymorphic and acts as a regulator in endothelial cell proliferation and vascular permeability. The secretion of interleukin 1 alpha leads to a pro-inflammatory cascade, which leads to high levels of circulating cytokines. This high amount of cytokines corroborates to structural and functional alterations in endothelial cells. The aim of this study was to investigate the vascular endothelial growth factor (VEGF) G-634C and interleukin 1 alpha (IL1A) rs3783550 polymorphism in a specific Brazilian pre-eclampsia group. The evaluation of the vascular endothelial growth factor polymorphism was performed by PCR–RFLP restriction enzyme BsmFI and the IL1A polymorphism by allele-specific PCR. Molecular investigation was carried out by fragment size analysis on agarose and/or polyacrylamide gels. However, no relation between polymorphism VEGF G-634C and pre-eclampsia was observed, indicating that further investigations with a larger sampling and other polymorphisms are still required. On the other hand, the rs3783550 polymorphism in the interleukin 1 alpha gene is correlated to pre-eclampsia, indicating that women with the allele A have a higher probability of developing the disease. Thus, the interleukin 1 alpha gene could be used as a therapeutic tool for the diagnosis, as well as for monitoring the patients.

Objective: to analyze the quality of life (QOL) of postpartum women and to correlate it with sociodemographic, clinical, obstetric and neonatal variables. Method: quantitative, cross-sectional study conducted in a teaching hospital in Uberaba-MG. 103 postpartum women were interviewed. Data were collected in 2017 and analyzed using simple descriptive statistics, Pearson correlation and Student's t-test. To measure QoL scores, the Ferrans and Powers Quality of Life Index instrument was used. The project was approved by the Research Ethics Committee. Results: adolescent mothers, income higher than two minimum wages, number of prenatal consultations, newborns over 4,000g and high Apgar score in the first minute favored the best QOL. Complications during pregnancy and / or childbirth, newborn health problems and alcoholism impaired QOL. Conclusion: the puerperal women had high QoL scores, highlighting the family and psycho-spiritual domains. Sociodemographic, clinical, obstetric and neonatal aspects influenced QOL. RESUMO Objetivo: analisar a qualidade de vida (QV) das puerperas e correlaciona-la com variaveis sociodemograficas, clinicas, obstetricas e neonatais. Metodo: estudo quantitativo, de delineamento transversal realizado em um hospital de ensino de Uberaba-MG. Foram entrevistadas 103 puerperas. Os dados foram coletados em 2017 e analisados por estatistica descritiva simples, correlacao de Pearson e o Teste t de Student. Para mensurar os escores de QV foi utilizado o instrumento Indice de Qualidade de Vida de Ferrans e Powers. O projeto foi aprovado pelo Comite de Etica em Pesquisa. Resultados: puerperas adolescentes, renda superior a dois salarios, numero de consultas pre-natal, recem-nascido (RN) macrossomico e Apgar no primeiro minuto favoreceram a melhor QV. Intercorrencias durante gestacao e/ou durante o parto, problemas de saude do RN e etilismo prejudicaram a QV. Conclusao: as puerperas apresentaram altos escores de QV, destacando-se os dominios familia e psicoespiritual. Aspectos sociodemograficos, clinicos, obstetricos e neonatais influenciaram a QV. RESUMEN Objetivo : analizar la calidad de vida (CV) de las madres y correlacionarla con variables sociodemograficas, clinicas, obstetricas y neonatales. Metodo: estudio transversal cuantitativo realizado en un hospital universitario de Uberaba-MG. Se entrevistaron 103 mujeres posparto. Los datos se recopilaron en 2017 y se analizaron mediante estadisticas descriptivas simples, correlacion de Pearson y prueba t de Student. Para medir los puntajes de la calidad de vida, se utilizo el instrumento Ferrans and Powers Quality of Life Index. El proyecto fue aprobado por el Comite de Etica en Investigacion. Resultados: madres adolescentes, ingresos superiores a dos salarios minimos, numero de consultas prenatales, recien nacidos de mas de 4.000 gy puntaje de Apgar alto en el primer minuto favorecieron la mejor calidad de vida. Complicaciones durante el embarazo y / o parto, problemas de salud del recien nacido y la calidad de vida deteriorada por el alcoholismo. Conclusion: las mujeres puerperales tuvieron altos puntajes de calidad de vida, destacando los dominios familiar y psicoespiritual. Los aspectos sociodemograficos, clinicos, obstetricos y neonatales influyeron en la calidad de vida

Objective: to measure the quality of life of women who are experiencing the puerperium. Methods: crosssectional study performed with 103 postpartum women, based on the application of the Ferrans and Powers Quality of Life Index. Results: the average overall quality of life index was 24.77 points. Among the domains, the highest score was obtained in the family domain, and the most affected was the socioeconomic. Presence of pain and socioeconomic conditions were the main reasons for postpartum dissatisfaction, while the most important and most satisfying item was Health of the child and of the family. Conclusion: the mothers had high quality of life scores. However, the socioeconomic domain was the most compromised and the family domain presented the best scores, indicating the importance and satisfaction linked to birth and family configuration. Objetivo: mensurar a qualidade de vida de mulheres que estão vivenciando o puerpério. Métodos: estudo transversal, realizado com 103 puérperas, a partir da aplicação do instrumento “Índice de Qualidade de Vida”, de Ferrans e Powers. Resultados: a média do índice de qualidade de vida geral foi de 24,77 pontos. Dentre os domínios, o que teve a maior pontuação foi o família e o mais afetado foi o socioeconômico. Presença de dor e condições socioeconômicas foram os principais motivos de insatisfação das puérperas, enquanto que a saúde dos filhos e da família foi sinalizada como o item mais importante e de maior satisfação. Conclusão: as puérperas apresentaram altos escores de qualidade de vida. Contudo, o domínio socioeconômico foi o mais comprometido e o domínio família o que apresentou melhores escores, indicando importância e satisfação diante do nascimento e da configuração familiar.

Vertical HIV transmission rates and associated factors among mother-infant pairs cared for at a Brazilian reference centre from 1988 to 1993 (period 1), and from 1996 to 1999 (period 2) were evaluated. A total of 150 and 239 infants born to HIV+ mothers were enrolled at birth during these periods. No zidovudine prophylaxis was available in period 1. In period 2, 92.4% of the infants were exposed to zidovudine (54% started at delivery or in the post-natal period). During period 1, 25 of 129 infants were found to be infected (19.4%; 95% confidence interval [CI]=13-27) vs 20 of 232 (8.6%; 95% CI=5-13) during period 2 ( P

Objective : to report the academic experience in promoting health education about warning signs and labor for pregnant women. Method : a qualitative, descriptive study, a type of experience report, in which 15 students were trained to form the group, in which they were discussed: warning signs, false and true labor and didactic strategies for approaching pregnant women, supported by articles and guidelines. Three academics interviewed 100 pregnant women with their own instrument containing ten questions. After the training and the collection, the group prepared an educational material that was evaluated and, after adjustments, folders were made. Results : only 21% of pregnant women received guidance on the subject. After responding to the questionnaire, all the women received guidance (n = 100) and 196 were collectively oriented through the waiting room and folder distribution strategies. Conclusion : there was a need for Health Education for pregnant women; indissociability between teaching-research-extension and the need to produce community-oriented knowledge on the subject. Descriptors : Parturition; Labor, Obstetric; Health Education. RESUMO Objetivo: relatar a experiencia academica em promover educacao em saude sobre sinais de alerta e de trabalho de parto para gestantes. Metodo: estudo qualitativo, descritivo, tipo relato de experiencia, em que foram capacitados 15 academicos para compor o grupo, no qual foram discutidos: sinais de alerta, falso e verdadeiro trabalho de parto e estrategias didaticas para a abordagem de gestantes, respaldados em artigos e diretrizes. Tres academicas entrevistaram 100 gestantes com instrumento proprio contendo dez questoes. Apos a capacitacao e a coleta, o grupo elaborou um material educativo que foi avaliado e, apos ajustes, foram confeccionados folders . Resultados: apenas 21% das gestantes receberam orientacoes sobre o tema. Apos responder ao questionario, todas as mulheres receberam orientacoes (n=100) e 196 foram orientadas coletivamente por meio das estrategias sala de espera e distribuicao de folder . Conclusao: verificou-se a necessidade de Educacao em Saude para as gestantes; indissociabilidade entre ensino-pesquisa-extensao e necessidade da producao de conhecimentos voltados para a comunidade sobre o tema. Descritores: Parto; Trabalho de Parto; Educacao em Saude. RESUMEN Objetivo: relatar la experiencia academica en promover educacion en salud sobre senales de alerta y de trabajo de parto para gestantes. Metodo: estudio cualitativo, descriptivo, tipo relato de experiencia, en que fueron capacitados 15 academicos para componer el grupo, en el cual fueron discutidos: signos de alerta, falso y verdadero trabajo de parto y estrategias didacticas para el abordaje de gestantes, respaldados en articulos y directrices. Tres academicas entrevistaron a 100 gestantes con instrumento propio conteniendo diez cuestiones. Despues de la capacitacion y la colecta, el grupo elaboro un material educativo que fue evaluado y despues de ajustes fueron confeccionados folders . Resultados: solo 21% das gestantes recibieron orientaciones sobre el tema. Despues de responder el cuestionario, todas las mujeres recibieron orientaciones (n=100) y 196 fueron orientadas colectivamente a traves de las estrategias: sala de espera y distribucion de folder. Conclusion: se verifico la necesidad de Educacion en Salud para las gestantes; disociacion entre ensenanza-investigacion-extension y necesidad de la produccion de conocimientos dirigidos a la comunidad sobre el tema. Descriptores : Parto; Trabajo de Parto; Educacion en Salud.

Cancer of the cervix is the most common malignancy diagnosed during pregnancy, with an incidence of 1–10 cases per 10,000 pregnancies. The desire of patients to maintain pregnancy and subsequent fertility is a difficult target to be achieved and should be widely studied, since it depends on the stage of disease, gestational age at diagnosis, and the woman's desire to maintain pregnancy. We describe in this report the case of a pregnant woman with invasive cervical adenocarcinoma in stage IB1 (FIGO) initially treated with neoadjuvant chemotherapy, followed by radical surgery and cesarean section in the same surgical procedure.

Introduction Among the causes of complications in pregnancy and childbirth, hypertensive disorders are responsible for high maternal and fetal morbidity and mortality rates. Among them, preeclampsia(PE) deserves special mention, as it is a multisystem disorder of unknown aetiology, specific to human pregnancies, which exposes the mother and infant to serious risks, and which has an incidence ranging from 5% to 7% . The pathophysiology of PE is not yet fully understood because it presents a complex interaction of environmental, genetic and immunological factors. Objectives This study aimed to evaluate the serum concentration of factors associated with placental angiogenesis in pre-eclamptic and normotensive pregnant women. Methods This was a prospective, cross-sectional, case-control study in which the pro-angiogenic factors PlGF, VEGF, and IL-10, and the anti-angiogenic factors IL -6, IL-17, and TNF- α of 55 pregnant women (31 with pre-eclampsia and 24 normotensive), with gestational age ⩾ 20 weeks, were measured in maternal blood through the enzyme-linked immunosorbent assay (ELISA). The Mann–Whitney and Kruskal–Wallis tests were used for comparison between groups. Results Serum PIGF was reduced in the group of pregnant women with PE when compared with the normotensive women (493.2 ± 55.1 pg/mL vs. 4.4 ± 26.5 pg/mL; p 0.001 ). There was no significant difference in PlGF levels in the pre-eclamptic pregnant women in relation to gestational age or proteinuria levels ( p > 0.05 ). The serum levels of VEGF, IL-17, IL-10, and TNF- α were lower in the pregnant women with PE when compared with their normotensive peers, while the IL-6 levels were higher; however, this difference was not statistically significant ( p > 0.05 ). Conclusions Serum PlGF levels were reduced in the pregnant women with PE and were unrelated to disease severity. Serum levels of VEGF, IL-17, IL-10, and TNF- α were reduced in the pre-eclamptic pregnant women when compared with their normotensive peers, without statistically significant differences.

Introduction Pre-eclampsia (PE) is a pregnancy-specific disease diagnosed by hypertension and proteinuria after 20th week of pregnancy. The methylenetetrahydrofolate reductase (MTHFR) is a crucial enzyme for folate and homocysteine metabolism. The A1298C (rs1801131) is a common polymorphism of MTHFR gene and has also been suspected as a contributor of altered serum homocysteine levels. Hyperhomocysteinemia has been associated with pregnancy complications such as pre-eclampsia. Objective Determine wheter MTHFR A1298C polymorphism is associated with PE susceptibility. Methods In this case-control study, a total of 53 preeclamptic pregnant women were recruited from Departament of Obstetrics and Gynecology of Clinical Hospital, of Triangulo Mineiro Federal University, Uberaba, Brazil. PE was defined according clinical findings, including increased blood pressure ( ⩾ 140 mmHg systolic or ⩾ 90 mmHg diastolic on 2 or more measurements at least 6 h apart) and proteinuria ⩾ 0.3 g/24 h or ⩾ +1 on a urine dipstick after 20 weeks of gestation. The control group included 179 normal pregnant women. None of PE patients and healthy controls had hypertension history. Genomic DNA was extracted from EDTA-treated whole blood by standard procedure of phenol–chloroform. Polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) was performed for MTHFR A1298C (rs1801131) genotyping and subsequent digestion of PCR products with MboII restriction enzyme. Differences in the distribution of genotypes and alleles between groups and deviations from the Hardy-Weinberg equilibrium were tested using the chi-square test. Results No deviation from the Hardy–Weinberg equilibrium was observed for MTHFR A1298C polymorphism either in PE patients or in healthy controls (p = 0.81 and p = 0.21 respectively). The frequency of 1298C allele in PE patients and controls was 28% and 20% and was not statistically different. The frequency of AA genotype was 54.2% and 62.3%, AC genotype was 36.3 and 33.9% and CC genotype was 9.5 and 3.8% in PE patients and controls, respectively, which was not significantly different (p = 0.337). Conclusion The MTHFR A1298C (rs1801131) polymorphism is not associated with risk of developing pre-eclampsia. Conflict of interest The authors declare that they have no conflicts of interest.

OBJETIVO: Identificar polimorfismos genéticos do fator de crescimento do endotélio vascular (VEGF), posições +936C/T e -2578C/A, em mulheres com pré-eclâmpsia. MÉTODOS:Trata-se de um estudo transversal,constituído por 80 mulheres distribuídas em dois grupos: pré-eclâmpsia e grupo controle. A caracterização da amostra foi realizada mediante entrevista pré-estruturadae complementada por dados transcritos dos prontuários. Para identificação dos polimorfismos foi realizada extração de DNA, amplificação das sequências pela Reação em Cadeia da Polimerase (PCR) com primers específicos e análise por Polimorfismos de Comprimentos de Fragmentos de Restrição (RFLP). A análise estatística dos resultados foi realizada de forma descritiva e pelo teste do . O modelo de regressão logística múltipla foi utilizado para determinar o efeito dos polimorfismos na pré-eclampsia. RESULTADOS: Evidenciou-se uma maior frequência do alelo T do polimorfismo VEGF +936C/T nas pacientes com pré-eclâmpsia, embora com diferença não significativa.A presença do alelo A do VEGF -2578C/A foi maior no grupo controle, com diferença significativa. CONCLUSÕES: Não foi observada associação significativa do polimorfismo VEGF +936C/T com a pré-eclâmpsia. Para o polimorfismo VEGF -2578C/A observa-se diferença significativa entre os grupos, sendo o alelo A mais frequente no controle, sugerindo a possibilidade da portadora do alelo A apresentar menor suscetibilidade para o desenvolvimento de pré-eclâmpsia. PURPOSE: To identify genetic polymorphisms of endothelial growth factor (VEGF), positions +936C/T and -2578C/A, in women with pre-eclampsia. METHODS: This was a cross-sectional study conducted on 80 women divided into two groups: pre-eclampsia and control. The sample was characterized using a pre-structured interview and data transcribed from the medical records. DNA extraction, amplification of sequences by the Polymerase Chain Reaction (PCR) with specific primers and polymorphism analysis of Restriction Fragment Length Polymorphism (RFLP) were performed to identify polymorphisms. The statistical analysis was performedin a descriptive manner and using the test. The multiple logistic regression model was used to determine the effect of polymorphisms on pre-eclampsia. RESULTS:Ahigher frequency of the T allele of theVEGF +936C/T polymorphism was observedin patients with pre-eclampsia, but with no significant difference. The presence of allele A of the VEGF -2578C/A was significantly higher in the control group. CONCLUSIONS:No significant association was observed between VEGF +936C/Tpolymorphism andpre-eclampsia. For the VEGF -2578C/A polymorphism a significant differencewas observed between thecontrol and pre-eclampsia group, with allele A being the most frequent in the control, suggesting the possibility that carriers of allele A have lower susceptibility to the development of pre-eclampsia.

To identify genetic polymorphisms of endothelial growth factor (VEGF), positions +936C/T and -2578C/A, in women with pre-eclampsia.This was a cross-sectional study conducted on 80 women divided into two groups: pre-eclampsia and control. The sample was characterized using a pre-structured interview and data transcribed from the medical records. DNA extraction, amplification of sequences by the Polymerase Chain Reaction (PCR) with specific primers and polymorphism analysis of Restriction Fragment Length Polymorphism (RFLP) were performed to identify polymorphisms. The statistical analysis was performed in a descriptive manner and using the x² test. The multiple logistic regression model was used to determine the effect of polymorphisms on pre-eclampsia.A higher frequency of the T allele of the VEGF +936C/T polymorphism was observed in patients with pre-eclampsia, but with no significant difference. The presence of allele A of the VEGF -2578C/A was significantly higher in the control group.No significant association was observed between VEGF +936C/T polymorphism and pre-eclampsia. For the VEGF -2578C/A polymorphism a significant difference was observed between the control and pre-eclampsia group, with allele A being the most frequent in the control, suggesting the possibility that carriers of allele A have lower susceptibility to the development of pre-eclampsia.

OBJETIVOS: Avaliar implicações do diabetes melito (DM) na morbimortalidade materno-fetal, segundo experiência da Universidade Federal do Triângulo Mineiro. MATERIAIS E METODOS: Procedeu-se à análise retrospectiva dos prontuários de gestantes diabéticas assistidas entre 1990 e 2009 focando dados e complicações maternas e neonatais. RESULTADOS: A última gestação de 93 diabéticas foi avaliada, sendo 34 com DM tipo 1, em que se observou maior ocorrência de tocotrauma (p = 0,023) e retinopatia (p = 0,023). Vinte e uma pacientes tinham DM tipo 2; suas necessidades de insulina aumentaram progressivamente (p < 0,01) e observou-se maior prevalência de tabagismo (p = 0,004). Trinta e oito tiveram diabetes gestacional e iniciaram acompanhamento do diabetes em idade gestacional mais tardia (p < 0,001), tiveram mais antecedentes de macrossomia fetal (p = 0,028) e maior prevalência de fatores de risco cardiovascular. CONCLUSÕES: Não obstante melhora do controle glicêmico durante a gestação, nenhum dos grupos atingiu alvos glicêmicos ideais. Ainda assim, a maioria das gestações em diabéticas, conduzidas em nosso meio, evoluiu favoravelmente.

Evaluation of the consequences of diabetes mellitus (DM) on maternal and fetal morbidity and mortality at Universidade Federal do Triângulo Mineiro.A retrospective review of medical records of pregnant women with diabetes was carried out at the hospital between 1990-2009, focusing on maternal and neonatal data and complications.The last pregnancy of 93 diabetics was evaluated. In thirty-four patients with type 1 diabetes a higher incidence of birth trauma (p = 0.023) and retinopathy (p = 0.023) was observed. Twenty-one type 2 DM subjects required progressively increased insulin therapy (p0.01) and showed a higher prevalence of smoking (p = 0.004). Thirty-eight had gestational diabetes. Their diabetic follow-up started at a later gestational age (p0.001), had more fetal macrosomia histories (p = 0.028) and cardiovascular risk factors.Despite improvement of glycemic control during pregnancy neither group attained the glycemic target. However, the majority of DM pregnancies evaluated in our group presented successful outcomes.

The objective of the present study was to assess infections and cytologic abnormalities in cervicovaginal smears from 153 HIV-positive women and 169 HIV-negative followed up at the UFTM School of Medicine between May 1999 and May 2002. The medical records and cervicovaginal smears were reviewed and the HIV-positive group was classified according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups (with or without disease; with or without therapy) and compared to HIV-negative group. We conclude that the frequency of Candida sp, Trichomonas vaginalis and bacterial vaginosis in cervicovaginal smear, is not different between HIV-positive and HIV-negative women, even if the HIV-group is subdivided according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups. The frequency of LSIL, in cervicovaginal smears, was greater in the HIV-group (17.6%) than in the HIV-negative (4.1%); there was no difference between the two groups according to frequency of HSIL (4.6% versus 1.8%), ASCUS/AGUS (7.8% versus 3.5%) and invasive carcinoma (1.3% versus 0.6%). The frequency of LSIL was greater in the HIV positive group with CD4 cell count < 350 cells/mm3. The viral load, therapeutic regimen and HIV subgroups (HIV-positive without therapy, HIV-positive with therapy, AIDS by immunological criteria and AIDS by clinical criteria) have not shown relationship with LSIL frequency, until now. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc.

Even though there are clinical studies emphasizing the diagnosis and the perinatal intercurrent diseases of the Hypertensive Syndromes in Pregnancy, few of these studies establish the clinical forms of the specific hypertensive syndromes with the associated morphological placental alterations. The lack of studies on placental morphology and the etiopathogenesis of the different clinical standards for HSP, together with the need to objectively characterize these morphological placental lesions justify this study. A retrospective study was carried out with 91 placentas examined throughout the period from 2000 to 2003. All placentas from patients presenting HSP in this period were included in the study. These were classified according to features well established by the literature such as laboratory and clinical criteria into: gestational hypertension (GH), chronic hypertension (CH), pre-eclampsia (PE) and pre-eclampsia superimposed on chronic hypertension (PSCH). The number of knots presented a positive correlation with the length of time and severity of the hypertension during gestation (Spearman correlation: 0.253; P = 0.0158). The fibrin deposit was greater in all HSP groups but the pattern of distribution changes in the most severe cases from perivillous to intravillous as in the PSCH group (P = 0.002). There was no statistically significant difference in the area of the stem vessel walls among the groups. The cases with PE and CH presented a larger number of terminal villi vessels (P

Osteosarcoma is the most common primary malignant bone tumor and it mainly affects large bones. In pregnant women it is a rare entity [1]. We presented a case of 26-years-old, 33-weeks pregnant, who had lost 8 kg after the onset of pregnancy and had progressive dyspnea, was admitted on 25th April 2007. The patient reported axillary and right shoulder pain. A nodule of 20 cm in diameter, with rapid growth during the last 6 months, was observed. Chest X-ray: pulmonary nodules; ultrasound: a mass in the right anterior axillary region extending towards the posterior axillary line and the scapular region; biopsy was performed. The patient developed respiratory failure and cesarean was performed. Then, it evolved to hemodynamic instability and death on 27th April 2007. Biopsy result after death was of high-grade osteosarcoma (grade 3 of 4). Anatomopathologic exam Osteosarcoma of the right scapula, measuring 19 9 15 9 10 cm and 2,600 g. Bilateral pulmonary metastases with multiple nodules. Microscopy: osteoblastic, chondroblastic and fibroblastic subtypes of osteosarcoma in the bone matrix; pleomorphic cells with atypical nuclei (Fig. 1a). There was accentuated Lactoferrin immunolabelling found in the bone matrix, nucleus and cytoplasm of neoplasic cells (Fig. 1b). Although osteosarcomas usually affect long bones [2], in this case the osteosarcoma affected the scapula, which is a flat bone. The occurrence of this type of neoplasia in pregnancy is extremely rare and the few cases reported in the literature showed rapid progress [1], similar to the aforementioned case. Delayed diagnosis may be due to the lack of data collection of all of the signs and/or symptoms during the gestation period [3]. Pregnancy can create conditions for the immune system to react using mechanisms which are similar to those used in tumor escape [4]. These data might explain why the neoplasia was only diagnosed in the third quarter of pregnancy, when immune system changes favor the development of osteosarcoma and its signs and symptoms become more evident. Immunological modulation during pregnancy may also contribute to the development of metastases [4]. In this case report, the patient had diffuse lung metastases, which were responsible for obstructing the bronchial light and death. During autopsy, other metastases were found in sites such as the lymph nodes and in sites considered to be less common by the literature [3], such as the kidney, thus showing how severe this case was. The immunohistochemistry demonstrated markedly positive staining to Lactoferrin in the neoplasic tissue. Lactoferrin can promote bone growth by stimulating the proliferation and the differentiation of primary osteoblasts and by inhibiting their apoptosis, supporting a significant role for this protein in promoting bone formation and in growth of neoplasic bone tissues in humans [5]. In this case the diagnosis was performed only after death, and the pregnancy contributed to a difficult clinical diagnosis and rapid progression of osteosarcoma. This seems to be one of the fewest reports of osteosarcoma, The study was conducted in Uberaba, Minas Gerais, Brazil.