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Search Results: 1 - 10 of 482367 matches for " Renato Augusto Moreira de Sá "
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Dopplerfluxometria de Ducto Venoso ? Avalia o da Acidemia em Fetos Prematuros com Centraliza o de Fluxo Sangüíneo
Sá Renato Augusto Moreira de
Revista Brasileira de Ginecologia e Obstetrícia , 2001,
Abstract:
Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography  [PDF]
Erica Stein Ciasca, Fernando Maia Peixoto-Filho, Pedro Daltro, Heron Werner, Adriana Viana, Renato Augusto Moreira de Sá
Advances in Computed Tomography (ACT) , 2013, DOI: 10.4236/act.2013.23018
Abstract:

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

Delivery assistance in fetal macrosomia
Sá Renato Augusto Moreira de,Bornia Rita Bernadete Guerios,Cunha Alfredo de Almeida,Sieczko Ludmila Sampaio
Revista Brasileira de Saúde Materno Infantil , 2003,
Abstract: OBJECTIVES: to evaluate delivery assistance in fetal macrosomia. METHODS: this was a hospital-based cohort study of consecutive births at a tertiary perinatal center from January 1, 1996 to October 31, 1999. A total of 5261 pregnancies met the inclusion criteria which were singleton pregnancies with minimal birth weight of 1000 g. Fetal macrosomia was defined as birth weight of 4000 g or more. We studied the mode of delivery, the newborn condition at birth, considered low when the Apgar scored below seven in the first or fifth minute, and the presence of abnormalities that could indicate a Caesarian section (disproportion, uterine dysfunction, prolonged second period of birth and fetal distress). RESULTS: 296 (5,6%) of the babies were macrosomic. Macrosomia was a risk factor for Caesarian section (RR = 1,59, p <0,001) and for operative vaginal delivery RR = 1,12 (p <0,001). Newborn conditions was not worse in macrosomic babies. There was a positive correlation between fetal macrosomia and disproportion but not with uterine dysfunction, prolonged second period of birth or fetal distress. CONCLUSIONS: caesarian section was indicated more often for macrosomic babies, but our data did not suggest that a more extensive use of C-Sections was justified.
Estudo do sonograma do ducto venoso em fetos com centraliza??o hemodinamica: avalia??o de repercuss?es perinatais
Carvalho, Paulo Roberto Nassar de;Moreira, Maria Elisabeth Lopes;Sá, Renato Augusto Moreira de;Cosmos, Ynesmara;Lopes, Laudelino Marques;
Revista Brasileira de Ginecologia e Obstetrícia , 2006, DOI: 10.1590/S0100-72032006000400006
Abstract: purpose: to evaluate the relationship between s/a ratio in ductus venosus (dv) and perinatal outcomes in fetuses with brain sparing reflex. methods: the study was designed as an observational, sectional study with prospectively collected data. forty-one fetuses with brain sparing reflex and gestational age between 25 and 33 weeks were studied between november 2002 and july 2005. the newborns were observed during the neonatal period in the intensive care unit of "clínica perinatal laranjeiras" in order to find adverse outcomes. the study population was divided into two groups according to dv assessment. in the normal group all the fetuses with s/a ratio values of 3.6 or less were included, and in the abnormal group the fetuses with values of s/a ratio greater than 3.6. the statistical analysis was performed by the mann-whitney u-test, c2 test and fisher exact test. the results were considered significant when p<0.05. gestational age, birth weight and apgar score less than 7 at 5 min were evaluated. perinatal outcome parameters were: intrauterine death, neonatal mortality, seizures, intraventricular hemorrhage, leukomalacia, need of surfactant, mechanical ventilation, myocardical failure, necrotizing enterocolitis, and length of stay in the intensive care unit. results: among the assessed 41 fetuses, 26 (63.4%) showed normal dv s/a ratio and the other 15 (36.6%) developed an abnormal dv s/a ratio (>3.6). there was no statistically signicant difference between the groups according to gestational age at delivery and apgar <7. the only significant association was between abnormal dv s/a ratio and neonatal death (p=0.049; fisher's exact test). no statistically significant association was observed for the other studied variables. conclusions: our results suggest that abnormal dv blood flow detected by doppler examination is not associated with adverse perinatal outcomes, except for neonatal mortality. this association may be considered statistically borderline (p=0.049). e
Dopplerfluxometria de ducto venoso: identifica??o n?o invasiva da acidemia em fetos prematuros centralizados
Sá, Renato Augusto Moreira de;Chaves Netto, Hermógenes;Lopes, Laudelino Marques;Carvalho, Paulo Roberto Nassar de;Cosmo, Ynesmara Coelho;
Revista Brasileira de Ginecologia e Obstetrícia , 2004, DOI: 10.1590/S0100-72032004000500003
Abstract: objective: to assess through dopllerfluxometry the s/a ratio of the ductus venosus and determine the cut-off point to identify preterm fetuses with the 'brain sparing phenomenon". method: a cross-sectional study was performed in 60 pregnant women that presented the "brain sparing phenomenon" (umbilical cerebral ratio >1) and gestational age between 25 and 33 weeks. the following parameters were studied: s/a ratio of the ductus venosus, ph and base excess (be) of a fetal blood sample collected from the umbilical vein immediately after birth. the fetuses were classified according to the gas analysis result. they were considered abnormal when ph <7.20 and be < -6 mmol/l. a receiver operator characteristic (roc) curve analysis was performed to examine the relationship between s/a ratio and fetal acidemia. results: sixty pregnant women in the period of january 1998 to january 2003 were selected. in the moment of the study the gestational age varied from 25 to 33 weeks, with an average of 29.7 weeks (±1.8 weeks). all of the fetuses presented the "brain sparing phenomenon". among them 14 presented abnormal gas analysis at birth and 46 presented normal gas analysis. the prevalence of fetuses with abnormal gas analysis in the studied material was 23.33%. significant association was observed between the abnormal ductus venosus velocimetry and abnormal gas analysis at birth (c2 = 784.44, p < 0.00001) in preterm fetuses with "brain sparing phenomenon". the best cut-off point of the s/a ratio (where the roc curves bent) was 3.4. conclusion: fetal acidemia in preterm fetuses with "brain sparing phenomenon" may be noninvasively identified by doppler measurement of the ductus venosus when the s/a rises above 3.4.
Dopplerfluxometria de ducto venoso: identifica o n o invasiva da acidemia em fetos prematuros centralizados
Sá Renato Augusto Moreira de,Netto Hermógenes Chaves,Lopes Laudelino Marques,Carvalho Paulo Roberto Nassar de
Revista Brasileira de Ginecologia e Obstetrícia , 2004,
Abstract:
Dopplerfluxometria do ducto venoso: rela o com a gasometria em fetos prematuros com centraliza o de fluxo sangüíneo
Sá Renato Augusto Moreira de,Netto Hermógenes Chaves,Lopes Laudelino Marques,Barreto Mário Jorge Viegas
Revista Brasileira de Ginecologia e Obstetrícia , 2003,
Abstract: OBJETIVO: avaliar o desempenho da dopplerfluxometria do ducto venoso (DV) na detec o da acidemia em fetos prematuros apresentando centraliza o de fluxo sangüíneo. MéTODOS: estudo observacional transversal. A popula o em estudo consistiu de 48 gestantes entre a 25a e a 33a semana de gesta o, que apresentavam centraliza o de fluxo sangüíneo fetal (rela o umbílico/cerebral >1). O tempo decorrido entre o diagnóstico de centraliza o fetal e o nascimento (cesariana sob anestesia peridural) foi de até cinco horas. Os seguintes parametros foram estudados: rela o sístole ventricular atrial (S/A) do ducto venoso, pH e base excess (BE) de amostra de sangue da veia umbilical colhida imediatamente após o nascimento. A rela o S/A do DV foi considerada anormal quando maior que 3,6. Os conceptos foram classificados quanto ao resultado da gasometria, sendo considerada gasometria anormal quando pH <7,26 e BE <6 mmol/L. O estudo estatístico utilizado foi o teste de Fisher, considerado significativo quando p < 0,05. RESULTADOS: a correla o entre a gasometria do cord o umbilical de fetos prematuros centralizados e a rela o S/A do DV foi significativa (p=0,0000082; teste de Fisher). A dopplervelocimetria do DV foi capaz de identificar 10 dos 14 fetos com gasometria anormal. Por outro lado, 32 dos 34 fetos com gasometria normal foram corretamente identificados. A sensibilidade da dopplerfluxometria do DV para o diagnóstico de acidemia fetal ao nascimento foi de 71%, a especificidade foi de 94%, a taxa de falso-negativo de 8%, a taxa de falso-positivo de 4%, o valor preditivo positivo de 83% e o valor preditivo negativo de 89%. A probabilidade pré-teste para um feto centralizado de apresentar acidemia ao nascimento foi de 31%. Já a probabilidade de acidemia após resultado do DV anormal (probabilidade após teste anormal) foi de 84%, ao passo que a probabilidade de acidemia fetal com o DV normal (probabilidade após-teste normal) foi de apenas 10%. CONCLUS O: a análise da rela o S/A do ducto venoso se mostra adequada para o diagnóstico de gasometria anormal em fetos prematuros, centralizados.
Delivery assistance in fetal macrosomia
Sá, Renato Augusto Moreira de;Bornia, Rita Bernadete Guerios;Cunha, Alfredo de Almeida;Sieczko, Ludmila Sampaio;Silva, Cristiane Barbosa da;Silva, Fernanda Campos da;
Revista Brasileira de Saúde Materno Infantil , 2003, DOI: 10.1590/S1519-38292003000400003
Abstract: objectives: to evaluate delivery assistance in fetal macrosomia. methods: this was a hospital-based cohort study of consecutive births at a tertiary perinatal center from january 1, 1996 to october 31, 1999. a total of 5261 pregnancies met the inclusion criteria which were singleton pregnancies with minimal birth weight of 1000 g. fetal macrosomia was defined as birth weight of 4000 g or more. we studied the mode of delivery, the newborn condition at birth, considered low when the apgar scored below seven in the first or fifth minute, and the presence of abnormalities that could indicate a caesarian section (disproportion, uterine dysfunction, prolonged second period of birth and fetal distress). results: 296 (5,6%) of the babies were macrosomic. macrosomia was a risk factor for caesarian section (rr = 1,59, p <0,001) and for operative vaginal delivery rr = 1,12 (p <0,001). newborn conditions was not worse in macrosomic babies. there was a positive correlation between fetal macrosomia and disproportion but not with uterine dysfunction, prolonged second period of birth or fetal distress. conclusions: caesarian section was indicated more often for macrosomic babies, but our data did not suggest that a more extensive use of c-sections was justified.
Síndromes hipertensivas da gesta??o e repercuss?es perinatais
Oliveira, Cristiane Alves de;Lins, Carla Pereira;Sá, Renato Augusto Moreira de;Netto, Hermógenes Chaves;Bornia, Rita Guerios;Silva, Nancy Ribeiro da;Amim Junior, Joffre;
Revista Brasileira de Saúde Materno Infantil , 2006, DOI: 10.1590/S1519-38292006000100011
Abstract: objectives: to assess perinatal effects of pregnancy hypertensive syndromes. methods: hospital-based observational and retrospective study of a tertiary brazilian center, from january, 1996 to october, 2003. twelve thousand and two hundred and seventy two (12.272) pregnancies met the inclusion criteria. two types of hypertension were considered: gestational hypertension (gh) and chronic hypertension (ch). results of the study demonstrated that newborns of mothers with gestational hypertension and chronic hypertension were small for gestational age (sga), had low apgar score in the 1o and 5o minutes, neonatal infection, meconium aspiration syndrome (mas), prematurity and respiratory distress syndrome (rds). results: 1259 (10.26%) had hypertension, 344 (2.80%) were classified as gh, 915 (7.45%) as ch and 11.013 (89.74%) had no hypertension. gh was risk factor for sga, low apgar score in the first and fifth minutes, neonatal infection and prematurity, but not for mas and rds. ch was a risk factor for sga, low apgar score in the first minute, mas, prematurity and rds, but not for low apgar score in the fifth minute and neonatal infection. when comparing the relative risk between ch and gh an increased risk for prematurity in ch was determined. conclusions: our data suggest that ch and gh increased the risks for the outcomes studied. an increased risk for prematurity in ch was noted.
Dopplerfluxometria do ducto venoso: rela??o com a gasometria em fetos prematuros com centraliza??o de fluxo sangüíneo
Sá, Renato Augusto Moreira de;Netto, Hermógenes Chaves;Lopes, Laudelino Marques;Barreto, Mário Jorge Viegas;Cabral, Ant?nio Carlos Vieira;
Revista Brasileira de Ginecologia e Obstetrícia , 2003, DOI: 10.1590/S0100-72032003000400007
Abstract: purpose: to evaluate doppler velocimetry of the ductus venosus as a noninvasive test of abnormal ph and gas analysis in preterm fetuses with "brain sparing reflex". methods: a cross-sectional study was performed. the studied population consisted of 48 pregnant women between the 25th and the 33rd week of gestation, whose fetuses presented brain sparing reflex (umbilical/cerebral ratio >1). the time elapsed between doppler velocimetry and the birth (cesarean section under peridural anesthesia) was of up to 5 h. the following parameters were studied: s/a ratio of the ductus venosus, ph and base excess (be) of fetal blood sample (collected from the umbilical vein immediately after birth). the s/a ratio of the ductus venosus was considered abnormal when superior to 3.6. the fetuses were classified according to the gas analysis result. they were considered abnormal when ph <7.26 and be £ 6 mmol/l. fisher's test was used for statistical analysis and considered significant when p £ 0.05. results: there was a significant correlation between umbilical blood gas analysis in preterm fetuses with brain sparing reflex and ductus venosus s/a ratio (p = 0.0000082; fisher test). ductus venosus doppler velocimetry identified 10 of 14 fetuses with abnormal gas analysis. on the other hand, 32 of 34 fetuses with normal gas analysis were correctly identified. the sensitivity of the ductus venosus s/a ratio for the diagnosis of abnormal blood gas analysis was 71%, specificity 94%, false-negative rate 8%, false-positive rate 4%, positive predictive value 83% and negative predictive value 89%. pretest likelihood, post-test posterior probability following a positive test result (post-test likelihood) and post-test posterior probability following a negative test result (post-test likelihood) were 31, 84 and 10%, respectively. conclusion: the analysis of the ductus venosus s/a ratio is adequate for the diagnosis of abnormal blood gas analysis in preterm fetuses presenting brain sparing reflex.
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