Prediction of Perinatal and Neurodevelopmental Outcomes in Newborns with a Birth Weight below the 3rd Percentile: Performance of Two International Curves - Prospective Cohort from a Brazilian City.

Objectives:  To evaluate the performance of Intergrowth-21 st (INT) and Fetal Medicine Foundation (FMF) curves in predicting perinatal and neurodevelopmental outcomes in newborns weighing below the 3rd percentile.

Methods:  Pregnant women with a single fetus aged less than 20 weeks from a general population in non-hospital health units were included. Their children were evaluated at birth and in the second or third years of life.

Applying a physiotherapy protocol to women during the active phase of labor improves obstetrical outcomes: a randomized clinical trial.

Background: Labor is a physiological process triggered by mechanical and hormonal events that promote uterine contractions to expel the fetus.

Objective: This study aimed to evaluate the effectiveness of a nonpharmacologic childbirth care protocol in women in the active phase of labor in improving obstetrical and perinatal outcomes.

Study Design: This was a randomized trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

Severe Adams-Oliver Syndrome after Maternal COVID-19 Infection Could Be Another Effect of the SARS-CoV-2 Inflammatory Storm? Case Report.

. Adams-Oliver syndrome is a congenital disease whose main findings are aplasia cutis congenita of the scalp and terminal transverse limb defect. The pathogenesis is unknown, but it is postulated that ischemic events in susceptible tissues cause the lesions in the embryonic period.

Enhanced elimination of betamethasone in dichorionic twin pregnancies.

Aim: No study has evaluated the betamethasone pharmacokinetics in twin pregnancies according to chorionicity. This study aimed to describe and compare the betamethasone pharmacokinetic parameters in singleton and dichorionic (DC) and monochorionic twin pregnancies in the third trimester of pregnancy.

Methods: Twenty-six pregnant women received 2 intramuscular doses of 6 mg of betamethasone sodium phosphate plus 6 mg betamethasone acetate due to preterm labour.

Magnetic resonance imaging of skull and brain parameters in fetuses with intrauterine growth restriction.

Objective: To compare fetuses with intrauterine growth restriction (IUGR) and those with normal growth, in terms of skull and brain measurements obtained by magnetic resonance imaging (MRI).

Materials And Methods: This was a prospective cohort study including 26 single fetuses (13 with IUGR and 13 with normal growth), evaluated from 26 to 38 weeks of gestation. Using MRI, we measured skull and brain biparietal diameters (BPDs); skull and brain occipitofrontal diameters (OFDs); corpus callosum length and area; transverse cerebellar diameter; extracerebral cerebrospinal fluid (eCSF); and right and left interopercular distances (IODs).

COVID-19: Uncertainties from Conception to Birth.

Scientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.

Wernicke Encephalopathy as a Complication of Hyperemesis Gravidarum: Case Report.

Wernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism. We report a rare case of WE due to hyperemesis gravidarum in a 25-year-old pregnant patient at 13 weeks and 5 days of gestation. Initially, the disease manifested as weakness, mental confusion, anterograde amnesia, and visual and auditory hallucinations.

Childbirth, Puerperium and Abortion Care Protocol during the COVID-19 Pandemic.

The new coronavirus (severe acute respiratory syndrome-related coronavirus 2, SARS-CoV-2) is a virus that causes a potentially serious respiratory disease that has spread in several countries, reaching humans in all age groups, including pregnant women. The purpose of this protocol is to provide technical and scientific support to Brazilian obstetricians regarding childbirth, postpartum and abortion care during the pandemic.

Influence of Religiosity on Situational Coping Scores in Women with Malformed Fetuses.

In clinical care settings, religiosity may serve as an important source of support for coping with the prenatal diagnosis of fetal abnormalities. This study evaluated the influence of religiosity on the situational coping of 28 pregnant women with fetal abnormalities. The study was approved by the institutional research ethics committee, and the informed consent document was obtained from all participants included in this study.

Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial.

Question: Among women in labour, does sequential application of non-pharmacological interventions relieve labour pain, shorten labour, and delay pharmacological analgesia use?

Design: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

Participants: Eighty women admitted in labour at the end of a low-risk pregnancy.

Intervention: Participants in the experimental group received three interventions for up to 40minutes each in particular stages of labour: exercise on a Swiss ball at 4 to 5cm of cervical dilation; lumbosacral massage at 5 to 6cm dilation; and a warm shower at >7cm dilation.

Limb Body Wall Complex Associated with Placenta Accreta: A Mere Coincidence or a Sign of an Etiopathogenic Link?

A case was reported of a fetus with the anomaly of limb body wall complex associated with placenta accreta. To date, only one account of this condition has been published in the world literature. Due to the low frequency of both complications, the hypothesis has been raised that this association may have happened not by mere coincidence, but rather by a possible common etiopathogenic mechanism.

Maternal uterine artery Doppler in the first and second trimesters as screening method for hypertensive disorders and adverse perinatal outcomes in low-risk pregnancies.

Objective: To assess the maternal demographic characteristics and uterine artery (UA) Doppler parameters at first and second trimesters of pregnancy as predictors for hypertensive disorders (HDs) and adverse perinatal outcomes.

Methods: This prospective cohort study comprised 162 singleton low-risk women undergoing routine antenatal care. The left and right UA were assessed by color and pulsed Doppler and the mean pulsatility and resistance indices as well as the presence of a bilateral protodiastolic notch were recorded at 11 to 14 and 20 to 24 weeks' gestation.

Epidemiological Risk Factors and Perinatal Outcomes of Congenital Anomalies.

Objectives To identify the epidemiological risk factors for congenital anomalies (CAs) and the impact of these fetal malformations on the perinatal outcomes. Methods This prospective cohort study comprised 275 women whose fetuses had CAs. Maternal variables to establish potential risk factors for each group of CA and perinatal outcomes were evaluated.

Longitudinal assessment of maternal-fetal Doppler parameters and maternal plasma level of matrix metalloproteinases 2 and 9.

Objective: To assess the behavior as well as the comparison between maternal circulating level of biochemical markers (matrix metalloproteinases - MMP-9 and MMP-2) and maternal-fetal Doppler parameters in all three trimesters of pregnancy.

Methods: We performed a prospective longitudinal study with 33 healthy pregnant women in three periods of pregnancy: A1 (12w0-14w6d), A2 (22w0d-24w6d) and A3 (34w0d and 36w6d). The following maternal Doppler parameters were assessed: mean pulsatility index (PI) uterine artery, resistance index (RI) umbilical artery and RI middle cerebral artery.

Predicting success of labor induction in singleton term pregnancies by combining maternal and ultrasound variables.

Objective: To assess pre-induction maternal and ultrasonographic factors in the prediction of the onset of labor within 12 h, and vaginal delivery (VD) irrespective of the induction-to-delivery interval in term pregnancies.

Methods: We performed a prospective cohort study with 204 singleton pregnant women between 37 and 42 weeks of gestation. The following maternal and ultrasonographic variables were assessed: parity, marital status, height, body mass index (BMI), previous cesarean section (Cs), Bishop score, variety of fetal position, single deepest pocket (SDP), fetal middle cerebral and umbilical artery resistance indices, cervical length (CL) measurement, posterior cervical angle (PCA), head circumference (HC) and estimated fetal weight (EFW).

Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial.

Questions: In the active phase of the first stage of labour, does transcutaneous electrical nerve stimulation (TENS) relieve pain or change its location? Does TENS delay the request for neuraxial analgesia during labour? Does TENS produce any harmful effects in the mother or the foetus? Are women in labour satisfied with the care provided?

Design: Randomised trial with concealed allocation, assessor blinding for some outcomes, and intention-to-treat analysis.

Participants: Forty-six low-risk, primigravida parturients with a gestational age > 37 weeks, cervical dilation of 4cm, and without the use of any medications from hospital admission until randomisation.

Intervention: The principal investigator applied TENS to the experimental group for 30minutes starting at the beginning of the active phase of labour.

Antepartum use of Epi-No birth trainer for preventing perineal trauma: systematic review.

Introduction And Hypothesis: In this systematic review we aimed to assess if the Epi-No birth trainer used during antepartum could prevent perineal trauma in nulliparous women.

Methods: We searched CENTRAL, MEDLINE, EMBASE, Scielo, and Conference abstracts, looking for randomized controlled studies (RCT). High heterogeneity (i(2) > 50 %) was corrected with random models.

Reference ranges of Doppler parameters of foetal pulmonary artery segments between 19 and 39 weeks of gestation.

Objective: To determine reference ranges of Doppler parameters of foetal pulmonary artery segments.

Methods: A prospective cross-sectional study was conducted to evaluate 150 healthy singleton pregnancies between 19 and 39 weeks of gestation. The proximal, middle and distal segments of the foetal pulmonary artery were assessed.

[Rupture and dehiscence of uterine scar: cases study at a low-risk maternity in the Brazilian Southeast].

Purpose: To evaluate the cases of uterine rupture and dehiscence of the uterine scar at a low-risk maternity and to point out possibilities for an improved approach to these complications.

Methods: A descriptive study was conducted at a 30-bed low-risk maternity hospital that provides care to users of the public health system. The investigation was carried out by searching for cases in the delivery room registry book and later reading the medical records in order to obtain the data.

Perineal trauma after vaginal delivery in healthy pregnant women.

Context And Objective: Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS) in healthy pregnant women after vaginal delivery.

Design And Setting: Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.

Massage reduced severity of pain during labour: a randomised trial.

Question: Does massage relieve pain in the active phase of labour?

Design: Randomised trial with concealed allocation, assessor blinding for some outcomes, and intention-to-treat analysis.

Participants: 46 women pregnant at ≥ 37 weeks gestation with a single fetus, with spontaneous onset of labour, 4-5cm of cervical dilation, intact ovular membranes, and no use of medication after admission to hospital.

Intervention: Experimental group participants received a 30-min lumbar massage by a physiotherapist during the active phase of labour.