Epidemiological profile of patients with preterm premature rupture of membranes at a tertiary hospital in São Paulo, Brazil.

Objective: To perform a descriptive analysis of preterm premature rupture of membranes (PPROM) cases attended in a tertiary hospital.

Method: Retrospective analysis of medical records and laboratory tests of patients admitted to a Brazilian tertiary hospital between 2006 and 2011, with a confirmed diagnosis of PPROM and gestational age (GA) at delivery <37 weeks.

Results: A total of 299 pregnant women were included in the study.

Spontaneous prematurity in fetuses with congenital diaphragmatic hernia: a retrospective cohort study about prenatal predictive factors.

Background: To evaluate possible predictive factors of spontaneous prematurity in fetuses with congenital diaphragmatic hernia (CDH).

Methods: A retrospective cohort study was performed. Inclusion criteria were presence of CDH; absence of fetoscopy; absence of karyotype abnormality; maximum of one major malformation associated with diaphragmatic hernia; ultrasound monitoring at the Obstetrics Clinic of Clinicas Hospital at the University of São Paulo School of Medicine, from January 2001 to October 2014.

Fetal thrombotic vasculopathy: A case report and literature review.

Introduction:: Fetal thrombotic vasculopathy is a recently described placental alteration with varying degrees of involvement and often associated with adverse perinatal outcomes. The diagnosis is made histologically and therefore is postnatal, which makes it a challenge in clinical practice.

Method:: Case report and review of literature on the subject.

[Relation between nucleated red blood cell count in umbilical cord and the obstetric and neonatal outcomes in small for gestational age fetuses and with normal Doppler velocimetry of umbilical artery].

Purpose: To analyze the obstetrical and neonatal outcomes of pregnancies with small for gestation age fetuses after 35 weeks based on umbilical cord nucleated red blood cells count (NRBC).

Methods: NRBC per 100 white blood cells were analyzed in 61 pregnancies with small for gestation age fetuses and normal Doppler findings for the umbilical artery. The pregnancies were assigned to 2 groups: NRBC≥10 (study group, n=18) and NRBC<10 (control group, n=43).

[Comparison between two growth curves for small for gestational age diagnosis].

Purpose: It was to compare the use of two growth curves for the diagnosis of small-for-gestational-age (SGA) infants, having the 10th percentile as reference.

Methods: In a retrospective study, data of 20,567 singleton live births from January 2003 to June 2014 were analyzed, and divided according to gestational age: (a) 23 to 26, (b) 26 to 29, (c) 29 to 32, (d) 32 to 35, (e) 35 to 38, (f) 38 to 41 and (g) >41 weeks. Data were paired and analyzed using the McNemar test, with the level of significance set at 0.

[Can genital infections alter the results of preterm birth predictive tests?].

Purpose: To determine if the presence of infectious agents in vaginal or cervical content can alter the results of the insulin-like growth factor binding protein-1 (phIGFBP-1) test and the measurement of cervical length (CC) by transvaginal ultrasonography.

Methods: A total of 107 pregnant women with a history of spontaneous preterm birth were submitted to the phIGFBP-1 test and to measurement of CC by transvaginal ultrasonography every 3 weeks, between 24 and 34 weeks of gestation. Genital infections were determined immediately before testing.

[Factors associated with false diagnosis of fetal growth restriction].

Purpose: The aim of this study was to analize and describe some characteristics related to a false diagnosis of intrauterine growth restriction (IUGR).

Methods: We retrospectively included 48 pregnant women referred to our service with a suspected diagnosis of IUGR that was not confirmed after birth and we compared them to another group with confirmed IUGR. We then analyzed the characteristics of the false-positive results.

[Preterm birth prediction: sequential evaluation of the cervix and the test for phosphorylated protein-1 linked to insulin-like growth factor].

Purpose: To investigate the usefulness of the measurement of cervical length and of the test for phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) performed sequentially in the prediction of preterm birth and the correlation between tests.

Methods: We analyzed data from 101 asymptomatic pregnant women with a history of premature delivery. The ultrasound measurement of cervical length and phIGFBP-1 test were performed in parallel every three weeks, between 24 and 34 week.

Neonatal outcomes of late-preterm birth associated or not with intrauterine growth restriction.

Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) infants of the comparable gestational ages (GAs). Methods.

[Management of preterm labor].

The main purpose of using uterulytic in preterm delivery is to prolong gestation in order to allow the administration of glucocorticoid to the mother and/or to accomplish the mother's transference to a tertiary hospital center. Decisions on uterolytic use and choice require correct diagnosis of preterm delivery, as well as the knowledge of gestational age, maternal-fetal medical condition, and medicine's efficacy, side-effects and cost. All the uterolytics have side-effects, and some of them are potentially lethal.

[Risk predictors for preterm birth].

Among the clinical factors for preterm birth, some confer substantial increased risk, including a history of preterm birth, multiple gestation and vaginal bleeding in the second trimester. However, these factors are present only in a minority of women who ultimately deliver preterm and thus have low sensitivity. Cervical dilatation, effacement and position as determined by manual examination have been related to an increased risk of preterm birth but also suffer from low sensitivity and positive predictive values.

Hematological indices at birth in relation to arterial and venous Doppler in small-for-gestational-age fetuses.

Objective: To correlate Doppler results with hematological indices at birth in small-for-gestational-age (SGA) fetuses.

Design: Prospective study.

Setting: Tertiary teaching hospital, Sao Paulo, Brazil.

[Atosiban as a tocolytic agent: a new proposal of a therapeutic approach].

Purpose: to test a therapeutic approach using atosiban for tocolysis, evaluating its safety and maternal and fetal side effects.

Methods: prospective study with 80 pregnant women with preterm labor admitted for tocolysis.

Inclusion Criteria: singleton pregnancy, regular uterine activity, cervical dilatation between 1 to 3 cm, cervical enfacement greater than 50%, 23 to 33 weeks and six days of gestational age, intact membranes, amniotic fluid index between 5 and 25, no maternal, fetal or placental diseases, no fetal growth restriction, no cervical incompetence, no fever.

Prediction of preterm delivery in the second trimester.

Objective: The aim of this study was to estimate the probability of spontaneous delivery at 34 weeks or less according to cervical assessment by transvaginal scan associated with previous obstetric history.

Methods: Ultrasound transvaginal cervical length and presence of funneling were evaluated in 1,958 singleton pregnancies between 21 and 24 weeks of gestation. For the prediction of preterm delivery, the results of cervical assessment were analyzed in association with the previous obstetric history of preterm delivery, spontaneous miscarriage, and curettage.