| Journal: | Revista brasileira de ginecologia e obstetricia |
| Database: | PERIÓDICA |
| System number: | 000304776 |
| ISSN: | 0100-7203 |
| Authors: | Yamamoto, Roseli Mieko1 Francisco, Rossana Pulcineli Vieira Miyadahira, Seizo Chuba, Catia Cristine Zugaib, Marcelo |
| Institutions: | 1Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo. Brasil |
| Year: | 2000 |
| Season: | Jul |
| Volumen: | 22 |
| Number: | 6 |
| Pages: | 353-363 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Experimental |
| English abstract | Purpose: to study the prognostic parameters for perinatal death in pregnancies with absent or reversed end-diastolic flow velocity on umbilical artery dopplervelocimetry. Methods: two hundred and four pregnancies were retrospectively reviewed. The methods used were cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry of ductus venosus, fetal aorta, middle cerebral artery, umbilical arteries and uterine artery. The logistic regression model was applied to one hundred and seventy cases in order to determine the most accurate variable for predicting perinatal death. Results: the mortality rates were: 28 cases of intrauterine fetal death (13.7%) and 45 neonatal deaths (22.1%). A statistically significant correlation was found between death and the studied variables. The perinatal death rate in the group with birth weight below 1,000 g was 74.7%, and in the group with gestational age at delivery below 31 weeks it was 66.3%. By logistic regression, birth weight was the most accurate variable for predicting perinatal death, and a probability curve for death according to this variable was obtained. Conclusions: absent or reversed end-diastolic flow velocity in the umbilical arteries is a severe fetal condition, where the risk of perinatal death is mainly related to birth weight and a gestational age at delivery below 31 weeks |
| Portuguese abstract | Objetivos: estudar os fatores prognósticos para o óbito perinatal em gestações com diagnóstico de diástole zero (DZ) ou reversa (DR) na dopplervelocimetria das artérias umbilicais. Métodos: foram analisadas retrospectivamente 204 gestantes com DZ ou DR, sendo realizados os exames de cardiotocografia, perfil biofísico fetal, índice do líquido amniótico e dopplervelocimetria do ducto venoso e das artérias umbilicais, uterinas, aorta e cerebral média. Em 170 casos foi aplicado o modelo de regressão logística para determinar a variável com melhor acurácia na predição do óbito perinatal. Resultados: a mortalidade foi de 28 casos de óbito fetal (13,7%) e 45 de óbito pós-natal (22,1%). Houve correlação significativa entre os óbitos e as variáveis analisadas. A proporção de óbitos no grupo com recém-nascidos de peso inferior a 1.000 g foi de 74,7% e no grupo com idade gestacional inferior a 31 semanas, de 66,3%. Na regressão logística, o peso do recém-nascido foi a melhor variável capaz de predizer o óbito perinatal (p<0,0001), permitindo a elaboração de uma curva de probabilidade de óbito de acordo com esta variável. Conclusões: a DZ ou DR representam um grave comprometimento fetal, cujo risco para óbito perinatal está relacionado principalmente ao peso do RN e à idade gestacional inferior a 31 semanas |
| Disciplines: | Medicina |
| Keyword: | Ginecología y obstetricia, Muerte fetal, Diástole, Arteria umbilical, Velocimetría doppler |
| Keyword: | Medicine, Gynecology and obstetrics, Fetal death, Diastole, Umbilical artery, Doppler velocimetry |
| Full text: | Texto completo (Ver HTML) |
