Maria Brizot | Universidade de Sao Paulo (original) (raw)

Papers by Maria Brizot

Research paper thumbnail of Translucência nucal aumentada e cariótipo normal: evolução pré e pós-natal

Revista da Associação Médica Brasileira, 2009

Research paper thumbnail of Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies

Research paper thumbnail of Fetal echocardiography:pregnant women's fantasies, expecations and understanding of the exam results and prognosis of the fetus

Research paper thumbnail of Maternal postpartum complications according to delivery mode in twin pregnancies

Clinics, 2014

OBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to ... more OBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors. METHODS: This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008). The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated. RESULTS: A total of 90 complications were observed in 56/817 (6.9%) deliveries: 7/131 (5.3%) vaginal, 10/251 (4.0%) elective cesarean and 39/435 (9.0%) emergency cesarean deliveries. Significant predictors included highrisk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34). CONCLUSIONS: Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.

Research paper thumbnail of The complex search for the cause of gastroschisis

Research paper thumbnail of Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia

Research paper thumbnail of Maternal nutrient intake and fetal gastroschisis: A case-control study

American Journal of Medical Genetics Part A, 2019

Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of the abdominal org... more Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of the abdominal organs. This multifactorial malformation occurs in young pregnant women, and the underlying cause of the disease remains unknown; however, nutritional factors may play a role in its development. This case‐control study explored the association of maternal nutrient intake with the occurrence of gastroschisis. The gastroschisis group (GG) comprised 57 pregnant women with fetuses with gastroschisis, and the control group (CG) comprised 114 pregnant women with normal fetuses matched for maternal age, gestational age, and preconception body mass index classification. Nutritional assessments related to the preconception period were obtained using the food consumption frequency questionnaire, and nutrient intakes were calculated using nutrition programs. The median daily calorie intake was higher (2,382.43 vs. 2,198.81; p = .041) in the GG than in the CG. The median intake of methionine (763.89 vs. 906.34; p = .036) and threonine (1,248.34 vs. 1,437.01; p = .018) was lower in the GG than in the CG. Pregnant women with fetuses with gastroschisis have a diet characterized by higher calorie intake and lower levels of essential amino acids (methionine and threonine) during the preconception period than pregnant women with normal fetuses.

Research paper thumbnail of Low serum fatty acid levels in pregnancies with fetal gastroschisis: A prospective study

American journal of medical genetics. Part A, 2018

Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of abdominal organs.... more Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of abdominal organs. The underlying cause of the disease remains unknown; however, studies suggest that nutritional factors may play a role in its development. This prospective case-control study explored the association of serum fatty acid levels of pregnant women and occurrence of gastroschisis. Gastroschisis group comprised 57 pregnant women with fetuses with gastroschisis, and the control group comprised 114 pregnant women with normal fetuses. Serum fatty acids levels were compared between the groups for the overall pregnancy at <34 weeks; ≤25 weeks, and >25 and <34 weeks; and at delivery. Total fatty acids (p = .008), unsaturated fatty acids (p = .002), and the C18:1n9/C18:00 ratio (p = .021) were lower in the gastroschisis group than in the control group during the overall pregnancy; however, the C16:00/C18:2n6 ratio (p = .018) was higher in the gastroschisis group than in the control group d...

Research paper thumbnail of Type II and III Selective Fetal Growth Restriction: Perinatal Outcomes of Expectant Management and Laser Ablation of Placental Vessels

Clinics (Sao Paulo, Brazil), 2018

To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) i... more To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) in monochorionic-diamniotic (MCDA) twin pregnancies treated with expectant management or laser ablation of placental vessels (LAPV). Retrospective analysis of cases of sFGR that received expectant management (type II, n=6; type III, n=22) or LAPV (type II, n=30; type III, n=9). The main outcomes were gestational age at delivery and survival rate. The smaller fetus presented an absent/reversed "a" wave in the ductus venosus (arAWDV) in all LAPV cases, while none of the expectant management cases presented arAWDV. The median gestational age at delivery was within the 32nd week for expectant management (type II and III) and for type II LAPV, and the 30th week for type III LAPV. The rate of at least one twin alive at hospital discharge was 83.3% and 90.9% for expectant management type II and III, respectively, and 90% and 77.8% for LAPV type II and III, respectively. LAPV in type II...

Research paper thumbnail of The effect of prenatal vaginal progesterone on cervical length in twin pregnancies

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Jan 8, 2017

The aim of this study was to investigate the influence of vaginal progesterone on cervical length... more The aim of this study was to investigate the influence of vaginal progesterone on cervical length in asymptomatic nonselected twin gestations. This was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies exposed to vaginal progesterone or placebo. The cervical length was examined at six different time periods: 18-21(+6) weeks (T1), 21-23(+6) weeks (T2), 24-26(+6) weeks (T3), 27-29(+6) weeks (T4), 30-32(+6) weeks (T5) and 33-34(+6) weeks (T6). The rate of cervical shortening per week and the percent cervical shortening were compared between the groups, with analyses of the entire cohort and of those who delivered spontaneously according to gestational age at birth. The final analysis included 184 women in the progesterone group and 188 women in the placebo group. The baseline characteristics were similar in both groups. No differences in cervical shortening in terms of absolute value or percent shortening were observed between the groups a...

Research paper thumbnail of Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2017

Objective To investigate the clinical and sonographic parameters associated with adverse fetal ou... more Objective To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion. Methods This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered non-recovery and categorized as an adverse outcome. Results The final analysis included ten singleton pregnancies: seven of which were categorized...

Research paper thumbnail of Placental weight and birth weight to placental weight ratio in monochorionic and dichorionic growth-restricted and non-growth-restricted twins

Clinics (Sao Paulo, Brazil), 2017

The aim of the present study was to compare the placental weight and birth weight/placental weigh... more The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic...

Research paper thumbnail of First-trimester fetal nuchal translucency thickness and risk for trisomies

Obstetrics and Gynecology, Aug 31, 1994

Page 1. First-Trimester Fetal Nuchal Translucency Thickness and Risk for Trisomies PRANAV P. PAND... more Page 1. First-Trimester Fetal Nuchal Translucency Thickness and Risk for Trisomies PRANAV P. PANDYA, MD, MARIA L. BR1ZOT, MD, PETER KUHN, MD, ROSALINDE JM SNIJDERS, PhD, AND KYPROS H. NICOLAIDES ...

Research paper thumbnail of Fetal gastroschisis: antepartum fetal heart rate analysis by computerized cardiotocography

The Journal of Maternal-Fetal & Neonatal Medicine, 2016

To describe the antenatal fetal heart rate (FHR) parameters analyzed by computerizedcardiotocogra... more To describe the antenatal fetal heart rate (FHR) parameters analyzed by computerizedcardiotocography (cCTG) in fetuses with gastroschisis and compare the FHR parameters with ultrasound gastrointestinal markers. A retrospective analysis of antepartum cCTG records were conducted in 87 pregnant cases with fetal gastroschisis between 28and 36 weeks (plus 6 days). A comparative analysis of the median distribution of the following FHR parameters was performed: basal FHR, short-term variation (STV), FHR accelerations and decelerations, episodes of high and low variations, and variations in low and high episodes. FHR parameters and ultrasound gastrointestinal markers were also compared. The majority of FHR parameters did not present significant changes throughout gestation. An increased number of records with episodes of low variation (p = 0.019) and an increased number of accelerations &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15 bpm (p = 0.001) were the only observed changes throughout gestation. Stomach herniation was significantly associated with a lower STV (p = 0.018) and a higher frequency of records with low episodes (p = 0.049). The cCTG analysis indicated that the FHR parameters in fetuses with gastroschisis presented different patterns from those observed in normal fetuses. Stomach herniation was associated with altered FHR patterns.

Research paper thumbnail of Intrauterine death in singleton pregnancies with trisomy 21, 18, 13 and monosomy X

Revista da Associação Médica Brasileira (1992), 2016

A retrospective study from November 2004 to May 2012, conducted at the Obstetric Clinic of Hospit... more A retrospective study from November 2004 to May 2012, conducted at the Obstetric Clinic of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP), which included 92 singleton pregnancies with prenatal diagnosis of trisomy of chromosome 21 (T21), 18, 13 (T13/18) and monosomy X (45X), with diagnosis performed until the 26th week of pregnancy. The aim of the study was to describe the frequency and to investigate predictors of spontaneous fetal death (FD). Diagnosis (T21, n=36; T13/18, n=25; 45X, n=31) was made at a mean gestational age of 18.3±3.7 weeks, through chorionic villus biopsy (n=22,24%), amniocentesis (n=66, 72%) and cordocentesis (n=4, 4%). Major malformations were present in 45 (49%); with hydrops in 32 (35%) fetuses, more frequently in 45X [n=24/31, 77% vs. T21 (n=6/36, 17%) and T13/18 (n=2/25, 8%), p<0.001]. Specialized fetal echocardiography was performed in 60% (55/92). Of these, 60% (33/55) showed changes in heart morphology and/or functi...

Research paper thumbnail of Fetal growth according to different reference ranges in twin pregnancies with placental insufficiency

Clinics (São Paulo, Brazil), 2015

The aim of this study was to compare different fetal growth curves in twin pregnancies with sever... more The aim of this study was to compare different fetal growth curves in twin pregnancies with severe placental insufficiency. A retrospective cross-sectional analysis of 47 twin pregnancies with absent or reverse end diastolic flow in the umbilical artery of one fetus was performed. Pregnancies with major fetal abnormalities, twin-twin transfusion or three or more fetuses were not included. The estimated fetal weight zeta-scores were calculated for both fetuses (abnormal Doppler and co-twin) according to the following criteria: Hadlock, Liao and Araújo. The abdominal circumference zeta-scores were calculated according to Hadlock, Liao, Araújo, Ong and Stirrup. The mean estimates of the zeta-score values were calculated using generalized estimating equation regression analysis. The mean gestational age at inclusion was 27.4±4.7 weeks. The fetal sex and the interaction Doppler findings × criteria correlated significantly with the zeta-score values (p <0.001 for both variables). The e...

Research paper thumbnail of Prediction of perinatal mortality in triplet pregnancies

Archives of Gynecology and Obstetrics, 2015

To investigate predictors of perinatal mortality in triplet pregnancies. Retrospective cohort man... more To investigate predictors of perinatal mortality in triplet pregnancies. Retrospective cohort managed in a tertiary teaching hospital (1998-2012) including all pregnancies with tree live fetuses at the first ultrasound examination, performed after 11 weeks of gestation. Primary end-point was defined as the number of children alive at hospital discharge. Ordinal stepwise regression analysis examined the association with maternal age, parity, pregnancy chorionicity, gestational age at our first ultrasound evaluation, presence of maternal clinical, obstetrical and fetal complications and gestational age at delivery. Sixty-seven triplet pregnancies were first seen at 18.5 ± 6.8 weeks, 33 (49.3 %) were trichorionic, obstetric complications occurred in 34 (50.7 %) and fetal complications were diagnosed in 17 (25.4 %). Perinatal mortality rate was 249 ‰ (95 % CI 189-317) and 138 (73 %) children were discharged alive from hospital (11 pregnancies with no survivors; single and double survival in ten cases each; all children alive in 36). Regression analysis showed that presence of fetal complications (OR 0.10, 95 % CI 0.03-0.36) and gestational age at delivery (OR 1.55, 95 % CI 1.31-1.85) are significant predictors of outcome (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Perinatal mortality in non-selected triplet pregnancies is high and is related to the presence of fetal complications and gestational age at delivery.

Research paper thumbnail of Lectin binding of pregnancy-associated plasma protein A purified from different sources

Biochemical Society Transactions, 1996

Research paper thumbnail of Non-placental production of pregnancy-associated plasma protein A (PAPP-A): old and new evidence

Early pregnancy : biology and medicine : the official journal of the Society for the Investigation of Early Pregnancy, 1997

Research paper thumbnail of Detection of human parvovirus B19 in cases of hydrops fetalis in São Paulo, Brazil

Jornal Brasileiro de Patologia e Medicina Laboratorial, 2008

Research paper thumbnail of Translucência nucal aumentada e cariótipo normal: evolução pré e pós-natal

Revista da Associação Médica Brasileira, 2009

Research paper thumbnail of Sonographic evaluation of umbilical cord thickness in monochorionic diamniotic twin pregnancies

Research paper thumbnail of Fetal echocardiography:pregnant women's fantasies, expecations and understanding of the exam results and prognosis of the fetus

Research paper thumbnail of Maternal postpartum complications according to delivery mode in twin pregnancies

Clinics, 2014

OBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to ... more OBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors. METHODS: This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008). The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated. RESULTS: A total of 90 complications were observed in 56/817 (6.9%) deliveries: 7/131 (5.3%) vaginal, 10/251 (4.0%) elective cesarean and 39/435 (9.0%) emergency cesarean deliveries. Significant predictors included highrisk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34). CONCLUSIONS: Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.

Research paper thumbnail of The complex search for the cause of gastroschisis

Research paper thumbnail of Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia

Research paper thumbnail of Maternal nutrient intake and fetal gastroschisis: A case-control study

American Journal of Medical Genetics Part A, 2019

Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of the abdominal org... more Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of the abdominal organs. This multifactorial malformation occurs in young pregnant women, and the underlying cause of the disease remains unknown; however, nutritional factors may play a role in its development. This case‐control study explored the association of maternal nutrient intake with the occurrence of gastroschisis. The gastroschisis group (GG) comprised 57 pregnant women with fetuses with gastroschisis, and the control group (CG) comprised 114 pregnant women with normal fetuses matched for maternal age, gestational age, and preconception body mass index classification. Nutritional assessments related to the preconception period were obtained using the food consumption frequency questionnaire, and nutrient intakes were calculated using nutrition programs. The median daily calorie intake was higher (2,382.43 vs. 2,198.81; p = .041) in the GG than in the CG. The median intake of methionine (763.89 vs. 906.34; p = .036) and threonine (1,248.34 vs. 1,437.01; p = .018) was lower in the GG than in the CG. Pregnant women with fetuses with gastroschisis have a diet characterized by higher calorie intake and lower levels of essential amino acids (methionine and threonine) during the preconception period than pregnant women with normal fetuses.

Research paper thumbnail of Low serum fatty acid levels in pregnancies with fetal gastroschisis: A prospective study

American journal of medical genetics. Part A, 2018

Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of abdominal organs.... more Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of abdominal organs. The underlying cause of the disease remains unknown; however, studies suggest that nutritional factors may play a role in its development. This prospective case-control study explored the association of serum fatty acid levels of pregnant women and occurrence of gastroschisis. Gastroschisis group comprised 57 pregnant women with fetuses with gastroschisis, and the control group comprised 114 pregnant women with normal fetuses. Serum fatty acids levels were compared between the groups for the overall pregnancy at <34 weeks; ≤25 weeks, and >25 and <34 weeks; and at delivery. Total fatty acids (p = .008), unsaturated fatty acids (p = .002), and the C18:1n9/C18:00 ratio (p = .021) were lower in the gastroschisis group than in the control group during the overall pregnancy; however, the C16:00/C18:2n6 ratio (p = .018) was higher in the gastroschisis group than in the control group d...

Research paper thumbnail of Type II and III Selective Fetal Growth Restriction: Perinatal Outcomes of Expectant Management and Laser Ablation of Placental Vessels

Clinics (Sao Paulo, Brazil), 2018

To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) i... more To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) in monochorionic-diamniotic (MCDA) twin pregnancies treated with expectant management or laser ablation of placental vessels (LAPV). Retrospective analysis of cases of sFGR that received expectant management (type II, n=6; type III, n=22) or LAPV (type II, n=30; type III, n=9). The main outcomes were gestational age at delivery and survival rate. The smaller fetus presented an absent/reversed "a" wave in the ductus venosus (arAWDV) in all LAPV cases, while none of the expectant management cases presented arAWDV. The median gestational age at delivery was within the 32nd week for expectant management (type II and III) and for type II LAPV, and the 30th week for type III LAPV. The rate of at least one twin alive at hospital discharge was 83.3% and 90.9% for expectant management type II and III, respectively, and 90% and 77.8% for LAPV type II and III, respectively. LAPV in type II...

Research paper thumbnail of The effect of prenatal vaginal progesterone on cervical length in twin pregnancies

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Jan 8, 2017

The aim of this study was to investigate the influence of vaginal progesterone on cervical length... more The aim of this study was to investigate the influence of vaginal progesterone on cervical length in asymptomatic nonselected twin gestations. This was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies exposed to vaginal progesterone or placebo. The cervical length was examined at six different time periods: 18-21(+6) weeks (T1), 21-23(+6) weeks (T2), 24-26(+6) weeks (T3), 27-29(+6) weeks (T4), 30-32(+6) weeks (T5) and 33-34(+6) weeks (T6). The rate of cervical shortening per week and the percent cervical shortening were compared between the groups, with analyses of the entire cohort and of those who delivered spontaneously according to gestational age at birth. The final analysis included 184 women in the progesterone group and 188 women in the placebo group. The baseline characteristics were similar in both groups. No differences in cervical shortening in terms of absolute value or percent shortening were observed between the groups a...

Research paper thumbnail of Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2017

Objective To investigate the clinical and sonographic parameters associated with adverse fetal ou... more Objective To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion. Methods This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered non-recovery and categorized as an adverse outcome. Results The final analysis included ten singleton pregnancies: seven of which were categorized...

Research paper thumbnail of Placental weight and birth weight to placental weight ratio in monochorionic and dichorionic growth-restricted and non-growth-restricted twins

Clinics (Sao Paulo, Brazil), 2017

The aim of the present study was to compare the placental weight and birth weight/placental weigh... more The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic...

Research paper thumbnail of First-trimester fetal nuchal translucency thickness and risk for trisomies

Obstetrics and Gynecology, Aug 31, 1994

Page 1. First-Trimester Fetal Nuchal Translucency Thickness and Risk for Trisomies PRANAV P. PAND... more Page 1. First-Trimester Fetal Nuchal Translucency Thickness and Risk for Trisomies PRANAV P. PANDYA, MD, MARIA L. BR1ZOT, MD, PETER KUHN, MD, ROSALINDE JM SNIJDERS, PhD, AND KYPROS H. NICOLAIDES ...

Research paper thumbnail of Fetal gastroschisis: antepartum fetal heart rate analysis by computerized cardiotocography

The Journal of Maternal-Fetal & Neonatal Medicine, 2016

To describe the antenatal fetal heart rate (FHR) parameters analyzed by computerizedcardiotocogra... more To describe the antenatal fetal heart rate (FHR) parameters analyzed by computerizedcardiotocography (cCTG) in fetuses with gastroschisis and compare the FHR parameters with ultrasound gastrointestinal markers. A retrospective analysis of antepartum cCTG records were conducted in 87 pregnant cases with fetal gastroschisis between 28and 36 weeks (plus 6 days). A comparative analysis of the median distribution of the following FHR parameters was performed: basal FHR, short-term variation (STV), FHR accelerations and decelerations, episodes of high and low variations, and variations in low and high episodes. FHR parameters and ultrasound gastrointestinal markers were also compared. The majority of FHR parameters did not present significant changes throughout gestation. An increased number of records with episodes of low variation (p = 0.019) and an increased number of accelerations &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15 bpm (p = 0.001) were the only observed changes throughout gestation. Stomach herniation was significantly associated with a lower STV (p = 0.018) and a higher frequency of records with low episodes (p = 0.049). The cCTG analysis indicated that the FHR parameters in fetuses with gastroschisis presented different patterns from those observed in normal fetuses. Stomach herniation was associated with altered FHR patterns.

Research paper thumbnail of Intrauterine death in singleton pregnancies with trisomy 21, 18, 13 and monosomy X

Revista da Associação Médica Brasileira (1992), 2016

A retrospective study from November 2004 to May 2012, conducted at the Obstetric Clinic of Hospit... more A retrospective study from November 2004 to May 2012, conducted at the Obstetric Clinic of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP), which included 92 singleton pregnancies with prenatal diagnosis of trisomy of chromosome 21 (T21), 18, 13 (T13/18) and monosomy X (45X), with diagnosis performed until the 26th week of pregnancy. The aim of the study was to describe the frequency and to investigate predictors of spontaneous fetal death (FD). Diagnosis (T21, n=36; T13/18, n=25; 45X, n=31) was made at a mean gestational age of 18.3±3.7 weeks, through chorionic villus biopsy (n=22,24%), amniocentesis (n=66, 72%) and cordocentesis (n=4, 4%). Major malformations were present in 45 (49%); with hydrops in 32 (35%) fetuses, more frequently in 45X [n=24/31, 77% vs. T21 (n=6/36, 17%) and T13/18 (n=2/25, 8%), p<0.001]. Specialized fetal echocardiography was performed in 60% (55/92). Of these, 60% (33/55) showed changes in heart morphology and/or functi...

Research paper thumbnail of Fetal growth according to different reference ranges in twin pregnancies with placental insufficiency

Clinics (São Paulo, Brazil), 2015

The aim of this study was to compare different fetal growth curves in twin pregnancies with sever... more The aim of this study was to compare different fetal growth curves in twin pregnancies with severe placental insufficiency. A retrospective cross-sectional analysis of 47 twin pregnancies with absent or reverse end diastolic flow in the umbilical artery of one fetus was performed. Pregnancies with major fetal abnormalities, twin-twin transfusion or three or more fetuses were not included. The estimated fetal weight zeta-scores were calculated for both fetuses (abnormal Doppler and co-twin) according to the following criteria: Hadlock, Liao and Araújo. The abdominal circumference zeta-scores were calculated according to Hadlock, Liao, Araújo, Ong and Stirrup. The mean estimates of the zeta-score values were calculated using generalized estimating equation regression analysis. The mean gestational age at inclusion was 27.4±4.7 weeks. The fetal sex and the interaction Doppler findings × criteria correlated significantly with the zeta-score values (p <0.001 for both variables). The e...

Research paper thumbnail of Prediction of perinatal mortality in triplet pregnancies

Archives of Gynecology and Obstetrics, 2015

To investigate predictors of perinatal mortality in triplet pregnancies. Retrospective cohort man... more To investigate predictors of perinatal mortality in triplet pregnancies. Retrospective cohort managed in a tertiary teaching hospital (1998-2012) including all pregnancies with tree live fetuses at the first ultrasound examination, performed after 11 weeks of gestation. Primary end-point was defined as the number of children alive at hospital discharge. Ordinal stepwise regression analysis examined the association with maternal age, parity, pregnancy chorionicity, gestational age at our first ultrasound evaluation, presence of maternal clinical, obstetrical and fetal complications and gestational age at delivery. Sixty-seven triplet pregnancies were first seen at 18.5 ± 6.8 weeks, 33 (49.3 %) were trichorionic, obstetric complications occurred in 34 (50.7 %) and fetal complications were diagnosed in 17 (25.4 %). Perinatal mortality rate was 249 ‰ (95 % CI 189-317) and 138 (73 %) children were discharged alive from hospital (11 pregnancies with no survivors; single and double survival in ten cases each; all children alive in 36). Regression analysis showed that presence of fetal complications (OR 0.10, 95 % CI 0.03-0.36) and gestational age at delivery (OR 1.55, 95 % CI 1.31-1.85) are significant predictors of outcome (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Perinatal mortality in non-selected triplet pregnancies is high and is related to the presence of fetal complications and gestational age at delivery.

Research paper thumbnail of Lectin binding of pregnancy-associated plasma protein A purified from different sources

Biochemical Society Transactions, 1996

Research paper thumbnail of Non-placental production of pregnancy-associated plasma protein A (PAPP-A): old and new evidence

Early pregnancy : biology and medicine : the official journal of the Society for the Investigation of Early Pregnancy, 1997

Research paper thumbnail of Detection of human parvovirus B19 in cases of hydrops fetalis in São Paulo, Brazil

Jornal Brasileiro de Patologia e Medicina Laboratorial, 2008