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The impact of first-trimester intrauterine hematoma on adverse perinatal outcomes
Alberto Borges Peixoto,Edward Araujo Júnior,Taciana Mara Rodrigues da Cunha Caldas,Caetano Galvão Petrini,Ana Cecília Palma Romero,Luciano Eliziário Borges Júnior,Wellington P. Martins 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.4
Purpose: The aim of this study was to evaluate whether the presence of an intrauterinehematoma (IUH) on an early pregnancy ultrasound scan showing a live fetus was related toadverse perinatal outcomes. Methods: We performed a retrospective cohort study to evaluate pregnant women whounderwent an ultrasound examination in early pregnancy, between 6 weeks 0 days and 10weeks 6 days. We compared the perinatal outcomes between women with and without firsttrimester IUH using the Mann-Whitney and Fisher exact tests. Furthermore, we performed astepwise regression analysis to identify possible predictors of miscarriage among maternalcharacteristics, ultrasound parameters, and IUH. Results: During the study period, data from 783 pregnancies were included, and the incidence ofIUH was 4.5% (35 of 783). We observed a higher proportion of miscarriage following the scan(28.6% vs. 10%, P=0.003) and a larger yolk sac diameter during the scan (4.8 mm vs. 3.8 mm,P<0.001) in the pregnant women with first-trimester IUH. There was no significant differenceregard the prevalence of low birth weight (LBW; P=0.091), very LBW (P=0.370), or extremelyLBW (P=0.600) between cases with IUH and without IUH, the cesarean section rate (68% vs. 81%, P=0.130), preterm delivery (16% vs. 16%, P>0.999), or the incidence of first-trimestervaginal bleeding (31% vs. 20%, P=0.130). Moreover, heart rate (HR) was the only variable thatpredicted miscarriage with statistical significance (P=0.017). Conclusion: Women with first-trimester IUH had a higher risk of miscarriage after the ultrasoundscan. HR was the only variable that predicted miscarriage with statistical significance.
( Alberto Borges Peixoto ),( Taciana Mara Rodrigues Da Cunha Caldas ),( Luisa Almeida Tahan ),( Caetano Galvao Petrini ),( Wellington P Martins ),( Fabricio Da Silva Costa ),( Edward Araujo Junior ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.4
Objective To assess the predictive capacity of cervical length (CL) measurement underwent during the second trimester ultrasound for prediction preterm birth <32, 34, and 37 weeks of gestation in an unselected risk population. Methods A retrospective cohort study was performed with 751 singleton pregnancies between 20 and 24+6 weeks of gestation. The CL measurement (mm) using the transvaginal route was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. To compare the preterm (<37 weeks) and term births (≥37 weeks), we used unpaired t test. We assessed whether the CL measurement was dependent of gestational age by performing a linear regression and assessing the coefficient of determination (R²). We additionally assessed the accuracy of CL measurement to predict preterm birth by assessing the area under receiver operating characteristics curves with its respective confidence intervals (CIs) 95%. Results Preterm birth <37 weeks was found in 13.6% (102/751) of pregnant women. Short cervix (≤25 mm) was found in 2.7% (20/751) of pregnancies. Only 30% (6/20) of pregnant women with short cervix have used progesterone to prevent preterm birth. There was a weak correlation between CL measurement and gestational age at delivery (R2=0.01, P=0.002). Receiver operating characteristics curve analysis of the ability of CL measurement to predict preterm birth <32, 34, and 37 weeks, showed an area under the curve of 0.693 (95% CI, 0.512 to 0.874), 0.472 (95% CI, 0.353 to 0.591), 0.490 (95% CI, 0.426 to 0.555), respectively. Conclusion There was a weak correlation between CL measurement and gestational age at delivery. In an unselected population, CL measurement screening at 20 to 24+6 weeks of gestation does not seem to be a good predictor of preterm birth.
( Alberto Borges Peixoto ),( Taciana Mara Rodrigues Da Cunha Caldas ),( Ana Helena Bittencourt Alamy ),( Wellington P. Martins ),( Rafael Frederico Bruns ),( Edward Araujo Junior ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.4
To establish reference values for the cervical length (CL) measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large Brazilian population. A retrospective cross-sectional study was performed with 996 singleton pregnancies. The CL measurement (mm) using the transvaginal ultrasound was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os. The median±standard deviation and ranges for the CL measurement (mm) was 37.0±10.7 (range, 8 to 51). CL measurement did not modify significantly with gestational age. The observed percentiles for the CL measurement (mm) considering all number case were the following: 5th, 28 mm; 50th, 37 mm; and 95th, 45 mm. Reference values for the CL measurement by transvaginal ultrasound between 20 and 24+6 weeks of gestation in a large heterogeneous Brazilian population were established.