Evaluation Of The Main Prenatal Routine Exams - Part 2 [avaliação Dos Exames De Rotina No Pré-natal - Parte 2]

A good quality prenatal assistance is essential to warrant perinatal and maternal health. Nowadays, due to the evolution of diagnostic methods and the change in illness prevalence, such as the increase in diabetes and sexually transmitted diseases, several propedeutic procedures are available. This introduces further difficulty for clinicians to select the most adequate procedures and when to apply them during gestation, assuring the best results for both mother and infant. The present review aimed at evaluating the main prenatal routine tests on the basis of the best scientific evidence presently available

Clinical And Laboratorial Profile And Complications Of Patients With Hellp Syndrome Admitted In An Obstetric Intensive Care Unit [perfil Clínico, Laboratorial E Complicações De Pacientes Com Síndrome Hellp Admitidas Em Uma Unidade De Terapia Intensiva Obstétrica]

PURPOSE: to describe the clinical and laboratorial profile of HELLP syndrome patients admitted at an Obstetric Intensive Care Unit (ICU) and included in a randomized clinical trial to evaluate the efficacy of dexamethasone in this clinical setting. METHODS: the present study is a secondary analysis of a randomized clinical trial design to evaluate the efficacy of dexamethasone in patients with HELLP syndrome. This sample of patients was composed of patients in the puerperium, with the diagnosis of HELLP syndrome (diagnosis made before or after delivery) who were not chronic corticosteroid users and not carriers of any chronic disease which could modify HELLP syndrome's laboratorial parameters. Patients who were too critical or whose condition did not allow them to consent to participate were not included. Data were extracted from the records used in the randomized clinical trial. Age, parity, gestational age at admission and delivery, time of diagnosis (before or after delivery), HELLP syndrome classification (partial or complete), arterial blood pressure, and diuresis at admission were considered for analysis. Among laboratorial findings, hemoglobin, platelet count, liver enzymes, LDH, and serum bilirubin were analyzed. Complications presented by the patients were also analyzed as well as need of blood transfusions and duration of hospitalization. Analysis was made by the Epi-Info 3.3.2 program. RESULTS: one hundred and five patients were analyzed. Age varied from 14 to 49 years (means of 26.7). Regarding parity, 56 patients (53.8%) were primiparas. Analyzing the timing of the diagnosis, 47 patients (45.2%) had the diagnosis before delivery. The mean gestational age in these patients was 32.4 weeks. Hemorrhagic manifestations were observed in 36 patients (34.3%), oliguria was present in 49 patients (46.7%) and criteria for acute renal failure were seen in 21 (20%) of the cases. Hemotransfusions were necessary in 35 (33.3%) patients. Seven patients (6.7%) had pulmonary edema and four patients died, corresponding to 3.8% of the cases. The mean time from diagnosis of HELLP syndrome to discharge or death was 10.3 days, varying from 1 to 33 days. CONCLUSIONS: HELLP syndrome is an ominous diagnosis, which implicates in elevated maternal morbimortality. Among complications, oliguria and hemorrhagic manifestations were the most common findings and hemotransfusions were frequently required. Lethality reached 3.8%.3028086Hypertension in pregnancy (1996) Technical Bulletin, 219. , American College of Obstetricians and Gynecologists, Washington, D.C: The College;Weistein, L., Syndrome of hemolysis, elevated liver enzymes, and low platelet count: A severe consequence of hypertension in pregnancy (1982) Am J Obstet Gynecol, 142 (2), pp. 159-167Williams, K.P., Wilson, S., Ethnic variation in the incidence of HELLP syndrome in a hypertensive pregnant population (1999) J Perinat Med, 25 (6), pp. 498-501Magann, E.F., Martin Jr., J.N., Twelve steps to optimal management of HELLP syndrome (1999) Clin Obstet Gynecol, 42 (3), pp. 532-550Suresh, M.S., HELLP syndrome: An anesthesiologist's perspective (1998) Anesthesiol Clin North Am, 16 (2), pp. 332-348Sibai, B.M., The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): Much ado about nothing? (1990) Am J Obstet Gynecol, 162 (2), pp. 311-316Santos, L.C., Amorim, M.M.R., Katz, L., Albuquerque, C.J.M., Terapia intensiva em obstetrícia. (2004) Rio de Janeiro: Medsi, pp. 63-75Vigil-De Gracia, P., García-Cáceres, E., Dexamethasone in the post-partum treatment of HELLP syndrome (1997) Int J Gynaecol Obstet, 59 (3), pp. 217-221Yalcin, O.T., Sener, T., Hassa, H., Ozalp, S., Okur, A., Effects of postpartum corticosteroids in patients with HELLP syndrome (1998) Int J Gynaecol Obstet, 61 (2), pp. 141-148Katz, L., (2007) Uso da dexametasona em pacientes com síndrome hellp: Ensaio clínico randomizado controlado com placebo [tese], , Campinas: Universidade de Campinas;Mecacci, F., Carignani, L., Cioni, R., Parreti, E., Mignosa, M., Piccioli, A., Time course of recovery and complications of HELLP syndrome with two different treatments: Heparin or dexamethasone (2001) Thromb Res, 102 (2), pp. 99-105Goodwin, A.A., Mercer, B.M., Does maternal race or ethnicity affect the expression of severe preeclampsia? (2005) Am J Obstet Gynecol, 193 (3 PART 2), pp. 973-978Haddad, B., Barton, J.R., Livingston, J.C., Chahine, R., Sibai, B.M., Risk factors for adverse maternal outcomes among women with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome (2000) Am J Obstet Gynecol, 183 (2), pp. 444-448Isler, C.M., Rinehart, B.K., Terrone, D.A., Martin, R.W., Magann, E.F., Martin Jr., J.N., Maternal mortality associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome (1999) Am J Obstet Gynecol, 181 (4), pp. 924-928Vallejo Maroto I, Miranda Guisado ML, Stiefel García-Junco P, Pamies Andreu E, Marenco ML, Castro de Gavilan D, et al. Clinical and biological characteristics of a group of 54 pregnant women with HELLP syndrome. Med Clin (Barc). 2004;122(7):259-61Martin Jr, J.N., Rinehart, B.K., May, W.L., Magann, E.F., Terrone, D.A., Blake, P.G., The spectrum of severe preeclampsia: Comparative analysis by HELLP (hemolysis, elevated liver enzyme levels, and low platelet count) syndrome classification (1999) Am J Obstet Gynecol, 180 (6 PART 1), pp. 1373-1384Romero Arauz, J.F., Lara Gonzalez, A.L., Ramos Leon, J.C., Izquierdo Puente, J.C., Maternal morbidity and mortality in HELLP syndrome (2001) Ginecol Obstet Mex, 69, pp. 189-193Audibert, F., Friedman, S.A., Frangieh, A.Y., Sibai, B.M., Clinical utility of strict diagnostic criteria for the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome (1996) Am J Obstet Gynecol, 175 (2), pp. 460-464Helguera-Martínez, A.M., Tenorio-Marañón, R., Vigil-de Gracia, P.E., García-Cáceres, E., HELLP syndrome. Analysis of 102 cases (1996) Ginecol Obstet Mex, 64, pp. 528-533Sibai, B.M., Taslami, M.M., el-Nazer, A., Amon, E., Mabie, B.C., Ryan, G.M., Maternal-perinatal outcome associated with the syndrome hemolysis, elevated liver enzymes, and low platelets in severe preeclampsiaeclampsia (1986) Am J Obstet Gynecol, 155 (3), pp. 501-509Isler, C.M., Barrilleaux, P.S., Magann, E.F., Bass, J.D., Martin Jr, J.N., A prospective, randomized trial comparing the efficacy of dexamethasone and betamethasone for the treatment of antepartum HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome (2001) Am J Obstet Gynecol, 184 (7), pp. 1332-1337Fonseca, J.E., Mendez, F., Catano, C., Arias, F., Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: A double-blind, placebo-controlled, randomized clinical trial (2005) Am J Obstet Gynecol, 193 (5), pp. 1591-1598Basavilvazo Rodríguez, A., Pacheco Pérez, C., Lemus Rocha, R., Martínez Pérez, J.M., Martínez Martínez, A., Hernández-Valencia, M., Maternal and perinatal surgical complications in low platelet count for HELLP syndrome in severe preeclampsia-eclampsia in intensive care (2003) Ginecol Obstet Mex, 71, pp. 379-386Malvino, E., Muñoz, M., Ceccotti, C., Janello, G., Mc Loughlin, D., Pawlak, A., Maternal morbidity and perinatal mortality in HELLP syndrome. Multicentric studies in intensive care units in Buenos Aires area (2005) Medicina (B Aires), 65 (1), pp. 17-23Sibai, B.M., Hypertension (2002) Obstetrics: Normal and problem pregnancies, pp. 945-1004. , Gabbe SG, Niebyl JR, Simpson JL, editors, 4th ed. New York: Churchill Livingstone;Briggs, R., Chari, R.S., Mercer, B., Sibai, B., Postoperative incision complications after cesarean section in patients with antepartum syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): Does delayed primary closure make a difference? (1996) Am J Obstet Gynecol, 175 (4 PART 1), pp. 893-896Martin Jr, J.N., Perry Jr, K.G., Blake, P.G., May, W.A., Moore, A., Robinette, L., Better maternal outcomes are achieved with dexamethasone therapy for postpartum HELLP (hemolysis, elevated liver enzymes, and thrombocytopenia) syndrome (1997) Am J Obstet Gynecol, 177 (5), pp. 1011-1017Sibai, B.M., Ramadan, M.K., Usta, I., Salama, M., Mercer, B.M., Friedman, S.A., Maternal-morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) (1993) Am J Obstet Gynecol, 169 (4), pp. 1000-1006Gul, A., Aslan, H., Cebeci, A., Polat, I., Ulusoy, S., Ceylan, Y., Maternal and fetal outcomes in HELLP syndrome complicated with acute renal failure (2004) Ren Fail, 26 (5), pp. 557-562Martínez de Ita, A.L., García Cáceres, E., Helguera Martínez, A.M., Cejudo Carranza, E., Acute renal insufficiency in HELLP syndrome (1998) Ginecol Obstet Mex, 66, pp. 462-46

Randomized clinical trial comparing the efficacy of the vaginal use of metronidazole with a Brazilian pepper tree (Schinus) extract for the treatment of bacterial vaginosis

A 7.4% vaginal extract of the Brazilian pepper tree (Schinus terebinthifolius Raddi) was compared with 0.75% vaginal metronidazole, both manufactured by the Hebron Laboratory, for the treatment of bacterial vaginosis, used at bedtime for 7 nights. The condition was diagnosed using the combined criteria of Amsel and Nugent in two groups of 140 and 137 women, aged between 18 and 40 years. Intention-to-treat analysis was performed. Women were excluded from the study if they presented delayed menstruation, were pregnant, were using or had used any topical or systemic medication, presented any other vaginal infections, presented hymen integrity, or if they reported any history suggestive of acute pelvic inflammatory disease. According to Amsel&#8217;s criteria separately, 29 patients (21.2%) treated with the extract and 87 (62.1%) treated with metronidazole were considered to be cured (P < 0.001). According to Nugent&#8217;s score separately, 19 women (13.9%) treated with the extract and 79 (56.4%) treated with metronidazole were considered to be cured (P < 0.001). Using the two criteria together, the so-called total cure was observed in 17 women (12.4%) treated with the extract and in 79 women (56.4%) treated with metronidazole (P < 0.001). In conclusion, the cure rate for bacterial vaginosis using a vaginal gel from a pepper tree extract was lower than the rate obtained with metronidazole gel, while side effects were infrequent and non-severe in both groups

Association Between Maternal Physical Activity, Gestational Weight Gain And Birth Weight In A Cohort Of 118 Pregnant Women In Campina Grande, Northeast Of Brazil [associação Entre O Padrão De Atividade Física Materna, Ganho Ponderal Gestacional E Peso Ao Nascer Em Uma Coorte De 118 Gestantes No Município De Campina Grande, Nordeste Do Brasil]

Objective: This survey evaluated the effects of physical activity on gestational weight gain and birth weight of pregnant women attended by the Family Health Program in Campina Grande, Northeast of Brazil. Methods: A cohort study enrolling 118 pregnant women was conducted between 2005 and 2006. Evaluation of the initial nutritional status was performed following Atalah's criteria and gestational weight gain was evaluated according to the Institute of Medicine. The pattern of physical activity was evaluated according to METs (metabolic equivalent) and its association with weight gain and birth weight was determined. Results: The predominant physical activity pattern at 16 weeks was mild, in 85.6% of pregnant women. An important reduction of physical activity levels was observed with evolution of pregnancy and 98.3% of pregnant women were sedentary at 24 weeks and 100% at 32 weeks. In the initial evaluation of nutritional status 50% were normal, 23% had low weight and 27% had overweight/obesity. At second and third trimesters about 45% of pregnant women had excessive weight gain. Adequate birth weight for gestational age was found in 85.6% of neonates but macrosomia was highly frequent (8.5%). A significant association between METs at 24 weeks and gestational weight gain was found in the second trimester (p=0.045). cOnclusiOn: All the pregnant women were sedentary in the third trimester and a significant association between physical activity pattern and gestational weight gain was found in the second trimester, but there was no association between this pattern and birth weight.553335341Caspersen, C.J., Kriska, A.M., Dearwater, S.R., Physical activity epidemiology as applied to elderly populations (1994) Baillieres Clin Rheumatol, 8, pp. 7-27(2002) The optimal duration of exclusive breast-feeding a systematic review, , World Health Organization (WHO), Geneva: World Health organizationClapp, J.F., Kim, H., Burciu, B., Lopez, B., Beginning regular exercise in early pregnancy: Effect on fetoplacental growth (2000) Am J obstet Gynecol, 183, pp. 1484-8Exercise during pregnancy and the postpartum period (1994) Washington (DC): ACoG Technical Bulletin, p. 189. , ACOG. American College of Obstetricians and GynecologistsCommittee on Obstetric. Exercise during pregnancy and the postpartum period (2002) Am Col obstet Gynecol., 99, pp. 171-3. , ACoG. American Colloge of obstetricians and Gynecologists, Pratice n. °267Clapp, J.F., Litlle, K.D., Effect of recreational exercise on pregnancy weight gain and subcutaneous fat deposition (1995) Med Sci Sports Exerc, 27, pp. 170-7Matsudo, V.K.R., Matsudo, S.M.M., Atividade física e esportiva na gravidez (2000) A grávida, pp. 53-81. , In: Tedesco JJ, editor, São Paulo: AtheneuHorns, P.N., Ratcliffe, L.P., Leggett, J.C., Pregnancy outcomes among active and sedentary primiparous women (1996) J obstet Gynecol Neonatal Nurs, 25, pp. 49-54Clapp, J.F., Kim, H., Burciu, B., Continuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth (2002) Am J Obstet Gynecol, 186, pp. 142-7Clapp, J.F., The effects of maternal exercice on fetal oxygenation and fetoplacental growth (2003) J obstet Gynecol Reprod Biol., 110 (SUPPL. 1), pp. s80-5Klebanoff, M.A., Shiono, P.H., Carey, J.C., The effect of physical activity during pregnancy on preterm delivey and bith weight (1990) Am J obstet Gynecol, 163, pp. 1450-6Campbell, M.K., Mottola, M.F., Recreational exercise and occupational activity during pregnancy and birth weight: A case-control study (2001) Am J obstet Gynecol, 184, pp. 403-8Reis, R.S., Petroski, E.L., Lopes, A.S., Medidas da atividade física: Revisão de métodos (2000) Rev Bras Cineantropometr Desemp Hum, 2, pp. 89-96Takito, M.Y., Benício, M.H.D.A., Latorre MRDo. Postura materna durante a gestação e sua influência sobre o peso ao nascer (2005) Rev Saude Pública., 39, pp. 325-32Jellife, D.B., Jellife, E.F.P., (1989) Community nutritional assessment, , New York: Oxford University PressAtalah, E., Castillo, C., Castro, R., Aldeã, A., Propuesta de um nuevo estándar de evoluación nutricional em embarazadas (1997) Rev Med Chile, 125, pp. 1429-36Subcommittee on nutritional status and weight gain during pregnancy (1990) Nutrition during pregnancy, , IoM. Institute of Medicine, Washington (DC): National Academy PressAinsworth, B.E., Haskell, W.L., Whitt, M.C., Irwin, M.L., Swartz, A.M., Strath, S.J., Compendium of physical activities: An update of activity codes and met intensites (2000) Med Sci Sports Exerc, 32, pp. 498-516Chasan-Taber, L., Schimdt, M.D., Roberts, D.E., Hosmer, D., Markenson, G., Freedson, P.S., Development and validatium of a pregnancy physical activity questionnary (2004) Med Sci Sports Exerc, 36, pp. 1750-60Aso, M., Assunção, P.L., Gondim, S.S.R., Carvalho, D.F., Amorim, M.M.R., Benício, M.H.D.A., et al, Estado nutricional materno, ganho de peso gestacional e peso ao nascer (2007) Rev Bras Epidemiol, 10, pp. 249-57Assunção, P.L., Aso, M., Gondim, S.S.R., Benicio, M.H.D., Amorin, M.M.R., Cardoso, M.A.A., Ganho ponderal e desfechos gestacionais em mulheres atendidas pelo Programa de Saúde da Família em Campina Grande, PB (Brasil) (2007) Rev Bras Epidemiol., 7, pp. 352-60Nucci, L.B., Duncan, B.B., Mengue, S.S., Avaliação de ganho ponderal intragestacional em serviços de assistência pré-natal no Brasil (2001) Cad Saude Pública, 17, pp. 1367-74Aquino, K.K.N.C., (2004) Determinantes do ganho ponderal excessivo em gestantes atendidas nos serviços públicos de pré-natal do distrito federal [dissertação]. Brasília, , DF): Universidade de Brasília - UNBAndreto, L.M., Souza, A.I., Figueiroa, J.N., Cabral-Filho, J.E., Fatores associados ao ganho ponderal excessivo em gestantes atendidas em um serviço público de pré-natal na cidade de recife, Pernambuco, Brasil (2006) Cad Saude Pública, 22, pp. 2401-09Prevedel, T.T.S., Calderon, I.M.P., de Conti, M.H., Consonni, E.B., Rudge, M.V.C., Reper-cussões maternas e perinatais da hidroterapia na gravidez (2003) Rev Bras Ginecol obstet, 25, pp. 53-9Monteiro, C.A., Benício, M.H.D.A., Ortiz, L.P., Tendência secular do peso ao nascer na cidade de São Paulo (1976-1998) (2000) Rev Saude Pública, 34, pp. 26-40Kac, G., Velásquez-Meléndez, G., Ganho de peso gestacional e macrossomia em uma coorte de mães e filhos (2005) J Pediatr, 81, pp. 47-53Tomić, V., Bosnjak, K., Petrov, B., Dikić, M., Knezević, D., Macrosomic births at mostar clinical hospital: A 2-year review (2007) Bosn J Basic Med Sci, 7, pp. 271-4Bergman, R.L., Richter, R., Bergman, K.E., Plagemann, A., Brauer, M., Dudenhausen, J.W., Secular trends in neonatal macrosomia in Berlin. Influences of potential determinants (2003) Paediatr Perinat Epidemiol, 17, pp. 244-9Orr, S.T., James, S.A., Garry, J., Prince, C.B., Newton, E.R., Exercise and pregnancy outcome among urban, low-income, black women (2006) Ethn Dis, 16, pp. 933-7Hatch, M.C., Shu, X.O., McLean, D.E., Maternal exercise during pregnancy, physical fitness, and fetal growth (1993) Am J Epidemiol, 137, pp. 1105-14Lindseth, G., Vari, P., Measuring physical activity during pregnancy (2005) West J Nurs Res, 27, pp. 722-3

Cervical Ultrasonography Versus Bishop Score As A Predictor Of Vaginal Delivery [ultrassonografia Do Colo Uterino Versus índice De Bishop Como Preditor Do Parto Vaginal]

PURPOSE: to compare the accuracy of transvaginal ultrasonographic measurement of the uterine cervix with Bishop's score for the prediction of vaginal delivery after labor induction, with 25 mcg of misoprostol. METHODS: a prospective study for the validation of a diagnostic test was conducted on 126 pregnant women with indication for labor induction. The patients were evaluated by Bishop's score and transvaginal ultrasonography for cervical measurement. They also undergone obstetric transabdominal ultrasound to evaluate static and fetal weight, as well as the amniotic fluid index, and basal cardiotocography for the evaluation of fetal vitality. Labor was induced with vaginal and sublingual misoprostol, one of the tablets containing 25 mcg of the drug and the other only placebo. The tablets were administered every six hours, with a maximum number of eight. Frequency tables were obtained, and measures of central tendency and dispersion were calculated. ROC curves were constructed for the evaluation of Bishop's score and ultrasonographic measurement of the uterine cervix for the prediction of vaginal delivery. RESULTS: the area under the ROC curve was 0.5 (p=0.8) for the ultrasonographic measurement of the uterine cervix, and 0.6 (p=0.02) for Bishop's score (cut point ≥4). Bishop's score had a sensitivity of 56.2% and specificity of 67.9% for prediction of vaginal delivery, with a positive likelihood ratio of 1.75 and a negative one of 0.65. CONCLUSIONS: ultrasonographic measurement of the uterine cervix was not a good predictor of evolution to vaginal delivery among patients with misoprostol-induced labor. Bishop's score was a better predictor of vaginal delivery under these circumstances.3311361366Ventura, S.J., Martin, J.A., Curtin, S.C., Mathews, T.J., Park, M.M., Births: Final data for 1998 (2000) Natl Vital Stat Rep, 48 (3), pp. 1-100(2002) Taxa De Parto Cesáreo, , http://bvsms.saude.gov.br/bvs/publicacoes/qualificacao_saude_sup/pdf/Atenc_saude2fase.pdf, Agência Nacional de Saúde Suplementar, [Internet]. [citado 2003 Jun 30]. Disponível emNorwitz, E.R., Robinson, J.N., Repke, J.T., Labor and delivery: Induction of labor (2002) Obstetrics: Normal and Problem Pregnancies, pp. 373-378. , In: Gabbe SG, Niebyl JR, Simpson JL, editors, 4th ed. New York: Churchill LivingstoneBishop, E.H., Pelvic scoring for elective induction (1964) Obstet Gynecol, 24 (2), pp. 266-268Mann, T., (1996) Clinical Guidelines: Using Clinical Guidelines to Improve Patient Care Within the NHS, , Leeds: NHS ExecutiveIams, J.D., Goldenberg, R.L., Meis, P.J., Mercer, B.M., Moawad, A., Das, A., The length of the cervix and the risk of premature delivery (1996) N Engl J Med, 334 (9), pp. 567-572Cheung, C.W., Leung, T.Y., Sahota, D.S., Chan, O.K., Chan, L.W., Fung, T.Y., Outcome of induction of labour using maternal characteristics, ultrasound assessment and biochemical state of the cervix (2010) J Matern Fetal Neonatal Med, 23 (12), pp. 1406-1412Bastani, P., Hamdi, K., Abasalizadeh, F., Pourmousa, P., Ghatrehsamani, F., Transvaginal ultrasonography compared with Bishop score for predicting cesarean section after induction of labor (2011) Int J Womens Health, 3, pp. 277-280Park, K.H., Kim, S.N., Lee, S.Y., Jeong, E.H., Jung, H.J., Oh, K.J., Comparison between sonographic cervical length and Bishop score in preinduction cervical assessment: A randomized trial (2011) Ultrasound Obstet Gynecol, 38 (2), pp. 198-204Feitosa, F.E., Sampaio, Z.S., Alencar Jr., C.A., Amorim, M.M., Passini Jr., R., Sublingual vs. vaginal misoprostol for induction of labor (2006) Int J Gynaecol Obstet, 94 (2), pp. 91-95Sanchez-Ramos, L., Kaunitz, A.M., Misoprostol for cervical ripening and labor induction: A systematic review of the literature (2000) Clin Obstet Gynecol, 43 (3), pp. 475-488Alfirevic, Z., Oral misoprostol for induction of labour (2001) Cochrane Database Syst Rev, (2), pp. CD001338Hofmeyr, G.J., Gulmezoglu, A.M., Vaginal misoprostol for cervical ripening and induction of labour (2003) Cochrane Database Syst Rev, (1), pp. CD000941Feitosa, F.E., Amorim, M.M.R., Alencar Jr., C.A., Coutinho, I.C., Sampaio, Z.S., Nova formulação de misoprostol sublingual (25mcg) na indução do trabalho de parto (2006) Ev Assoc Med Bras, 52 (4), pp. 251-255Gómez, L.A.M., Sánchez, F.G., Gimenez, J.H., Martínez, M.S., Valverde, M.J.A., Vizcaíno, V.M., Comparison of ultrasonographic cervical length and the Bishop score in predicting successful labor induction (2007) Acta Obstet Gynecol Scand, 86 (7), pp. 799-804Vankayalapati, P., Sethna, F., Roberts, N., Ngeh, B., Thilagananthan, B., Bhide, A., Ultrasound assessment of cervical length in prolonged pregnancy: Prediction of spontaneous onset of labor and successful vaginal delivery (2008) Ultrasound Obstet Gynecol, 31 (3), pp. 328-331Eggebo, T.M., Okland, I., Heien, C., Gjessing, L.K., Romundstad, P., Salvesen, K.A., Can ultrasound measurement replace digitally assessed elements of the Bishop score? (2009) Acta Obstet Gynecol Scand, 88 (3), pp. 325-331Bartha, J.L., Romero-Carmona, L., Martínez-Del-Fresno, P., Comino-Delgado, R., Bishop score and transvaginal ultrasound for preinduction cervical assessment: A randomized clinical trial (2005) Ultrasound Obstet Gynecol, 25 (2), pp. 155-159Khoury, S., Odeh, M., Korshonov, M., Wolfson, M., Oettinger, M., Transvaginal evaluation of the cervix before induction of labor (1997) Proceedings of the 8th World Congress of Ultrasound in Obstetrics and Gynecology, , Washington, DC, USACano, A., Carrillo, M., Baquero, R., Lozano, F., Sarmiento, A., Pinzón, W., Cervicometría transvaginal como factor predictor de êxito en indución del trabajo de parto com misoprostol (2000) Rev Colomb Obstet Gynecol, 51 (3), pp. 214-217Tan, P.C., Suguna, S., Vallikkannu, N., Hassan, J., Ultrasound and clinical predictors for Caesarean delivery after labour induction at term (2006) Aust N Z J Obstet Gynaecol, 46 (6), pp. 505-509Uyar, Y., Erbay, G., Demir, B.C., Baytur, Y., Comparison of the Bishop score, body mass index and transvaginal cervical length in predicting the success of labor induction (2009) Arch Gynecol Obstet, 280 (3), pp. 357-362Baacke, K.A., Edwards, R.K., Preinduction cervical assessment (2006) Clin Obstet Gynecol, 49 (3), pp. 564-572Crane, J.M., Factors predicting labor induction success: A critical analysis (2006) Clin Obstet Gynecol, 49 (3), pp. 573-584Sampaio, Z.S., Alencar Jr., C.A., Feitosa, F.E.L., Amorim, M.M.R., Fatores associados ao parto vaginal em gestantes de alto risco submetidas à indução do parto com misoprostol (2004) Ev Bras Ginecol Obstet, 26 (1), pp. 1-9Pandis, G.K., Papageorghiou, A.T., Ramanathan, V.G., Thompson, M.O., Nicolaides, K.H., Preinduction sonographic measurement of cervical length in the prediction of successful induction of labor (2001) Ultrasound Obstet Gynecol, 18 (6), pp. 623-62

Detecção molecular e isolamento de Mycoplasma spp. em psitacídeos no estado de Pernambuco, Brasil

Objetivou-se com este estudo investigar a ocorrência de Mycoplasma spp., Mycoplasma galissepticum (MG) e Mycoplasma synoviae (MS) em psitacídeos de cativeiro localizado no estado de Pernambuco, Brasil. Foram estudadas 85 aves provenientes do Parque Estadual Dois Irmãos, localizado no estado do Pernambuco, Brasil. De cada psitacídeo analisado foram obtidas três amostras por meio de swabs da cloaca, palato e conjuntiva totalizando 255 amostras. As amostras coletadas foram submetidas à extração de DNA e à reação em cadeia da polimerase (PCR), sendo as positivas submetidas ao isolamento em ágar Frey. O DNA de Mycoplasma spp. foi detectado em 16,47% (14/85) dos psitacídeos estudados. Das 255 amostras analisadas, 6,66% (17/255) foram positivas para a presença de Mycoplasma spp., sendo 41,18% (7/17) provenientes da conjuntiva, 35,29% (6/17) do palato e 23,53% (4/17) da cloaca. Nenhuma amostra foi positiva para MG ou MS na PCR. Os resultados obtidos permitem confirmar a presença do DNA de Mycoplasma spp. em conjuntiva, palato e cloaca nas aves estudadas. Foram detectadas colônias semelhantes a membros da classe Mollicutes em 17,64% das amostras (3/17). Esse é o primeiro relato da presença de Mycoplasma spp. em psitacídeos de cativeiro no Nordeste do Brasil

Biologia floral e fenologia reprodutiva de Schinus terebinthifolius Raddi (Anacardiaceae) em Restinga do Norte Fluminense Floral biology and reproductive phenology of Schinus terebinthifolius Raddi (Anacardiaceae) in the restinga of northern Rio de Janeiro State

A fenologia reprodutiva, a morfologia floral e o sistema reprodutivo de Schinus terebinthifolius foram investigados em duas fisionomias de vegetação da restinga de Grussaí/Iquipari, Rio de Janeiro, no período de janeiro a dezembro/2004. Schinus terebinthifolius apresentou estratégia de florescimento do tipo cornucópia, com dois picos de floração ao ano na estação chuvosa, e frutificou no período seco. A análise morfológica das flores e os experimentos de polinização confirmaram que esta espécie é dióica e apresenta reprodução xenógama obrigatória. Ocorreu alta sincronia entre plantas masculinas e femininas, considerada importante estratégia para espécies dióicas. Não houve diferença entre a frutificação por polinização natural e polinização cruzada, nem entre as duas fitosionomias estudadas, sendo os valores encontrados menores do que os observados em outros trabalhos.<br>Reproductive phenology, floral morphology and the reproductive system of Schinus terebinthifolius were investigated in two physiognomies of restinga vegetation at Grussai/Iquipari, Rio de Janeiro, from January to December/2004. Schinus terebinthifolius had cornucopia flowering strategy, with two flowering peaks during the year, both in the rainy season; fruit was set in the dry period. Morphological analysis of the flowers and pollination experiments confirmed dioicism and obligatory xenogamy in this species. High synchrony between male and female plants occurred, an important strategy for dioecious species. No difference in fruit set was found between natural and cross pollinations in the two physiognomies studied, indicating lower values than those observed in others studies