Ultrasonographic fetal weight estimation in term pregnancy

Aim: To ascertain the accuracy of ultrasonographic fetal weight estimation in term pregnancy. Population: A total of 446 pregnant women who underwent obstetric ultrasound in our Maternal and Fetal Medicine Unit. Design: Retrospective, transversal, descriptive study. Methods: From the database of ultrasound exams conducted between July 2007 and June 2008, cases were selected if they complied with the following inclusion criteria: singleton pregnancy, absence of malformations, normal amniotic fluid index, complete record of fetal biometries, exam performed between the 37th and 42nd week of gestation by a senior Obstetrician, and delivery of a live newborn within 6 days of the ultrasound. Fetal weight was estimated according to 26 formulas. Results: Mean gestational age at the time of the exam was 38.6 weeks with a standard deviation (sd) of 0.8. Delivery occurred within 3.9 (sd=2.1) days. The most accurate formula for prediction of newborn weight was Hadlock, which revealed an error of 6.2% (sd=5,2%), a Pearson coefficient of 0.81, and 78% of correct estimations considering a +10% error. There were no significant differences in accuracy between the four senior Obstetricians who performed the exam, nor if the subjects were divided according to gestational age. Cephalic presentations rendered more accurate estimations than breech [6.0 (sd=5.2) vs 7.8 (sd=5.1), p = 0.03]. Fetuses with low birth were less accurately estimated than those who were macrossomic [13.3 (sd=5.5) vs 6.9 (sd=5.6), p = 0.03]. Higginbottom and Warsof formulas had the highest accuracy for identification of low birthweight and macrossomic fetuses, respectively. Conclusions: Ultrasonographic fetal weight estimation at term is a relatively accurate procedure, and the Hadlock formula provides the most precise results in fetuses with normal weigh. Breech presentation, low-birth weight and macrossomic fetuses pose specific challenges to this methodology

Yeasts as a model for assessing the toxicity of the fungicides Penconazol, Cymoxanil and Dichlofluanid

In the present work the sensitivity of yeast strains of Kluyveromyces marxianus, Pichia anomala, Candida utilis, Schizosaccharomyces pombe and Saccharomyces cerevisiae, to the fungicides cymoxanil, penconazol, and dichlofluanid, was evaluated. Dichlofluanid induced the most negative effects, whereas penconazol in general was not very toxic. Overall, our results show that the parameters IC50 for specific respiration rates of C. utilis and S. cerevisiae and CD for cell viability of S. cerevisiae can be applied to quantify the toxicity level of the above compounds in yeast. Hence, could be explored as an alternative or at least as a complementary test in toxicity studies and, therefore, its potential for inclusion in a tier testing toxicity test battery merits further research.http://www.sciencedirect.com/science/article/B6V74-40PXN3P-K/1/4f1eeec82c0a8b9702653d95b1ed431

Trombose do sistema venoso porta após o parto numa doente com síndrome de anticorpos antifosfolípidos

Introdução: A síndrome de anticorpos antifosfolípidos (SAAF) é uma trombofilia autoimune de etiologia mal definida e que condiciona tromboses vasculares e complicações gestacionais. Caso clínico: Uma mulher de 27 anos de idade com diagnóstico de SAAF previamente estabelecido recorreu ao Serviço de Urgência por dor no hipocôndrio direito cinco dias após parto eutócico de termo. As análises demonstraram elevação das transaminases e trombocitopénia. A TC abdominal evidenciou alterações do parênquima hepático sugestivas de enfarte por isquémia venosa. O eco-doppler abdominal documentou trombose do ramo esquerdo da veia porta com inversão do fluxo e arterialização da vascularização do lobo esquerdo do fígado. Foi instituída terapêutica com heparina de baixo peso molecular (HBPM) e corticóides e observou-se progressiva melhoria clínica, analítica e imagiológica. Discussão: A trombose aguda da veia porta ou dos seus ramos é extremamente rara na ausência de factores de risco loco-regionais e a principal complicação é a necrose intestinal

Inter-arm blood pressure difference: a study in pregnant women

Aim: To ascertain the prevalence of inter-arm blood pressure difference in excess of 10 mmHg in pregnant women. Population: A total of 114 pregnant women selected at random from those admitted to our Maternal and Fetal Medicine Unit. Design: Prospective, descriptive study. Methods: Blood pressure was measured on both arms twice (same operator, method and equipment). Other variants analysed were maternal age, admission diagnosis, gestational age, weight, parity, heart rate, ethnicity, handedness and pulse pressure. Results: Mean age was 26.9 years with a standard deviation (sd) of 6.2; Most women were admitted for labour induction (37%) or because of hypertensive disorders of pregnancy (18%). Mean gestational age was 34.1 weeks (sd=6.9) . Right arm blood pressure was on average 121.4 (sd=20.4) over 74.6 (sd=13.8) mmHg. Mean left arm blood pressure was 121.2 (sd=20.1) over 74.7 (sd=13.4). Mean interarm blood pressure differences were 5.2 (sd=4.5) mmHg during systole and 3.3 (sd=3.3) during diastole. Results were not significantly different in hypertensive women. Differences exceeding 10 mmHg were found in 14.0% of women Correlations between inter-arm blood pressure differences exceeding 10 mmHg and age, gestational age, weight, and parity were weak. Conclusions: It is not possible to recommend one arm in which to measure blood pressure. A possible strategy is to evaluate both arms at the first clinical appointment, and to follow-up with the arm showing the highest BP

A new formaldehyde optical sensor: detecting milk adulteration

A sensor consisting of an optical fibre with the exposed tip coated with the polyoxometalate salt [(C4H9)4N]4H[PMo10V2O40], specially designed to be insoluble in water, which UV-Vis spectrum changed in contact with formaldehyde, is presented. The sensor limit of detection for formaldehyde was 0.2 mg L-1, and the limit of quantification was 0.6 mg L-1, which were close to the conventional spectrophotometric method values of 0.2 mg L-1 and 0.5 mg L-1, respectively, and lower than the tolerable limit for ingested food. The sensor was tested for formaldehyde quantification in milk, as its deliberate addition is a matter of concern. The results obtained analysing formaldehyde in milk samples by the optical sensor and by the conventional method were not statistically different (α = 0.05).publishe

Multidisciplinary effort to avoid an outbreak of mumps in a maternity hospital

Mumps is a disease caused by paramyxovirus, whose notification to health authorities is mandatory. Vaccination in Portugal was started in 1987. There have been several outbreaks worldwide, even in populations with high vaccination rates, but none were reported in maternity hospitals. We report the case of a 36 year-old primigravida, admitted in the 37th week of pregnancy, because of fever, painful uterine contractions and a non-reassuring cardiotocograph. A caesarean section was performed 28 hours after admission due to non-reassuring fetal status, and a newborn with normal Apgar score was delivered. The following day she developed headache, tender bilateral parotid swelling, effacement of the mandibular angle, and tender cervical limphadenopathies. The patient was isolated, and blood samples were collected for paramyxovirus’ serology. All her contacts (healthcare providers and puerperas) were clinically evaluated and non-immunized subjects were vaccinated. Relatives were contacted and counselled. Primary healthcare facilities were asked to facilitate access to the vaccination unit. The Neonatology Department was alerted and the newborn’s blood was sampled for serologic testing. Public authorities were notified through an appropriate declaration form. The patient progressively recovered. Disease was serologically confirmed in the newborn but was asymptomatic. Healthcare providers, contacted puerperas and their newborns were followed up for 4 weeks but none developed symptom

Doença inflamatória pélvica: um desfecho inesperado

Pelvic inflammatory disease is a polymicrobial infection of the upper genital tract, representing the most common complication of sexually transmitted diseases. Multiple agents are frequently involved, although some unusual agents have also been reported. The presentation is frequently sub-clinical, but may assume an acute form. We report a clinical case of a 39-year-old woman with recurrent pelvic inflammatory disease, resistant to systemic antibiotics, submitted to an exploratory surgery, with a histologic finding of tubal cysticercosis

Perceções parentais acerca dos conflitos e benefícios associados com a gestão da família e do trabalho

O presente estudo teve como objetivo analisar a existência do possível conflito entre a gestão da vida profissional e familiar, analisando variáveis sociodemográficas características das famílias em estudo. Participaram 532 famílias bi-parentais, em que ambos os pais trabalham, com crianças com idades compreendidas entre os 2 e os 5 anos de idade oriundas de vários distritos de Portugal continental. Os resultados indicam que, na perspetiva de ambos os pais, os benefícios associados aos dois contextos parecem sobrepor-se aos constrangimentos. Os resultados indicam que níveis mais elevados das habilitações literárias de ambos os pais estão associados à perceção materna de maiores benefícios na relação entre o trabalho e a família. Quanto mais horas as mães trabalham, mais constrangimentos e sentimentos de interferência do trabalho na família percecionam. Verificou-se, ainda, diferenças em função do género para os pais nas dimensões de recompensa. Os resultados serão discutidos no contexto das teorias expansionistas