CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais
Autor(a) principal: | |
---|---|
Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/5858 |
Resumo: | Introduction: fetal growth restriction, also called intrauterine growth restriction (IUGR) is a major complication of pregnancy. It is associated with high rates of perinatal morbidity and mortality and childhood, requiring high financial investments to enable adequate care for these newborns. Justification: need for a clinical and sonographic marker, through which one can predict the risk of a fetus likely to have impaired growth, enabling early, and better perinatal care intervention. Purpose: Check the relationship between the measure the placental volume obtained by antenatal ultrasonography, and immediately after birth by macroscopic in fetuses of pregnant women with suspected IUGR and low-risk pregnant women, and perinatal outcomes. Methods: Cross-sectional, prospective, observational study involving 30 low-risk pregnant women and 19 pregnant women of fetuses with suspected IUGR (weigth and/or waist circumference below the 10th percentile for gestational age), treated at Hospital Universitário de Santa Maria (HUSM). The antepartum placental volume, in cm3, was measured by the method described by Azpurua et al, which uses the measurements of length, height and thickness placenta; through the application provided by the same author, it was determined that percentile is the volume found for the given gestational age. The postpartum volume was measured by Archimedes Principle. Perinatal data were obtained from birth records and medical records of newborns. The measures of the variables were analyzed in the form of mean and standard deviation (parametric data), median and quartiles (nonparametric data). Statistical tests: t-Student, Mann-Whitney test, Pearson correlation; It was satisfactory a significance level of 5%, and the data stored and analyzed using the SPSS version 21.0. Results: There was a highly significant difference between the ultrasound and macroscopic placental volume in both groups (p<0,001); was a correlation between placental volume and Apgar in the first minute in the IUGR group (p<0,02); there was a highly significant association between admission to the neonatal intensive care unit, being higher in IUGR group (p<0,01); 94,7% of patients in the group IUGR had placentas with volume below the p10, used in the application. Conclusions: the volume of the placenta after delivery was lower than calculated before birth, in both groups, which is expected, due to the loss of blood through the placenta after placental delivery Adverse perinatal outcomes were present when the placental volume is small but that could be justified by prematurity. Thus, the findings of this study are suggestive of the placental volume in fetuses with IUGR is decreased and associated with few adverse perinatal outcomes. Studies with larger samples may confirm these assumptions. |
id |
UFSM_bc045a3a1628830d8481a5c613230cee |
---|---|
oai_identifier_str |
oai:repositorio.ufsm.br:1/5858 |
network_acronym_str |
UFSM |
network_name_str |
Manancial - Repositório Digital da UFSM |
repository_id_str |
|
spelling |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinataisIUGR: correlation between measurements of placental volume at antenatal ultrasound and macroscopic avaluation after birth, and perinatal outcomesUltrassonografia pré-natalPlacentaRetardo do crescimento fetalUltrasoundFetal growth retardationCNPQ::CIENCIAS DA SAUDEIntroduction: fetal growth restriction, also called intrauterine growth restriction (IUGR) is a major complication of pregnancy. It is associated with high rates of perinatal morbidity and mortality and childhood, requiring high financial investments to enable adequate care for these newborns. Justification: need for a clinical and sonographic marker, through which one can predict the risk of a fetus likely to have impaired growth, enabling early, and better perinatal care intervention. Purpose: Check the relationship between the measure the placental volume obtained by antenatal ultrasonography, and immediately after birth by macroscopic in fetuses of pregnant women with suspected IUGR and low-risk pregnant women, and perinatal outcomes. Methods: Cross-sectional, prospective, observational study involving 30 low-risk pregnant women and 19 pregnant women of fetuses with suspected IUGR (weigth and/or waist circumference below the 10th percentile for gestational age), treated at Hospital Universitário de Santa Maria (HUSM). The antepartum placental volume, in cm3, was measured by the method described by Azpurua et al, which uses the measurements of length, height and thickness placenta; through the application provided by the same author, it was determined that percentile is the volume found for the given gestational age. The postpartum volume was measured by Archimedes Principle. Perinatal data were obtained from birth records and medical records of newborns. The measures of the variables were analyzed in the form of mean and standard deviation (parametric data), median and quartiles (nonparametric data). Statistical tests: t-Student, Mann-Whitney test, Pearson correlation; It was satisfactory a significance level of 5%, and the data stored and analyzed using the SPSS version 21.0. Results: There was a highly significant difference between the ultrasound and macroscopic placental volume in both groups (p<0,001); was a correlation between placental volume and Apgar in the first minute in the IUGR group (p<0,02); there was a highly significant association between admission to the neonatal intensive care unit, being higher in IUGR group (p<0,01); 94,7% of patients in the group IUGR had placentas with volume below the p10, used in the application. Conclusions: the volume of the placenta after delivery was lower than calculated before birth, in both groups, which is expected, due to the loss of blood through the placenta after placental delivery Adverse perinatal outcomes were present when the placental volume is small but that could be justified by prematurity. Thus, the findings of this study are suggestive of the placental volume in fetuses with IUGR is decreased and associated with few adverse perinatal outcomes. Studies with larger samples may confirm these assumptions.Introdução: A restrição do crescimento fetal, também denominada crescimento intrauterino restrito (CIUR), é uma das principais complicações da gravidez. Está associada a elevados índices de morbimortalidade perinatal e na infância, requerendo investimentos financeiros elevados para possibilitar assistência adequada a esses recém-nascidos. Justificativa: Necessidade de pesquisa de marcador clínico-ecográfico, através do qual se possa predizer o risco de um feto vir a ter restrição do crescimento ou desfecho gestacional desfavorável, possibilitando intervenção precoce, e melhor assistência perinatal. Objetivos: Verificar relação entre a medida do volume placentário obtida pela ultrassonografia antenatal, e imediatamente após o nascimento pela macroscopia, em gestantes de fetos com suspeita de CIUR e gestantes de baixo risco, e os achados perinatais. Materiais e métodos: estudo transversal, prospectivo e observacional, realizado com 30 gestantes de baixo risco e 19 gestantes de fetos com suspeita de CIUR (peso fetal estimado e/ou circunferência abdominal abaixo do percentil 10 para a idade gestacional), atendidas no Hospital Universitário de Santa Maria (HUSM). O volume placentário anteparto, em cm3, foi mensurado pelo método descrito por Azpurua et al, que utiliza as medidas do comprimento, altura e espessura placentários; através do aplicativo disponibilizado pelo mesmo autor, determinou-se o percentil em que se encontrava o volume, para a determinada idade gestacional. O volume pós-parto foi medido pelo Princípio de Arquimedes. Dados perinatais foram obtidos dos registros de nascimento e prontuários dos recém-nascidos. As medidas das variáveis estudadas foram analisadas sob a forma de média e desvio padrão (dados paramétricos), mediana e quartis (dados não paramétricos). Testes estatísticos: t-Student, Mann-Whitney, correlação de Pearson; foi considerado satisfatório um nível de significância de 5%, e os dados armazenados e analisados no pacote estatístico SPSS versão 21.0. Resultados: houve diferença altamente significante entre o volume placentário ecográfico e macroscópico, em ambos os grupos (p<0,001); foi verificada correlação entre o volume placentário e o APGAR no primeiro minuto no grupo CIUR (p<0,02); existiu associação altamente significante entre internação na UTI-Neonatal, sendo maior no grupo CIUR (p<0,01); 94,7% das pacientes do grupo CIUR tinham placentas com volume abaixo do p10, no aplicativo utilizado. Conclusões: o volume da placenta no pós-parto foi menor que o calculado antes do nascimento, em ambos os grupos, o que é esperado, em razão da perda de sangue pela placenta após dequitação. Desfechos perinatais desfavoráveis estiveram presentes quando o volume placentário é pequeno, mas que poderiam ser justificados pela prematuridade. Assim, os achados do presente estudo são sugestivos de que o volume placentário em fetos com CIUR é reduzido, e associado a alguns desfechos perinatais adversos, mas estudos com amostras maiores são necessários para confirmar essas hipóteses.Universidade Federal de Santa MariaBRMedicinaUFSMPrograma de Pós-Graduação em Ciências da SaúdeMorais, Edson Nunes dehttp://lattes.cnpq.br/9416441421463638Gallarreta, Francisco Maximiliano Pancichhttp://lattes.cnpq.br/6610643089938647Haeffner, Leris Salete Bonfantihttp://lattes.cnpq.br/4056008693346464Feltrin, Marcelo Lorensi2016-06-292016-06-292016-02-17info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfapplication/pdfFELTRIN, Marcelo Lorensi. IUGR: correlation between measurements of placental volume at antenatal ultrasound and macroscopic avaluation after birth, and perinatal outcomes. 2016. 44 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2016.http://repositorio.ufsm.br/handle/1/5858porinfo:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2022-03-16T18:41:28Zoai:repositorio.ufsm.br:1/5858Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2022-03-16T18:41:28Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.none.fl_str_mv |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais IUGR: correlation between measurements of placental volume at antenatal ultrasound and macroscopic avaluation after birth, and perinatal outcomes |
title |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
spellingShingle |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais Feltrin, Marcelo Lorensi Ultrassonografia pré-natal Placenta Retardo do crescimento fetal Ultrasound Fetal growth retardation CNPQ::CIENCIAS DA SAUDE |
title_short |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
title_full |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
title_fullStr |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
title_full_unstemmed |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
title_sort |
CIUR: relação entre o volume placentário anteparto por ecografia e pós-parto por macroscopia, e achados perinatais |
author |
Feltrin, Marcelo Lorensi |
author_facet |
Feltrin, Marcelo Lorensi |
author_role |
author |
dc.contributor.none.fl_str_mv |
Morais, Edson Nunes de http://lattes.cnpq.br/9416441421463638 Gallarreta, Francisco Maximiliano Pancich http://lattes.cnpq.br/6610643089938647 Haeffner, Leris Salete Bonfanti http://lattes.cnpq.br/4056008693346464 |
dc.contributor.author.fl_str_mv |
Feltrin, Marcelo Lorensi |
dc.subject.por.fl_str_mv |
Ultrassonografia pré-natal Placenta Retardo do crescimento fetal Ultrasound Fetal growth retardation CNPQ::CIENCIAS DA SAUDE |
topic |
Ultrassonografia pré-natal Placenta Retardo do crescimento fetal Ultrasound Fetal growth retardation CNPQ::CIENCIAS DA SAUDE |
description |
Introduction: fetal growth restriction, also called intrauterine growth restriction (IUGR) is a major complication of pregnancy. It is associated with high rates of perinatal morbidity and mortality and childhood, requiring high financial investments to enable adequate care for these newborns. Justification: need for a clinical and sonographic marker, through which one can predict the risk of a fetus likely to have impaired growth, enabling early, and better perinatal care intervention. Purpose: Check the relationship between the measure the placental volume obtained by antenatal ultrasonography, and immediately after birth by macroscopic in fetuses of pregnant women with suspected IUGR and low-risk pregnant women, and perinatal outcomes. Methods: Cross-sectional, prospective, observational study involving 30 low-risk pregnant women and 19 pregnant women of fetuses with suspected IUGR (weigth and/or waist circumference below the 10th percentile for gestational age), treated at Hospital Universitário de Santa Maria (HUSM). The antepartum placental volume, in cm3, was measured by the method described by Azpurua et al, which uses the measurements of length, height and thickness placenta; through the application provided by the same author, it was determined that percentile is the volume found for the given gestational age. The postpartum volume was measured by Archimedes Principle. Perinatal data were obtained from birth records and medical records of newborns. The measures of the variables were analyzed in the form of mean and standard deviation (parametric data), median and quartiles (nonparametric data). Statistical tests: t-Student, Mann-Whitney test, Pearson correlation; It was satisfactory a significance level of 5%, and the data stored and analyzed using the SPSS version 21.0. Results: There was a highly significant difference between the ultrasound and macroscopic placental volume in both groups (p<0,001); was a correlation between placental volume and Apgar in the first minute in the IUGR group (p<0,02); there was a highly significant association between admission to the neonatal intensive care unit, being higher in IUGR group (p<0,01); 94,7% of patients in the group IUGR had placentas with volume below the p10, used in the application. Conclusions: the volume of the placenta after delivery was lower than calculated before birth, in both groups, which is expected, due to the loss of blood through the placenta after placental delivery Adverse perinatal outcomes were present when the placental volume is small but that could be justified by prematurity. Thus, the findings of this study are suggestive of the placental volume in fetuses with IUGR is decreased and associated with few adverse perinatal outcomes. Studies with larger samples may confirm these assumptions. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-06-29 2016-06-29 2016-02-17 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
FELTRIN, Marcelo Lorensi. IUGR: correlation between measurements of placental volume at antenatal ultrasound and macroscopic avaluation after birth, and perinatal outcomes. 2016. 44 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2016. http://repositorio.ufsm.br/handle/1/5858 |
identifier_str_mv |
FELTRIN, Marcelo Lorensi. IUGR: correlation between measurements of placental volume at antenatal ultrasound and macroscopic avaluation after birth, and perinatal outcomes. 2016. 44 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Santa Maria, Santa Maria, 2016. |
url |
http://repositorio.ufsm.br/handle/1/5858 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria BR Medicina UFSM Programa de Pós-Graduação em Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria BR Medicina UFSM Programa de Pós-Graduação em Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Manancial - Repositório Digital da UFSM |
collection |
Manancial - Repositório Digital da UFSM |
repository.name.fl_str_mv |
Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
_version_ |
1805922098838765568 |