RESUMO
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was signiï¬cantly higher in the MM group by 1.675 g/dL (p < 0.05) and initial hematocrit by 5.36% (p < 0.05), but no differences in the need of transfusion during the first 30 days after delivery were found (RR 0.8; 95% CI 0.22-2.85). Peak serum bilirubin was similar in both groups (11,097 ± 3.21 vs. 11,247 ± 3.56 mg/dL, p = 0.837). Phototherapy requirements were higher in the MM group (RR 1.62; 95% CI 1.1-2.38). No differences regarding the need of oral iron supplementation, platelet transfusion, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, meconium aspiration syndrome, use of surfactant, days of oxygen supplementation, need of vasopressors, length of stay in the neonatal intensive care unit, or postpartum hemorrhage were found. CONCLUSION: MM does not reduce the need for red blood cell transfusions and increases phototherapy requirements in preterm infants.
Assuntos
Sangue Fetal , Recém-Nascido Prematuro , Circulação Placentária , Nascimento Prematuro/sangue , Cordão Umbilical/cirurgia , Adulto , Constrição , Transfusão de Eritrócitos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Fototerapia , Gravidez , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/fisiopatologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Cordão Umbilical/fisiopatologiaAssuntos
Gravidez de Gêmeos/genética , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética , Cesárea , Quimera/genética , Transferência Embrionária , Feminino , Fertilização in vitro , Aconselhamento Genético , Testes Genéticos/métodos , Idade Gestacional , Humanos , Cariotipagem , Masculino , Pessoa de Meia-Idade , Doação de Oócitos , Placenta/patologia , Gravidez , Análise para Determinação do Sexo/métodos , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
Cystic endosalpingiosis refers to the existence of heterotopic cystic müllerian tissue resembling structures of the fallopian tubes. We report a case of florid cystic endosalpingiosis discovered in a pregnant woman during a scheduled cesarean section and review the current knowledge of this disease. A 30-year-old woman with a twin pregnancy attended the hospital day unit at term. The first twin was in a breech presentation and a cesarean section was scheduled. During the procedure the uterine fundus and part of the body were seen completely seeded with multitude of cyst-like structures resembling hydatids of Morgagni. The immunohistochemistry analysis showed a positive expression for PAX8 (Box-8), CK7, and estrogen and progesterone receptors. The lesions did not disappear after pregnancy. Cystic endosalpingiosis should be always borne in mind, even in pregnancy, when it comes to making the differential diagnosis of a pelvic or systemic multicystic mass.