[Utilization of different iron concentrations on pregnant adolescents also supplemented with zinc and folate]. / Utilização de diferentes concentrações de ferro por adolescentes grávidas também suplementadas com zinco e ácido fólico.

The pregnant teenager is considered at nutritional risk specially due to the fact that most of them still growing and developing. Therefore the demands of pregnancy compete with those of growth causing an extra need for her and the fetus (1). Iron, zinc and folate are essential nutrients that are frequently low on the teenagers diet. Besides that there is not much specific information available about these nutrient recommendations and their interaction among each other. The data available is limited and demands more investigation. This study was conducted at a Public Maternity Hospital located at Teresina, Piauf, Brazil. The main objective of this study was to investigate the effect of different concentrations of iron supplementation (80 and 120 mg of ferrous sulfate) together with folate (250 micrograms) and zinc (5 mg) on the hemoglobin concentration and iron stores (plasma ferritin) of pregnant adolescents. The supplementation was done from the 16th to 20th weeks of gestation until delivery. The data founded proved that either 80 mg or 120 mg of iron supplements had similar effect on the improvement of hemoglobin concentration although results showed no statistical significance.

Indicadores de risco gravidico no Piaui. / Indicators of pregnancy risk in Piaui

O presente trabalho traduz estudo prospectivo sobre indicadores de risco gravidico no Piaui. Para tanto, foi elaborada ficha contendo indicadores socio-economicos e medico-cirurgicos, aos quais foram dados valores arbitrarios de 0 a 8. Considerou-se alto risco quando a soma de pontos foi maior ou igual 8, medio risco de 4 a 7 e baixo risco menor 4. Os dados foram obtidos na primeira consulta de gestantes assistidas nos servicos pre-natal da Maternidade Dona Evangelina Rosa (capital do Estado), do bairro Dirceu Arcoverde (periferico da capital) e zona rural da cidade de Barras, que dista 120Km da capital. Esses grupos populacionais apresentaram em comum o fato de pertencerem a classes sociais com limitados recursos financeiros e, por isso, dependentes, quase exclusivamente, da assistencia medica gratuita oferecida pelo Estado. Os resultados demonstraram que os problemas socio-economicos repercutem na aceitacao da gravidez e interferem negativamente na assistencia prenatal. Dentre os problemas medicos destacam-se a sifilis, os estados de hipertensao arterial, as lesoes pre-malignas e malignas do colo uterino e as infeccoes urinarias. Dos tres grupos em estudo, o que apresentou indice mais elevado de gravidez de alto risco foi o da zona rural de Barras, seguido daquele assistido no pre-natal da Maternidade Dona Evangelina Rosa

O uso do estimulo sonoro repetitivo sobre o feto como prova de avaliacao do bem-estar fetal. / The use of a repeated sound stimulation of the fetus as test for evaluation of fetal well-being

O efeito do som sobre o feto humano foi estudado em 20 gestantes normais entre a 34o. e 40o. semana de gravidez. A aplicacao de um estimulo sonoro sobre o abdome adjacente ao polo cefalico fetal, com intensidade de 120 db, frequencia de 850 cps, duracao de 5 s, repetido a cada 3-4 minutos durante 30 minutos aumentou significativamente o numero de movimentos fetais (mf) e das aceleracoes dos batimentos cardiacos fetais (bcf) quando comparado a um teste nao-estressante executado na mesma gestante por identico periodo de tempo. Os resultados mostram sensivel reducao dos testes nao-reativos. Finalmente, os autores propoem um criterio de tres ou mais aceleracoes dos bcf como reacao normal ao estimulo sonoro repetitivo e definem um protocolo que utiliza o teste sonoro como prova primaria na propedeutica da gestacao de risco

Estimulo sonoro total repetitivo: diminuicao dos resultados falso-positivos das provas nao estressantes. / Repeated sounding stimulation of the fetus: decrease in the false positive results of non-stress tests

O emprego de um estimulo sonoro fetal, repetitivo, com intensidade de 120 db, frequencia de 2000 cps e duracao de 5 seg. diminui em 60% a incidencia de resultados falso-positivos das provas nao estressantes num grupo de 20 gestantes consideradas como clinicamente normais. Os movimentos fetais referidos pelas gestantes foram significativamente de maior frequencia na etapa sonora quando comparados com a fase nao estressante (Wilcoxon 5%). O estimulo sonoro fetal firma-se como prova estressante obrigatoria na avaliacao intrauterina do concepto

Angiotensin-converting enzyme: serum levels during normal pregnancy.

ACE activity of the serum of 52 normal pregnant women was measured in vitro under conditions of substrate saturation with Hip-His-Leu as substrate. The product His-Leu was measured by fluorimetry after reaction with o-phthaldehyde. ACE activity (nmol/min/ml serum) was 30.6 +/- 7.8, 28.8 +/- 7.4, and 30.9 +/- 8.2 for the first, second, and third trimester of pregnancy, respectively. No statistically significant differences (p greater than 0.05) in ACE activity were detected among the three trimesters of normal pregnancy with either serum volume or serum protein as reference value. These values are within the range reported by Friedland and Silverstein13 for 51 male and seven female healthy blood bank donors. We conclude that the evolution of normal pregnancy does not significantly modify the levels of ACE in peripheral blood serum.

[Maternal mortality in the Hospital das Clinicas, Faculdade de Medicina de Ribeirao Preto (USP) from 1957 to 1977. Pt. 1: Incidence (Author's transl)]. / Mortalidade materna no Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto (USP) no periodo 1957-1977. Pt.1: Incidencia.

PIP: A study was carried out from 1957-1977 which investigated the incidence of maternal mortality in the Hospital das Clinicas, Faculdade de Medicina de Ribeirao Preto. The yearly distribution of these deaths related to the resolution of pregnancy always showed predominance of the abortion group over the others (pregnant patients, normal delivery, and surgical delivery), with increased evidence starting at the beginning of the 1970's. When the deaths were distributed by relating pregnancy resolution to marital status, absolute predominance of married over single patients was observed, including the abortion group. When the site of the 21st obstetrical aid was considered, it was observed that in 17 of 68 cases studied, the patients were directed to another hospital or delivered at home assisted by a midwife. The mortality rate for the entire period studied was 22.04%. When the cases receiving 1st obstetrical aid outside the Hospital das Clinicas are subtracted, the rate drops to 16.53% and to 8.1% when the abortion group is also excluded. On the basis of these data, it was concluded that abortion is the greatest medical-social problem detected in this study.^ieng