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Eur J Obstet Gynecol Reprod Biol ; 234: 58-62, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30660038


INTRODUCTION: To evaluate the impact of the mode of delivery of twin pregnancies with the first twin in breech position for all parities combined after introduction of a policy of planned caesarean section in 38 weeks' gestation in nulliparas. MATERIAL AND METHODS: A retrospective study of the mode of delivery of twin pregnancies with the first twin in breech position was conducted from January 2007 to December 2015 after the implementation of a planned caesarean section in 38 weeks' gestation in nulliparas. Maternal and neonatal outcomes were compared according to the decision of attempted vaginal or planned caesarean delivery. RESULTS: Among the 134 women included, an attempted vaginal delivery was decided for 30.6% women (n = 41), with 95% (n = 39) who delivered vaginally and 5% (n = 2) by caesarean section during labour. Among the 69.4% women (n = 93) with a planned caesarean section, 64.5% (n = 60) and 11.8% (n = 11) delivered by caesarean before labour and during labour, respectively, and 23.7% (n = 22) delivered vaginally. The overall vaginal delivery rate was 45.5%, and the overall rate of caesarean section was 54.5% for all parities combined. In nulliparous women, the rate of caesarean section during labour was 33%. There were no significant differences in maternal mortality or morbidity between the two groups. CONCLUSION: A selective policy of attempted vaginal delivery based on parity for twin pregnancies with the first twin in breech position can lead to a reduction in the overall rate of caesarean section in this population.

Apresentação Pélvica/epidemiologia , Cesárea/estatística & dados numéricos , Gravidez de Gêmeos , Prova de Trabalho de Parto , Adulto , Apresentação Pélvica/terapia , Feminino , Humanos , Início do Trabalho de Parto , Gravidez , Estudos Retrospectivos , Adulto Jovem
Eur J Med Genet ; 62(9): 103539, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30240710


A 5,6 Mb de novo 19q12-q13.12 interstitial deletion was diagnosed prenatally by array-comparative genomic hybridization in a 26 weeks male fetus presenting with intra-uterine growth retardation, left clubfoot, atypical genitalia and dysmorphic features. Autopsic examination following termination of pregnancy identified a severe disorder of sex development (DSD) including hypospadias, micropenis, bifid scrotum and right cryptorchidism associated with signs of ectodermal dysplasia: scalp hypopigmentation, thick and frizzy hair, absence of eyelashes, poorly developed nails and a thin skin with prominent superficial veins. Other findings were abnormal lung lobation and facial dysmorphism. This new case of DSD with a 19q12q13 deletion expands the phenotypic spectrum associated with this chromosomal rearrangment and suggests that WTIP is a strong candidate gene involved in male sex differentiation.

Transtornos Cromossômicos/genética , Cromossomos Humanos Par 19/genética , Transtornos do Desenvolvimento Sexual/genética , Displasia Ectodérmica/genética , Retardo do Crescimento Fetal/genética , Deleção de Genes , Adulto , Transtornos Cromossômicos/patologia , Proteínas Correpressoras/genética , Proteínas do Citoesqueleto/genética , Transtornos do Desenvolvimento Sexual/patologia , Displasia Ectodérmica/patologia , Feminino , Retardo do Crescimento Fetal/patologia , Humanos , Masculino , Gravidez