How do maternal factors impact preeclampsia prediction in Brazilian population?

Objective: To evaluate the impacts of maternal risk factors described by the Fetal Medicine Foundation's 2012 algorithm (FMF2012) in a Brazilian population. Methods: All singleton pregnancies submitted to first-trimester preeclampsia (PE) screening using the FMF2012 algorithm were considered for study inclusion. Maternal factors, recorded via a patient questionnaire, were described and compared between PE outcome groups. A Gaussian regression model was derived to measure the effects of maternal factors, and to identify factors that contributed significantly (p < .05) to the alteration of gestational age at delivery, in pregnancies with PE. Results: Of the 1934 cases considered for study inclusion, the final sample consisted of 1531 cases. The sample included 120 (7.8%) cases of PE, of which 26 (1.7%) were preterm PE (PE < 37 weeks) and 11 (0.72%) were early PE (PE < 34 weeks). The PE rate did not differ according to ethnicity, smoking, family history of PE, or use of assisted reproductive technology. Significant differences (p < .05) between the normal and PE groups in maternal age, maternal weight, previous history of PE, chronic hypertension, and types 1 and 2 diabetes were detected. Conclusions: The significance and magnitude of associations of maternal factors in our sample differed from those incorporated in the FMF2012 model, implying the need to derive a fitted model for our population.

Avaliaçäo da vitabilidade fetal pela cardiotocografia basal: estudo comparativo entre índices cardiotocográficos / Fetal vitability avaliation by cardiotocography: comparative study between cardiotocographic indices

Foram analisados 302 exames cardiotocográficos pertencentes a um igual número de gestantes de alto risco acompanhadas no Hospital-Maternidade Praça XV. Os referidos exames, que necessariamente deveriam ter um mínimo de 30 minutos de duraçiao e com um intervalo máximo de sete dias para o parto, doram analisados com a utilizaçäo dos índices cardiotocográficos propostos por Kubli e Rüttgers (1972), Fisher et al. (1976), Käär (1980), Krebs e Petres (1978), Behle e Zugaib (1981) e Montenegro et al. (1982). Os resultados dos exames avaliados pelos índices investigados forma comparados as condiçöes de higidez do neonato avaliadas pelo índice de apgar. Verificou-se que todos os índices estudados se prestam ao prognóstico da súde fetal (p < 0,05). Ao se estudar diferença do poder de prediçäo entre os referidos índices, observou-se, através da análise da sensibilidade e posteriormente da especificidade, eficiência, valor preditivo dos resultados normais e anormais e taxa de falsos-positivos e falsos-negativos, que, para avaliaçiao da higidez fetal, os smelhores säo os de Krebs e Petres (1978) e Käär (1980)