Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Mais filtros











Base de dados
Intervalo de ano de publicação
1.
Reprod Biomed Online ; 46(2): 379-389, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36503681

RESUMO

RESEARCH QUESTION: Does multiple gestation alter the risks for adverse obstetric outcomes in women with polycystic ovary syndrome (PCOS)? DESIGN: Retrospective population-based cohort study using data from the HCUP-NIS from 2004 to 2014. A total of 14,882 women with PCOS, who delivered within that time period, were identified. The study group comprised women with PCOS who had had a multiple gestation (n = 880); the reference group was comprised of the remaining women with PCOS and singleton gestation (n = 14,002). RESULTS: In women with PCOS, multiple gestation increased the risks of pregnancy complications including pregnancy-induced hypertension (adjusted odds ratio [aOR] 2.030; 95% confidence interval [CI] 1.676-2.460), pre-eclampsia (aOR 2.879; 95% CI 2.277-3.639), pre-eclampsia and eclampsia superimposed on pre-existing hypertension (aOR 1.917; 95% CI 1.266-2.903) and gestational diabetes (aOR 1.358; 95% CI 1.114-1.656). Multiple gestation increases the risk of preterm premature rupture of membranes (aOR 5.807; 95% CI 4.153-8.119), preterm delivery (aOR 8.466; 95% CI 7.071-10.135), Caesarean section (aOR 5.146; 95% CI 4.184-6.329), post-partum haemorrhage (aOR 1.540; 95% CI 1.065-2.228) and the need for transfusion (aOR 3.268; 95% CI 2.010-5.314), as well as wound complications (aOR 3.089; 95% CI 1.647-5.794). Neonates born to mothers with PCOS and having multiple gestations are more likely to be small for gestational age when compared to singleton neonates born to mothers with PCOS (aOR 4.606; 95% CI 3.480-6.095). Among PCOS women with multiple gestations, obesity increased the risks of developing pregnancy-induced hypertension (P < 0.001), pre-eclampsia (P < 0.001) and wound complications (P = 0.045). CONCLUSION: These results highlight the importance of single embryo transfer and ovulation induction to develop a single follicle in women with PCOS. Obesity further increases obstetrical complications.


Assuntos
Hipertensão Induzida pela Gravidez , Síndrome do Ovário Policístico , Pré-Eclâmpsia , Nascimento Prematuro , Recém-Nascido , Gravidez , Feminino , Humanos , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/etiologia , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/etiologia , Estudos Retrospectivos , Estudos de Coortes , Cesárea/efeitos adversos , Gravidez Múltipla , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Obesidade/complicações , Resultado da Gravidez
2.
Reprod Biomed Online ; 45(1): 159-167, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35577722

RESUMO

RESEARCH QUESTION: How does the presence of obesity modify the risks for adverse obstetric outcomes in women with polycystic ovary syndrome (PCOS)? DESIGN: Retrospective population-based cohort study using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2004-2014. A total of 14,855 women with PCOS were identified (study group: obese women with PCOS [BMI ≥30 kg/m2] [n = 3286]; reference group: remaining women with PCOS [n =11 569]). Logistic regression analysis was used to explore the associations between obesity, pregnancy, delivery and neonatal outcomes. RESULTS: Obesity was associated with a higher prevalence of chronic hypertension (P < 0.001), pregestational diabetes (P < 0.001) and a previous caesarean delivery (P < 0.001). Obesity increased the risk of gestational diabetes (adjusted [a]OR 1.745; 95% CI 1.473 to 2.067), pregnancy-induced hypertension (aOR1.889; 95% CI 1.589 to 2.246), gestational hypertension (aOR 1.555; 95% CI 1.219 to 1.983) and preeclampsia (aOR 2.170; 95% CI 1.683 to 2.798). Maternal obesity in PCOS increased the risk of chorioamnionitis (aOR 1.548; 95% CI 1.072 to 2.235) and caesarean delivery (aOR 1.414; 95% CI 1.210 to 1.653) and decreased the likelihood of a spontaneous vaginal delivery (aOR 0.751; 95% CI 0.644 to 0.876). Infants born to obese mothers with PCOS were not more likely to be SGA (aOR 0.775; 95% CI 0.511 to 1.175) or to have congenital anomalies (aOR 0.849; 95% CI 0.483 to 1.490). CONCLUSION: In women with PCOS, obesity increases the risk of specific pregnancy and delivery complications.


Assuntos
Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Síndrome do Ovário Policístico , Estudos de Coortes , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido , Obesidade/complicações , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Gravidez , Estudos Retrospectivos
3.
Clin Otolaryngol ; 47(1): 75-80, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34510770

RESUMO

OBJECTIVES: The aim of this study was to ascertain the relationship between Bethesda category and molecular mutation of thyroid nodules in patients undergoing thyroidectomy. DESIGN: A retrospective cohort of patients who underwent thyroidectomy following needle biopsy and molecular profile testing was performed. SETTING: Two tertiary care academic hospitals. PARTICIPANTS: Consecutive patients with a dominant thyroid nodule who underwent both USFNA and molecular profile testing followed by thyroidectomy were included in the study. MAIN OUTCOME AND MEASURES: The main outcome was postoperative diagnosis of thyroid cancer and aggressivity of disease based on histopathological variants, nodal metastasis or extra-thyroidal extension. Associations between Bethesda category, molecular mutation and postoperative pathology was assessed using descriptive analysis and chi-square testing. RESULTS: Four hundred fifty-one patients were included. 95.9% (93/97) of patients with a BRAFV600E mutation had a Bethesda category V or VI (p < .001), and all had confirmed thyroid cancer on postoperative pathology. Those with H, K or N RAS or EIF1AX mutations, gene expression profiling (GEP) or copy number alterations showed an association with Bethesda categories III and IV (p ≤ .01). Those with no identified molecular mutation had a lower incidence of aggressive thyroid cancer compared to those with an identified mutation (12.6% vs. 44.3%, p < .01). CONCLUSION: BRAFV600E mutations were associated with thyroid cancer subtypes known to be more aggressive whereas RAS and EIF1AX mutations, copy number alterations, and GEP were related to Bethesda categories III and IV. These findings may help thyroid specialists better identify aggressive thyroid nodules associated with indeterminate Bethesda categories.


Assuntos
Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/patologia , Tireoidectomia/métodos , Adulto , Idoso , Biópsia por Agulha Fina , Feminino , Perfilação da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA