The prevalence and perinatal repercussions of preeclampsia after the implementation of a prophylaxis protocol with aspirin.

OBJECTIVES: To evaluate the prevalence and perinatal repercussions of preeclampsia (PE) after the implementation of a prophylaxis protocol with aspirin in singleton pregnancy at Maternity School of Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (2015-2106). METHODOLOGY: PE prevalence according to gestational age (GA) and the prevalence ratio (PR) between PE and prematurity, small for gestational age (SGA), and fetal death were calculated in patients assisted during 2015 and 2016. RESULTS: PE occurred in 373(10.75%) of 3468 investigated cases, where PE < 37 weeks was of 2.79% and PE greater than 37 weeks was of 7.95%. A total of 413 (11.9%) prematurity cases, 320 SGA (9.22%), and 50 fetal deaths (1.44%) occurred. In the PE group, 97 premature newborns (PR 0.90) and 51 SGA (PR 1.16) were born, and two fetal deaths occurred (PR 7.46). Concerning PE < 37 weeks, 27 SGA cases (PR 1.42) and two fetal deaths (PR 2.62) were observed. Regarding PE greater than 37 weeks, 24 SGA (PR 1.09) were born, and no fetal deaths were observed. Our findings were compared to previously published results. CONCLUSIONS: PE was significantly associated with SGA newborns, especially premature PE. Prescribing aspirin for PE prophylaxis based only on clinical risk factors in a real-life scenario does not appear to be effective but resulted in a PE screening and prophylaxis protocol review and update at ME/UFRJ.

Evaluation of two incubation environments--ISO class 8 versus ISO class 5--on intracytoplasmic sperm injection cycle outcome.

OBJECTIVE: To evaluate the impact of two different incubation environments-class 8 versus class 5-on embryo quality and pregnancy rate. DESIGN: Retrospective comparative study. SETTING: Private fertility and gynecology clinic. PATIENT(S): 123 consecutive intracytoplasmic sperm injection (ICSI) cycles were analyzed from January 2002 to February 2005. Cycles were divided into two groups: in group I (n = 60), the embryo culture was performed in class 8 air quality; in group II (n = 63), the embryo culture was performed in class 5 air quality. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Number of embryos available for transfer, number of good quality embryos transferred, implantation rate, and clinical pregnancy. RESULT(S): Age of women, duration of stimulation, total doses of gonadotropins, endometrial thickness on the day of human chorionic gonadotropin (hCG) administration, number of oocytes metaphase II retrieved, number of embryos available, number of good quality embryos transferred, fertilization and cleavage rates, implantation rate, and clinical pregnancy were not statistically different between the groups. CONCLUSION(S): Our study demonstrated that incubation environment class 8 is as good as incubation environment class 5 when compared in relation to the parameters analyzed. We believe that there is still room for improvement in the overall outcome of ICSI embryos.