RESUMO
OBJECTIVE: The purpose of the present investigation was to analyze the effets of zidovudine on the postimplantation embryo and fetus. METHODS: Pregnant Sprague-Dawley rats were given various doses (10 mg/kg, 30 mg/kg, 150 mg/kg) of zidovudine or saline by an endotracheal tube during the period of embryogenesis (days 6-8, 9-11, 6-11 postconception). The animals were sacrificed on days 18-19 of pregnancy, and their fetuses were removed by hysterotomy. Autopsies under low (15x) and high (40x) power light microscopy were performed on all fetuses. RESULTS: There was no statistically significant difference among the groups with respect to maternal weight gain. There were more pregnancy resorptions in the group receiving high-dose zidovudine (150 mg/kg/day) throughout embryogenesis than in the control group (P = 0.001, respectively). Four major structural anomalies were noted among the 689 fetuses examined, but zidovudine was not associated with an increased frequency of congenital anomalies in rats when it was administered in doses similar to, 3-, and 15-fold higher than the regimen recommended for adult humans. The drug, however, was embryocidal in the high-dose group (P = 0.002). CONCLUSIONS: These findings are consistent with previous studies of preimplantation mouse embryos that demonstrated an embryocidal effect on preimplantation conceptuses. In summary, post-implantation embryonic zidovudine exposure was associated with significantly increased pregnancy losses (resorptions and intrauterine deaths).
RESUMO
OBJECTIVE: The null hypothesis for this investigation was that there was no difference in the frequency of wound disruption between women who had their subcutaneous tissues approximated with suture and those who did not during cesarean section. METHODS: During alternating months, consecutive women delivered by cesarean section either did (N = 716) or did not (N = 693) have their subcutaneous tissues closed with suture. All data were analyzed using chi square, Student's t-test, Fisher's exact probability test, analysis of variance, or logistic regression. RESULTS: A 32% decrease in the frequency of wound disruption was observed when subcutaneous tissues were brought into apposition with suture at cesarean section (P = 0.03). CONCLUSIONS: Closure of Scarpa's and Camper's fascia with suture during cesarean section significantly decreased the frequency of wound disruption in this population.
