[Maternal mortality in maternidade do Hospital Geral de Goiania (1975-1983)]. / Mortalidade materna na maternidade do Hospital Geral de Goiania (1975-1983).

PIP: A retrospective study was made of maternal deaths at the General Hospital of Goiania/INAMPS during the years 1974-1983. The objective was to analyse the general and annual incidence of maternal mortality, as well as the incidence by age group, parity, gestational age, type of delivery, etiology, general state of the patient at admission, and avoidability of death (i.e., analysis of responsibility). The study revealed a maternal mortality rate of 31.12 per 100,000 live births. This rate has been decreasing over the years, but in an irregular manner. The rate compares with maternal mortality rates in other developing countries and is much too high. By classifying causes of death as obstetric-related, indirect obstetric-related, and nonobstetric, it was discovered that 76.45% of deaths were from obstetric-related causes. Of these, infection, principally due to illegal abortion, was the primary cause of death in the obstetric clinic, followed by eclampsia and hemorrhage. This fact makes one consider the absence of family planning services in many areas of Brazil, and that nothing is being done to change the situation. More deaths occur in the 1st trimester of pregnancy (26.47%) than at any other period; again, this figure indicates the high number of deaths due to illegal induced abortions. As for age specific mortality, attention is called to the high incidence of mortality among adolescents (17.65%), who are paying too high a price for the lack of sex edcuation, family planning, and psychosocial assistance to adolescents. In relation to mortality by type of procedure the date are: vaginal delivery, 29.41%; cesarean, 26.4%, curettage, 29.41%; and other (hysterectomy and clinical treatment), 14.7%. As to avoidability of death, 61.77% of patients were seriously ill at the time of admission to the hospital. This is largely due to lack of medical care as well as the social, economic, and clutural conditions that impede adequate prenatal care and family planning services. Therefore, considering the state of health of patients on admission, 73.74% of deaths were classified as unavoidable. The authors conclude that the maternal mortality rate will continue to be high until profound changes are made in the provision of health services in Brazil.^ieng

Neoplasia trofoblastica gestacional: I. Imagem ultra-sonografica na neoplasia trofoblastica maligna. / Gestational trophoblastic neoplasm. I.Ultrasonographic image in malignant trophoblastic neoplasm

O exame ultra-sonografico no diagnostico da mola hidatiforme esta bem estabelecido, entretanto, e incipiente o estudo na neoplasia trofoblastica maligna. Dez pacientes foram avaliadas pela ultra-sonografia e encontramos imagem caracteristica que foi correlacionada com a arteriografia, mostrando ser um exame fiel, seguro e facilmente repetido, tanto no diagnostico como na avaliacao da resposta a quimioterapia durante e apos o tratamento

Estudo clinico-anatomopatologico de 260 placentas examinadas pelo servico de anatomia patologica da Maternidade Nossa Senhora de Lourdes no periodo de janeiro/78 a janeiro/79. / Clinical-histopathologic study of 260 placentae examined by the Pathologic Anatomy Service of Maternidade Nossa Senhora de Lourdes from January 1978 to January 1979.

Fez-se um levantamento de 260 placentas examinadas pelo Servico de Anatomia Patologica da Maternidade Nossa Senhora de Lourdes, Goiania, no periodo de janeiro de 1978 a janeiro de 1979. Procurou-se relacionar os achados histopatologicos aos aspectos clinicos e obstetricos das pacientes, bem como com os motivos que levaram o tocologo a solicitar o exame anatomopatologico de placenta. Observou-se que 55,76% das placentas apresentaram alteracoes divididas em oito categorias: infeccoes inespecificas, sofrimento vascular, incompatibilidade sanguinea materno-fetal, placenta imatura, tumores benignos, patologias do cordao umbilical e sofrimento fetal cronico, constatando-se a existencia de relacao entre os varios tipos de alteracoes e os quadros clinico e obstetrico das pacientes, confirmando, uma vez mais, a importancia do exame anatomopatologico de placenta na investigacao e conclusao diagnostica em obstetricia.}