RESUMO
PURPOSE OF INVESTIGATION: The objective of this study was to evaluate cervix length and the presence of cervical gland area (CGA) in ultrasounds performed before and after the administration of vaginal isosorbide mononitrate (IMN) for cervical ripening. METHODS: We performed an observational, descriptive, and longitudinal study of pregnant patients indicated for labor induction and with a Modified Bishop Score (MBS) lower than six. For cervical ripening, 40 mg of vaginal IMN was administered at 0, 16, and 24 hours after the initiation of cervix preparation. RESULTS: After enrolling 11 patients, the study had to be discontinued due to adverse effects. Three patients requested that they be withdrawn. Headaches were reported by all patients. Nausea, dizziness, dyspnea, and vomiting were also reported. The average cervical lengths at 0, 16, 24 and 36 hours were 27.6, 27.7, 25.9, and 23.0 mm, respectively. CGA disappeared in one of seven patients. CONCLUSIONS: The use of IMN appears to increase the MBS, slightly reducing cervical length without altering the appearance of CGA. Considering the importance of maternal wellbeing during labor, the routine use of IMN cannot be recommended for cervical ripening in the third trimester due to the frequency and intensity of side-effects.
Assuntos
Maturidade Cervical/efeitos dos fármacos , Dinitrato de Isossorbida/análogos & derivados , Doadores de Óxido Nítrico/efeitos adversos , Administração Intravaginal , Adulto , Cardiotocografia , Colo do Útero/diagnóstico por imagem , Colo do Útero/efeitos dos fármacos , Término Precoce de Ensaios Clínicos , Feminino , Humanos , Dinitrato de Isossorbida/administração & dosagem , Dinitrato de Isossorbida/efeitos adversos , Trabalho de Parto Induzido , Doadores de Óxido Nítrico/administração & dosagem , Satisfação do Paciente , Projetos Piloto , Gravidez , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to investigate risk factors associated to fetal death in a Brazilian population. DESIGN: A case control study. SETTING: The Hospital Maternidade Leonor Mendes de Barros in São Paulo. PARTICIPANTS: 122 pregnant women with diagnosis of fetal death and gestation age of 20 or more weeks and 244 controls of pregnant women who delivered liveborns. VARIABLES STUDIED: The fetal death (dependent variable), independent variable (the social demographic factors, clinical and obstetrical history, prenatal care indicators and pathological conditions). RESULTS: The risk factors associated to fetal death were abruptio placentae, syphilis, few prenatal care visits, one or more previous stillbirths, hospitalization during pregnancy, diabetes, age above or equal to 25 years, hypertension during pregnancy, anemia and age below 20 years. CONCLUSIONS: Results of the current study might be useful to orientate a primary prevention health program, specially those concerning antenatal care.
