Pregnancy After Bariatric Surgery: a Comparative Study of Post-Bariatric Pregnant Women Versus Non-Bariatric Obese Pregnant Women.

PURPOSE: To evaluate the impact of bariatric surgery on the gestational outcomes. MATERIALS AND METHODS: Retrospective study of pregnant women hospitalized for delivery in the maternity in Curitiba, Brazil, who had a body mass index (BMI) greater than or equal to 30 kg/m2 and/or who had undergone bariatric surgery. Interviews were performed, and the patients' medical records and antenatal information cards were evaluated. RESULTS: Ninety-three pregnant women who had bariatric surgery and 205 obese pregnant women were selected. A lower occurrence of hypertensive diseases was observed in pregnant women who had undergone bariatric surgery (14%) compared with obese pregnant women (56.6%). Moreover, a reduced occurrence of diabetes was found in post-bariatric pregnant women (16.1%) compared with obese pregnant women (30.2%). There were no differences in the frequency of prematurity, in delivery methods, or in postpartum complications. There was a higher number of cases of babies who were small for gestational age and a lower number of babies who were large for gestational age in the post-bariatric group. When comparing obese pregnant women to post-bariatric pregnant women who had remained obese, a reduced frequency of hypertensive diseases and diabetes was found in the latter group, but the weight difference between their newborns was not statistically significant. CONCLUSION: There was a lower occurrence of health-related issues complicating pregnancy among women who had undergone bariatric surgery, but these women's newborns were more likely to be small for gestational age, a finding which was less significant the less weight the mother had lost.

Perinatal outcome of hypertensive pregnant women is related to the severity of preeclampsia

Introduction: Hypertension in pregnancy plays a key role in perinatal morbidity and mortality. This study aims to analyze maternal and perinatal outcomes associated with hypertension in pregnant women. Methods: A prospective longitudinal study was conducted at the University Hospital of Santa Maria, RS, Brazil, involving hypertensive pregnant women admitted for delivery. The results were analyzed using the chi-square test and the Mann-Whitney test. Results: Of the 162 hypertensive pregnant women studied, 61.1% were diagnosed with preeclampsia. Cesarean section was the most frequent mode of delivery (79.6%). Overall, 46.2% of newborns were premature; of these, 23.4% required intensive neonatal care. Preeclampsia and severe preeclampsia were associated with prematurity in 56.2% of cases (p = 0.011) and 75.7% of cases (p = 0.004), respectively. Severe preeclampsia was associated with neonatal complications (45.9%), and no neonatal complications were associated with mild preeclampsia in 78% (p = 0.014) and gestational hypertension in 96% (p = 0.001). Neonatal deaths occurred in 11.1% of cases admitted to the neonatal intensive care unit, corresponding to a neonatal mortality rate of 24 per 1,000 live births. Conclusions: The association of severe preeclampsia with prematurity and adverse perinatal outcomes corroborates the need . (AU)

[Results of two treatment regimens for pyelonephritis during pregnancy and correlation with pregnancy outcome]. / Resultados de dois esquemas de tratamento da pielonefrite durante a gravidez e correlação com o desfecho da gestação.

PURPOSE: To determine the epidemiological profile of women admitted for urinary tract infection as well as to verify the most prevalent agents and response to antibiotic therapy. METHODS: A retrospective study of 106 pregnant women admitted to a university hospital for urinary tract infection treatment during the period between January 2007 to December 2010. The evaluation was based on analysis of the medical records of these pregnant women, with the observation of hospitalization and pregnancy data, as well as its outcome. Statistical analysis was performed using Statistical Package for the Social Science, version 15.0. The bilateral Fisher exact test and Student's t test were used for data analysis, as well as descriptive statistical methods. RESULTS: Positive urine cultures were observed in 60.5% of pregnant women admitted due to urinary tract infection. The most frequent infectious agent was Escherichia coli and no difference in resistance, recurrence or complications was observed between the most frequent etiologic agents. Pregnant women with previous UTI had a higher recurrence risk (OR=10.8; p<0.05). The antibiotics most commonly used during hospitalization were ampicillin and cefazolin. Change of therapeutic agent due to bacterial resistance occurred in 11.9% of patients who took cefazolin and in 20% of patients who took ampicillin (OR=5.5; p<0.05). The rate of gestational complications was the same for both treatments. There was no difference in mean number of days of hospitalization between the treatments. CONCLUSION: In the studied population ampicillin showed a higher rate of bacterial resistance than cefazolin, requiring a larger number of treatment regimen exchanges, without resulting in differences in clinical outcome or time of hospitalization.

Resultados de dois esquemas de tratamento da pielonefrite durante a gravidez e correlação com o desfecho da gestação / Results of two treatment regimens for pyelonephritis during pregnancy and correlation with pregnancy outcome

OBJETIVO: Determinar o perfil epidemiológico das gestantes internadas por infecção do trato urinário, bem como verificar os agentes mais prevalentes e a resposta à antibioticoterapia. MÉTODOS: Estudo retrospectivo, que incluiu 106 gestantes internadas para tratamento de infecção do trato urinário no período entre janeiro de 2007 a dezembro de 2010. A avaliação constituiu-se de análise de prontuários dessas gestantes, observando-se informações sobre a internação e a gestação, bem como seu desfecho. Foi realizada a análise estatística por meio do programa Statistical Package for the Social Science, versão 15.0. Foram utilizados, para análise dos dados, o teste bilateral exato de Fisher e o teste t de Student, bem como métodos de estatística descritiva. RESULTADOS: Uroculturas positivas foram encontradas em 60,5% das gestantes internadas por infecção do trato urinário. O agente infeccioso mais frequente foi Escherichia coli e não houve diferença quanto à resistência, à recorrência ou a complicações entre os agentes etiológicos mais frequentes. Gestantes com infecção do trato urinário prévia tiveram maior risco de recorrência (OR=10,8; p<0,05). Os antibióticos mais frequentemente utilizados na internação foram ampicilina e cefazolina. Troca de esquema terapêutico por resistência bacteriana ocorreu em 11,9% das pacientes que usaram cefazolina e em 20% das que usaram ampicilina (OR=5,5; p<0,05). O índice de complicações gestacionais foi igual nos dois tratamentos. Não houve diferença entre as médias do número de dias de internação para os dois tratamentos. CONCLUSÃO: A ampicilina esteve associada a maior índice de resistência bacteriana que a cefazolina, necessitando de maior número de trocas do esquema terapêutico, sem resultar em diferença nos desfechos clínicos e tempo de internação.

PURPOSE: To determine the epidemiological profile of women admitted for urinary tract infection as well as to verify the most prevalent agents and response to antibiotic therapy. METHODS: A retrospective study of 106 pregnant women admitted to a university hospital for urinary tract infection treatment during the period between January 2007 to December 2010. The evaluation was based on analysis of the medical records of these pregnant women, with the observation of hospitalization and pregnancy data, as well as its outcome. Statistical analysis was performed using Statistical Package for the Social Science, version 15.0. The bilateral Fisher exact test and Student's t test were used for data analysis, as well as descriptive statistical methods. RESULTS: Positive urine cultures were observed in 60.5% of pregnant women admitted due to urinary tract infection. The most frequent infectious agent was Escherichia coli and no difference in resistance, recurrence or complications was observed between the most frequent etiologic agents. Pregnant women with previous UTI had a higher recurrence risk (OR=10.8; p<0.05). The antibiotics most commonly used during hospitalization were ampicillin and cefazolin. Change of therapeutic agent due to bacterial resistance occurred in 11.9% of patients who took cefazolin and in 20% of patients who took ampicillin (OR=5.5; p<0.05). The rate of gestational complications was the same for both treatments. There was no difference in mean number of days of hospitalization between the treatments. CONCLUSION: In the studied population ampicillin showed a higher rate of bacterial resistance than cefazolin, requiring a larger number of treatment regimen exchanges, without resulting in differences in clinical outcome or time of hospitalization.