Analise da dopplervelocimetria feto-placentaria em gestantes hipertensas e resultados perinatais segundo a idade gestacional
AUTOR(ES)
Pedro Pires Ferreira Neto
DATA DE PUBLICAÇÃO
2006
RESUMO
Objetive: To evaluate the capacity of the pulsatility Index of the umbilical artery and of the median cerebral artery and of the umbilical/cerebral ratio to predict adverse perinatla outcomes. Métodos: Dopplervelocimetric evaluation of the pulsatility Index of the umbilical artery (IPAU) and of the Median cerebral artery (IPACM) and of the umbilical/cerebral ratio (IPAU/IPACM) was carried out 289 pregnant women with hypertension at 24 through 41 weeks of gestation. Abscent or reverse diastolic flux and, IPAU above the 95 percentil, IPACM below percentil 10 and IPAU/IPACM ratio over the 95 percentil were evaluated in relation to its associasaion with adverse perinatal outcomes (5 minutes Apgar score <7, small for gestational age (PIG), hialine membrane disease (DMH), hipoxic ischemic syndrome (SHI) and perinatal death. These results were compare before and after adjustment by gestational age at birth. Results: Abnormal Doppler results were not associated with the risk of 5 minutes Apgar score <7 before adjustment by gestational age. After adjustment the risk increased, but only adnormal IPAU was significantly associated with. 5 minutes Apgar score <7. The risk of PIG was 5 to 7 times higher before adjustment and arround 3 times and significantly higher after adjustment in cases with alterations in any of the three Doppler indicators studied. The risk of SHI was increased between 2 and 5 times before adjustment, but after adjustment the risk was significantly higher when the IPAU and the IPAU/IPACM ratio were adnormal. The risk DMH appeared to be between 2 and 6 times higher before adjustment, but became insignificant for the three indicators after adjustment. The risk of perinatal death before adjustment was between 3 and 10 times higher in cases with alteration in the IPAU, IPACM and the IPAU/IPACM ratio. After adjustment, only adnormal IPAU was associated with a three folds increase risk, that was statistiocally significant. Conclusion: In this selected group of preganat women with hypertension the isolated analysys of IPAU showed the best correlation with adverse perinatal outcomes, particularly after adjustment by gestational age
ASSUNTO(S)
efeito de doppler velocimeter hipertensão na gravidez doppler effect laser hypertension in pregnancy doppler velocimetro doppler por laser
ACESSO AO ARTIGO
http://libdigi.unicamp.br/document/?code=vtls000406345Documentos Relacionados
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