RESUMO Objetivo O estudo teve como objetivos o desenvolvimento e validação de conteúdo de um Programa de Intervenção em Processamento Auditivo, destinado a crianças em idade escolar, com perturbação do processamento auditivo, falantes do português europeu. Método A primeira etapa consistiu no desenvolvimento do programa e respetivo manual de instruções, que inclui objetivos, atividades, procedimentos, materiais, reforços, instruções e estímulos verbais utilizados, para as competências auditivas de discriminação auditiva, atenção auditiva, memória auditiva, fechamento, figura-fundo; separação binaural, integração binaural e fusão binaural; a segunda etapa consistiu na validação de conteúdo, por dois painéis de peritos que analisaram o programa, através de um questionário. A validade de conteúdo foi calculada usando o índice de validade de conteúdo. Resultados A avaliação do programa revela uma excelente validade de conteúdo. Alguns itens foram modificados depois da análise dos comentários e sugestões dos peritos (ex: instruções, desníveis de intensidade, personagem principal). Conclusão O estudo permitiu o desenvolvimento e validação de um programa de intervenção em processamento auditivo, com estímulos verbais, selecionados de acordo com critérios linguísticos rigorosos. Futuramente, está prevista a realização de estudos de aceitabilidade e eficácia do programa junto da população alvo.

ABSTRACT Purpose The study aimed at the development and content validation of an Auditory Processing Intervention Program for school-aged European Portuguese speaking children with Auditory Processing Disorder. Methods The first step was the program’s development and its instructions manual, which includes objectives, activities, procedures, materials, reinforcement, instructions, and verbal stimuli used, for the following auditory skills: auditory discrimination, auditory attention; auditory memory; auditory closure; figure-ground; auditory separation; auditory integration; binaural fusion; content validation was performed next, with two expert panels analyzing the program, through the use of a questionnaire. Content validity was calculated using the content validity index. Results Program evaluation shows an excellent content validity. Some items were modified after analyzing the experts’ comments and suggestions (e.g. instructions, intensity differences, main character). Conclusion This work allowed the development and content validation of an auditory processing intervention program, with verbal stimuli, selected according to strict linguistic criteria. In the future, the acceptability and efficacy of this program with the target population should be analyzed.

RESUMO Contexto: Carcinoma hepatocelular (CHC) é o tipo mais comum de câncer de fígado. Os fatores de risco para CHC incluem infecção pelo vírus da hepatite C (VHC) e B (VHB), cirrose alcoólica e alterações genéticas que podem afetar diversas vias celulares. Objetivo: Este estudo teve como objetivo analisar a expressão gênica e proteica sérica de VEGF, AFP, CSTB, β-catenina e GPC3 em grupos com CHC, cirrose ou VHC e controles, e sua relação com o estadiamento clínico nos grupos CHC e cirrose, bem como sua valores de sensibilidade e especificidade. Métodos: Duzentos e trinta indivíduos foram distribuídos no Grupo 1 (G1) - 80 pacientes com CHC; Grupo 2 (G2) - 76 pacientes com cirrose de qualquer etiologia; Grupo 3 (G3) - 33 pacientes com VHC; Grupo 4 (G4 - Controles) - 41 indivíduos sem sinais clínicos ou bioquímicos de qualquer doença hepática. A expressão gênica foi analisada por qRT-PCR e as proteínas séricas foram realizadas pelo método ELISA. Resultados: Aumento da expressão de VEGF e AFP pode ser observado em pacientes BCLC estágio D em comparação com pacientes estágio B, e pacientes estágio C apresentaram maior expressão de CTNNB1, em comparação com pacientes estágio B (P<0,05). Para VEGF e GPC3, foi observado poder discriminatório entre pacientes com CHC e controles (AUC = 0,71; 0,82, respectivamente). O CSTB mostrou poder discriminatório na comparação entre pacientes com VHC e controles (AUC =0,74). Conclusão: O presente estudo confirma a sensibilidade do CSTB sérico no diagnóstico da hepatite C, e a expressão gênica de VEGF e GPC3 sérica conferem sensibilidade e especificidade para o diagnóstico de CHC.

ABSTRACT Background: Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Risk factors for HCC include hepatitis C (HCV) and B (HBV) virus infection, alcoholic cirrhosis and genetic alterations that can affect several cellular pathways. Objective: This study purposed to analyze the gene and serum protein expression of vascular endothelial growth factor (VEGF), angiogenesis, alpha fetoprotein, cystatin B (CSTB), β-catenin and glypican-3 (GPC3) in groups with HCC, cirrhosis or HCV and controls, and their relation with clinical staging in the HCC and cirrhosis groups, as well its sensitivity and specificity values. Methods: A total of 230 individuals were distributed in Group 1 (G1) - 80 patients with HCC; Group 2 (G2) - 76 patients with cirrhosis due to any etiology; Group 3 (G3) - 33 patients with HCV; Group 4 (G4 - controls) - 41 individuals without clinical or biochemical signs of any liver disease. Gene expression was analyzed by qRT-PCR and serum proteins were performed using the ELISA method. Results: Increased VEGF and angiogenesis, alpha fetoprotein expression could be observed in BCLC stage-D patients compared to stage-B patients, and stage-C patients showed higher expression of β-catenin, compared to stage-B patients (P<0.05). For VEGF and GPC3, discriminatory power was observed between HCC patients and controls (AUC =0.71; 0.82, respectively). CSTB showed discriminatory power in the comparison between patients with HCV and controls (AUC =0.74). Conclusion The present study confirms the sensitivity of serum CSTB in the diagnosis of hepatitis C, and gene expression of VEGF and serum GPC3, confer both sensitivity and specificity for the diagnosis of HCC.

Resumo Introdução: As informacoes relativas as caracteristicas clinicas e demograficas dos doentes portugueses hospitalizados com COVID-19 sao limitadas. Material e Métodos: Estudo ambispetivo dos doentes internados com COVID-19 num hospital terciario portugues entre marco e agosto de 2020. Foram excluidos os doentes assintomaticos, mulheres gravidas e os internados por causas sociais. Resultados: Dos 432 doentes internados, foram incluidos 279. A idade mediana foi de 69 anos, 57% do sexo masculino. As comorbilidades mais frequentes foram a hipertensao arterial (66,3%), dislipidemia (33,3%), diabetes (27,1%) e doenca cardiovascular (DCV) (26,5%). A sintomatologia mais frequente a admissao foi febre (74,4%), tosse (67,0%) e dispneia (59,9%). As alteracoes laboratoriais mais frequentes foram niveis elevados de ferritina (86,3%), proteina c-reativa (74,8%) e d-dimeros (73,9%). A taxa de mortalidade foi 17,3%, 32,3% dos doentes desenvolveram sindrome de dificuldade respiratoria aguda, 31,9% foram admitidos numa unidade de cuidados intensivos e 20,8% foram ventilados mecanicamente. Na analise multivariavel, a idade (OR 1,04, 95% CI 1,01-1,09, p=0,023), DCV (OR 2,68, 95% CI 1,21-5,93, p=0,015) e linfopenia <0,5x109/L (OR 6,61, 95% CI 2,23-19,62, p=0,001) identificaram-se como os principais fatores de risco de mortalidade intra-hospitalar. Discussão: Os nossos dados demograficos e desfechos clinicos equiparam-se aos estudos publicados ate a data. Em comparacao com os estudos em populacoes europeias, relatamos uma menor taxa de mortalidade intra-hospitalar, o que podera refletir um melhor controlo da primeira vaga da pandemia no nosso pais. Conclusão: Este estudo fornece informacao acerca das caracteristicas clinicas dos doentes com COVID-19 hospitalizados em Portugal.

Abstract Introduction: Clinical characteristics of Portuguese inpatients with coronavirus disease 2019 (COVID-19) are scarce. We aim to describe the demographic characteristics, clinical course and outcomes of hospitalized patients with COVID-19 and to analyze risk factors for in-hospital mortality. Material and Methods: Ambispective cohort study of adult COVID-19 patients admitted to a Portuguese tertiary hospital between March and August 2020. Asymptomatic, pregnant and all patients admitted due to social reasons were excluded. Results: Of the 432 admitted patients, 279 individuals were included. The median age was 69 years and 57% were male. The most common comorbidities were high blood pressure (66.3%), dyslipidemia (33.3%), diabetes (27.1%) and cardiovascular disease (CVD) (26.5%). The most common symptoms included fever (74.4%), cough (67.0%) and dyspnea (59.9%). Ferritin, C-reactive protein and D-dimer levels were elevated in 86.3%, 74.8% and 73.9% of patients, respectively. Mortality rate was 17.3%. 32.3% of the patients developed acute respiratory distress syndrome, 31.9% were admitted to intensive care unit and 20.8% were ventilated. In multivariable analysis, age (OR 1.04, 95% CI 1.01-1.09, p=0.023), CVD (OR 2.68, 95% CI 1.21-5.93, p=0.015) and lymphocyte count <0.5x109/L (OR 6.61, 95% CI 2.23-19.62, p=0.001) were risk factors for in-hospital mortality. Discussion: Our demographics, clinical and severity outcomes are in-line with international reports. Compared to other European countries, our less expressive in-hospital mortality rate might reflect a modestly controlled first outbreak in our country. Conclusion: This single-center study provides data on the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Portugal.

Pretende-se apresentar uma análise do papel desempenhado pela língua na metodologia de trabalho de projeto e das aprendizagens linguísticas assim desencadeadas. A partir da análise de materiais didáticos, produções das crianças, registos fotográficos de situações de ensino e aprendizagem e relatos de ocorrências, são discutidos tópicos em torno de dois eixos: a forma como as competências nucleares da língua contribuem para a realização de trabalhos de projeto (i) e o impulso que estes imprimem às aprendizagens linguísticas nos domínios referidos (ii). A análise realizada evidenciou a relação dialógica que se estabelece entre a construção de conhecimentos específicos relacionados com a temática dos projetos e a área científica ou artística em que se inserem e o desenvolvimento de competências linguísticas, destacando-se: a) a relevância de um trabalho explícito focalizado na didática da língua na preparação da realização de trabalhos de projeto e nas várias fases que estes atravessam; b) a riqueza de que se reveste esta metodologia para a contextualização das aprendizagens linguísticas; c) os benefícios que tais contextos envolvem para a construção de saberes em uso, de natureza complexa, que enformam o conceito de literacia e que potenciam o exercício da cidadania.

Nous avons l'intention de présenter une analyse du rôle joué par les langues dans la méthodologie de travail de projet et de l'apprentissage des langues ainsi déclenché. À partir de l'analyse du matériel pédagogique, des productions des enfants, des enregistrements photographiques de situations d'enseignement et d'apprentissage et des comptes rendus d'événements, les sujets sont abordés autour de deux axes: la contribution des compétences de base du langage à la réalisation du projet (i) et l'élan que cela donne à l'apprentissage des langues dans les domaines mentionnés (ii). L'analyse a montré la relation dialogique établie entre la construction de connaissances spécifiques liées au thème des projets et le domaine scientifique ou artistique dans lequel elles sont insérées et le développement des compétences linguistiques, en soulignant: a) la pertinence de la focalisation explicite sur la didactique des langues dans la préparation des travaux de projets et les différentes étapes de leur réalisation; b) la richesse de cette méthodologie pour la contextualisation de l'apprentissage des langues; c) les avantages que de tels contextes entraînent pour la construction de connaissances en cours d'utilisation, de nature complexe, qui façonnent le concept de litératie et renforcent l'exercice de la citoyenneté.

The aim of this text is to present an analysis of the role of language in project-based learning and the linguistic progress that takes place through the use of this methodology. From the analysis of didactic resources, children's works, photographic records of teaching and learning contexts and reports of events, several topics are brought into the discussion regarding two axis: which linguistic competencies contribute to the development of projects by students (i) and the boost that these working contexts print to linguistic learnings in the mentioned areas (ii). The analysis has evinced the dialogical relation between the development of specific knowledge related to the thematic of the projects and the scientific or artistic field in which they can be integrated and the development of linguistic competencies, such as, a) the relevance of an explicit action focused on the didactics of language in the preparation of the development of projects and in every step of the way; b) the wealth of project-based learning and teaching for the contextualization of linguistic learnings; c) and the benefits that such contexts implicate for the development of knowledge in use, complex in nature, that form the concept of literacy and enhance citizenship exercise.

Abstract When exposure of the pulp to external environment occurs, reparative dentinogenesis can be induced by direct pulp capping to maintain pulp tissue vitality and function. These clinical situations require the use of materials that induce dentin repair and, subsequently, formation of a mineralized tissue. Objective: This work aims to assess the effect of tricalcium silicate cements and mineral trioxide aggregate cements, including repairing dentin formation and inflammatory reactions over time after pulp exposure in Wistar rats. Methodology: These two biomaterials were compared with positive control groups (open cavity with pulp tissue exposure) and negative control groups (no intervention). The evaluations were performed in three stages; three, seven and twenty-one days, and consisted of an imaging (nuclear medicine) and histological evaluation (H&E staining, immunohistochemistry and Alizarin Red S). Results: The therapeutic effect of these biomaterials was confirmed. Nuclear medicine evaluation demonstrated that the uptake of 99mTc-Hydroxymethylene diphosphonate (HMDP) showed no significant differences between the different experimental groups and the control, revealing the non-occurrence of differences in the phosphocalcium metabolism. The histological study demonstrated that in mineral trioxide aggregate therapies, the presence of moderate inflammatory infiltration was found after three days, decreasing during follow-ups. The formation of mineralized tissue was only verified at 21 days of follow-up. The tricalcium silicate therapies demonstrated the presence of a slight inflammatory infiltration on the third day, increasing throughout the follow-up. The formation of mineralized tissue was observed in the seventh follow-up day, increasing over time. Conclusions: The mineral trioxide aggregate (WhiteProRoot®MTA) and tricalcium silicate (Biodentine™) present slight and reversible inflammatory signs in the pulp tissue, with the formation of mineralized tissue. However, the exacerbated induction of mineralized tissue formation with the tricalcium silicate biomaterial may lead to the formation of pulp calcifications

Resumo A radiação electromagnética é amplamente usada na medicina quer para diagóstico quer para terapêutica. A utilização em terapêutica pressupõe a existência de efeitos biológicos nocivos os quais são criteriosamente selecionados para causar dano onde é necessário (e.g. células cancerigenas) e proteger o restante organismo. Em diagnóstico o possível dano causado pela radiação é minimizado podendo ser usada em segurança quer para os doentes quer para os profissionais de saúde. Tendo em conta esta dicotomia do bem e do mal apresentam-se as principais caracteristicas da radiação e o seu uso na cliníca.

Abstract Electromagnetic radiation is widely used in medicine for both diagnosis and therapy. Its use in therapy assumes the existence of deleterious biological effects which are carefully selected to cause damage where it is necessary (e.g. cancer cells) and to protect the remaining organism. In diagnosis the possible damage caused by radiation is minimized and can be safely used for both patients and health professionals. Taking into account this dichotomy of good and evil the main characteristics of radiation and its use in the clinic are presented.

Abstract Background: Teduglutide is an enterotrophic analogue of glucagon-like peptide-2, with an indirect and poorly understood mechanism of action, approved for the rehabilitation of short-bowel syndrome. This study aims to analyze the response of tissue growth factors to surgical injury and teduglutide administration on an animal model of intestinal anastomosis. Methods: Wistar rats (n = 59) were distributed into four groups: "ileal resection" or "laparotomy", each one subdivided into "postoperative teduglutide administration" or "no treatment"; and sacrificed at the third or the seventh day, with ileal sample harvesting. Gene expression of insulin-like growth factor 1 (Igf1), vascular endothelial growth factor a (Vegfa), transforming growth factor β1 (Tgfβ1), connective tissue growth factor (Ctgf), fibroblast growth factor 2 (Fgf2), fibroblast growth factor 7 (Fgf7), epidermal growth factor (Egf), heparin-binding epidermal-like growth factor (Hbegf), platelet-derived growth factor b (Pdgfb) and glucagon-like peptide 2 receptor (Glp2r) was studied by real-time polymerase chain reaction. Results: Upregulation of Fgf7, Fgf2, Egf, Vegfa and Glp2r at the third day and of Pdgf at the seventh day was verified in the perianastomotic segment. Teduglutide administration was associated with higher fold-change of relative gene expression of Vegfa (3.6 ± 1.3 vs. 1.9 ± 2.0, p = 0.0001), Hbegf (2.2 ± 2.3 vs. 1.1 ± 0.9, p = 0.001), Igf1 (1.6 ± 7.6 vs. 0.9 ± 0.7, p = 0.002) and Ctgf (1.1 ± 2.1 vs. 0.6 ± 2.0, Conclusions: Those results underscore the recognized role of Igf1 and Hbegf as molecular mediators of the effects of teduglutide and suggest that other humoral factors, like Vegf and Ctgf, may also be relevant in the perioperative context. Induction of Vegfa, Igf1 and Ctgf gene expressions might indicate a favorable influence of teduglutide on the intestinal anastomotic healing.

Resumen Introducción: teduglutida es un análogo intestinotrófico do péptido-2 similar al glucagón, con un mecanismo de acción indirecto y poco conocido, aprobado para la rehabilitación del síndrome de intestino corto. Este estudio propone analizar la respuesta de los factores de crecimiento tisulares a la agresión quirúrgica y a la administración de teduglutida en un modelo animal de anastomosis intestinal. Métodos: ratones Wistar (n = 59) fueron distribuidos en cuatro grupos: "resección ileal" o "laparotomía", cada uno subdividido en "administración post-operatoria de teduglutida" o "sin tratamiento"; y sacrificados en el tercero o el séptimo día, con recogida de muestras ileales. La expresión génica de Igf1, Vegfa, Tgfβ1, Ctgf, Fgf2, Fgf7, Egf, Hbegf, Pdgfb y Glp2r fue analizada por qRT-PCR. Resultados: en el segmento perianastomótico se verificó una sobrerregulación de Fgf7, Fgf2, Egf, Vegfa y Glp2r al tercer día y de Pdg al séptimo día. La administración de teduglutida se asoció con mayor cambio de la expresión génica relativa de Vegfa (3.6 ± 1.3 vs. 1.9 ± 2.0, p = 0.0001), Hbegf (2.2 ± 2.3 vs. 1.1 ± 0.9, p = 0.001), Igf1 (1.6 ± 7.6 vs. 0.9 ± 0.7, p = 0.002) y Ctgf (1.1 ± 2.1 vs. 0.6 ± 2.0, p = 0.013); y menor cambio de Tgfβ1, Fgf7 y Glp2r. Conclusiones: estos resultados refuerzan el reconocido papel de Igf1 y Hbegf como mediadores moleculares de los efectos de la teduglutida y sugieren que otros factores humorales, como Vegf y Ctgf, también pueden ser relevantes en el contexto perioperatorio. La inducción de las expresiones de los genes Vegfa, Igf1 y Ctgf podría indicar una influencia favorable de teduglutida en la cicatrización anastomótica intestinal.

Abstract Purpose: To investigate the inflammatory and redox responses to teduglutide on an animal model of laparotomy and intestinal anastomosis. Methods: Wistar rats (n=62) were allocated into four groups: “Ileal Resection and Anastomosis” vs. “Laparotomy”, each one split into “Postoperative Teduglutide Administration” vs. “No Treatment”; and euthanized at the third or the seventh day. Ileal and blood samples were recovered at the baseline and at the euthanasia. Flow cytometry was used to study the inflammatory response (IL-1α, MCP-1, TNF-α, IFN-γ and IL-4 levels), oxidative stress (cytosolic peroxides, mitochondrial reactive species, intracellular glutathione and mitochondrial membrane potential) and cellular viability and death (annexin V/propidium iodide double staining). Results: Postoperative teduglutide treatment was associated with higher cellular viability index and lower early apoptosis ratio at the seventh day; higher cytosolic peroxides level at the third day and mitochondrial overgeneration of reactive species at the seventh day; higher tissue concentration of IL-4 and lower local pro-to-anti-inflammatory cytokines ratio at the seventh day. Conclusion: Those findings suggest an intestinal pro-oxidative and anti-inflammatory influence of teduglutide on the peri-operative context with a potential interference in the intestinal anastomotic healing.

This paper discusses the influence of the flow of a fluid from the static regime to the turbulent in CO2 corrosion experienced by low carbon steel. A more comprehensive approach to CO2 corrosion implies taking the free flowing velocity and shear stress of the fluid and the surface roughness of the material into consideration. Low carbon steel samples in two different superficial finish conditions were used as the rotating cylinder electrode. The corrosion rate were determined by linear polarization at 25 °C in a 0.5 mol/L NaHCO3 solution purged with CO2 at 1 atm pressure in pH 7.5. The effect of superficial finish on CO2 corrosion in flow conditions was studied. The results obtained showed that the corrosion rate increases with flow velocity and is influenced by surface roughness.

PURPOSE: To investigate the impact of selective hepatic artery clamping (SHAC) in hepatocellular function. METHODS: Three groups of Wistar male rats were subjected to SHAC ischemia period of 60min: Group A continuous SHAC were subjected to SHAC ischemia period of 60min, Group B intermittent SHAC of 30min with 5min of reperfusion and Group C intermittent SHAC of 15min with 5min of reperfusion. Animals without SHAC were included-Group D. To evaluate hepatocellular function blood markers and hepatic extraction function (HEF) using 99mTc-mebrofenin were performed before and after surgery. Flow cytometry was used to analyze oxidative stress and cell viability. RESULTS: A mortality rate of 7.6% in Group A was observed. HEF maintained normal values between the groups. Flow cytometry demonstrated no significant differences between the groups in viability, type of cell death as well as in the production of reactive oxygen species. CONCLUSIONS: The selective hepatic artery clamping compared to other clamping techniques results on increased cell viability and decreased hepatocyte death. The SHAC is a potential alternative to decrease per-operative bleeding while maintaining hepatocellular function.

OBJETIVO: Apresentar novo modelo de adenocarcinoma distal em camundongos atímicos. MÉTODOS: Foram utilizados sete camundongos atímicos. Desvio do cólon distal e fístula foram feitas. Células de adenocarcinoma foram inoculadas na submucosa da fístula. O crescimento do tumor foi monitorado diariamente. Cintilografia com 99mTc-MIBI foi realizada para identificar o tumor. RESULTADOS: O modelo de câncer de cólon distal é viável. Detecção do tumor foi possível macroscopicamente e por imagem molecular. Todas as ressecções demonstraram tumores pouco diferenciados. Obstrução do cólon ocorreu em um caso, de forma semelhante à evolução em tumores humanos do cólon distal. CONCLUSÃO: O modelo de câncer do cólon distal proposto é viável, permite a monitorização fácil do crescimento tumoral macroscopicamente e por imagem molecular, sendo adequado para o estudo da evolução de tumor com aplicação de terapia citotóxica in vivo.

PURPOSE: The present a novel adenocarcinoma model in athymic mice. METHODS: Seven athymic mice were used. Colon diversion and distal fistula were made. Adenocarcinoma cells were inoculated in the submucosa of fistula. Tumor growth was monitored daily. Scintigraphy with 99mTc-MIBI was performed to identify the tumor. RESULTS: The model of distal colon cancer is feasible. Tumor detection was possible by both, macroscopically and molecular imaging. All resections demonstrated poorly differentiated tumors. Colon obstruction occurred in one case, similarly to evolution in human tumors of distal colon. CONCLUSION: The proposed model of distal colon cancer is feasible, allows for easy monitoring of tumoral growth by both, macroscopically and molecular imaging, and is suitable for studying the evolution of tumor with implementation of cytotoxic therapy in vivo.

Objetivo: avaliar a eficácia da amnioinfusão para a propedêutica do oligoidrâmnio acentuado. Metodologia: foram incluídas neste estudo 12 gestantes com diagnóstico de oligoidrâmnio acentuado no 2º e 3º trimestre da gestação encaminhadas para realização de amnioinfusão. O procedimento foi realizado utilizando-se soro fisiológico a 37ºC a uma velocidade de 20 mL/min seguido da injeção de 5 mL de corante. A avaliação do índice de líquido amniótico (ILA) foi realizada antes e 30 minutos após o procedimento e as anomalias fetais quando presentes foram registradas. A idade gestacional das pacientes variou de 18 a 34 semanas (média 25 ± 4 semanas). O ILA inicial variou de zero a 7,3 cm (média 10,3 cm) e o final de 10,0 a 25,4 cm (média 16,36 ± 6 cm). O volume infundido variou de 300 a 1000 mL (média 605,4 ± 224,1 mL). Resultados: em nove pacientes (75%) o exame permitiu o diagnóstico etiológico: quatro roturas de membranas e malformações fetais em cinco casos. Em duas pacientes o oligoidrâmnio era idiopático e em uma gestante o estudo anatomopatológico revelou infarto placentário. Nove gestações (75%) foram interrompidas após o diagnóstico e três foram mantidas sob observação por tempo médio de 8,8 semanas após a amnioinfusão. Todos fetos evoluíram para o óbito, sendo sete natimortos e os demais neomortos. Conclusão: a amnioinfusão mostrou ser método propedêutico de alta acurácia permitindo o diagnóstico etiológico do oligoidrâmnio acentuado em 75% dos casos.

Purpose: to evaluate the effectiveness of diagnostic amnioinfusion in severe oligohydramnios. Methods: twelve patients with severe oligohydramnios in the second and third trimester of pregnancy were submitted to amnioinfusion. The procedure was done using a warm physiological saline at a rate of 20 mL/min followed by the instillation of 5 mL of dye. The amniotic fluid index (AFI) was measured before the procedure and 30 min afterwards and in case of fetal anomalies, it was documented. The gestational age ranged from 18 to 34 weeks (average 25 ± 4 weeks). The average of the initial ILA was 10.3cm and after the procedure was 16.4 cm. The volume of saline solution infused ranged from 300 to 1000 mL (605.4 ± 224.1 mL). Results: in nine patients (75%) the procedure led to an etiologic diagnosis: four cases of premature rupture of membranes and major malformations in five fetuses. In two patients the oligohydramnios was considered idiopathic and in one patient the pathological examination revealed a placental infarct. Nine pregnancies (75%) were interrupted after the diagnosis and in three cases it was maintained for 8.8 weeks after the amnioinfusion. All fetuses died, seven of them had neonatal death and the remaining had intrauterine death. Conclusion: amnioinfusion is an effective method with high precision, enabling the etiologic diagnosis of severe oligohydramnios in 75% of the cases.