SUMMARY OBJECTIVE: This study aimed to evaluate cardiac contractility in fetuses from pregestational diabetes mellitus pregnancies by three-dimensional ultrasound using spatiotemporal image correlation in rendering mode. METHODS: A retrospective cross-sectional study was performed on 40 fetuses from nondiabetic pregnancies and 28 pregestational diabetic pregnancies between 20 and 33 weeks and 6 days. Cardiac contractility was assessed by measuring the ventricular myocardial area in diastole subtracted from the ventricular myocardial area in systole. RESULTS: Pregestational diabetic pregnancies had a lower maternal age than nondiabetic pregnancies (26.7 vs. 39.9 years, p=0.019). Cardiac contractility in fetuses from diabetic and nondiabetic pregnancies was similar (p=0.293). A moderately positive and significant correlation was observed between gestational age and cardiac contractility (r=0.46, p=0.0004). A 1-week increase in gestational age was responsible for a 0.1386 cm2 increase in cardiac contractility. CONCLUSION: Cardiac contractility as evaluated by three-dimensional ultrasound using spatiotemporal image correlation in rendering mode showed no significant differences across fetuses with and without pregestational diabetes. OBJECTIVE threedimensional three dimensional METHODS crosssectional cross sectional 4 2 3 days systole RESULTS 26.7 267 26 7 (26. vs 399 39 9 39. years p=0.019. p0019 p p=0.019 . 0 019 p=0.019) p=0.293. p0293 p=0.293 293 (p=0.293) r=0.46, r046 r 46 (r=0.46 p=0.0004. p00004 p=0.0004 0004 p=0.0004) 1week week 1 01386 1386 0.138 cm CONCLUSION 26. (26 p001 p=0.01 01 p029 p=0.29 29 (p=0.293 r=0.46 r04 (r=0.4 p0000 p=0.000 000 0138 138 0.13 (2 p00 p=0.0 p02 p=0.2 (p=0.29 r=0.4 r0 (r=0. p000 p=0.00 00 013 13 0.1 ( p0 p=0. (p=0.2 r=0. (r=0 0. p=0 (p=0. r=0 (r= p= (p=0 r= (r (p= (p

SUMMARY OBJECTIVE: The aim of this study was to compare the obstetric and perinatal complications in women who became pregnant with autologous oocytes and those who received donated oocytes (DO) in intracytoplasmic sperm injection cycles (ICSI). METHODS: A retrospective cohort study was carried out by collecting data from medical records between 2019 and 2022. Only patients who underwent ICSI in an induced cycle using their own or freshly DO, with male infertility factor and tubal factor, were included. RESULTS: A total of 120 patients were assessed, comprising 51 cases utilizing their own oocytes (control group) and 69 cases employing DO (study group). Patients receiving DO (n=69) exhibited a significantly higher mean age compared to those utilizing their own oocytes (n=51) (41.96±2.16 vs 38.54±1.42 years, p<0.001). There was no significant association between the source of oocytes and gestational age at delivery (p=0.296), birth weight (p=0.836), admission to neonatal intensive care unit (ICU) (p=0.120), or maternal admission to adult ICU (p=0.767). Additionally, the origin of oocytes did not demonstrate any significant association with the risk of pre-eclampsia (p=0.357), gestational diabetes mellitus (p=0.187), premature rupture of membranes (p=0.996), uterine atony (p=0.996), placenta previa (p=0.393), oligohydramnios (p=0.393), or gestational hypertension (p=0.393)." CONCLUSION: An increase in obstetric and perinatal complications was not observed in pregnancies with DO compared to pregnancies with autologous oocytes in women undergoing ICSI without prior comorbidities. Further studies with larger sample sizes are required to validate our findings. OBJECTIVE (DO ICSI. . (ICSI) METHODS 201 2022 included RESULTS 12 assessed 5 control group 6 group. n=69 n69 n (n=69 n=51 n51 (n=51 41.96±2.16 4196216 41 96 2 16 (41.96±2.1 3854142 38 54 1 42 38.54±1.4 years p<0.001. p0001 p p<0.001 0 001 p<0.001) p=0.296, p0296 p=0.296 , 296 (p=0.296) p=0.836, p0836 p=0.836 836 (p=0.836) (ICU p=0.120, p0120 p=0.120 (p=0.120) p=0.767. p0767 p=0.767 767 (p=0.767) Additionally preeclampsia pre eclampsia p=0.357, p0357 p=0.357 357 (p=0.357) p=0.187, p0187 p=0.187 187 (p=0.187) p=0.996, p0996 p=0.996 996 (p=0.996) p=0.393, p0393 p=0.393 393 (p=0.393) p=0.393. (p=0.393). CONCLUSION comorbidities findings (ICSI 20 202 n=6 n6 (n=6 n=5 n5 (n=5 41.96±2.1 419621 4 9 (41.96±2. 385414 3 38.54±1. p000 p<0.00 00 p029 p=0.29 29 (p=0.296 p083 p=0.83 83 (p=0.836 p012 p=0.12 (p=0.120 p076 p=0.76 76 (p=0.767 p035 p=0.35 35 (p=0.357 p018 p=0.18 18 (p=0.187 p099 p=0.99 99 (p=0.996 p039 p=0.39 39 (p=0.393 n= (n= 41.96±2. 41962 (41.96±2 38541 38.54±1 p00 p<0.0 p02 p=0.2 (p=0.29 p08 p=0.8 8 (p=0.83 p01 p=0.1 (p=0.12 p07 p=0.7 7 (p=0.76 p03 p=0.3 (p=0.35 (p=0.18 p09 p=0.9 (p=0.99 (p=0.39 (n 41.96±2 4196 (41.96± 3854 38.54± p0 p<0. p=0. (p=0.2 (p=0.8 (p=0.1 (p=0.7 (p=0.3 (p=0.9 41.96± 419 (41.96 385 38.54 p<0 p=0 (p=0. 41.96 (41.9 38.5 p< p= (p=0 41.9 (41. 38. (p= 41. (41 (p (4 (

Abstract Objective To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital. Methods We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression. Results There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653). Conclusion Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a. (PPH lowrisk low hospital 201 2021 age parity Groups . 4a) Chisquare Chi square ttests t tests performed regression 11935 11 935 11,93 period Robsons s 482 48 2 48.2 5,750/11,935 575011935 5 750 261 26 26.1 3,124/11,935. 312411935 3,124/11,935 124 3,124/11,935) 3.5 35 (3. vs 27 7 2.7% p=0.028. p0028 p p=0.028 0 028 p=0.028) 188 18 8 18.8 RR (RR 1188 1.188 95 CI 1.021.36, 102136 1.02 1.36, 02 36 1.02-1.36 p=0.030. p0030 p=0.030 030 p=0.030) x23=10.6, x23106 x x2 =10.6, 10 6 [x2(3)=10.6 OR 726 7.26 95%CI 95CI 3.3215.84, 3321584 3.32 15.84, 32 15 84 3.32-15.84 R Nagelkerke 0011 011 0.011 p<0.001 p0001 001 x24=59.0, x24590 4 =59.0, 59 [x2(4)=59.0 1001 1.001 95%CI1.0011.001, 95CI10011001 95%CI:1.001-1.001 0033 033 0.033 area curve 0612 612 0.612 0.5720.653. 05720653 0.572 0.653 572 653 0.572-0.653) 20 202 1193 93 11,9 48. 5,750/11,93 57501193 75 26. 31241193 3,124/11,93 12 3. (3 2.7 p002 p=0.02 18. 118 1.18 9 021 1.021.36 10213 102 1.0 136 1.36 1.02-1.3 p003 p=0.03 03 x23 x23=10.6 x2310 106 =10.6 [x2(3)=10. 72 7.2 3215 3.3215.84 332158 332 3.3 1584 15.84 3.32-15.8 01 0.01 p<0.00 p000 00 x24 x24=59.0 x2459 590 =59.0 [x2(4)=59. 100 1.00 CI1 95%CI1.0011.001 95CI1001100 95%CI:1.001-1.00 003 0.03 061 61 0.61 5720 0.5720.653 0572065 0572 0.57 0653 0.65 57 65 0.572-0.653 119 11, 5,750/11,9 5750119 3124119 3,124/11,9 ( 2. p00 p=0.0 1.1 1.021.3 1021 1. 13 1.3 1.02-1. x23=10. x231 =10. [x2(3)=10 7. 321 3.3215.8 33215 33 158 15.8 3.32-15. 0.0 p<0.0 x24=59. x245 =59. [x2(4)=59 95%CI1.0011.00 95CI100110 95%CI:1.001-1.0 06 0.6 0.5720.65 057206 057 0.5 065 0.572-0.65 5,750/11, 575011 312411 3,124/11, p0 p=0. 1.021. 1.02-1 x23=10 =10 [x2(3)=1 3.3215. 3321 15. 3.32-15 0. p<0. x24=59 =59 [x2(4)=5 95%CI1.0011.0 95CI10011 95%CI:1.001-1. 0.5720.6 05720 05 0.572-0.6 5,750/11 57501 31241 3,124/11 p=0 1.021 1.02- x23=1 =1 [x2(3)= 3.3215 3.32-1 p<0 x24=5 =5 [x2(4)= 95%CI1.0011. 95CI1001 95%CI:1.001-1 0.5720. 0.572-0. 5,750/1 5750 3124 3,124/1 p= x23= = [x2(3) 3.321 3.32- p< x24= [x2(4) 95%CI1.0011 95CI100 95%CI:1.001- 0.5720 0.572-0 5,750/ 575 312 3,124/ [x2(3 [x2(4 95%CI1.001 95CI10 95%CI:1.001 0.572- 5,750 31 3,124 [x2( 95%CI1.00 95CI1 95%CI:1.00 5,75 3,12 [x2 95%CI1.0 95%CI:1.0 5,7 3,1 [x 95%CI1. 95%CI:1. 5, 95%CI1 95%CI:1

SUMMARY OBJECTIVE: The aim of this study was to evaluate the success rate and predictors of labor induction using vaginal misoprostol in a low-risk pregnant women population. METHODS: A prospective cohort study was carried out with 196 pregnant women. Groups 2 and 4 of the Robson Classification admitted for induction of labor with vaginal misoprostol (25 μg tablets every 6 h, up to 4 tablets, for a maximum of 24 h). The success of labor induction was considered the achievement of vaginal delivery. Binary logistic regression was used to determine the best predictors of successful induction of labor with vaginal misoprostol. RESULTS: Of all the pregnant women analyzed, 140 (71.4%) were successful and 56 (28.6%) were unsuccessful. Pregnant women who achieved successful induction had a higher number of pregnancies (1.69 vs. 1.36, p=0.023), a higher number of deliveries (0.57 vs. 0.19, p<0.001), a higher Bishop score (2.0 vs. 1.38, p=0.002), and lower misoprostol 25 μg tablets (2.18 vs. 2.57, p=0.031). No previous deliveries [x2(1)=3.14, odds ratio (OR): 0.24, 95% confidence interval (CI): 0.10–0.57, R2 Nagelkerke: 0.91, p=0.001] and the presence of one previous delivery [x2(1)=6.0, OR: 3.40, 95% CI: 1.13–10.16, R2 Nagelkerke: 0.043, p=0.029] were significant predictors of successful induction of labor with vaginal misoprostol. CONCLUSION: A high rate of labor induction success using vaginal misoprostol in a low-risk population was observed, mainly in multiparous and with gestational age>41 weeks. No previous delivery decreased the success of labor induction, while one previous delivery increased the success of labor induction. OBJECTIVE lowrisk low risk METHODS 19 (2 h h. . h) RESULTS analyzed 14 71.4% 714 71 (71.4% 5 28.6% 286 28 (28.6% unsuccessful 1.69 169 1 69 (1.6 vs 136 36 1.36 p=0.023, p0023 p p=0.023 , 0 023 p=0.023) 0.57 057 57 (0.5 019 0.19 p<0.001, p0001 p<0.001 001 p<0.001) 2.0 20 (2. 138 38 1.38 p=0.002, p0002 p=0.002 002 p=0.002) 2.18 218 18 (2.1 257 2.57 p=0.031. p0031 p=0.031 031 p=0.031) x21=3.14, x21314 x x2 =3.14, 3 [x2(1)=3.14 OR (OR) 024 0.24 95 CI (CI) 010057 10 0.10–0.57 R Nagelkerke 091 91 0.91 p=0.001 x21=6.0, x2160 =6.0, [x2(1)=6.0 340 40 3.40 1131016 13 16 1.13–10.16 0043 043 0.043 p=0.029 p0029 029 CONCLUSION observed age41 age 41 age>4 weeks ( 71.4 7 (71.4 28.6 (28.6 1.6 (1. 1.3 p002 p=0.02 02 0.5 05 (0. 01 0.1 p000 p<0.00 00 2. p=0.00 2.1 21 2.5 p003 p=0.03 03 x21 x21=3.14 x2131 314 =3.14 [x2(1)=3.1 (OR 0.2 9 (CI 01005 0.10–0.5 09 0.9 x21=6.0 x216 60 =6.0 [x2(1)=6. 34 3.4 113101 1.13–10.1 004 04 0.04 age4 age> 71. (71. 28. (28. 1. (1 p00 p=0.0 0. (0 p<0.0 x21=3.1 x213 31 =3.1 [x2(1)=3. 0100 0.10–0. x21=6. =6. [x2(1)=6 3. 11310 1.13–10. 0.0 (71 (28 p0 p=0. p<0. x21=3. =3. [x2(1)=3 010 0.10–0 x21=6 =6 [x2(1)= 1131 1.13–10 (7 p=0 p<0 x21=3 =3 0.10– x21= = [x2(1) 113 1.13–1 p= p< 0.10 [x2(1 11 1.13– [x2( 1.13 [x2 1.1 [x

SUMMARY OBJECTIVE: The aim of this study was to evaluate the impact of therapeutic hypothermia on maternal and perinatal outcomes in newborns with Apgar score<7 at the 5th min. METHODS: A retrospective cohort study was carried out with 55 newborns who had an Apgar score<7 at the 5th min (35 without and 20 with therapeutic hypothermia) from low-risk pregnancies between 33 and 41 weeks gestation. The Apgar score was calculated through an objective assessment by a neonatologist in the delivery room. Therapeutic hypothermia was indicated by a neonatologist in the delivery room, according to the protocol established by the Brazilian Society of Pediatrics. The maternal and perinatal outcomes of both groups (without and with therapeutic hypothermia) were compared. RESULTS: A rate of Apgar score<7 at the 5th min was 1.02%. No statistical differences were observed between the two groups (without and with therapeutic hypothermia) regarding maternal/perinatal complications. The presence of maternal/perinatal complications did not increase the odds ratio of neonatal therapeutic hypothermia in newborns with Apgar score<7 at the 5th min. CONCLUSION: The rate of Apgar score<7 at the 5th min was low, and it was not associated with any maternal/perinatal complications. There was no significant difference in maternal/perinatal complications between newborns who received therapeutic hypothermia and those who did not. OBJECTIVE score7 7 score< th METHODS 5 35 (3 2 lowrisk low risk 3 4 gestation room Pediatrics compared RESULTS 102 1 02 1.02% maternalperinatal CONCLUSION ( 10 0 1.02 1.0 1.

SUMMARY OBJECTIVE: The aim of the study was to compare two labor induction regimens (4 and 6 h), to determine predictors of successful labor induction with intravaginal misoprostol 25 μg tablets, and to evaluate the association with adverse perinatal outcomes. METHODS: This was a retrospective cohort study that included singleton pregnancies undergoing induction of labor with an intravaginal misoprostol 25 μg tablet between 37 and 42 weeks of gestation. The pregnant women were divided into two groups: Group 1—intravaginal misoprostol 25 μg every 4 h and Group 2—intravaginal misoprostol 25 μg every 6 h. RESULTS: Pregnant women were divided into Group 1 (n=289) and Group 2 (n=278). Group 1 had a higher median number of intravaginal misoprostol 25 μg tablets (3.0 vs. 2.0 tablets, p<0.001), a lower prevalence of postpartum hemorrhage (7.6 vs. 32.7%, p<0.001), and a higher need for oxytocin (odds ratio [OR]: 2.1, 95%CI: 1.47–2.98, p<0.001) than Group 2. Models including intravaginal misoprostol 25 μg tablets every 4 and 6 h [x2(1)=23.7, OR: 4.35, p<0.0001], parity [x2(3)=39.4, OR: 0.59, p=0.031], and Bishop’s score [x2(4)=10.8, OR: 0.77, p=0.019] were the best predictors of failure of labor induction. A statistically significant difference between groups was observed between the use of the first intravaginal misoprostol 25 μg tablet at the beginning (Breslow p<0.001) and the end of the active labor phase (Long Hank p=0.002). CONCLUSION: Pregnant women who used intravaginal misoprostol 25 μg every 4 h had a longer time from the labor induction to the beginning of the active phase of labor and higher rates of adverse perinatal outcomes than women who used intravaginal misoprostol 25 μg every 6 h. OBJECTIVE ( h, , h) METHODS 3 gestation 1intravaginal 2intravaginal RESULTS n=289 n289 n 289 (n=289 n=278. n278 n=278 . 278 (n=278) 3.0 30 0 (3. vs 20 p<0.001, p0001 p p<0.001 001 7.6 76 7 (7. 327 32 32.7% odds OR [OR] 21 2.1 95%CI 95CI CI 95 147298 47 98 1.47–2.98 x21=23.7, x21237 x x2 =23.7, 23 [x2(1)=23.7 435 35 4.35 p<0.0001, p00001 p<0.0001 0001 p<0.0001] x23=39.4, x23394 =39.4, 39 [x2(3)=39.4 059 59 0.59 p=0.031, p0031 p=0.031 031 p=0.031] Bishops Bishop s x24=10.8, x24108 =10.8, 10 8 [x2(4)=10.8 077 77 0.77 p=0.019 p0019 019 Breslow Long p=0.002. p0002 p=0.002 002 p=0.002) CONCLUSION n=28 n28 28 (n=28 n27 n=27 27 (n=278 3. (3 p000 p<0.00 00 7. (7 32.7 [OR 9 14729 1.47–2.9 x21 x21=23.7 x2123 237 =23.7 [x2(1)=23. 43 4.3 p0000 p<0.000 000 x23 x23=39.4 x2339 394 =39.4 [x2(3)=39. 05 5 0.5 p003 p=0.03 03 x24 x24=10.8 x2410 108 =10.8 [x2(4)=10. 07 0.7 p=0.01 p001 01 p=0.00 n=2 n2 (n=2 (n=27 p00 p<0.0 32. 1472 1.47–2. x21=23. x212 =23. [x2(1)=23 4. x23=39. x233 =39. [x2(3)=39 0. p=0.0 x24=10. x241 =10. [x2(4)=10 n= (n= p0 p<0. 147 1.47–2 x21=23 =23 [x2(1)=2 x23=39 =39 [x2(3)=3 p=0. x24=10 =10 [x2(4)=1 (n p<0 14 1.47– x21=2 =2 [x2(1)= x23=3 =3 [x2(3)= p=0 x24=1 =1 [x2(4)= p< 1.47 x21= = [x2(1) x23= [x2(3) p= x24= [x2(4) 1.4 [x2(1 [x2(3 [x2(4 1. [x2( [x2 [x

Resumo Objetivo: Avaliar os níveis sanguíneos maternos de ácidos graxos (AGs) em gestações com restrição de crescimento fetal (RCF). Métodos: Este estudo prospectivo transversal incluiu gestantes com idade gestacional entre 26 e 37 semanas e 6 dias com RCF e fetos adequados para a idade gestacional (AIG). Os níveis de ácidos graxos saturados, trans, monoinsaturados e poliinsaturados foram medidos usando centrifugação e cromatografia líquida. O teste t-Student, o teste de Mann-Whitney e o modelo linear geral, com idade gestacional e peso materno como covariantes, foram utilizados para comparar os níveis de AGs e os grupos RCF e AIG. O teste Qui-quadrado foi utilizado para avaliar a associação entre os grupos e as variáveis estudadas. Resultados: Amostra de sangue materno foi coletada de 64 gestantes, sendo 24 RCF e 40 AIG. Uma correlação positiva fraca foi encontrada entre o nível de ácido palmitoleico e o peso materno (r = 0,285, p = 0,036). Uma correlação negativa fraca foi encontrada entre o nível de ácido gama-linoleico ea idade gestacional (r = −0,277, p = 0,026). A mediana do nível de ácido elaídico (2,3 vs. 4,7 ng/ml, p = 0,045) e ácido gama-linoleico (6,3 vs. 6,6 ng/ml, p = 0,024) foram significativamente menores no grupo RCF do que no grupo AIG. O nível de ácido palmitoleico foi significativamente maior no grupo RCF do que no grupo AIG (50,5 vs. 47,6 ng/ml, p = 0,033). Conclusão: Gestantes com RCF apresentaram níveis mais baixos de ácido elaídico e ácido gama-linoleico e níveis mais elevados de ácido palmitoleico do que os fetos AIG. Objetivo (AGs RCF. . (RCF) Métodos 2 3 (AIG) saturados trans líquida tStudent, tStudent t Student, Student t-Student MannWhitney Mann Whitney geral covariantes Quiquadrado Qui quadrado estudadas Resultados 4 r 0285 0 285 0,285 0,036. 0036 0,036 036 0,036) gamalinoleico gama linoleico 0277 277 −0,277 0,026. 0026 0,026 026 0,026) 2,3 23 (2, vs 47 7 4, ngml ng ml ng/ml 0,045 0045 045 6,3 63 (6, 66 6, 0,024 0024 024 50,5 505 50 5 (50, 476 47, 0,033. 0033 0,033 033 0,033) Conclusão (RCF (AIG 028 28 0,28 003 0,03 03 027 27 −0,27 002 0,02 02 2, (2 0,04 004 04 (6 50, (50 0,2 00 0,0 −0,2 ( (5 0, −0, −0 −

Abstract Objective: To assess the maternal blood levels of fatty acids (FAs) in pregnancies with fetal growth restriction (FGR). Methods: This prospective cross-sectional study included pregnant women with gestational age between 26 and 37 + 6 weeks with FGR and appropriate for gestational age (AGA) fetuses. The levels of saturated, trans, monounsaturated, and polyunsaturated FAs were measured using centrifugation and liquid chromatography. The Student’s t-test, Mann-Whitney test, and general linear model, with gestational age and maternal weight as covariants, were used to compare FA levels and the FGR and AGA groups. The Chi-square was used to evaluate the association between groups and studied variables. Results: Maternal blood sample was collected from 64 pregnant women, being 24 FGR and 40 AGA. A weak positive correlation was found between the palmitoleic acid level and maternal weight (r = 0.285, p = 0.036). A weak negative correlation was found between the gamma-linoleic acid level and gestational age (r = −0.277, p = 0.026). The median of the elaidic acid level (2.3 vs. 4.7ng/ml, p = 0.045) and gamma-linoleic acid (6.3 vs. 6.6ng/ml, p = 0.024) was significantly lower in the FGR than the AGA group. The palmitoleic acid level was significantly higher in the FGR than AGA group (50.5 vs. 47.6ng/ml, p = 0.033). Conclusion: Pregnant women with FGR had lower elaidic acid and gamma-linoleic acid levels and higher palmitoleic acid levels than AGA fetuses. Objective (FAs FGR. . (FGR) Methods crosssectional cross sectional 2 3 (AGA fetuses saturated trans monounsaturated chromatography Students Student s ttest, ttest t test t-test MannWhitney Mann Whitney model covariants Chisquare Chi square variables Results 4 r 0285 0 285 0.285 0.036. 0036 0.036 036 0.036) gammalinoleic gamma linoleic 0277 277 −0.277 0.026. 0026 0.026 026 0.026) 2.3 23 (2. vs 47ngml ngml 7ng ml ng 4.7ng/ml 0.045 0045 045 6.3 63 (6. 66ngml 6ng 6.6ng/ml 0.024 0024 024 50.5 505 50 5 (50. 476ngml 47 47.6ng/ml 0.033. 0033 0.033 033 0.033) Conclusion (FGR 028 28 0.28 003 0.03 03 027 27 −0.27 002 0.02 02 2. (2 0.04 004 04 6. (6 50. (50 0.2 00 0.0 −0.2 ( (5 0. −0. −0 −

SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between antibiotic prophylaxis and adverse perinatal outcomes in premature rupture of membranes. METHODS: This retrospective cohort included pregnant women with premature rupture of membranes (between 24 and 33+6 weeks) who used or did not use prophylactic antibiotics. Pearson's chi-square (χ²) test, Student's t-test, and binary logistic regression were used for statistical analysis. RESULTS: A significant effect was observed in patients with premature rupture of membranes using prophylactic antibiotics regarding amniotic fluid index (p=0.007), deepest vertical pocket (p=0.049), duration of antibiotic therapy (p≤0.001), C-reactive protein level upon admission (p≤0.001), leukocyte count upon admission (p=0.007), and length of stay in neonatal intensive care (p=0.047). A significant association was observed between the abovementioned patients and surfactant use during the neonatal period (p=0.04). A higher prevalence of surfactant use was noted in these patients (20.0 vs. 8.7%; p=0.04). CONCLUSION: No association was found between antibiotic prophylaxis and the presence of adverse perinatal outcomes in pregnant women with premature rupture of membranes between 24 and 33+6 weeks of gestation. OBJECTIVE METHODS 2 336 33 6 33+ Pearsons Pearson s chisquare chi square χ² χ (χ² test Students Student ttest, ttest t t-test analysis RESULTS p=0.007, p0007 p p=0.007 , 0 007 (p=0.007) p=0.049, p0049 p=0.049 049 (p=0.049) p≤0.001, p0001 p≤0.001 001 (p≤0.001) Creactive C reactive p=0.047. p0047 p=0.047 . 047 (p=0.047) p=0.04. p004 p=0.04 04 (p=0.04) 20.0 200 20 (20. vs 8.7% 87 8 7 p=0.04) CONCLUSION gestation 3 (χ p000 p=0.00 00 (p=0.007 (p=0.049 p≤0.00 (p≤0.001 (p=0.047 p00 p=0.0 (p=0.04 20. (20 8.7 (p=0.00 p≤0.0 (p≤0.00 p0 p=0. (p=0.0 (2 8. p≤0. (p≤0.0 p=0 (p=0. ( p≤0 (p≤0. p= (p=0 p≤ (p≤0 (p= (p≤ (p

SUMMARY OBJECTIVE: The aim of this study was to evaluate the accuracy of intrapartum cardiotocography in identifying acidemia at birth by umbilical cord blood gasometry in high-risk pregnancies. METHODS: This was a retrospective cohort study of singleton high-risk parturients using intrapartum cardiotocography categories I, II, and III. The presence of fetal acidemia at birth was identified by the analysis of umbilical cord arterial blood pH (<7.1). Associations between variables were determined using the chi-square test and Kruskal-Wallis tests. RESULTS: We included 105 cases of cardiotocography category I, 20 cases of cardiotocography category II, and 10 cases of cardiotocography category III. cardiotocography category III had a higher prevalence of cesarean sections compared to cardiotocography category I (90.0 vs. 42.9%, p<0.006). Venous pH was higher in patients with cardiotocography category I compared to cardiotocography category III (7.32 vs. 7.23, p=0.036). Prevalence of neonatal intensive care unit (NICU) admission was lower in neonates of patients with cardiotocography category I compared to cardiotocography category III (3.8 vs. 30.0%, p=0.014). Prevalence of composite adverse outcomes was lower in neonates of patients with cardiotocography category I compared to cardiotocography category II (9.5 vs. 30.0%, p=0.022) and cardiotocography category III (9.5 vs. 60.0%, p=0.0004). cardiotocography categories II and III had low sensitivity (0.05 and 0.00, respectively) and high negative predictive value (NPV) (0.84 and 0.91, respectively) for identifying fetal acidemia at birth. The three categories of intrapartum cardiotocography showed high specificities (96.0, 99.0, and 99.0%, respectively). CONCLUSION: All three categories of intrapartum cardiotocography showed low sensitivity and high specificity for identifying acidemia at birth. OBJECTIVE highrisk risk pregnancies METHODS <7.1. 71 <7.1 . 7 1 (<7.1) chisquare chi square KruskalWallis Kruskal Wallis tests RESULTS 2 90.0 900 90 0 (90. vs 429 42 9 42.9% p<0.006. p0006 p p<0.006 006 p<0.006) 7.32 732 32 (7.3 723 23 7.23 p=0.036. p0036 p=0.036 036 p=0.036) NICU (NICU 3.8 38 3 8 (3. 300 30 30.0% p=0.014. p0014 p=0.014 014 p=0.014) 9.5 95 5 (9. p=0.022 p0022 022 600 60 60.0% p=0.0004. p00004 p=0.0004 0004 p=0.0004) 0.05 005 05 (0.0 000 00 0.00 respectively NPV (NPV 0.84 084 84 (0.8 091 91 0.91 96.0, 960 96 (96.0 990 99 99.0 99.0% respectively. CONCLUSION <7. (<7.1 90. (90 4 42.9 p000 p<0.00 7.3 73 (7. 72 7.2 p003 p=0.03 03 3. (3 30.0 p001 p=0.01 01 9. (9 p=0.02 p002 02 6 60.0 p0000 p=0.000 0.0 (0. 0.8 08 09 0.9 96.0 (96. 99. <7 (<7. 42. p00 p<0.0 7. (7 p=0.0 ( 30. 60. p=0.00 0. (0 96. (96 < (<7 p0 p<0. p=0. (< p<0 p=0 p< p=

ABSTRACT Objective To assess the effects of enfuvirtide on pregnancy in albino rats and their fetuses. Methods Forty pregnant EPM 1 Wistar rats were randomly allocated into four groups: control (E) (distilled water twice/day), G1 (4mg/kg/day enfuvirtide), G2 (12mg/kg/day enfuvirtide), and G3 (36mg/kg/day enfuvirtide) groups. On the 20th day of gestation, the rats were anesthetized and subjected to cesarean section. Their blood was collected for laboratory analysis, and they were sacrificed. The offspring’s fragments of their kidneys, liver, and placentas and the maternal rats’ fragments of their lungs, kidneys, and liver were separated in the immediate postpartum period for light microscopy analysis. Results No maternal deaths occurred. In the second week at the end of pregnancy, the mean weight of the G3 Group was significantly lower than that of the G2 Group (p=0.029 and p=0.028, respectively). Analyzing blood laboratory parameters, the G1 Group had the lowest mean amylase level, and the G2 Group had the lowest mean hemoglobin level and the highest mean platelet count. In the morphological analysis, there were no changes in organs, such as the kidneys and liver, in both the maternal rats and offspring. Three maternal rats in the G3 Group had pulmonary inflammation in the lungs. Conclusion Enfuvirtide has no significant adverse effects on pregnancy, conceptual products, or functional alterations in maternal rats. fetuses groups E (E distilled twice/day, twiceday twice/day , twice twice/day) G 4mg/kg/day 4mgkgday mgkgday 4mg kg mg enfuvirtide, 12mg/kg/day 12mgkgday 12mg 36mg/kg/day 36mgkgday 36mg th gestation section analysis sacrificed offsprings offspring s lungs occurred p=0.029 p0029 p 0 029 (p=0.02 p0028 028 p=0.028 respectively. respectively . respectively) parameters count organs products p=0.02 p002 02 (p=0.0 p=0.0 p00 (p=0. p=0. p0 (p=0 p=0 (p= p= (p

SUMMARY OBJECTIVE: The aim of this study was to evaluate the accuracy of intrapartum cardiotocography in identifying fetal acidemia by umbilical cord blood analysis in low-risk pregnancies. METHODS: This is a retrospective cohort study of low-risk singleton pregnancies in labor after performing intrapartum cardiotocography categories I, II, and III. The presence of fetal acidemia at birth was identified by analyzing the pH of umbilical cord arterial blood (pH<7.1). RESULTS: No significant effect of the cardiotocography category on the arterial (p=0.543) and venous (p=0.770) pH of umbilical cord blood was observed. No significant association was observed between the cardiotocography category and the presence of fetal acidemia (p=0.706), 1-min Apgar score <7 (p=0.260), hospitalization in the neonatal intensive care unit (p=0.605), newborn death within the first 48 h, need for neonatal resuscitation (p=0.637), and adverse perinatal outcomes (p=0.373). Sensitivities of 62, 31, and 6.0%; positive predictive values of 11.0, 16.0, and 10.0%; and negative predictive values of 85, 89.0, and 87.0% were observed for cardiotocography categories I, II, and III, respectively. CONCLUSION: The three categories of intrapartum cardiotocography presented low sensitivities and high negative predictive values to identify fetal acidemia at birth in low-risk pregnancies. OBJECTIVE lowrisk risk METHODS I II III pH<7.1. pH71 pH<7.1 . 7 1 (pH<7.1) RESULTS p=0.543 p0543 p 0 543 (p=0.543 p=0.770 p0770 770 (p=0.770 p=0.706, p0706 p=0.706 , 706 (p=0.706) 1min min < p=0.260, p0260 p=0.260 260 (p=0.260) p=0.605, p0605 p=0.605 605 (p=0.605) 4 h p=0.637, p0637 p=0.637 637 (p=0.637) p=0.373. p0373 p=0.373 373 (p=0.373) 62 31 6.0% 60 6 110 11 11.0 160 16 16.0 10.0% 100 10 85 890 89 89.0 870 87 87.0 respectively CONCLUSION pH7 pH<7. (pH<7.1 p=0.54 p054 54 (p=0.54 p=0.77 p077 77 (p=0.77 p070 p=0.70 70 (p=0.706 p026 p=0.26 26 (p=0.260 p060 p=0.60 (p=0.605 p063 p=0.63 63 (p=0.637 p037 p=0.37 37 (p=0.373 3 6.0 11. 16. 10.0 8 89. 87. pH<7 (pH<7. p=0.5 p05 5 (p=0.5 p=0.7 p07 (p=0.7 (p=0.70 p02 p=0.2 2 (p=0.26 p06 p=0.6 (p=0.60 (p=0.63 p03 p=0.3 (p=0.37 6. 10. pH< (pH<7 p=0. p0 (p=0. (p=0.2 (p=0.6 (p=0.3 (pH< p=0 (p=0 (pH p= (p= (p

SUMMARY OBJECTIVE: This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia. METHODS: This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)—analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)—analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)—analgesia performed with cervical dilatation ≥9.0 cm. RESULTS: Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50–9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62–6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%). CONCLUSION: Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes. OBJECTIVE METHODS groups n=83analgesia n83analgesia nanalgesia n=83 n 83 40 4 0 ≤4. n=82analgesia n82analgesia n=82 82 50 5 5. 80 8 8. 90 9 ≥9. RESULTS 3.86fold 386fold fold 3.86 86 OR 386 95CI CI 95 1.50–9.87 150987 87 p=0.009 p0009 p 009 delivery 3.31fold 331fold 3.31 31 331 1.62–6.77 162677 62 6 77 p=0.0016 p00016 0016 section 20.7%, 207 20.7% , 20 7 (20.7%) 6.1%, 61 6.1% (6.1%) 4.9%. 49 4.9% . (4.9%) ≤ < st 44.6%. 446 44.6% 44 (44.6%) CONCLUSION 83analgesia n83 n=8 82analgesia n82 ≥9 86fold 3.8 38 1.50–9.8 15098 p=0.00 p000 00 31fold 3.3 33 1.62–6.7 16267 p=0.001 p0001 001 20.7 (20.7% 6.1 (6.1% 4.9 (4.9% 44.6 (44.6% n8 n= ≥ 3. 1.50–9. 1509 p=0.0 p00 1.62–6. 1626 20. (20.7 6. (6.1 4. (4.9 44. (44.6 1.50–9 150 p=0. p0 1.62–6 162 (20. (6. (4. (44. 1.50– 15 p=0 1.62– 16 (20 (6 (4 (44 1.50 p= 1.62 (2 ( 1.5 1.6 1.

Resumo Objetivo: Avaliar a capacidade do Doppler fetal e características materno-obstétricas na predição de cesariana por comprometimento fetal intraparto (CFI), índice de Apgar de 5º min < 7 e desfecho perinatal adverso (DPA) em uma população de alto risco. Materiais e Métodos: Estudo de coorte prospectivo envolvendo 613 parturientes admitidas para indução ou em início de trabalho de parto espontâneo que realizaram ultrassonografia Doppler nas 72 horas anteriores ao parto. Os desfechos foram cesariana por CFI, índice de Apgar de 5º min < 7 e DPA. Resultados: As características maternas não foram associadas nem preditoras de DPA. Índice de resistência (IR) da artéria umbilical (AU) anormal (p = 0,03) e necessidade de medidas de ressuscitação intrauterina (p < 0,0001) permaneceram como fatores de risco significativos para cesariana por CFI. IR AU > 95º e razão cerebroplacentária (RCP) < 0,98 foram preditores de cesariana. Idade gestacional e IR AU > 0,84 foram os preditores de índice de Apgar de 5º min < 7 para recém-nascidos < 29 e ≥ 29 semanas, respectivamente. IR AU e RCP apresentaram acurácia moderada na predição de DPA (área sob a curva ROC de 0,76 e 0,72, respectivamente). Conclusão: IR UA mostrou-se preditor significativo de DPA. RCP revelou-se possível preditora de cesariana por CFI e DPA em recémnascidos prematuros tardios e a termo. Objetivo maternoobstétricas materno obstétricas , (CFI) º (DPA Métodos 61 Resultados (IR (AU p 0,03 003 0 03 0,0001 00001 0001 (RCP 098 98 0,9 084 84 0,8 recém nascidos 2 semanas respectivamente área 076 76 0,7 072 0,72 . respectivamente) Conclusão mostrouse mostrou se revelouse revelou termo (CFI 6 0,0 00 0,000 0000 000 09 9 0, 08 8 07 0,00

Abstract Objective: To evaluate the capacity of fetal Doppler, maternal, and obstetric characteristics for the prediction of cesarean section due to intrapartum fetal compromise (IFC), a 5-min Apgar score < 7, and an adverse perinatal outcome (APO), in a high-risk population. Materials and Methods: This was a prospective cohort study involving 613 singleton pregnant women, admitted for labor induction or at the beginning of spontaneous labor, who underwent Doppler ultrasound within the last 72 h before delivery. The outcome measures were cesarean section due to IFC, a 5-min Apgar score < 7, and any APO. Results: We found that maternal characteristics were neither associated with nor predictors of an APO. Abnormal umbilical artery (UA) resistance index (RI) and the need for intrauterine resuscitation were found to be significant risk factors for cesarean section due to IFC (p = 0.03 and p < 0.0001, respectively). A UA RI > the 95th percentile and a cerebroplacental ratio (CPR) < 0.98 were also found to be predictors of cesarean section due to IFC. Gestational age and a UA RI > 0.84 were found to be predictors of a 5-min Apgar score < 7 for newborns at < 29 and ≥ 29 weeks, respectively. The UA RI and CPR presented moderate accuracy in predicting an APO, with areas under the ROC curve of 0.76 and 0.72, respectively. Conclusion: A high UA RI appears to be a significant predictor of an APO. The CPR seems to be predictive of cesarean section due to IFC and of an APO in late preterm and term newborns. Objective , (IFC) 5min min 5 (APO) highrisk population Methods 61 women delivery Results (UA (RI 003 0 03 0.0 00001 0001 0.0001 respectively . respectively) th (CPR 098 98 0.9 084 84 0.8 2 weeks 076 76 0.7 072 0.72 Conclusion (IFC (APO 6 00 0. 0000 000 0.000 09 9 08 8 07 0.00

Resumo Objetivo Avaliar a associação da intensidade da dor na fase ativa da dilatação do parto em mulheres de acordo com a utilização ou não de métodos não farmacológicos para alívio da dor em cenário de vida real. Métodos Trata-se de um estudo observacional de corte transversal. As variáveis analisadas foram obtidas através de questionário com as puérperas (até 48 horas pós-parto) investigando a intensidade da dor no parto pela escala visual analógica (EVA). As medidas não farmacológicas de alívio da dor, utilizadas rotineiramente na prática obstétrica, foram avaliadas pela consulta aos prontuários. As pacientes foram separadas em dois grupos: Grupo I – pacientes que não utilizaram medidas não farmacológicas para alívio da dor e Grupo II - pacientes que utilizaram estas medidas. Resultados Foram incluídas 439 mulheres que tiveram parto vaginal, sendo que 386 (87,9%) utilizaram, pelo menos, uma medida não farmacológica e 53 (12,1%) não utilizaram. As mulheres que não utilizaram as medidas não farmacológicas apresentaram idade gestacional significativamente menor (37,2 versus 39,6 semanas, p < 0,001) e menor duração do trabalho de parto (24 versus 114 minutos, p < 0,001) quando comparadas às que utilizaram as medidas. Não houve diferença estatisticamente significativa na pontuação da escala da dor pela EVA de acordo com a categorização pelo uso ou não de métodos não farmacológicos (mediana 10 [mínimo 2–máximo 10] versus 10 (mínimo 6–máximo 10), p = 0,334]. Conclusão Em cenário de vida real, as pacientes submetidas aos métodos não farmacológicos não apresentaram diferença em relação à intensidade da dor quando comparadas às que não os utilizaram durante a fase ativa do trabalho de parto. real Tratase Trata se transversal até 4 pósparto pós pós-parto EVA. . (EVA) obstétrica prontuários grupos 43 vaginal 38 87,9% 879 87 9 (87,9% menos 5 12,1% 121 12 1 (12,1% 37,2 372 37 2 (37, 396 39 6 39, semanas 0,001 0001 0 001 24 (2 11 minutos mediana mínimo 2máximo máximo 6máximo 10, , 10) 0,334. 0334 0,334 334 0,334] (EVA 3 87,9 8 (87,9 12,1 (12,1 37, (37 0,00 000 00 ( 033 0,33 33 87, (87, 12, (12, (3 0,0 03 0,3 (87 (12 0, (8 (1

Abstract Objective To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario. Methods This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I – patients who did not use nonpharmacological methods for pain relief and Group II –patients who used these methods. Results A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2– maximum 10] versus 10 [minimum 6–maximum 10] p = 0.334). Conclusion In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor. reallife real life scenario crosssectional cross sectional study up 4 postpartum VAS. . (VAS) records groups 43 included 38 87.9% 879 87 9 (87.9% 5 12.1% 121 12 (12.1% 37.2 372 37 2 (37. 396 39 6 39. weeks 0.001 0001 0 001 24 (2 11 min median minimum 6maximum 0.334. 0334 0.334 334 0.334) setting (VAS 3 87.9 8 (87.9 12.1 (12.1 37. (37 0.00 000 00 ( 033 0.33 33 87. (87. 12. (12. (3 0.0 03 0.3 (87 (12 0. (8 (1