Resumo Introdução: A doença renal crônica (DRC) e a síndrome metabólica (SM) são reconhecidas como problemas de saúde pública relacionados ao excesso de peso e a fatores cardiometabólicos. O objetivo deste estudo foi desenvolver um modelo para prever a SM em pessoas com DRC. Métodos: Este foi um estudo transversal prospectivo de pacientes de um centro de referência em São Luís, MA, Brasil. A amostra incluiu voluntários adultos classificados de acordo com a presença de DRC leve ou grave. Para o rastreamento da SM, o algoritmo de classificação k-nearest neighbors (KNN) foi utilizado com os seguintes dados: sexo, tabagismo, circunferência do pescoço e relação cintura-quadril. Os resultados foram considerados significativos com p < 0,05. Resultados: Foram avaliados 196 pacientes adultos com média de idade de 44,73 anos, 71,9% do sexo feminino, 69,4% com sobrepeso e 12,24% com DRC. Desses últimos, 45,8% apresentaram SM, a maioria tinha até 3 componentes metabólicos alterados, e o grupo com DRC apresentou significância estatística em: circunferência da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia de jejum. O algoritmo KNN comprovou ser um bom preditor para a triagem de SM com acurácia e sensibilidade de 79% e especificidade de 80% (área sob a curva ROC – AUC = 0,79). Conclusão: O algoritmo KNN pode ser usado como um método de triagem de baixo custo para avaliar a presença de SM em pessoas com DRC. Introdução (DRC (SM cardiometabólicos Métodos Luís MA Brasil grave knearest k nearest (KNN dados tabagismo cinturaquadril. cinturaquadril cintura quadril. quadril cintura-quadril 005 0 05 0,05 Resultados 19 4473 44 73 44,7 anos 719 71 9 71,9 feminino 694 69 4 69,4 1224 12 24 12,24 últimos 458 45 8 45,8 alterados sistólica jejum 79 80 área 0,79. 079 0,79 . 0,79) Conclusão 00 0,0 1 447 7 44, 71, 6 69, 122 2 12,2 45, 07 0,7 0, 12,

Abstract Introduction: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD. Methods: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05. Results: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve – AUC = 0.79). Conclusion: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD. Introduction (CKD (MS factors Methods crosssectional cross sectional Luís MA Brazil tracking knearest k nearest (KNN inputs gender smoking circumference waisttohip hip ratio 005 0 05 0.05 19 4473 44 73 44.7 years 719 71 9 71.9 female 694 69 4 69.4 1224 12 24 12.24 latter 458 45 8 45.8 components pressure glucose 79 80 area 0.79. 079 0.79 . 0.79) Conclusion lowcost low cost 00 0.0 1 447 7 44. 71. 6 69. 122 2 12.2 45. 07 0.7 0. 12.

Abstract RhD alloimmunization in pregnancy is still the main cause of hemolytic disease of the fetus and neonate (HDFN). Nevertheless, there are other antigens that may be associated with the occurrence of this phenomenon and that have been growing in proportion, given that current prevention strategies focus only on anti-RhD antibodies. Although not widespread, the screening and diagnostic management of the disease caused by these antibodies has recommendations in the literature. For this reason, the following review was carried out with the objective of listing the main red blood cell antigen groups described — such as Rh, ABO, Kell, MNS, Duffy, Kidd, among others — addressing the clinical importance of each one, prevalence in different countries, and recommended management when detecting such antibodies during pregnancy. HDFN. HDFN . (HDFN) Nevertheless proportion antiRhD anti widespread literature reason Rh ABO Kell MNS Duffy Kidd one countries (HDFN

SUMMARY OBJECTIVE: The aim of this study was to analyze the outcomes of newborns with Down syndrome admitted to three neonatal intensive care units in the city of Rio de Janeiro, Brazil. METHODS: A retrospective cohort study was conducted by analyzing the medical records between 2014 and 2018 of newborns with Down syndrome admitted to three neonatal intensive care units. The following variables were analyzed: maternal and perinatal data, neonatal malformations, neonatal intensive care unit intercurrences, and outcomes. RESULTS: A total of 119 newborns with Down syndrome were recruited, and 112 were selected for analysis. The most common maternal age group was >35 years (72.07%), the most common type of delivery was cesarean section (83.93%), and the majority of cases were male (53.57%). The most common reasons for neonatal intensive care unit hospitalization were congenital heart disease (57.66%) and prematurity (23.21%). The most common form of feeding was a combination of human milk and formula (83.93%). The second most common malformation was duodenal atresia (9.82%). The most common complications during neonatal intensive care unit hospitalization were transient tachypnea of the newborn (63.39%), hypoglycemia (18.75%), pulmonary hypertension (7.14%), and sepsis (7.14%). The mean length of stay in the neonatal intensive care unit was 27 days. The most common outcome was discharge (82.14%). Furthermore, 12.50% of newborns were transferred to an external neonatal intensive care unit, and 6% died. CONCLUSION: Newborns with Down syndrome are more likely to be admitted to the neonatal intensive care unit, and the length of hospital stay is longer due to complications related to congenital malformations common to this syndrome and prematurity. OBJECTIVE Janeiro Brazil METHODS 201 analyzed data intercurrences RESULTS 11 recruited analysis 35 >3 72.07%, 7207 72.07% , 72 07 (72.07%) 83.93%, 8393 83.93% 83 93 (83.93%) 53.57%. 5357 53.57% . 53 57 (53.57%) 57.66% 5766 66 (57.66% 23.21%. 2321 23.21% 23 21 (23.21%) 83.93%. 9.82%. 982 9.82% 9 82 (9.82%) 63.39%, 6339 63.39% 63 39 (63.39%) 18.75%, 1875 18.75% 18 75 (18.75%) 7.14%, 714 7.14% 7 14 (7.14%) 7.14%. 2 days 82.14%. 8214 82.14% (82.14%) Furthermore 1250 12 50 12.50 6 died CONCLUSION 20 1 3 > 720 72.07 0 (72.07% 839 83.93 8 (83.93% 535 53.57 5 (53.57% 57.66 576 (57.66 232 23.21 (23.21% 98 9.82 (9.82% 633 63.39 (63.39% 187 18.75 (18.75% 71 7.14 (7.14% 821 82.14 (82.14% 125 12.5 72.0 (72.07 83.9 (83.93 53.5 (53.57 57.6 (57.6 23.2 (23.21 9.8 (9.82 63.3 (63.39 18.7 (18.75 7.1 (7.14 82.1 (82.14 12. 72. (72.0 83. (83.9 53. (53.5 57. (57. 23. (23.2 9. (9.8 63. (63.3 18. (18.7 7. (7.1 82. (82.1 (72. (83. (53. (57 (23. (9. (63. (18. (7. (82. (72 (83 (53 (5 (23 (9 (63 (18 (7 (82 (8 ( (2 (6 (1

Resumo Objetivo: Estudar o efeito da administração antenatal de corticosteroides na hemodinâmica fetal mediante análise longitudinal do Doppler na artéria umbilical (AU) e artéria cerebral média (ACM). Materiais e Métodos: Este foi um estudo retrospectivo que incluiu 30 fetos com risco de nascimento pré-termo. Vinte e oito gestantes foram tratadas com betametasona para maturação pulmonar fetal. Os exames de Doppler da AU e da ACM foram realizados uma vez antes e depois da administração de corticosteroides, num total de três ou oito observações. Utilizamos o modelo linear hierárquico com abordagem Bayesiana. Foram construídos os intervalos de referência e testadas associações entre variáveis (idade gestacional e pré-eclâmpsia). Resultados: A média ± desvio-padrão da idade materna, idade gestacional na administração de betametasona e idade gestacional no parto foram 32,6 ± 5,89 anos, 30,2 ± 2,59 semanas e 32,9 ± 3,42 semanas, respectivamente. No Doppler da AU, verificou-se diminuição significativa do índice de pulsatilidade (IP) com a terapêutica com corticosteroides (média: 0,1147 [0,03687-0,191]; em três observações) (mediana: 0,1437 [0,02509-0,2627]; em oito observações). No entanto, não foi observada alteração significativa no IP do Doppler da ACM, independentemente da idade gestacional e do diagnóstico de pré-eclâmpsia. Conclusão: Os corticosteroides pré-natais induziram diminuição significativa no IP do Doppler da AU, mas não houve alteração na vasculatura cerebral. Objetivo (AU ACM. . (ACM) Métodos 3 prétermo. prétermo pré termo. termo pré-termo observações Bayesiana préeclâmpsia. préeclâmpsia eclâmpsia pré-eclâmpsia) Resultados desviopadrão desvio padrão materna 326 32 6 32, 589 5 89 5,8 anos 302 2 30, 259 59 2,5 329 9 342 42 3,4 respectivamente verificouse verificou se (IP (média 01147 0 1147 0,114 0,036870,191 0036870191 0,03687 0,191 03687 191 [0,03687-0,191] mediana (mediana 01437 1437 0,143 0,025090,2627 00250902627 0,02509 0,2627 02509 2627 [0,02509-0,2627] entanto eclâmpsia. pré-eclâmpsia Conclusão prénatais natais (ACM 58 8 5, 25 2, 34 4 3, 0114 114 0,11 036870 0,036870,19 003687019 003687 0,0368 0191 0,19 0368 19 [0,03687-0,191 0143 143 0,14 025090 0,025090,262 0025090262 002509 0,0250 02627 0,262 0250 262 [0,02509-0,2627 011 11 0,1 0,036870,1 00368701 00368 0,036 019 036 1 [0,03687-0,19 014 14 0,025090,26 002509026 00250 0,025 0262 0,26 025 26 [0,02509-0,262 01 0, 0,036870, 0036870 0036 0,03 03 [0,03687-0,1 0,025090,2 00250902 0025 0,02 026 0,2 02 [0,02509-0,26 0,036870 003 0,0 [0,03687-0, 0,025090, 0025090 002 [0,02509-0,2 00 [0,03687-0 0,025090 [0,02509-0, [0,03687- [0,02509-0 [0,03687 [0,02509- [0,0368 [0,02509 [0,036 [0,0250 [0,03 [0,025 [0,0 [0,02 [0, [0 [

Abstract Objective: To study the effect of antenatal corticosteroid administration on fetal hemodynamics using longitudinal analysis of Doppler waveforms in the umbilical artery (UA) and middle cerebral artery (MCA). Materials and Methods: This was a retrospective study that included 30 fetuses at risk for preterm birth. Twenty-eight pregnant women were treated with betamethasone for fetal lung maturation. Doppler examinations of the UA and MCA were performed once before and three or eight times after corticosteroid administration. We used a Bayesian hierarchical linear model. Reference ranges were constructed, and associations between variables (gestational age and pre-eclampsia) were tested. Results: The mean maternal age, gestational age at betamethasone administration, and gestational age at delivery were 32.6 ± 5.89 years, 30.2 ± 2.59 weeks, and 32.9 ± 3.42 weeks, respectively. On UA Doppler, there was a significant decrease in the pulsatility index (PI) after corticosteroid administration, with a mean of 0.1147 (credibility interval: 0.03687-0.191) in three observations and a median of 0.1437 (credibility interval: 0.02509-0.2627) in eight observations. However, there was no significant change in the Doppler MCA PI, regardless of gestational age and the presence or absence of pre-eclampsia. Conclusion: Although antenatal corticosteroid administration induced a significant decrease in the Doppler UA PI, we observed no change in the cerebral vasculature. Objective (UA MCA. . (MCA) Methods 3 birth Twentyeight Twenty maturation model constructed preeclampsia pre eclampsia pre-eclampsia tested Results 326 32 6 32. 589 5 89 5.8 years 302 2 30. 259 59 2.5 weeks 329 9 342 42 3.4 respectively PI (PI 01147 0 1147 0.114 credibility interval 0.036870.191 0036870191 0.03687 0.191 03687 191 0.03687-0.191 01437 1437 0.143 0.025090.2627 00250902627 0.02509 0.2627 02509 2627 0.02509-0.2627 However preeclampsia. eclampsia. Conclusion vasculature (MCA 58 8 5. 25 2. 34 4 3. 0114 114 0.11 036870 0.036870.19 003687019 003687 0.0368 0191 0.19 0368 19 0.03687-0.19 0143 143 0.14 025090 0.025090.262 0025090262 002509 0.0250 02627 0.262 0250 262 0.02509-0.262 011 11 0.1 0.036870.1 00368701 00368 0.036 019 036 1 0.03687-0.1 014 14 0.025090.26 002509026 00250 0.025 0262 0.26 025 26 0.02509-0.26 01 0. 0.036870. 0036870 0036 0.03 03 0.03687-0. 0.025090.2 00250902 0025 0.02 026 0.2 02 0.02509-0.2 0.036870 003 0.0 0.03687-0 0.025090. 0025090 002 0.02509-0. 00 0.03687- 0.025090 0.02509-0 0.02509-

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 evaluate the serum hCG level in the differential diagnosis between non-molar miscarriage and complete hydatidiform mole in<11 weeks gestation. METHODS: This was a retrospective collaborative cohort study. This study included women with gestational age<11 weeks, with ultrasound evidence of failed pregnancy and available serum hCG pre-uterine evacuation, divided into two groups: the non-molar miscarriage group and the complete hydatidiform mole group. Serum hCG levels were compared according to gestational age. Statistical analysis used a nonparametric test with a 5% significance level (p<0.05). RESULTS: In total, 416 patients were included, out of which 79 were included in the non-molar miscarriage group and 337 in the complete hydatidiform mole group. The calculated power of the sample was more than 80%. Data analysis showed that the 75th quartile of the median in the non-molar miscarriage group was always lower than the 25th quartile of the median in the complete hydatidiform mole group [9,721 mUI/mL/16,435 mUI/mL (6–7 weeks), 20,229 mUI/mL/64,911 mUI/mL (8–9 weeks), and 29,633 mUI/mL/126,278 mUI/mL (10–11 weeks), respectively; p<0.001]. CONCLUSION: Facing failed pregnancies, hCG>16,435 mUI/mL at 6–7 weeks, hCG>64,911 mUI/mL at 8–9 weeks, and hCG >126,278 mUI/mL at 10–11 weeks were most prevalent on complete hydatidiform mole diagnosis. On the contrary, hCG<30,000 mUI/mL at 10–11 weeks was most prevalent in non-molar miscarriage diagnosis. OBJECTIVE nonmolar non molar in11 11 in<1 gestation METHODS age11 age age<1 preuterine pre uterine evacuation groups 5 p<0.05. p005 p p<0.05 . 0 05 (p<0.05) RESULTS total 41 7 33 80 80% th 9,721 9721 9 721 [9,72 mUImL16435 mUImL mUI mL 16 435 mUI/mL/16,43 67 6 (6– , weeks) 20229 20 229 20,22 mUImL64911 64 911 mUI/mL/64,91 89 8 (8– 29633 29 633 29,63 mUImL126278 126 278 mUI/mL/126,27 1011 10 (10–1 respectively p<0.001. p0001 p<0.001 001 p<0.001] CONCLUSION pregnancies hCG16435 hCG>16,43 6– hCG64911 hCG>64,91 8– 126278 >126,27 10–1 contrary hCG30000 30 000 hCG<30,00 in1 1 in< age1 age< p00 p<0.0 (p<0.05 4 3 9,72 972 72 [9,7 mUImL1643 43 mUI/mL/16,4 (6 2022 2 22 20,2 mUImL6491 91 mUI/mL/64,9 (8 2963 63 29,6 mUImL12627 12 27 mUI/mL/126,2 101 (10– p000 p<0.00 00 hCG1643 hCG>16,4 hCG6491 hCG>64,9 12627 >126,2 10– hCG3000 hCG<30,0 p0 p<0. (p<0.0 9,7 97 [9, mUImL164 mUI/mL/16, ( 202 20, mUImL649 mUI/mL/64, 296 29, mUImL1262 mUI/mL/126, (10 hCG164 hCG>16, hCG649 hCG>64, 1262 >126, hCG300 hCG<30, p<0 (p<0. 9, [9 mUImL16 mUI/mL/16 mUImL64 mUI/mL/64 mUImL126 mUI/mL/126 (1 hCG16 hCG>16 hCG64 hCG>64 >126 hCG30 hCG<30 p< (p<0 [ mUImL1 mUI/mL/1 mUImL6 mUI/mL/6 mUImL12 mUI/mL/12 hCG1 hCG>1 hCG6 hCG>6 >12 hCG3 hCG<3 (p< mUI/mL/ hCG> >1 hCG< (p >

Abstract Objective: To evaluate whether there were differences in the presentation of patients with tubal ectopic pregnancy (EP) during the first year of the COVID-19 pandemic. Methods: We performed a retrospective cohort study of all cases of tubal EP between March 2019 and March 2020 (pre-pandemic) and between March 2020 and March 2021 (pandemic). We compared between these two groups the risk factors, clinical characteristics, laboratory data, sonographic aspects, treatment applied and complications. Results: We had 150 EP diagnoses during the two years studied, of which 135 were tubal EP. Of these, 65 were included in the pre-pandemic and 70 in the pandemic period. The prevalence of lower abdominal pain was significantly higher in the pandemic compared to the pre-pandemic period (91.4% vs. 78.1%, p=0.031). There was no significant difference in shock index, initial beta-hCG level, hemoglobin level at diagnosis, days of menstrual delay, aspect of the adnexal mass, amount of free fluid on ultrasound, and intact or ruptured presentation between the groups. Expectant management was significantly higher during the pandemic period (40.0% vs. 18.5%, p=0.008), surgical management was lower during the pandemic period (47.1% vs. 67.7%, p=0.023), and number of days hospitalized was lower in the pandemic period (1.3 vs. 2.0 days, p=0.003). Conclusion: We did not observe a significant difference in patient history, laboratory and ultrasound characteristics. Abdominal pain was more common during the pandemic period. Regarding treatment, we observed a significant increase in expectant and a decrease in surgical cases during the pandemic period. Objective (EP COVID19 COVID 19 COVID-1 Methods 201 202 prepandemic pre (pre-pandemic . (pandemic) factors characteristics data aspects complications Results 15 studied 13 6 7 91.4% 914 91 4 (91.4 vs 781 78 1 78.1% p=0.031. p0031 p p=0.031 0 031 p=0.031) index betahCG beta hCG diagnosis delay mass 40.0% 400 40 (40.0 185 18 5 18.5% p=0.008, p0008 p=0.008 , 008 p=0.008) 47.1% 471 47 (47.1 677 67 67.7% p=0.023, p0023 p=0.023 023 p=0.023) 1.3 3 (1. 20 2 2. p=0.003. p0003 p=0.003 003 p=0.003) Conclusion history COVID1 COVID- (pandemic 91.4 9 (91. 78.1 p003 p=0.03 03 40.0 (40. 18.5 p000 p=0.00 00 47.1 (47. 67.7 p002 p=0.02 02 1. (1 91. (91 78. p00 p=0.0 40. (40 18. 47. (47 67. ( (9 p0 p=0. (4 p=0 p=

Abstract Objective To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses. Methods Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10). Results Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476). Conclusion Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses. (RC (FGR (SGA 2018 (201 2019. 2019 . 2019) Consensus 1–5.1 151 5 (1–5. 5.2–10. 5210 5.2–10 2 5.2–10) 85 included n 85, , 85) 20 n=747. n747 n=747 747 (n=747) 1500 500 1,50 p<0.001 p0001 p 0 001 (p<0.001 (CS p<0.001. 51 5. 52 15.1 1-5. p=0.476. p0476 p=0.476 476 (p=0.476) 60 morbidity Therefore 201 (20 1–5. 15 (1–5 521 5.2–1 8 n74 n=74 74 (n=747 150 50 1,5 p<0.00 p000 00 (p<0.00 15. 1-5 p047 p=0.47 47 (p=0.476 6 (2 1–5 (1– 5.2– n7 n=7 7 (n=74 1, p<0.0 p00 (p<0.0 1- p04 p=0.4 4 (p=0.47 ( 1– (1 n= (n=7 p<0. p0 (p<0. p=0. (p=0.4 (n= p<0 (p<0 p=0 (p=0. p< (p< p= (p=0 (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.

ABSTRACT Objective: This study aimed to evaluate whether severity changes with colposcopic lesion size, regardless of age. Methods: This retrospective comparative study reviewed the records of 428 women with altered cytopathology reports who were directed by primary health care. Only those women with colposcopic alterations were evaluated (n=411). Histopathological analyses were restricted to patients who underwent excisional treatment (n=345). According to their age, they were grouped into the following: <21, 21–24, 25–35, and >35 years, and also, ≤24 and ≥25 years. The cytopathological, colposcopic, and histopathological findings were grouped according to severity. Lesion size was subjectively assessed from the colposcopic drawing recorded in the chart and according to the number of quadrants of the total cervical surface affected by colposcopic alterations in the transformation zone. Statistical significance was set at p<0.05. Results: The evaluations suggested that the lesion size was directly related to the severity of the cytopathology, colposcopy, and histopathology reports for the age groups ≤24 or ≥25 years. We observed associations between lesion size and severity of the cytopathology (≤24 years, p=0.037) and histopathology (≥25 years, p=0.003) findings. Conclusion: The size of the lesion was directly related to the severity of the histopathological lesion in patients aged ≥25 years and cytopathological in patients aged ≤24 years. Objective Methods 42 care n=411. n411 n n=411 . 411 (n=411) n=345. n345 n=345 345 (n=345) following 21 <21 2124 24 21–24 2535 25 35 25–35 >3 also ≤2 ≥2 zone p005 p 0 05 p<0.05 Results colposcopy (≤2 p=0.037 p0037 037 (≥2 p=0.003 p0003 003 Conclusion 4 n41 n=41 41 (n=411 n34 n=34 34 (n=345 2 <2 212 21–2 253 3 25–3 > ≤ ≥ p00 p<0.0 (≤ p=0.03 p003 03 (≥ p=0.00 p000 00 n4 n=4 (n=41 n3 n=3 (n=34 < 21– 25– p0 p<0. ( p=0.0 n= (n=4 (n=3 p<0 p=0. (n= p< p=0 (n p=

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