Abstract Objectives: the objective this study was evaluating the prevalence of maternal colonization by Group B beta-hemolytic Streptococcus (GBS) in pregnant women who delivered preterm and its relationship with adverse maternal/perinatal outcomes. Methods: we carried out a retrospective cohort study with singleton pregnancies with or without a culture for GBS (vaginal-rectum) who delivered spontaneously <37 weeks of gestation. Results: the study included 190 pregnant women, 53.1% (101/190) did not undergo culture for GBS and 46.8% (89/101) have done. Among the patients who had a culture, 13.5% (12/89) had positive culture for GBS and 86.5% (77/89) had a negative culture. Pregnant women without GBS culture had higher prevalence of preterm birth (74.3 vs. 59.6%, p=0.031) and lower prevalence of antibiotic prophylaxis (27.7 vs. 56.2%, p<0.001) than pregnant women with GBS culture. Higher prevalence of crystalline penicillin G use was observed in pregnant women with positive culture compared to pregnant women with negative culture for GBS (100 vs. 39%, p<0.0001). There was no significant association between pregnant women with or without a culture for GBS or positive and negative GBS cultures and adverse maternal/perinatal outcomes. Conclusion: No significant association was found between GBS culture or not, GBS positive or negative culture, adequate or inadequate GBS prophylaxis, and the prevalence of adverse maternal/perinatal outcomes.

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.

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 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=

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

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 BACKGROUND: Concerns regarding high open surgery-related maternal morbidity have led to improvements in minimally invasive fetal surgeries. OBJECTIVE: To analyze the perinatal and maternal outcomes of minimally invasive fetal surgery performed in Rio de Janeiro, Brazil. DESIGN AND SETTING: Retrospective cohort study conducted in two tertiary reference centers. METHODS: This retrospective descriptive study was conducted using medical records from 2011 to 2019. The outcomes included maternal and pregnancy complications, neonatal morbidity, and mortality from the intrauterine period to hospital discharge. RESULTS: Fifty mothers and 70 fetuses were included in this study. The pathologies included twin-twin transfusion syndrome, congenital diaphragmatic hernia, myelomeningocele, lower urinary tract obstruction, pleural effusion, congenital upper airway obstruction syndrome, and amniotic band syndrome. Regarding maternal complications, 8% had anesthetic complications, 12% had infectious complications, and 6% required blood transfusions. The mean gestational age at surgery was 25 weeks, the mean gestational age at delivery was 33 weeks, 83% of fetuses undergoing surgery were born alive, and 69% were discharged from the neonatal intensive care unit. CONCLUSION: Despite the small sample size, we demonstrated that minimally invasive fetal surgeries are safe for pregnant women. Perinatal mortality and prematurity rates in this study were comparable to those previously. Prematurity remains the most significant problem associated with fetal surgery. BACKGROUND surgeryrelated related OBJECTIVE Janeiro Brazil SETTING centers METHODS 201 2019 complications discharge RESULTS 7 twintwin twin syndrome hernia myelomeningocele effusion 8 12 6 transfusions 2 weeks 3 83 alive 69 unit CONCLUSION size women previously 20 1

SUMMARY OBJECTIVE: The aim of this study was to understand the dynamics of families with children with myelomeningocele undergoing intrauterine fetal surgery. METHODS: A retrospective cohort pilot study was carried out with 11 mothers of children who had undergone intrauterine myelomeningocele repair. Participants in this study responded to an electronic questionnaire (via Google Forms), developed by the study authors, that consisted of 22 multiple-choice questions, of which 17 were closed-ended and 5 had a standardized format. RESULTS: The mean (± standard deviation) of the mothers’ age was 37.6 (± 3.5) years. The median of gestational age at delivery and birthweight were 34.9 (range, 33 to 36.1) weeks and 2,300 (range, 1,950 to 2,763) g, respectively. The majority of mothers were white (81.8%), had university degree (81.8%), were Catholic (63.6%), and were married (100%). The majority of mothers rated their relationship with their husband, family, and friends as excellent (54.5, 72.7, and 54.5%, respectively). All 11 mothers reported that the newborn with myelomeningocele was born <37 weeks gestation and the birthweight most often<2,500 g. Approximately 64% of the mothers reported that their child required adaptations or had special needs, of which walking aids (50%) and bladder control (50%) were the most common ones. CONCLUSION: Telemedicine proved to be a useful tool in the long-term follow-up of children who underwent intrauterine surgery to correct myelomeningocele. OBJECTIVE METHODS 1 repair via Forms, Forms , Forms) authors 2 multiplechoice multiple choice questions closedended closed ended format RESULTS ± ( deviation 376 37 6 37. 3.5 35 3 years 349 34 9 34. range, range (range 36.1 361 36 2300 300 2,30 1950 950 1,95 2,763 2763 763 g respectively 81.8%, 818 81.8% 81 8 (81.8%) 63.6%, 636 63.6% 63 (63.6%) 100%. 100 100% . (100%) husband family 54.5, 545 54 (54.5 727 72 7 72.7 54.5% respectively) <3 often2500 often 500 often<2,50 64 needs 50% 50 (50% ones CONCLUSION longterm long term followup follow up 3. 36. 230 30 2,3 195 95 1,9 2,76 276 76 81.8 (81.8% 63.6 (63.6% 10 (100% 54.5 (54. 72. < often250 often<2,5 (50 23 2, 19 1, 2,7 27 81. (81.8 63. (63.6 (100 54. (54 often25 often<2, (5 (81. (63. (10 often2 often<2 (81 (63 (1 often< (8 (6

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 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 >

SUMMARY OBJECTIVE: The aim of this study was to assess the dietary pattern of healthy adult and adolescent women, pregnant and non-pregnant, and relate this profile to clinical and laboratory characteristics. METHODS: A prospective cohort study was carried out with 40 women who met the selection criteria: 10 non-pregnant adults, 10 pregnant adults, 10 non-pregnant adolescents, and 10 pregnant adolescents. Dietary data were collected using a registration form, a 24-h recall, and a food frequency questionnaire. Serum levels of interleukin 6 and tumor necrosis factor α were determined by capture ELISA. RESULTS: The majority of women were married (22.5%), had completed high school (57.5%), and were white (47.5%). Overall, only one (10%) pregnant adult reported smoking. Dietary supplement use was reported by eight (80%) pregnant adults, four (40%) pregnant adolescents, two (20%) non-pregnant adolescents, and no non-pregnant adults. Pregnant adolescents had a higher intake of omega-3 when compared to pregnant adults and non-pregnant adults (p=0.01 and 0.02, respectively). Pregnant adolescents consumed less minimally processed foods than pregnant adults, non-pregnant adults, and non-pregnant adolescents (p=0.008, 0.019, and 0.024, respectively). Serum levels of tumor necrosis factor α and interleukin 6 did not show statistical differences among the four groups (p=0.229 and 0.440, respectively). CONCLUSIONS: The dietary patterns of healthy adult and adolescent women, whether pregnant or not, were similar, with pregnant adolescents having a higher intake of omega-3. Pregnant adolescents ate less in natura (minimally processed) food than all the other women. OBJECTIVE nonpregnant, nonpregnant non pregnant, characteristics METHODS 4 criteria 1 form 24h h 24 recall questionnaire ELISA RESULTS 22.5%, 225 22.5% , 22 5 (22.5%) 57.5%, 575 57.5% 57 (57.5%) 47.5%. 475 47.5% . 47 (47.5%) Overall 10% (10% smoking 80% 80 (80% 40% (40% 20% 20 (20% omega3 omega 3 omega- p=0.01 p001 p 0 01 (p=0.0 002 02 0.02 respectively. respectively respectively) p=0.008, p0008 008 (p=0.008 0019 019 0.019 0024 024 0.024 p=0.229 p0229 229 (p=0.22 0440 440 0.440 CONCLUSIONS similar omega3. 3. 2 22.5 (22.5% 57.5 (57.5% 47.5 (47.5% (10 8 (80 (40 (20 p=0.0 p00 (p=0. 00 0.0 p=0.008 p000 (p=0.00 001 0.01 p=0.22 p022 (p=0.2 044 44 0.44 22. (22.5 57. (57.5 47. (47.5 (1 (8 (4 (2 p=0. p0 (p=0 0. p=0.00 p=0.2 p02 04 0.4 (22. (57. (47. ( p=0 (p= (22 (57 (47 p= (p (5