Abstract Introduction Chagas’ Disease is responsible for a high rate of morbimortality in Brazil however its real relevance on the maternal mortality is unknown. Objective The aim of this study is to review the literature on the impact of Chagas’ Disease on the Brazilian maternal mortality during the pregnancy-puerperal cycle. Method A review of literature was conducted to identify publications about maternal mortality and Chagas’ Disease. Documents were also searched in the websites of the Brazilian Ministry of Health, World Health Organization (WHO), System of Information about Mortality (SIM) and Brazilian Society of Cardiology (SBC). Manuscripts, master’s degree and PhD thesis, consensus, epidemiologic bulletins and manuals were analyzed. Results Initially were found 1326 paper, however just 14 answered the objective. Five epidemiologic bulletins, 4 manuals of Ministry of Health, 3 consensuses of SBC, 1 book and 3 master’s degree thesis were also used. There is no description of the number of deaths of pregnant women per year caused by complications of Chagas’ Disease in the data of the Ministry of Health and in the SIM. According to the data found, one third of pregnant women with Chagas' Disease are cardiac patients and the mortality among them is 3.5%, therefore is expected a mortality of about 1% in the pregnant-puerperal cycle. There is evidence of underreporting of maternal mortality among chagasic pregnant women. Conclusion The maternal mortality caused by Chagas’ Disease is not known, therefore more studies about it are necessary, in all clinical forms of the disease. Chagas unknown pregnancypuerperal pregnancy puerperal cycle WHO, WHO , (WHO) SIM (SIM SBC. SBC . (SBC) Manuscripts masters master s consensus analyzed 132 paper objective used 35 5 3.5% pregnantpuerperal known necessary disease (WHO (SBC 13 3.5 3.

ABSTRACT Objective Vitamin D has several metabolic functions and possible reproductive functions. This study aimed to determine the prevalence of vitamin D deficiency among Brazilian women of reproductive age, and to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and infertility causes. Subjects and methods This retrospective cross-sectional study evaluated data from a private Brazilian assisted reproduction center that were collected between January 1 and May 5, 2012. Serum 25(OH)D concentrations were measured and compared for infertile and fertile women. Concentrations of 25(OH)D that were < 20 ng/mL were defined as deficiency and concentrations of 21-30 ng/mL were defined as hypovitaminosis D. Results Among the 369 evaluated women, 81.1% exhibited hypovitaminosis D and 32.0% exhibited deficiency. The infertile and control patients did not exhibit any significant differences in the prevalence of vitamin D deficiency (30.2% vs. 35%, respectively; p = 0.33) or in the mean 25(OH)D concentrations (24.3 ± 7.9 ng/mL vs. 23.8 ± 8.7 ng/mL, respectively; p = 0.51). Furthermore, there were no significant differences in the mean 25(OH)D concentrations among subgroups of patients with single infertility factors, or between these subgroups and the control group. Conclusions A high proportion of Brazilian women of reproductive age exhibited vitamin D deficiency, regardless of their fertility status. Thus, it may be useful to evaluate this population for vitamin D deficiency, although future studies are needed to determine whether this deficiency might affect the outcomes of treatments for infertility.

OBJETIVO: verificar a freqüência de gestação intra-uterina em pacientes que foram submetidas à recanalização tubária no Hospital Regional da Asa Sul nos últimos 30 anos e avaliar o índice de gestação ectópica destes procedimentos e a influência da idade e do tempo decorrido entre a laqueadura e a recanalização no sucesso terapêutico. MÉTODOS: foram analisados 71 prontuários, tendo sido excluídos os que apresentavam outras alterações que pudessem influenciar no prognóstico de fertilidade do casal e os casos em que não foi possível a cirurgia de recanalização. As variáveis coletadas foram: a ocorrência de gestação intra-uterina, chegando esta a termo ou a abortamento; a ocorrência de gestação ectópica após a cirurgia; a não-concepção após a reversão; a idade das mulheres na data da recanalização e o tempo decorrido entre a laqueadura e a sua reversão. RESULTADOS: verificaram-se um índice de gravidez de 67,6%, sendo 73,2% para as recanalizações bilaterais e 46,6% para as unilaterais, e um percentual de gravidez ectópica de 5,6%. Nas faixas etárias entre 20 e 24 anos, foi observado 33% de gravidez; entre 25 e 29, 60%; entre 30 e 34, 69,2%; entre 35 e 39, 65%, e entre 40 e 44, 42,9%. A casuística foi pequena para análise dos grupos de 20 e 24 e 40 e 44 anos. O intervalo de tempo entre a laqueadura e a recanalização (ITLR) variou de um a 18 anos. O intervalo de tempo entre a ITLR foi dividido em três grupos que apresentaram as taxas de gravidez: de um a seis anos, 59%; de sete a 12 anos, 66,6%; de 13 a 18 anos, 57%. CONCLUSÕES: o índice de gestação foi de 67,6%, sendo 5,6%, ectópicas. Comparando as faixas etárias, não houve influência significativa da idade no sucesso terapêutico entre 25 e 39 anos. Verificou-se que não houve influência do tempo de esterilidade sobre os resultados da reversão.

PURPOSE: to verify the ratio of intra-uterine gestation in patients submitted to recanalization in the Hospital Regional da Asa Sul in the last 30 years and to assess the rate of ectopic gestation of such procedures, the influence of age and time interval between salpingectomy and recanalization in the therapeutic success. METHODS: medical files of 71 patients were analyzed, after exclusion of those presenting other alterations that could influence fertility prognosis, plus the cases when recanalization was impossible. Variables collected were: occurrence of intra-uterine gestation, coming to term or to abortion; occurrence of ectopic pregnancy after salpingectomy; no-conception after reversion, women's age at the recanalization, and time interval between salpingectomy and its reversion. RESULTS: there has been a pregnancy rate of 67.6%, 73.2% for bilateral recanalization and 46.6% for unilateral, as well as 5.6% of ectopic pregnancies. Concerning the patients' age group, it was observed a pregnancy rate of 33%, from 20 to 24; 60%, from 25 to 29; 69.2%, from 30 to 34; 65%, from 35 to 39, and 42.9%, from 40 to 44 years old. The number of cases was small for age the groups 20 to 24 and 40 to 44 years old. The time interval between salpingectomy and recanalization (TISR) has varied from one to 18 years. TISR has been divided in three groups presenting the following pregnancy rates: one to six year interval, 59%; seven to 12, 66.6%; 13 to 18, 57%. CONCLUSIONS: gestation rate has been 67.6%, 5.6% being ectopic. In the comparison of age groups, there has been no significant influence of age on the therapeutic success of patients from 25 to 39 years old. Sterility duration did not influence the reversion results.

OBJETIVO: descrever o perfil epidemiológico das pacientes inscritas em lista de espera e principais indicações para o programa de ovo recepção do Hospital Regional da Asa Sul (HRAS) em Brasília, Distrito Federal. MÉTODOS: estudo descritivo prospectivo em que foram pesquisadas 330 mulheres inscritas na lista de espera do programa, das quais foram incluídas 67 mulheres independente do fator de infertilidade e que ainda não tinham sido contempladas com o tratamento. Foram excluídas 30 mulheres que moravam em outras cidades, 50 pacientes com idade superior ou igual a 50 anos, 24 pacientes que não desejavam participar do trabalho, nove pacientes que pediram exclusão do programa e 150 pacientes não localizadas por contato telefônico. As pacientes incluídas foram chamadas a responder a um questionário e tiveram seus prontuários recuperados para confirmar a realização da propedêutica necessária, a fim de estabelecer a causa da infertilidade. Os dados foram registrados e analisados pelo programa SPSS versão 12.0. RESULTADOS: o perfil epidemiológico das pacientes inclui faixa etária de 40 a 49 anos (82%), não brancas (77,6%), católicas (71,6%), casadas (59,7%), com escolaridade de primeiro ou segundo grau (76,1%), com infertilidade secundária (53,6%) por laqueadura tubária (40,3%) e que começaram a tentar engravidar até 35 anos (91%). Para estas mulheres, a principal indicação para ovo recepção foi idade no momento da inscrição no programa, seguida por baixa reserva ovariana. CONCLUSÃO: os resultados encontrados demonstram a realização indiscriminada de laqueadura tubária. O programa de ovo recepção beneficia mulheres com prognóstico reprodutivo reservado.

PURPOSE: describe epidemiologic profile of patients enrolled in the oocyte reception program at Hospital Regional da Asa Sul (HRAS) in Brasília, Distrito Federal, Brazil, and its main indications. METHODS: prospective descriptive study, in which 330 patients enrolled in the waiting list program were studied. Sixty-seven women, irrespective of their infertility factor and that had not been contemplated by the treatment were included. Thirty women who lived in other cities, 50 patients over 50 years old, 24 patients that didn't want to take part in the study, nine patients that asked to be left out of the program and 150 women that couldn't be found by phone calls were excluded. The 67 patients included were interviewed in order to answer a questionnaire. Their medical handbook was recovered to confirm that the investigation required to establish the cause of infertility had been done. The data was registered and analyzed by SPSS version 12.0 software. RESULTS: the patients' epidemiologic profile is age range 40 to 49 years old (82%), non-white skinned (77,6%), catholic (71,6%), married (59,7%), in high school (76,1%), secondary infertility (53,6%) from which due to tubal sterilization (40,3%) and those ones who started trying to conceive before 35 years old (91%). The main indication to enroll in this oocyte reception program was age and low ovarian reserve. CONCLUSION: the results demonstrated the indiscriminate tubal sterilization. The oocyte reception program benefits women with reserved reproductive prognostic.