Resumo Objetivo Avaliar se existe alguma relação entre os valores plasmáticos de progesterona no dia da transferência de um blastocisto desvitrificado em ciclos hormonalmente substituídos e a taxa de gravidez, aborto ou nascido vivo. Métodos Estudo observacional, ambispectivo, incluindo todos os ciclos de transferência de blastocistos congelados no nosso departamento, entre maio de 2018 e junho de 2019. Avaliou-se a taxa de gravidez e de nascidos vivos após 24 semanas de gestação. Os grupos foram comparados de acordo com os valores de progesterona plasmáticos dosados no dia da transferência do blastocisto: comparou-se o 1° quartil com os outros e depois os 2° e 3° quartis com o 4°. Resultados Avaliaram-se 140 transferências: 87 com β gonadotrofina coriônica humana (β-HCG)>10 IU/L (62%), 50 das quais terminaram em nascido vivo (36% do total), enquanto 37 tiveram um aborto (42% das gravidezes). Verificou-se uma tendência para menor número de recém-nascidos nas transferências com níveis de progesterona no 1° quartil (<10.7ng/mL) (26 versus 39%; p>0.05) e ummaior número de abortos (64 versus 33%; p<0.01). Comparando o 2° e 3° quartis com o 4°, verificouse que nos casos em que a progesterona estava acima do percentil 75, apesar de uma taxa de gravidez semelhante (60 versus 57%; p>0.05), houve uma tendência para uma maior taxa de nascidos vivos (43 versus 31%; p>0.05) emenor número de abortos (28 versus 45%; p>0.05) abaixo do percentil 75. Estas diferenças não foram estatisticamente significativas. Conclusão Não se verificaram diferenças estatisticamente significativas para taxa de gravidez e de nascido vivo. A taxa de aborto foi maior no primeiro quartil.

Abstract Objective To establish a relationship between serum progesterone values on the day of frozen blastocyst transfer in hormone-replaced cycles with the probability of pregnancy, miscarriage or delivery. Methods This was an ambispective observational study including all frozen-thawed embryo transfer cycles performed at our department following in vitro fecundation from May 2018 to June 2019. The outcomes evaluated were β human chorionic gonadotropin (β-hCG)-positive pregnancy and delivery. Groups were compared according to the level of serum progesterone on the day of embryo transfer: the 1st quartile of progesterone was compared against the other quartiles and then the 2nd and 3rd quartiles against the 4th quartile. Results A total of 140 transfers were included in the analysis: 87 with β-HCG>10 IU/L (62%), of which 50 (36%) delivered and 37 had a miscarriage (42%).Women with lower progesterone levels (< 10.7ng/mL) had a trend toward higher β-HCG-positive (72 versus 59%; p>0.05), lower delivery (26 versus 39%; p>0.05) and higher miscarriage rates (64 versus 33%; p<0.01). Comparing the middle quartiles (P25-50) with those above percentiles 75, the rate of pregnancy was similar (60 versus 57%; p>0.05), although there was a trend toward a higher number of deliveries (43 versus 31%; p>0.05) and a lower number of miscarriages (28 versus 45%; p>0.05). These differences were not statistically significant. Conclusion There were no differences in pregnancy and delivery rates related with the progesterone level when measured in the transfer day. The miscarriage rate was higher in the 1st quartile group.

Endometriosis is a complex disease with a poorly understood etiology. In women with infertility its prevalence reaches 50%. Several pathophysiological mechanisms have been proposed, ranging from a decreased oocyte quantity and quality, modified tube-ovarian function, endometrial receptivity or inflammatory environment due to the peritoneal fluid. The best approach to women with infertility and endometriosis is still under discussion, and assisted reproductive technology treatments are a frequent alternative.

Overview and Aims: Urinary tract infections (UTI) are frequent in pregnancy and are associated with increased preterm delivery and low birth weight. Asymptomatic bacteriuria (ABU) is the most common clinical entity and in the absence of treatment it can progress to pyelonephritis in 25% to 30% of the cases. The culture of a urine specimen is the gold standard for the diagnosis of UTI, being Escherichia coli the most common agent. The aim of this study is 1) to identify which are the main microbial agents of the urine cultures in a pregnant population, 2) to observe the agents' antibiotic resistance and sensitivity, 3) to investigate which are the best antimicrobials for the treatment of an UTI in pregnant women, and 4) to compare with a similar study conducted at the same hospital between 2005 and 2006 in order to analyze the evolution of the antimicrobial resistances pattern. Study design: Retrospective observational study. Population: 305 cases with positive urine cultures obtained in the obstetrics outpatient clinic of a tertiary care hospital, between January 2014 and December 2015. Results: E. coli was isolated in 48,9% of cases. Streptococcus agalactiae was identified in 18,4%, Klebsiella pneumoniae in 10,1% and Proteus mirabilis in 8,5%. The global antimicrobial resistance profile was: ampicillin 50%, nitrofurantoin 24%, cotrimoxazole 17%, cefalotin 11%, amoxicilin+clavulanate and gentamycin both 6%, cefuroxime 3%, ceftazidime ceftriaxone and piperacilin-tazobactam 0%. Conclusions: In our population, the most frequent agent was E. coli. Cefuroxime is a good choice as a first-line agent for empiric treatment. Ampicillin and cotrimoxazole presented both high global and E. coli specific resistance rates. Comparatively to 2005 and 2006, the resistances have increased for nitrofurantoin and decreased for amoxicilin+clavulanate

Overview and Aims: In Portugal, induced abortion for non-medical reasons by woman's choice until 10 weeks of gestation is permitted since 2007, when conducted in official recognized establishments. The main goal was to compare the demography of women admitted for abortion by request, following depenalization and the beginning of the world financial crisis, with the period post-troika, represented by the years 2008 and 2015, respectively. Study design and Population: Retrospective, observational and comparative study of women's clinical files that attended at our service for abortion in 2008 and 2015. Methods: We compared the referral source, women's age, number of previous induced abortions, nationality, place of residence, marital status, progeny, couple cohabitation, literacy, women and partner labor, contraception use and gestational age. Results: Were included 1212 women (2008: 665 and 2015: 547). The mean age was 28,1 vs 27,99 (2008 vs 2015). The results were higher at 2008 than 2015 in couple cohabitation: 52% vs 42% (p=0.001) and contraception use: 74% vs 65% (p=0,002). The results were lower at 2008 than 2015 in number of previous induced abortions: 19% vs 29% (p<0,001), in women inhabiting in the same area of our institution: 87% vs 94% (p <0.001), in unmarried women: 63% vs 77% (p< 0,001), in women with more than third grade of primary school: 76% vs 89% (p <0.001), on unemployment in woman: 17% vs 28% (p=0.002) and partner: 8% vs 19% (p <0.001) and in abortions at 10 weeks: 2% vs 14% (p<0.001). We haven't observed statistically significant alterations on the other cases. Conclusions: Between 2008 and 2015 there was an increase in previous induced abortions, women inhabiting in the same area of our institution, unmarried women, literacy, unemployed woman and partner and gestational age attended for abortion. There was a decrease in couple cohabitation and in contraception use choice until 10 weeks of gestation is permitted since 2007, when conducted in official recognized establishments. The main goal was to compare the demography of women admitted for abortion by request, following depenalization and the beginning of the world financial crisis, with the period post-troika, represented by the years 2008 and 2015, respectively

OBJETIVO: comparar parto e seguimento de gravidez entre grávidas adolescentes e não-adolescentes que pariram num hospital terciário da região de Lisboa (Portugal). MÉTODOS: estudo retrospectivo com 10.656 partos. Foram avaliados: seguimento da gravidez, idade gestacional no parto, tipo de parto, necessidade de episiotomia e lacerações graves, índice de Apgar no quinto minuto e peso ao nascer. As grávidas foram divididas em dois grupos, acima e abaixo dos 20 anos. O grupo abaixo dos 20 anos foi depois subdividido entre grávidas com menos ou mais de 16 anos. Foi usado o teste do χ2 para análise estatística. RESULTADOS: as adolescentes tiveram pior seguimento: primeira consulta após as 12 semanas (46,4 versus 26,3%) e menos de quatro consultas (8,1 versus 3,1%), menos distocia (21,5 versus 35,1%), menos cesarianas (10,6 versus 20,7%) e menor necessidade de indução do trabalho de parto (16,5 versus 26,5%). Não houve diferença significativa para idade gestacional no parto e taxa de recém-nascidos de baixo peso. Entre adolescentes, as menores de 16 anos tiveram mais recém-nascidos de baixo peso (12 versus 7,4%) e mais partos entre 34 e 37 semanas (10,8 versus 4,2%). CONCLUSÕES: num hospital com serviço dedicado a grávidas adolescentes com apoio social e psicológico, apesar de pior seguimento pré-natal vigilância, o seu desempenho não foi pior. Uma atenção especial deve, no entanto, ser dada a grávidas abaixo dos 16 anos.

PURPOSE: to compare delivery and pregnancy follow-up among adolescent and non-adolescent pregnant women whose delivery occurred in a tertiary hospital from Região de Lisboa (Portugal). METHODS: retrospective study with 10,656 deliveries. Pregnancy follow-up, delivery type, need of episiotomy and severe lacerations, Apgar index at the fifth minute and the delivery weight have been evaluated. The pregnant women were divided into two groups, over and under 20 years old. The group with women under 20 was further subdivided in pregnant women under or over 16. The χ2 test has been used for statistical analysis. RESULTS: adolescents presented worse follow-up: first appointment after 12 weeks (46.4 versus 26.3%) and less than four appointments (8.1 versus 3.1%), less dystocia (21.5 versus 35.1%), less caesarian sections (10.6 versus 20.7%), and lower need for inducing labor (16.5 versus 26.5%). There was no significant difference concerning gestational age at delivery and ratio of low weight newborns. Among adolescents, the ones under 16 had more low weight newborns (12 versus 7.4%) and more deliveries between 34 and 37 weeks (10.8 versus 4.2%). CONCLUSIONS: in a hospital attending adolescents with social and psychological support, the fact of them having had a worse follow-up in the pre-natal phase, their performance has not been worse. Nevertheless, special attention might be given to pregnant women under 16.