Navegando por Palavras-chave "Fluxometria por laser-doppler"
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- ItemEmbargoAvaliação em gestantes da cicatriz uterina resultante de cesariana prévia pelo histograma escala-cinza e as repercussões na dopplervelocimetria das artérias uterinas(Universidade Federal de São Paulo (UNIFESP), 2010-04-28) Santos Filho, Octavio de Oliveira [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate Cesarean uterine scar by the grey-level histogram (GLH) in women with a previous cesarean section, performed either during labor or before labor (elective cesarean). Likewise, this work had also the objective of analyzing in the current pregnancy the possible repercussions of the scar of previous cesarean in the dopplervelocimetria of the uterine arteries between 26 and 32 weeks, based on the data from the histogram. Methods: longitudinal prospective study was conducted with 49 women between 11 and 14 weeks of gestation, who were allocated in three groups: 18 pregnant women with a previous elective Cesarean (group A); 14 with a previous Cesarean section performed during labor (group B); and 17 pregnant women with a single previous vaginal delivery (group C). The GLH was made with transvaginal ultrasound, between 11 and 14 weeks, and the dopplervelocimetria of the uterine arteries between 26 and 32 weeks, using the abdominal via. It was calculated the mean, medium and standard deviation (SD) for each group in study. The mean values of the histograms of the control group were used as normality parameter to be compared with the other groups. To compare the average of the three groups, the test of ANOVA was used. A value of (p) < 0.05 was considered statistically significant. Regarding the Index of Pulsatility, the comparison of the groups was made by the no-parametric test of Kruskal-Wallis. Results: GLH in group A varied it from 7,0 to 40,5 (mean: 24,32 and DP: 10,67), in group B from 20,5 to 47,2 (mean: 32,14 and DP: 8,86) and in group C from 21,7 to 58,8 (mean: 41,14and DP: 11,47) p = 0.0001. The medium values of the Index of Pulsatility of group A varied from 0.60 to 1.60 (mean: 0.90 and DP: 0.29), in group B from 0.53 to 1.43 (mean: 0.87 and DP: 0.24) and in group C from 0.65 to 1.65 (mean:1.01 and DP: 0.37) p = 0.6329. Conclusions: There was significant difference of GLH in the region of the uterine scar of previous cesarean, when this was electively and when performed during labor, suggesting larger tissue change in the elective cesarean. There were not repercussions of the scar of previous cesarean in the dopplervelocimetria of the appraised uterine arteries from 26 to 32 weeks, based on the data from the histogram.
- ItemAcesso aberto (Open Access)Doplervelocimetria das artérias oftálmica e central da retina em gestantes normais(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2005-04-01) Diniz, Angélica Lemos Debs [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Santos, Maria Célia dos; Sass, Nelson [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Universidade Federal de Uberlândia Hospital de Clínicas Setor de Ultra-sonografia; Universidade Federal de São Paulo (UNIFESP); UFU; Centro de Treinamento de Ultra-sonografiaPURPOSE: to evaluate ophthalmic and retinal central artery Doppler indices during the second and third trimesters of normal pregnancy and to compare the right with left eye Doppler indices of normotensive women. METHODS: a cross-sectional study which evaluated central retinal and ophthalmic artery Doppler velocimetry values of 51 normal pregnant women, in the 20th to 38th week of gestation. The following values were analyzed: pulsatility and resistance indexes (PI, RI), peak systolic and end-diastolic flow velocity (PSV, EDFV) and peak velocity ratio (PVR). The Doppler indices in the right and left eyes were studied by the median. The paired Student's t test was used to confront the right and left eye values and the Pearson linear correlation analysis was performed to study the value changes throughout the gestation, with the level of significance set at 5%. RESULTS: Doppler velocimetry indices of ophthalmic and central retinal arteries (median values) were, respectively: PI=1.83; RI=0.78; PSV=34.20; EDFV=6.80; PVR=0.48 and PI=1.34; RI=0.70; PSV=7.40; EDFV=2.10. There was no significant difference between the right and left side Doppler values. Linear correlation analysis showed no association between the arterial values and pregnancy age. CONCLUSION: the unilateral analysis of ophthalmic and central retinal artery Doppler velocimetry values can be used in systemic maternal disease. There is no significant change in ophthalmic and central retinal artery Doppler velocimetry values throughout normal pregnancy.
- ItemSomente MetadadadosA dopplervelocimetria arterial e venosa em gestantes tabagistas crônicas e seus nascituros(Universidade Federal de São Paulo (UNIFESP), 2007) Viggiano, Marcello Braga [UNIFESP]; Camano, Luiz [UNIFESP]Objetivos: Analisar os efeitos do tabagismo materno cronico na dinamica vascular arterial e venosa por meio da avaliacao Dopplervelocimetrica da circulacao materno-fetal e fetoplacentaria. Pacientes e Metodo: Estudo prospectivo do tipo coorte, realizado por unico observador, envolvendo 125 gestantes, sendo 32 nao-fumantes e 93 fumantes, no Hospital Materno Infantil de Goiania - 00, entre setembro de 2005 e fevereiro de 2007. Foram utilizados como criterios de inclusao as gestacoes unicas nas quais as gestantes tabagistas fumassem por periodo superior a seis meses do inicio da pesquisa. Como criterios de exclusao, adotaram-se o tabagismo por periodo inferior a seis meses, consumo de derivados do tabaco, drogas ilicitas ou bebidas alcoolicas, presenca de malformacoes fetais, gestacoes multiplas, apresentacoes nao-cefalicas, patologias maternas que pudessem alterar o desenvolvimento placentario ou a hemodinamica utero-placentaria, pacientes que interromperam o tabagismo apos o dignostico de gravidez ou que perderam por algum motivo um dos exames seriados. As gestantes tabagistas foram divididas em grupos segundo consumo diario de cigarros. Cada participante foi submetida a tres exames de Dopplervelocimetria colorida e pulsatil, na 288,328 e 368 semanas, para avaliacao dos indices de pulsatilidade (IP) das arterias uterinas, umbilical e cerebral media, e da relacao entre a velocidade de pico sistolico e velocidade maxima de contracao atrial (S/A) do duto venoso. As tabagistas foram orientadas a nao fumar por pelo menos 3 horas antes dos exames. As associacoes estatisticas entre habito tabagistico, variaveis obstetricas e medidas Dopplervelocimetricas foram determinadas por analise de variancia ou teste do l quando apropriado, com nivel de significancia fixado em 5 por cento. Resultados: Observou-se elevacao significativa no IP medio das arterias uterinas direita e esquerda nas tabagistas que consumiam entre 11 e 20 cigarros/dia na 368 semana (2,03; p < 0,04) e durante todo o periodo estudado nas pacientes que consumiam mais que 20 cigarros/dia (2,30; 2,14 e 2,10; respectivamente; p < 0,05). As arterias umbilicais apresentaram elevacao dos indices pulsatilidade (1,14; p < 0,05) na 368 semana para o grupo de moderado consumo tabagistico e durante todo o periodo gestacional para as gestantes com elevado consumo (1,29; 1,27 e 1,26; respectivamente; p < 0,03). As arterias cerebrais medias demonstraram, no grupo de moderado consumo, diminuicao significativa na 288 semana (1,86; p < 0,04). As relacoes S/A dos dutos venosos apresentaram-se significativamente inferiores nos conceptos de gestantes tabagistas durante todas as idades gestacionais pesquisadas em comparacao com as do grupo controle. Conclusoes: Verificou-se aumento na impedancia vascular da circulacao utero-placentaria e feto-placentaria nos grupos de fumantes, especialmente naquelas com moderado ou elevado consumo diario de cigarros; enquanto demonstrou-se diminuicao transitoria da resistencia ao fluxo no territorio cerebral fetal entre fumantes moderadas, assim como tendencia ao hiperfluxo miocardico nos conceptos das gestantes tabagistas em relacao ao grupo controle, sugerindo possivel resposta fetal protetora relacionada ao tabagismo materno cronico
- ItemSomente MetadadadosEfeitos da reposição estrogênica nos parâmetros doppler velocimétricos dos vasos peri-uretrais em mulheres na pós-menopausa com incontinência urinária de esforço(Universidade Federal de São Paulo (UNIFESP), 1998) Girão, Manoel João Batista Castello [UNIFESP]O deficit estrinico, caracteristico da pos-menopausa, promove alteracoes significativas no trato urinario inferior da mulher, com enorme repercussao nos mecanismos de continencia urinaria, em especial na mucosa uretral, nos receptores adrenergicos da uretra, no tecido colageno e vascular peri-uretral. O leito vascular uretral, por sua vez, responde por cerca de um terco da pressao uretral e, como sofre marcante influencia hormonal, interessou-nos estudar seu comportamento antes e durante reposicao estrogenica. Selecionamos 25 pacientes com incontinencia urinaria de esforco na pos-menopausa e sem contra-indicacao para terapia de reposicao hormonal. Todas submeteram-se a rigorosa avaliacao clinica e urodinamica. Nao incluimos pacientes com outras causas de incontinencia urinaria ou qualquer situacao clinica que pudesse interferir nos vasos peri-uretrais. A reposicao hormonal foi feita com estrogenios conjugados equinos na dose de 0,625 mg diarios, exceto nos primeires sete dias de cada mes, sem administracao de progesterona...(au)
- ItemAcesso aberto (Open Access)Efeitos das isoflavonas sobre o assoalho pélvico e a vascularização peri-uretral de mulheres na pós-menopausa(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-09-01) Accorsi, Leni Aparecida Spagna [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; Simões, Ricardo Santos [UNIFESP]; Accorsi Neto, Alfeu Cornélio; Mosquette, Rejane [UNIFESP]; Soares Júnior, José Maria [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Catanduva Departamento de Ginecologia; Universidade de São Paulo (USP)PURPOSE: to evaluate muscular strength of the pelvic floor and the periurethral vessels of postmenopausal women before and after six months of soybean extract treatment. METHODS: the study was conducted on 30 postmenopausal women before and after six consecutive months of soyabean extract (100 mg/day) administration. Urinary loss and muscular strength of the pelvic floor were investigated through digital perineometer and functional evaluation. Digital color Doppler in the periurethral region was used to count the number of vessels. For statistical analysis, the paired Student t test was applied to compare the results before and after the treatment. RESULTS: twenty women reported urinary incontinence before the treatment period. The amelioration of this symptom was observed in 15 (75%) women after the treatment. Vaginal pressure (muscular strength of the pelvic floor) was 12.95±1.73 and 15.86±1.86 Sauers, before and after the treatment, respectively (p<0.001). Twenty-two women (73.3%) presented an increase in the pressure at the end of this study. In relation to the function evaluation, 18 (60%) had improvement in muscular strength and 12 women did not present any change. On ultrasonography (Doppler), the number of vessels was 2.20±0.15 blood vessels/field in the beginning of this study and 3.46±0.25 blood vessels/field at the end of the treatment (p<0.001). An increase in the number of periurethral vessels was detected in 21 women (70%). CONCLUSION: it is important to emphasize that these are preliminary results. A double blind randomized and placebo-controlled clinical trial with a high number of participants is necessary. However, the treatment with concentrated soybean extract (100 mg per day) for six consecutive months may determine an improvement in pelvic floor muscular strength and an increase in the number of periurethral vessels in postmenopausal women.
- ItemAcesso aberto (Open Access)Repercussões do tabagismo na ultra-sonografia da placenta e a doplervelocimetria útero-placentária(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-06-01) Saraiva Filho, Sebastião José [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Bailão, Luiz Antonio; Rizzi, Maria Christina Dos Santos; Nakamura, Mary Uchiyama [UNIFESP]; Centro de Treinamento em Ultra-sonografia; Universidade Federal de São Paulo (UNIFESP)PURPOSE: the study the effects of maternal cigarette smoking during pregnancy on placental maturation (calcifications) and the placental-uterine circulation, evaluated through umbilical and uterine Doppler. METHODS: prospective cohort study involving 244 pregnant women, 210 of them non-smokers and 34 smokers. Participants were submitted to four serial sonograms. The first was performed up to the 16th week of pregnancy to determine gestational age, and the other three at 28, 32 and 36 weeks for fetal biometry, evaluation of placental texture and Doppler studies of the uterine and umbilical arteries. Premature placental calcification was defined as grade III before 36 weeks. The chi2 and Fisher exact tests were used to compare placental grading, and the Mann-Whitney test to evaluate the resistance index of uterine and umbilical arteries. RESULTS: the frequency of grade III placenta and the resistance of the uterine arteries did not differ significantly between smokers and non-smokers, at all gestational ages. Umbilical artery Doppler was significantly higher in smokers than in non-smokers at 32 weeks. CONCLUSIONS: no association was found between cigarette smoking and premature placental calcification. Smoking was associated with increased umbilical artery resistance at 32 weeks.
- ItemAcesso aberto (Open Access)Valor preditivo do resultado fetal da dopplervelocimetria de ducto venoso entre a 11ª e a 14ª semanas de gestação(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2008-01-01) Gollo, Carlos Alberto; Murta, Carlos Geraldo Viana; Bussamra, Luiz Cláudio [UNIFESP]; Santana, Renato Martins [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal do Espírito Santo; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to study the value of Doppler velocimetry of the ductus venosus, between the 11th and 14th weeks of pregnancy, associated to the nuchal translucency thickness measurement, in the detection of adverse fetal outcome. METHODS: a transversal and prospective study in which a total of 1,268 fetuses were studied consecutively. In 56 cases, a cytogenetic study was performed on material obtained from a biopsy of the chorionic villus and, in 1,181 cases, the postnatal phenotype was used as a basis for the result. In addition to the routine ultrasonographic examination, all the fetuses were submitted to measurement of the nuchal translucency thickness and to Doppler velocimetry of the ductus venosus. Aiming at prevalence and accuracy indices, sensitivity, specificity, positive predictive value, negative predictive value, probability of false-positive, probability of false-negative, reason of positive probability and reason of negative probability were calculated and analyzed. RESULTS: from the total of 1,268 fetuses, 1,183 cases were selected for analysis. From this number, 1,170 fetuses were normal (98.9%) and 13 fetuses presented adverse outcome at birth (1.1%), including fetal death (trisomy 21 and 22) in two cases; genetic syndrome (Nooman) in one case; two cases of polymalformed fetuses; cardiopathy in three cases; and other structural defects in five cases. The prevalence of the modified ductus venosus (wave A zero/reverse) in the studied population was of 14 cases (1.2%), with a false-positive rate of 0.7%. CONCLUSIONS: there is a significant correlation between the alteration of the ductus venosus Doppler velocimetry and the thickness of the nuchal translucency as an ultrasonographic marker for the first trimester of gestation, in the detection of adverse fetal outcome, especially serious malformations. The ductus venosus was able to diminish the false-positive result in comparison to the isolated use of the nuchal translucency thickness, improving considerably the positive predictive value of the test.