Maternity School Assis Chateaubriand Research Articles

Socioeconomic, demographic and obstetric profile of pregnant women with Hypertensive Syndrome in a public maternity.

To describe the socioeconomic, demographic and obstetric profile of pregnant women with Gestational Hypertensive Syndrome. A descriptive and correlational study, conducted in Maternity School Assis Chateaubriand, with 120 pregnant women, through a questionnaire analyzed by descriptive and analytical statistics. most women had chronic hypertension (60.83%). Regarding the socioeconomic and demographic profile, most pregnant women had a mean age of 30.9 ± 6.9 years, were Catholic, brown skin color, employed, in stable unions, complete high school education, and income of up to R$ 954.00. Regarding the obstetric profile, their Body Mass Index was up to 66, slightly elevated blood pressure, an average of five prenatal consultations, two pregnancies, one delivery and no abortions. Women with chronic hypertension were older (p = 0.0024), had lower gestational age (p = 0.0219) and a higher number of abortions (p = 0.0140). Pregnant women are overweight/obese, with a mean age of 30.9 years and are socially vulnerable. Pregnant women with chronic hypertension are older and have a higher number of abortions.

Characterization Of Obstetric Assistance At Labor And Childbirth In Low-Risk Women On A Maternity Of Reference To Maternal And Child Health

Objectives: To describe the prevalence of the implementation of obstetric interventions for labor and birth in normal-risk women in reference to maternity Stork Network.
 Methodology: cross-sectional study was performed from April 2014 to January 2015, with 421 participants in the Maternity School Assis Chateaubriand - UFC, admitted during spontaneous or induced labor with a live fetus and single pregnancy term and their fetuses weighing between 2,500 and 4.499g. The data collection instrument was divided into blocks with sociodemographic and clinical characteristics, obstetric, data care during labor, delivery and birth, maternal morbidity, maternal outcome and obstetric practices in categories A and B from WHO and perinatal outcomes. The values ​​are presented as mean ± standard deviation.
 Results: The age ranged from 13 to 44; the average gestational age at admission was 38.9 ± 1.1 weeks; 52.2% with only one child; 8.6% had a previous cesarean section. There was 96.2% of pre-natal coverage with an average of 6.4 consultations. 76.2% had vaginal delivery. Obstetric practices in category A were more prevalent oxytocin in the third stage (97.1%), partograph (95%), non-invasive methods for pain relief (87.2%), companion (84.6%). While in section B were more of a vaginal examination at 2 hours (50.4%) and intravenous infusion (44.9%) and oxytocin in the expansion phase (28.8%). The present study had as limitations the loss of some data, which depended on the filling of third parties, which are characteristic of searches in medical records, or any documentary archive because it is a collection of secondary data.
 Conclusions: It was possible to identify that the "Good labor assistance practices" has been developed in a good proportion considered; however some practices that should be discouraged are still performed relatively frequently.

127 Hypertension at an early stage of prenatal is a major risk factor for adverse neonatal outcomes

Objective To analyze which of the maternal risk factors for PE is more predictive unfavorable perinatal outcomes between women diagnosed with Severe PE. Methods Over a period of twelve months, (2014–2015), 208 cases of severe preeclampsia were included in a observational and retrospective cohort study. This study was conducted at the Maternity School Assis Chateaubriand in Fortaleza, State of Ceara, Brazil. The maternal risk factors were analized by the Student ’T’ test and logistic regression Results Of the 208 patients analyzed obtained in perinatal outcomes 39 (18%) cases of SGA, 17 (8.17%) cases of intrapartum anoxia and 10 (4.8%) cases of fetal death. Early- and late-onset severe preeclampsia differed from each other remarkably. The increased arterial systolic and diastolic pressure early in the prenatal care was the most important predictive factor to unfavorable perinatal outcomes (OR = 1.13, CI- 1.00 to 1.06; p = 0,03) Conclusion women with Hypertension in the beginning of prenatal care was an important risk factor to early preeclampsia and unfavorable perinatal outcomes; therefore, the Primiparity was protector parameter.

A Fuzzy Intelligent Agent for Analysis and Classification of Fetuses' Cardiac Signals

The signal analysis provided by fetal monitoring equipment called cardiotocograph such as fetal heart rate, allows early diagnosis about possible health problems related to the fetus and therefore the safety of their well being. This paper presents a proposal for an intelligent system that, after analyzing the signals collected by cardiotocograph automatically provides the diagnosis. The analysis is done through a hazy inference system (fuzzy) modeled in partnership with the medical staff of the Maternity School Assis Chateaubriand (MEAC). This system is implemented using the Matlab software. Tests are performed, obtaining promising results according to team MEAC since achieves a hit percentage from 85% to 93% in the analysis carried out in two databases. It is important to note that this work has a multi-institutional partnership between Brazil and Germany, involving the Federal University of Ceara (UFC), through the Department of Computer Engineering (DETI) and the Maternity School Assis Chateaubriand (MEAC), Technische Universitat Munchen (TUM), the Bundeswehr Universitat Munchen and the company Trium Analysis Online GmbH.

Método canguru: percepção materna acerca da vivência na unidade de terapia intensiva neonatal

Objective: To investigate the maternal perception of the experience in the first phase of the Kangaroo Mother Care Method in the Neonatal Intensive Care Unit (NICU). Methods: Descriptive, exploratory and qualitative study, conducted in the period from August to October 2014, with 10 mothers of newborn preterm (NP) infants, who were admitted to the Maternity School Assis Chateaubriand (MEAC) in Fortaleza, Brazil, and had received skin-to-skin contact through the Kangaroo Care Method during hospitalization in the NICU. Data was collected by semi-structured interview, directed by guiding questions. Content analysis was used for processing the data, being established four categories: “The bond and the attachment”, “Maternal competence”, “The fear of losing the baby” and “The importance of the multidisciplinary team”. Results: The Kangaroo Care Method is a safe and pleasurable practice for mothers and relatives, in addition to providing social and psychoaffective benefits, found in the imagery of the method institutionalization and in the mothers’ experience when properly supported. The meanings of the maternal feelings of apprehension as a result of the first physical contact with the hospitalized child can be evidenced. Regarding the evaluation of its clinical practice, this method has provided better development of the newborn infant and a reduction in hospital stay. Conclusion: The study shows relevance, since the evidence of the maternal perception of this method supports its establishment as a mandatory practice in maternity hospitals, in view of the benefits to the mother and the neonate.

Association of TP53 codon 72 and intron 3 16-bp Ins/Del polymorphisms with cervical cancer risk.

Cervical cancer incidence has grown worldwide, with it being a more significant problem in developing countries. Invasive squamous cell cervical cancers are preceded by a long phase of preinvasive disease, known as cervical intraepithelial neoplasia. Cervical cancer can develop when the virus takes advantage of any TP53 gene dysfunction of the host organism. TP53 is responsible for encoding the tumor suppressor p53 phosphoprotein, which helps preserve genome integrity. Currently, many studies have focused on genetic polymorphisms as an important contribution to cancer susceptibility, but few related to cervical intraepithelial neoplasia (CIN). Thus, the present study aimed to see whether patients with suspected CIN had TP53 gene polymorphisms that might have contributed to the development of neoplasia. This study included 133 women who were referred to the Cervical Pathology Clinic of the Maternity School Assis Chateaubriand MEAC for suspected cervical lesions. Polymorphism genotyping was carried out by the PCR-RFLP technique using DNA extracted from patients' blood. The most frequent genotype in both CIN(+) and CIN(-) patients was Arg/Pro TP53 codon 72 and A1A1 for 16-bp Del in intron 3. No risk of cervical cancer was found for the polymorphisms studied. However, a significant association was found when the two polymorphisms were combined: patients with the A1A1/ArgPro genotype were statistically more frequent in the CIN(-) group (p = 0.042), while A2A2-A1A2/ProArg was significantly more frequent in the CIN(+) group. The results of our study suggest that combined analysis of TP53 polymorphisms Arg72Pro and 16-bp Ins/Del may help to monitor the development of CIN in Brazilian women.

Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

To check the rate of sentinel lymph node (SLN) identification in patients with locally advanced breast cancer who underwent neoadjuvant chemotherapy comparing intraoperative contact cytology (imprint) and embedded in paraffin and validation of methods. A cross-sectional validation of diagnostic test involving 34 patients from the outpatient clinic of the Maternity School Assis Chateaubriand. The patients had locally advanced breast cancer and were treated with neoadjuvant chemotherapy. Those with clinically negative axilla underwent SLN biopsy, studied by imprint and histopathology in paraffin. All patients underwent axillary dissection and its histopathological study. The SLN identification rate was 85.3% (29/34). The sensitivity of imprint associated with paraffin on detection of metastasis compared to histopathology of the axillary content was 84.62% and specificity of 100% with false-negative rate of 12.01% and an accuracy of 92.77%. The search for metastases in the SLN by imprint and histopathological analysis in paraffin compared to the gold standard (axillary dissection) had a low sensitivity with high rate of false negatives in our sample.

Influência do internamento materno prolongado nos resultados maternos e perinatais de duas séries de pacientes com placenta prévia

To compare the maternal and perinatal outcomes of patients with placenta previa, after the adoption of a prolonged maternal hospital stay, to those of a 1991 series. We performed a retrospective study comparing 108 cases of placenta previa hospitalized in the Maternity School Assis Chateaubriand, Universidade Federal do Ceará, during the period from 01/01/2006 to 12/31/2010, with those obtained in 1991, when 101 cases of the pathology were observed at our institution. The following maternal and perinatal data were collected: maternal age, parity, gestational age at delivery, mode of delivery, maternal stay length, Apgar scores at the 1st and 5th minutes, birth weight, adequacy of birth weight, neonatal length stay, maternal and neonatal morbidity and mortality rates (maternal, fetal, neonatal and perinatal). Statistical analysis was performed using the χ² and Fisher's exact tests. The results were considered significant when p<0.05. In 1991, placenta previa was found in 1.13% of cases (101/8900). In the present study, the prevalence was 0.43% (108/24726). No maternal death was observed in either series. Regarding the study of 1991, the current patients were significantly younger, with lower parity, were hospitalized longer, had better Apgar scores at 1st and 5th minutes, and had longer neonatal hospitalization. Also, we identified reduction of fetal, neonatal and perinatal mortality. Perinatal outcomes in patients with placenta previa were significantly improved between 1991 and the years 2006 and 2010. However, we can not say whether this improvement was due to the prolonged maternal hospital stay.