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Background: The aim of this study was to elaborate a randomized clinical trial protocol to evaluate the effectiveness of class I restorations in resin-modified glass ionomer cement (RMGIC) and bulk-fill resin in primary molars with untreated early childhood caries in toddlers. Material and Methods: A total of 59 toddlers up to 36 months old with at least two primary molar teeth with untreated dental caries of single surface on different sides of the mouth will be selected at the Pediatric Dentistry Clinics of the Faculty of Dentistry at Federal University of Minas Gerais (UFMG), Brazil. Teeth with untreated dental caries in the left and right sides of each patient's mouth will be randomly distributed into 2 groups: Group 1 (Control): encapsulated RMGIC restoration with Riva light cure (SDI, Florida, USA) and Group 2 (Test): Filtek bulk-fill composite resin restoration (3M/ESPE, St. Paul, USA) with universal single bond adhesive system (3M/ESPE, St. Paul, USA). A single trained dentist will perform all restorative procedures. The restorations will be evaluated after 1, 6, 12, 18 and 24 months by two trained and calibrated examiners. Cost-efficacy analysis will be carried out. Kaplan-Meier survival analysis, Log-rank test, Cox regression, Poisson regression analysis, Mann-Whitney test or Kruskal-Wallis will be performed to analyze data. Conclusion: The protocol will make it possible to determine the most efficacy material for the restoration of cavities in cavities in primary molars of toddlers.
Antecedentes: El objetivo de este estudio fue elaborar un protocolo de ensayo clínico aleatorizado para evaluar la efectividad de las restauraciones de clase I en cemento de ionómero de vidrio modificado con resina (RMGIC) y resina bulk-fill en molares primarios con caries de la primera infancia no tratadas en niños preescolares. Material y Métodos: Un total de 59 niños de hasta 36 meses de edad con al menos dos molares temporales con caries no tratada de superficie única en diferentes lados de la boca serán seleccionados en las Clínicas de Odontología Pediátrica de la Facultad de Odontología de la Universidad Federal de Minas Gerais (UFMG), Brasil. Los dientes con caries no tratada en los lados izquierdo y derecho de la boca de cada paciente se distribuirán aleatoriamente en 2 grupos: Grupo 1 (Control): restauración RMGIC encapsulada con fotopolimerización Riva (SDI, Florida, EE. UU.) Y Grupo 2 (Prueba): Restauración de resina compuesta bulk-fill Filtek (3M / ESPE, St. Paul, EE. UU.) con sistema adhesivo de unión simple universal (3M / ESPE, St. Paul, EE. UU.). Un solo dentista capacitado realizará todos los procedimientos de restauración. Las restauraciones serán evaluadas después de 1, 6, 12, 18 y 24 meses por dos examinadores capacitados y calibrados. Se llevará a cabo un análisis de coste-eficacia. Se realizarán análisis de supervivencia de Kaplan-Meier, prueba de rango logarítmico, regresión de Cox, análisis de regresión de Poisson, prueba de Mann-Whitney o Kruskal-Wallis para analizar los datos. Conclusión: El protocolo permitirá determinar el material más eficaz para la restauración de caries en molares temporales de niños preescolares.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Resinas Compostas/uso terapêutico , Cimentos de Ionômeros de Vidro/uso terapêutico , Brasil/epidemiologia , Odontopediatria , Adaptação Marginal Dentária , Cárie Dentária , Restauração Dentária Permanente/métodos , Dente MolarRESUMO
Abstract Objective To describe the immunological and hematological reference intervals of low-risk pregnant women. Methods A cross-sectional retrospective database analysis of a basic and translational study analyzing the hematological evaluation blood counts and immunophenotyping of TCD3 + , TCD4 + , TCD8 + , B, and natural killer (NK) cells of the peripheral blood in 79 low-risk pregnant women and of 30 control women from the state of Pernambuco, Brazil, was performed. Results No significant differences were detected between the hematological profiles of the 2nd and 3rd trimesters. Nevertheless, the median level of B cells decreased significantly in the 2nd (174 x 103 μL; p < 0.002) and 3rd trimesters (160 x 103 μL; p < 0.001), compared with the control group (296 x 103 μL). Similarly, the median level of NK cells was lower in the 2nd (134 x 103 μL; p < 0.0004) and 3rd trimesters (100 x 103 μL, p < 0.0004), compared with the control group (183 x 103 μL). In contrast, relative TCD4+ and TCD8+ levels increased in the 2nd and 3rd trimesters compared with the controls (TCD4 + : 2nd trimester = 59%; p < 0.001; 3rd trimester = 57%; p < 0.01; control = 50%; and TCD8 + : 2nd trimester = 31%; p < 0.001; 3rd trimester = 36%; p < 0.01; control = 24%). Conclusion Low-risk pregnant women have ~ 40% less B and NK cells in the peripheral blood, compared with non-pregnant women. These parameters may improve health assistance for mothers and contribute to define reference values for normal pregnancies.
Resumo Objetivo Descrever o intervalo de referência imunológico e hematológico de gestantes de baixo risco. Métodos Realizou-se uma análise retrospectiva, de um estudo básico e translacional, analisando o perfil hematológico e a imunofenotipagem das células TCD3 + , TCD4 + , TCD8 + , B e natural killer (NK) do sangue periférico de 79 gestantes de baixo risco e de 30 mulheres (controles) do estado de Pernambuco, Brasil. Resultados Não observamos diferenças significativas entre os perfis hematológicos do 2° e 3° trimestres. No entanto, houve redução das células B no 2° (média = 174 x 103 μL; p < 0,002) e no 3° trimestres (160 x 103 μL; p < 0,001), comparado como grupo controle (296 x 103 μL). A mediana das células NK foi menor no 2° (134 x 103 μL; p < 0,0004) e no 3° trimestres (100 x 103 μL; p < 0,0004), comparado com o grupo controle (183 x 103 μL). Porém, o percentual de TCD4+ e de TCD8+ aumentou no 2° e 3° trimestres em relação aos controles (TCD4 + : 2° trimestre = 59%; p < 0,001; 3° trimestre = 57%; p < 0,01; controle = 50%; e TCD8 + : 2° trimestre = 31%; p < 0,001; 3° trimestre = 36%; p < 0,01; controle = 24%). Conclusão Mulheres grávidas de baixo risco têm ~ 40% menos células B e NK no sangue periférico em comparação com mulheres não grávidas. Estes parâmetros podem melhorar a assistência à saúde das mães e contribuir para a definição de valores de referência para gestações normais.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Gravidez/imunologia , Células Matadoras Naturais/fisiologia , Linfócitos T/fisiologia , Trimestres da Gravidez , Valores de Referência , Gravidez/sangue , Estudos Transversais , Estudos Retrospectivos , Bases de Dados FactuaisRESUMO
OBJECTIVE: To describe the immunological and hematological reference intervals of low-risk pregnant women. METHODS: A cross-sectional retrospective database analysis of a basic and translational study analyzing the hematological evaluation blood counts and immunophenotyping of TCD3 + , TCD4 + , TCD8 + , B, and natural killer (NK) cells of the peripheral blood in 79 low-risk pregnant women and of 30 control women from the state of Pernambuco, Brazil, was performed. RESULTS: No significant differences were detected between the hematological profiles of the 2nd and 3rd trimesters. Nevertheless, the median level of B cells decreased significantly in the 2nd (174 × 103 µL; p < 0.002) and 3rd trimesters (160 × 103 µL; p < 0.001), compared with the control group (296 × 103 µL). Similarly, the median level of NK cells was lower in the 2nd (134 × 103 µL; p < 0.0004) and 3rd trimesters (100 × 103 µL, p < 0.0004), compared with the control group (183 × 103 µL). In contrast, relative TCD4+ and TCD8+ levels increased in the 2nd and 3rd trimesters compared with the controls (TCD4 + : 2nd trimester = 59%; p < 0.001; 3rd trimester = 57%; p < 0.01; control = 50%; and TCD8 + : 2nd trimester = 31%; p < 0.001; 3rd trimester = 36%; p < 0.01; control = 24%). CONCLUSION: Low-risk pregnant women have â¼ 40% less B and NK cells in the peripheral blood, compared with non-pregnant women. These parameters may improve health assistance for mothers and contribute to define reference values for normal pregnancies.
OBJETIVO: Descrever o intervalo de referência imunológico e hematológico de gestantes de baixo risco. MéTODOS: Realizou-se uma análise retrospectiva, de um estudo básico e translacional, analisando o perfil hematológico e a imunofenotipagem das células TCD3 + , TCD4 + , TCD8 + , B e natural killer (NK) do sangue periférico de 79 gestantes de baixo risco e de 30 mulheres (controles) do estado de Pernambuco, Brasil. RESULTADOS: Não observamos diferenças significativas entre os perfis hematológicos do 2° e 3° trimestres. No entanto, houve redução das células B no 2° (média = 174 × 103 µL; p < 0,002) e no 3° trimestres (160 × 103 µL; p < 0,001), comparado com o grupo controle (296 × 103 µL). A mediana das células NK foi menor no 2° (134 × 103 µL; p < 0,0004) e no 3° trimestres (100 × 103 µL; p < 0,0004), comparado com o grupo controle (183 × 103 µL). Porém, o percentual de TCD4+ e de TCD8+ aumentou no 2° e 3° trimestres em relação aos controles (TCD4 + : 2° trimestre = 59%; p < 0,001; 3° trimestre = 57%; p < 0,01; controle = 50%; e TCD8 + : 2° trimestre = 31%; p < 0,001; 3° trimestre = 36%; p < 0,01; controle = 24%). CONCLUSãO: Mulheres grávidas de baixo risco têm â¼ 40% menos células B e NK no sangue periférico em comparação com mulheres não grávidas. Estes parâmetros podem melhorar a assistência à saúde das mães e contribuir para a definição de valores de referência para gestações normais.
Assuntos
Células Matadoras Naturais/fisiologia , Gravidez/imunologia , Linfócitos T/fisiologia , Adolescente , Adulto , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Gravidez/sangue , Trimestres da Gravidez , Valores de Referência , Estudos Retrospectivos , Adulto JovemRESUMO
RESUMO Este estudo objetivou investigar o efeito crônico da óleo de peixe (FO) e o treinamento resistido (ST) nos parâmetros sanguíneos (glicemia, triglicérides e HDL, LDL colesterol VLDL) de mulheres idosas. Quarenta e cinco mulheres (64 ± 1,4 anos) foram distribuídas em três grupos: um grupo que realizou 90 dias de treinamento resistido (ST; n = 15), um grupo que realizou 90 dias de treinamento resistido associado à 2g / dia de óleo de peixe (ST90; n = 15) e o ultimo grupo que consumiu óleo de peixe por 60 dias antes de iniciar os 90 dias de treinamento resistido associado ao FO (ST150; n = 15). O treinamento foi realizado 3 vezes / semana, durante 12 semanas. Os parâmetros sanguíneos foram avaliados nos 3 grupos nas condições, pré-suplementação e pré-treinamento (PRÉ) e pós-suplementação (PÓS60) e pós-treinamento (PÓS). Os efeitos positivos foram comprovados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas (ST90 e ST150). A glicemia de ST e ST150 não apresentou mudanças entre PRÉ-PÓS e PRÉ-PÓS60, respectivamente. No entanto, quando foi combinado o exercício com o FO reduções na glicemia foram encontrados no ST90 (21%) e ST150 (19%) a partir de PRÉ e PÓS (p <0,05). A FO causou ganhos significativos no HDL (ST150 PRE- PÓS60). Contudo, o exercício foi eficaz quando acompanhado da suplementação FO (ST90, ST150, PRÉ-PÓS, p<.0.05). Os triglicérides do sangue diminuiu quando FO e o exercício resistido (p<0,05) foram aplicados separadamente (ST, ST90 e ST150 PRÉ, PÓS 60 e PÓS). Houve uma redução nas concentrações de VLDL em todos os grupos (26% de ST, 35% em ST90, ST150 de PÓS60 em 35% e 36% em PÓS). A LDL não foi alterada. Conclui-se que os parâmetros sanguíneos (triglicérides e VLDL) diminuiu quando FO e exercícios foram aplicados separadamente. Os efeitos positivos foram evidenciados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas.
ABSTRACT It was aimed to investigate the chronic effect of FO and ST on blood parameters (glycaemia, triglycerides, and HDL, LDL VLDL cholesterol) of elderly women. METHODS: Forty-five women (64 ± 1.4 years) were assigned to one group of strength training (ST; n=15), one group of strength and 2g/day of FO supplemented by 90 (ST90; n=15) and 150 days (ST150; n=15). The ST150 started FO 60 days before commencing the strength training. Training was performed 3 times/wk, for 12 weeks. The blood parameters were assessed at before supplementation (POST60), pre-training (PRE) and post-training (POST). Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined (ST90 e ST150). The glycaemia of ST and ST150 showed no changes between PRE-POST and POST60-PRE, respectively. However, when training was combined with FO supplementation reductions in the glycaemia were found in the ST90 (21%) and ST150 (19%) from PRE to POST (p<0.05). The FO caused significant gains in HDL (ST150 POST 60-PRE). The HDL was not influenced by exercise alone (ST PRE-POS; p>0.05). However, exercise was effective when accompanied by FO supplementation (ST90, ST150, PRE-POST, p<.0.05). The triglycerides decreased when FO and exercises (p<0.05) were applied separately (ST, ST90 and ST150 POST60-POST). No additional reductions were found by combining FO and exercise. There was a reduction in the concentrations of VLDL in all groups (26% for ST, 35% in ST90, ST150 base in 35% and 36% in post ST150). The LDL was not altered. In concluision The blood parameters (triglycerides and VLDL) decreased when FO and exercises were applied separately. No additional reductionswere found by combining FO and exercise. Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined.
RESUMO
INTRODUCTION: Few studies about discrimination and patterns of alcohol consumption among youth populations have been conducted outside the United States addressing different types of discriminatory experiences, in addition to racially motivated events. This study investigated moderators of the association between discrimination attributed to single and multiple reasons and patterns of alcohol consumption. METHODS: This cross-sectional study enrolled a representative sample (n = 1,264) of undergraduate students from Florianópolis, southern Brazil, in 2013. Analyses included adjustment of associations for covariates in ordinal logistic regression models and the examination of effect modification by common mental disorders, year of study and age. RESULTS: Discrimination was reported by 65.8% of the students, and alcohol consumption, by 80.0%. Over half of the students reported being discriminated against for two or more reasons. The odds of alcohol-related problems were higher among lastyear students that reported discrimination (odds ratio [OR] = 1.9, 95% confidence interval [95%CI] 1.0-3.4) or multiple reasons for being discriminated against (OR = 2.3, 95%CI 1.3- 4.3), when compared to first-year students that did not report discrimination. For the whole sample, there were no associations between discrimination, discrimination attributed to multiple reasons and patterns of alcohol consumption (OR = 1.0, 95%CI 0.8-1.4; and OR = 0.9, 95%CI 0.5-1.6). CONCLUSIONS: The effects of discrimination on the patterns of alcohol consumption are seen at a critical period in university life, specifically during the completion of undergraduate studies.
Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Discriminação Social/psicologia , Estudantes/psicologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo , Universidades , Adulto JovemRESUMO
Immune function changes with ageing and is influenced by physical activity (strength training, ST) and diet (fish oil, FO). The present study investigated the effect of FO and ST on the immune system of elderly women. Forty-five women (64 (sd 1.4) years) were assigned to ST for 90 d (ST; n 15), ST plus 2 g/d FO for 90 d (ST90; n 15) or 2 g/d FO for 60 d followed by ST plus FO for 90 d (ST150; n 15). Training was performed three times per week, for 12 weeks. A number of innate (zymosan phagocytosis, lysosomal volume, superoxide anion, peroxide of hydrogen) and adaptive (cluster of differentiation 4 (CD4), CD8, TNF-α, interferon-γ (IFN-γ), IL-2, IL-6 and IL-10 produced by lymphocytes) immune parameters were assessed before supplementation (base), before (pre-) and after (post-) training. ST induced no immune changes. FO supplementation caused increased phagocytosis (48 %), lysosomal volume (100 %) and the production of superoxide anion (32 %) and H2O2(70 %) in the ST90. Additional FO supplementation (ST150) caused no additive influence on the immune system, as ST150 and ST90 did not differ, but caused greater changes when compared to the ST (P< 0·05). FO increased CD4+ and CD8+ lymphocytes in the ST150, which remained unchanged when training was introduced. The combination of ST and FO reduced TNF-α in the ST150 from base to post-test. FO supplementation (ST150, base-pre) when combined with exercise (ST150, pre-post) increased IFN-γ, IL-2, IL-6 and IL-10 production. The immune parameters improved in response to FO supplementation; however, ST alone did not enhance the immune system.
Assuntos
Óleos de Peixe/administração & dosagem , Sistema Imunitário/fisiologia , Treinamento Resistido , Idoso , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos , Suplementos Nutricionais , Ácidos Graxos/análise , Ácidos Graxos/sangue , Feminino , Óleos de Peixe/química , Humanos , Peróxido de Hidrogênio/metabolismo , Sistema Imunitário/efeitos dos fármacos , Imunidade/efeitos dos fármacos , Imunidade/fisiologia , Interferon gama/sangue , Interleucinas/sangue , Contagem de Linfócitos , Lisossomos/ultraestrutura , Pessoa de Meia-Idade , Neutrófilos/imunologia , Neutrófilos/metabolismo , Fagocitose/efeitos dos fármacos , Fagocitose/fisiologia , Superóxidos/metabolismo , Fator de Necrose Tumoral alfa/sangueRESUMO
Introduction: Few studies about discrimination and patterns of alcohol consumption among youth populations have been conducted outside the United States addressing different types of discriminatory experiences, in addition to racially motivated events. This study investigated moderators of the association between discrimination attributed to single and multiple reasons and patterns of alcohol consumption. Methods: This cross-sectional study enrolled a representative sample (n = 1,264) of undergraduate students from Florianópolis, southern Brazil, in 2013. Analyses included adjustment of associations for covariates in ordinal logistic regression models and the examination of effect modification by common mental disorders, year of study and age. Results: Discrimination was reported by 65.8% of the students, and alcohol consumption, by 80.0%. Over half of the students reported being discriminated against for two or more reasons. The odds of alcohol-related problems were higher among lastyear students that reported discrimination (odds ratio [OR] = 1.9, 95% confidence interval [95%CI] 1.0-3.4) or multiple reasons for being discriminated against (OR = 2.3, 95%CI 1.3- 4.3), when compared to first-year students that did not report discrimination. For the whole sample, there were no associations between discrimination, discrimination attributed to multiple reasons and patterns of alcohol consumption (OR = 1.0, 95%CI 0.8-1.4; and OR = 0.9, 95%CI 0.5-1.6). Conclusions: The effects of discrimination on the patterns of alcohol consumption are seen at a critical period in university life, specifically during the completion of undergraduate studies. .
Introdução: Há uma escassez de estudos sobre discriminação e consumo de álcool conduzidos fora dos Estados Unidos com populações jovens e abordando outros tipos de discriminação, além da racial. Este estudo investigou a associação entre experiências de discriminação, suas motivações e consumo de álcool, conforme potenciais modificadores de efeito. Métodos: Realizou-se um estudo transversal com amostra representativa (n = 1.264) de graduandos de uma universidade pública de Florianópolis, sul do Brasil, em 2013. As associações foram ajustadas para covariáveis através de regressão logística ordinal, incluindo modificação de efeito por transtornos mentais comuns, ano de estudo e idade. Resultados: Entre os estudantes, 65,8% relataram ter sofrido discriminação, e 80,0 % referiram consumir álcool. Mais da metade dos estudantes indicou que suas experiências de discriminação foram motivadas por duas ou mais razões. A chance de apresentar problemas relacionados ao consumo de álcool foi maior entre os alunos do último ano da graduação, que referiram discriminação (odds ratio [OR] = 1,9, intervalo de confiança de 95% [IC95%] 1,0-3,4) ou múltiplas motivações para terem sido discriminados (OR = 2,3, IC95% 1,3-4,3), quando comparados com os calouros, que não relatam discriminação. Para o conjunto da amostra, não houve associação entre discriminação, suas motivações e o padrão de consumo de álcool (OR = 1,0, IC95% 0,8-1,4 e OR = 0,9, IC95% 0,5-1,6). Conclusões: Os efeitos da discriminação sobre o padrão de consumo de álcool se manifestam em um período crítico da vida universitária, especificamente durante a finalização dos estudos de graduação. .
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Discriminação Social/psicologia , Fatores Socioeconômicos , Fatores de Tempo , Universidades , Brasil/epidemiologia , Modelos Logísticos , Fatores Sexuais , Estudos Transversais , Pessoa de Meia-IdadeRESUMO
Fish oil (FO) has been shown to affect cancer cachexia, tumor mass, and immunity cell. n-3 PUFA, specifically α-linolenic fatty acid (ALA), has controversial effects. We investigated this in nontumor-bearing Wistar rats fed regular chow (C), fed regular chow and supplemented with FO or Oro Inca oil (OI), and Walker 256 tumor-bearing rats fed regular chow (W), fed regular chow and supplemented with FO (WFO) or OI (WOI). Rats were supplemented (1g/kg body weight/day) during 4 wk and then the groups tumor-bearing were inoculated with Walker 256 tumor cells suspension and 14 days later the animals were killed. WFO increased EPA fivefold and DHA 1.5-fold in the tumor tissue compared to W (P < 0.05). OI supplementation increased of threefold of ALA when compared to W (P < 0.05). Tumor mass in WFO and OI was of 2.3-fold lower, as well as tumor cell proliferation of 3.0-fold tumor tissue lipoperoxidation increased of 76.6% and cox-2 expression was 20% lower. Cachexia parameters were attenuate, blood glucose (25% higher), Triacylglycerolemia (50% lower), and plasma TNF-α (65% lower; P < 0.05) and IL-6 (62.5% lower). OI, rich in ALA, caused the same effect on cancer as those seen in FO.
Assuntos
Caquexia/prevenção & controle , Carcinoma 256 de Walker/patologia , Proliferação de Células/efeitos dos fármacos , Óleos de Peixe/administração & dosagem , Ácido alfa-Linolênico/administração & dosagem , Animais , Linhagem Celular Tumoral , Suplementos Nutricionais , Inibidores do Crescimento/farmacologia , Masculino , Ratos , Ratos WistarRESUMO
PURPOSE: To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section. METHODS: An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours. RESULTS: Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%). CONCLUSIONS: The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate.
Assuntos
Catéteres , Trabalho de Parto Induzido/instrumentação , Trabalho de Parto Induzido/métodos , Gravidez de Alto Risco , Nascimento Vaginal Após Cesárea , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Adulto JovemRESUMO
OBJETIVO: Descrever os desfechos materno-fetais com o uso da sonda de Foley para indução do trabalho de parto em gestantes de alto risco com cesariana anterior. MÉTODOS: Foi realizado um estudo de intervenção e descritivo, no período de novembro de 2013 a junho de 2014. Foram incluídas 39 gestantes a termo, com feto vivo, apresentação cefálica, peso estimado <4.000 g, cesariana prévia, com indicação de indução do trabalho de parto, escore de Bishop ≤6 e índice de líquido amniótico >5 cm. A sonda de Foley nº 16F foi introduzida, por no máximo 24 horas, sendo considerado satisfatória quando a paciente entrou em trabalho de parto nas primeiras 24 horas. RESULTADOS: O trabalho de parto foi induzido satisfatoriamente em 79,5% das gestantes. Nove mulheres evoluíram para parto vaginal (23,1%), com uma frequência de 18% de partos vaginais ocorridos dentro de 24 horas. As principais indicações da indução do parto foram as síndromes hipertensivas (75%). As médias dos intervalos entre a colocação da sonda de Foley e o início do trabalho de parto e o parto foram de 8,7±7,1 e 14,7±9,8 horas, respectivamente. A eliminação de mecônio foi observada em 2 pacientes e o escore de Apgar <7 no primeiro minuto foi observado em 5 recém-nascidos (12,8%). CONCLUSÕES: A sonda de Foley é uma alternativa para indução do trabalho de parto em gestantes com cesariana anterior, apesar da baixa taxa de parto vaginal. .
PURPOSE: To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section. METHODS: An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours. RESULTS: Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%). CONCLUSIONS: The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate. .