MARCO AURELIO KNIPPEL GALLETTA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
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bookPart Obesidade e gravidez(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças endócrinas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças tromboembólicas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira- Comparative analysis of Insulin-like growth factor binding protein-1, placental alpha-microglobulin-1, phenol and pH for the diagnosis of preterm premature rupture of membranes between 20 and 36 weeks(2019) GALLETTA, Marco A. K.; BITTAR, Roberto E.; RODRIGUES, Agatha S.; FRANCISCO, Rossana P. V.; ZUGAIB, MarceloAim Preterm premature rupture of membranes (PPROM) is responsible for approximately one-third of premature births worldwide, and although the diagnosis is often straightforward, this condition can still present difficulties. The purpose of this research was to compare the accuracy of several PPROM diagnostic tests. Methods A total of 94 pregnant women with clinical suspicion of PPROM who were between 20 and 36 weeks of pregnancy were examined by vaginal speculum, and tests were performed for phenol, pH, insulin-like growth factor binding protein-1 (IGFBP-1) and placental alpha-microglobulin-1 (PAMG-1). All patients were followed up until the diagnosis was fully defined, and a diagnosis of PROM was confirmed by a definitive evolution of the clinical symptoms (visualization of vaginal amniotic fluid or persistence of oligohydramnios). Results After excluding the cases that could not be definitively diagnosed, a good diagnostic performance of the immunochromatographic tests was observed that was superior to that of the clinical tests. Similar accuracies were observed for IGFBP-1 (98.7%) and PAMG-1 (93.9%). However, while the IGFBP-1 test differed from a vaginal pH >= 7 (88.9%) and the phenol test (85.7%), this did not occur for the PAMG-1 test. The performance of the tests was modified only by the presence of bleeding (with lower specificity rates for pH and phenol), without interference of gestational age or maternal morbidities. Conclusion Immunochromatographic tests are good tools but should be used sparingly in resource-poor settings because they are expensive, and there is no significant difference between PAMG-1 and traditional tests.
- Prevalence of oncogenic human papillomavirus in pregnant adolescents, association with colpocytological changes, risk factors and obstetric outcomes(2022) SOUZA, Henrique Diorio de; WAISSMAN, Adriana Lippi; DIORIO, Giselle Rodrigues Mota; PERES, Stela Verzinhasse; FRANCISCO, Rossana Pulcineli Vieira; GALLETTA, Marco Aurelio KnippelPurpose: The authors aim to carry out an investigation on the impact of cervical oncogenic Human Papillomavirus (HPV) detection in pregnant adolescents, to clarify the prevalence and risk factors, considering the importance and lack of data on this topic in Brazil. Methods: A cross-sectional study was conducted with adolescents receiving prenatal care in a tertiary hospital in Sao Paulo, Brazil, with routine Pap smear and oncogenic HPV detection test in the uterine cervix. The authors sought to associate the results of these tests with demographic and obstetric variables. Results: A total of 303 pregnant adolescents whose mean age was 15.30 +/- 1.22 years comprised the study subjects. The frequency of high-risk HPV cervical detection was 50.50%. Multivariate analysis revealed that a large number of partners in their lifetime (OR = 1.27) and having a religion (OR = 2.05) were risk factors for cervical detection of oncogenic HPV, while schooling appeared as a protective factor (OR = 0.85). There was an association between this detection and colpocytological alterations, reaching almost 30% of patients, but without association with obstetric and neonatal outcomes. Conclusion: The prevalence found is one of the highest in Brazil and worldwide. A greater number of partners during their lifetime and having religion were detected as possible factors associated with cervical HPV detection. Detection of cervical HPV-DNA did not influence obstetric and neonatal outcomes. The findings of this study reinforce the need to implement educational measures capable of modifying the incidence of sexually transmitted infections in this population and capable of promoting adherence to HPV vaccination programs.
bookPart Estatísticas vitais(2015) GALLETTA, Marco Aurélio Knippel; CARVALHO, Mário Henrique Burlacchini de; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; ASSUNçãO, Tatiana Silva debookPart Avaliação preconcepcional(2015) GALLETTA, Marco Aurélio Knippel; CARVALHO, Mário Henrique Burlacchini de; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; ASSUNçãO, Tatiana Silva de- Adverse Perinatal Outcomes among Adolescent Pregnant Women Living with HIV: A Propensity-Score-Matched Study(2023) OSMUNDO JUNIOR, G. D. S.; CABAR, F. R.; PERES, S. V.; WAISSMAN, A. L.; GALLETTA, M. A. K.; FRANCISCO, R. P. V.HIV infection and adolescent pregnancy are known to increase the risk of adverse perinatal outcomes. However, data are limited concerning the outcomes of pregnancies among adolescent girls living with HIV. This retrospective propensity-score matched study aimed to compare adverse perinatal outcomes in adolescent pregnant women living with HIV (APW-HIV-positive) with HIV-negative adolescent pregnant women (APW-HIV-negative) and adult pregnant women with HIV (PW-HIV). APW-HIV-positive were propensity-score matched with APW-HIV-negative and PW-HIV. The primary endpoint was a composite endpoint of adverse perinatal outcomes, comprising preterm birth and low birth weight. There were 15 APW-HIV-positive and 45 women in each control group. The APW-HIV-positive were aged 16 (13–17) years and had had HIV for 15.5 (4–17) years, with 86.7% having perinatally acquired HIV. The APW-HIV-positive had higher rates of perinatally acquired HIV infection (86.7 vs. 24.4%, p < 0.001), a longer HIV infection time (p = 0.021), and longer exposure to antiretroviral therapy (p = 0.034) compared with the PW-HIV controls. The APW-HIV-positive had an almost five-fold increased risk of adverse perinatal outcomes compared with healthy controls (42.9% vs. 13.3%, p = 0.026; OR 4.9, 95% CI 1.2–19.1). The APW-HIV-positive and APW-HIV-negative groups had similar perinatal outcomes.
bookPart Placentação e hormologia da placenta(2015) GALLETTA, Marco Aurélio Knippel; CARVALHO, Mário Henrique Burlacchini de; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; ASSUNçãO, Tatiana Silva de- Epidemiological profile of patients with preterm pre-mature rupture of membranes at a tertiary hospital in Sao Paulo, Brazil(2019) GALLETTA, Marco Aurelio Knippel; BITTAR, Roberto Eduardo; AGRA, Isabela; GUERRA, Eliane Cerqueira Leite; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloOBJECTIVE: To perform a descriptive analysis of preterm premature rupture of membranes (PPROM) cases attended in a tertiary hospital. METHOD: Retrospective analysis of medical records and laboratory tests of patients admitted to a Brazilian tertiary hospital between 2006 and 2011, with a confirmed diagnosis of PPROM and gestational age (GA) at delivery <37 weeks. RESULTS: A total of 299 pregnant women were included in the study. Nine patients evolved to abortion, and 290 pregnant women remained for the final analysis. There was initial diagnostic doubt in 17.6% of the cases. The oligohydramnios rate [amniotic fluid index (AFI) <5] was 27.9% on admission. Chorioamnionitis was initially diagnosed in 10.8% of the patients and was retrospectively confirmed in 22.9% of the samples. The latency period had a mean of 9.1 days. The main reasons for interruption were premature labor (55.2%), GA >= 36 weeks (27.2%), and fetal distress (6.9%). The delivery method was cesarean section in 55% of cases. The mean birth weight was 2,124 grams, and 67% of the neonates had a low birth weight (<2500 g). The GA at delivery averaged 33.5 weeks. The stillbirth rate was 5.3%, and the early neonatal mortality rate was 5.6%. There were complications at delivery in 18% of mothers. CONCLUSION: In one of the few Brazilian reports on the epidemiological profile of PPROM, with GA until 37 weeks and intercurrences generally excluded from assessments (such as twinning and fetal malformations), there is a favorable evolution, with an acceptable rate of complications.