MARCELO ZUGAIB
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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conferenceObject IMPACT OF PREVIOUS HYPERTENSIVE DISORDER DURING PREGNANCY ON ANTHROPOMETRIC MEASUREMENTS, 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS(2021) VERARDINO, Renata; RODRIGUES, Sara; BERGER, Ana; COSTA-HONG, Valeria; MACEDO, Thiago; BAPTISTA, Fernanda; BORTOLOTTO, Maria; FRANCISCO, Rossana; ZUGAIB, Marcelo; BORTOLOTTO, Luiz- Outcomes following medical termination versus prolonged pregnancy in women with severe preeclampsia before 26 weeks(2021) CARVALHO, Mariana A.; BEJJANI, Lina; V, Rossana P. Francisco; PATINO, Elizabeth G.; VIVANTI, Alexandre; BATISTA, Fernanda S.; ZUGAIB, Marcelo; MERCIER, Frederic J.; BERNARDES, Lisandra S.; BENACHI, AlexandraObjective To compare maternal complications and describe neonatal outcomes in women with severe preeclampsia at <= 26(+0) weeks in two countries with different management policies: expectant management (Brazil) versus termination of pregnancy (France). Methods We conducted a retrospective comparative study by reviewing the medical records of women with severe preeclampsia at <= 26(+0) weeks, from January 2010 to June 2018, in two centers: Hospital das Clinicas da Faculdade de Medicina, in Sao Paulo, Brazil (where medical abortion is forbidden in this indication) and Hopital Antoine-Beclere, Clamart, France (where medical termination is accepted). We collected information on maternal characteristics, laboratory tests, maternal complications and fetal and newborn characteristics. We used Student's t-test and the Mann-Whitney U nonparametric test to compare quantitative variables, and Chi-square test or Fisher's exact test to evaluate the associations between the qualitative variables. Results There was no between-group difference in maternal complications during hospitalization (p = 0.846). In Brazil, the rate of cesarean section was 66.7%, and 20% of patients had vertical incision. The rate of spontaneous fetal death was 35.6% and among the live-born infants 26.6% were discharged from hospital. In France, one patient had a cesarean section with vertical incision. Conclusion When comparing termination of pregnancy to expectant management in severe preeclampsia before 26 weeks, maternal complications were equivalent but maternal reproductive future might have been compromised in 20% of cases due to a higher risk of uterine rupture in subsequent pregnancies for patients having classic cesarean (vertical incision). 26.6% of children survived the neonatal period when pregnancy was pursued, however we lack information on their long-term follow-up.
- Urinary Bacterial Profile and Antibiotic Susceptibility in Pregnant Adolescents and Pregnant Low Obstetric Risk Adult Women(2021) SOUZA, Henrique Diorio de; HASE, Eliane Azeka; GALLETTA, Marco Aurelio Knippel; DIORIO, Giselle Rodrigues Mota; WAISSMAN, Adriana Lippi; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloIntroduction: Significant bacteriuria is associated with clinical and obstetric complications. The existing studies on the profile of urinary pathogens in pregnant women have widely divergent results and they hardly include data on pregnant adolescents. Methods: This observational retrospective study was conducted in a tertiary hospital in the city of Sao Paulo with 388 pregnant adolescents and 2547 pregnant low-risk obstetric care adults who began prenatal care between January 2010 and January 2016. They were compared in terms of urine sediment, urine culture, and antibiogram results. Results: The prevalence of bacteriuria was 17.01% (66/388) among adolescents and 10.13% (258/2547) among adults. Adolescence was a risk factor for bacteriuria in pregnancy (OR=1.82, CI95%=1.35-2.44, p=0.08). The most frequently isolated pathogen in urine culture was Escherichia coli, both in adolescents (49%) and in adults (42.18%). In positive urine cultures, urinary leukocytes were present in greater numbers in adolescents than in adults (p<0.001). Resistance to quinolones in general was more frequent among adults (OR=5.86, CI95%=0.78-44.20, p<0.001), but the tendency was not statistically significant. Conclusion: Escherichia coli and the less frequent Streptococcus agalactiae were the etiologic agents most often found in the urine cultures both of adolescents and adults. Higher rates of bacteriuria and of abnormal urine sediments prevailed among adolescents.