ROSSANA PULCINELI VIEIRA FRANCISCO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
64 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 64
bookPart Analgesia e anestesia(2016) YOSHIZAKI, Carlos Tadashi; FITTIPALDI, Felipe Silva; OSMUNDO JUNIOR, Gilmar de Souza; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; BUNDUKI, VictorbookPart Ultrassonografia(2016) ROLNIK, Daniel Lorber; BAPTISTA, Fernanda Spadotto; BRIZOT, Maria de Lourdes; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli VieirabookPart Distocias(2016) YOSHIZAKI, Carlos Tadashi; FITTIPALDI, Felipe Silva; OSMUNDO JUNIOR, Gilmar de Souza; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; BUNDUKI, Victor- Reduced placental volume and flow in severe growth restricted fetuses(2016) ABULE, Renata Montes Dourado; BERNARDES, Lisandra Stein; DORO, Giovana Farina; MIYADAHIRA, Seizo; FRANCISCO, Rossana Pulcinelli VieiraOBJECTIVES: To evaluate placental volume and vascular indices in pregnancies with severe fetal growth restriction and determine their correlations to normal reference ranges and Doppler velocimetry results of uterine and umbilical arteries. METHODS: Twenty-seven fetuses with estimated weights below the 3rd percentile for gestational age were evaluated. Placental volume and vascular indices, including vascularization, flow, and vascularization flow indices, were measured by three-dimensional ultrasound using a rotational technique and compared to a previously described nomogram. The observed-to-expected placental volume ratio for gestational age and observed-to-expected placental volume ratio for fetal weight were calculated. Placental parameters correlated with the Doppler velocimetry results of uterine and umbilical arteries. RESULTS: The mean uterine artery pulsatility index was negatively correlated with the observed-to-expected placental volume ratio for gestational age, vascularization index and vascularization flow index. The observed-to-expected placental volume ratio for gestational age and observed-to-expected placental volume ratio for fetal weight and vascularization index were significantly lower in the group with a bilateral protodiastolic notch. No placental parameter correlated with the umbilical artery pulsatility index. CONCLUSIONS: Pregnancies complicated by severe fetal growth restriction are associated with reduced placental volume and vascularization. These findings are related to changes in uterine artery Doppler velocimetry. Future studies on managing severe fetal growth restriction should focus on combined results of placental three-dimensional ultrasound and Doppler studies of uterine arteries.
- Antenatal Corticosteroid Administration for Reducing the Risk of Neonatal Morbidities from Prematurity(2016) BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, Marcelo
bookPart Influência da Gravidez sobre as Doenças do Tecido Conjuntivo(2016) ANDRADE, Joelma Queiroz; WAISSMAN, Adriana Lippi; FRANCISCO, Rossana Pulcineli Vieira- Fetal thrombotic vasculopathy: A case report and literature review(2016) PELEJA, Ana Berquo; MARTINELLI, Silvio; RIBEIRO, Renata Lopes; BITTAR, Roberto Eduardo; SCHULTZ, Regina; FRANCISCO, Rossana Pulcineli VieiraIntroduction: Fetal thrombotic vasculopathy is a recently described placental alteration with varying degrees of involvement and often associated with adverse perinatal outcomes. The diagnosis is made histologically and therefore is postnatal, which makes it a challenge in clinical practice. Method: Case report and review of literature on the subject. Results: The present case refers to a pregnant woman presenting fetal growth restriction, with poor obstetrical past, and sent late to our service. Even with weekly assessments of fetal vitality (fetal biophysical profile and Doppler velocimetry) and prenatal care, the patient progressed with fetal death at 36 weeks and 1 day. There was no association with inherited and acquired thrombophilia. Pathological examination of the placenta revealed fetal thrombotic vasculopathy. Conclusion: The fetal thrombotic vasculopathy may be associated with adverse perinatal outcomes including fetal death, but much remains to be studied regarding its pathogenesis. Diagnosis during pregnancy is not possible and there is still no proven treatment for this condition. Future studies are needed so that strategies can be developed to minimize the impact of fetal thrombotic vasculopathy.
bookPart Fórcipe(2016) YOSHIZAKI, Carlos Tadashi; FITTIPALDI, Felipe Silva; OSMUNDO JUNIOR, Gilmar de Souza; FRANCISCO, Rossana Pulcineli Vieira; MARTINELLI, Silvio; BUNDUKI, Victor- Associations of maternal personal exposure to air pollution on fetal weight and fetoplacental Doppler: A prospective cohort study(2016) CARVALHO, Mariana A.; BERNARDES, Lisandra S.; HETTFLEISCH, Karen; PASTRO, Luciana D. M.; VIEIRA, Sandra E.; SALDIVA, Silvia R. D. M.; SALDIVA, Paulo H. N.; FRANCISCO, Rossana P. V.We determined the influence of maternal air pollution exposure during each trimester of pregnancy on fetal and birth weight and fetoplacental hemodynamics. In total, 366 women with singleton pregnancies were prospectively followed in the city of Sao Paulo, Brazil. Nitrogen dioxide (NO2) and ozone (O-3) were measured during each trimester using passive personal samplers. We evaluated fetal weight and Doppler velocimetry data from the umbilical, middle cerebral, and uterine arteries in the 3rd trimester, and birth weight. Multivariate analysis was performed, controlling for known determinants of fetal weight. Exposure to higher levels of O-3 during the 2nd trimester was associated with higher umbilical artery pulsatility indices (PIs) [p = 0.013; beta = 0.017: standard error (SE) = 0.007]. Exposure to higher levels of O-3 during the 3rd trimester was associated with lower umbilical artery PIs (p = 0.011; beta = 0.021; SE = 0.008). Our results suggest that in the environment of Sao Paulo, 03 may affects placental vascular resistance.
- Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death(2016) BACCEGA, Felipe; BRIZOT, Maria de Lourdes; KREBS, Vera Lucia Jornada; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloAim: To determine the ultrasonographic findings that predict death in fetal ascites. Methods: This was a retrospective cohort study involving pregnancies with ultrasonographic findings related to fetal ascites. The inclusion criteria were as follows: single pregnancy with a live fetus; ultrasound findings of ascites; ascites unrelated to maternal fetal alloimmunization; and pregnancy follow-up at our institution. The chi(2)-test was used to evaluate the association of ultrasound findings and death. Multiple logistic regression analysis was performed to determine the ultrasound findings that are predictive of death prior to hospital discharge. Results: A total of 154 pregnancies were included in the study. In 8 (5.19%) cases, ascites was an isolated finding, and in 146 cases, other alterations were observed during the ultrasound evaluation. Death before hospital discharge occurred in 117 cases (76.00%). The following ultrasonographic findings were significantly associated with death: gestational age at diagnosis <24 weeks (P < 0.0001); stable/progressive ascites evolution (P = 0.004); the presence of hydrops (P < 0.0001); and the presence of cystic hygroma (P < 0.0001). The presence of hydrops, the presence of respiratory tract malformations, and stable/progressive ascites evolution were significantly associated with the prediction of death. Conclusions: Based on ultrasound examination, the presence of hydrops, malformation of the respiratory tract, and stable/progressive evolution of ascites increase the chances of death in cases of fetal ascites.