ADOLFO WENJAW LIAO
Projetos de Pesquisa
Unidades Organizacionais
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
58 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 58
bookPart Aconselhamento genético(2016) LIAO, Adolfo Wenjaw; ROLNIK, Daniel Lorber; BERNARDES, Lisandra Stein; BRIZOT, Maria de Lourdes; CARVALHO, Mário Henrique Burlacchini de- Fetal Growth Pattern and Prediction of Low Birth Weight in Gastroschisis(2015) CENTOFANTI, Sandra F.; BRIZOT, Maria de Lourdes; LIAO, Adolfo W.; FRANCISCO, Rossana P. V.; ZUGAIB, MarceloObjectives: To examine growth patterns and predictions of low birth weight in gastroschisis fetuses. Methods: This is a retrospective study of isolated fetal gastroschisis before week 24. Ultrasound fetal biometric parameters - head circumference (HC), abdominal circumference (AC), femur length, HC/AC ratio and estimated fetal weight (EFW) - were plotted against normal growth charts. The percentage difference in mean values between normal and gastroschisis fetuses was determined. The growth deficit for each ultrasound parameter was calculated for the fetuses with 1 examination in each designated period (period I: weeks 20-25(+6); period II: weeks 26-31(+6); period III: from week 32 until term). For low birth weight prediction, measurements below the 10th percentile in periods I and II were tested. Results: Seventy pregnancies were examined. For all fetal parameters, the mean measurements were lower in fetuses with gastroschisis (p < 0.005). The EFW revealed an increased growth deficit between the periods (p = 0.030). HC was predictive of low birth weight in period II (OR = 6.07; sensitivity = 70.8%; specificity = 71.4%). Conclusions: Fetuses with gastroschisis present a reduced growth pattern, and it appears that no growth recovery occurs after the growth restriction has been established. Between week 26 and week 31(+6), an HC measurement below the 10th percentile is associated with an increased risk of low birth weight. (C) 2015 S. Karger AG, Basel
bookPart Rastreamento das anomalias cromossômicas(2016) LIAO, Adolfo Wenjaw; ROLNIK, Daniel Lorber; BERNARDES, Lisandra Stein; BRIZOT, Maria de Lourdes; CARVALHO, Mário Henrique Burlacchini de- Prediction of the rate of decline in fetal hemoglobin levels between first and second transfusions in red cell alloimmune disease(2012) NISHIE, Estela Naomi; LIAO, Adolfo Wenjaw; BRIZOT, Maria de Loudes; ASSUNCAO, Renata A.; ZUGAIB, MarceloObjective To determine variables that predict the rate of decline in fetal hemoglobin levels in alloimmune disease. Method Retrospective review of singleton pregnancies that underwent first and second intrauterine transfusions for treatment of fetal anemia because of maternal Rh alloimmunization in a tertiary referral center. Results Forty-one first intrauterine transfusions were performed at 26.1?weeks (standard deviation, SD, 4.6), mean volume of blood transfused was 44.4?mL (SD 23.5) and estimated feto-placental volume expansion was 51.3% (SD 14.5%). Between first and second transfusion, hemoglobin levels reduced on average 0.40?g/dl/day (SD 0.25). Stepwise multiple regression analysis demonstrated that this rate significantly correlated with hemoglobin levels after the first transfusion, the interval between both procedures, and middle cerebral artery systolic velocity before the second transfusion. Conclusion The rate of decline in fetal hemoglobin levels between first and second transfusions in alloimmune disease can be predicted by a combination of hemoglobin levels after the first transfusion, interval between both procedures, and middle cerebral artery systolic velocity before the second transfusion. (C) 2012 John Wiley & Sons, Ltd.
bookPart Restrição do crescimento fetal(2016) LIAO, Adolfo Wenjaw; FITTIPALDI, Felipe Silva; LIN, Lawrence Hsu; BERNARDES, Lisandra Stein; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; CODARIN, Rodrigo Rocha- Maternal postpartum complications according to delivery mode in twin pregnancies(2014) STACH, Sonia Leme; LIAO, Adolfo Wenjaw; BRIZOT, Maria de Lourdes; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloOBJECTIVE: We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors. METHODS: This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008). The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated. RESULTS: A total of 90 complications were observed in 56/817 (6.9%) deliveries: 7/131 (5.3%) vaginal, 10/251 (4.0%) elective cesarean and 39/435 (9.0%) emergency cesarean deliveries. Significant predictors included high risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34). CONCLUSIONS: Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.
- Twin Pregnancies: Evaluation of Major Depression, Stress, and Social Support(2013) BENUTE, Glaucia R. G.; NOZZELLA, Debora C. R.; PROHASKA, Cecilia; LIAO, Adolfo; LUCIA, Mara C. S. de; ZUGAIB, MarceloBackground: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Conclusion: Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.
- Should fetal growth be a matter of concern in isolated single umbilical artery?(2014) CALDAS, Lorena Mesquita; LIA, Adolfo; CARVALH, Mario Henrique; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloObjective: To examine birth weight in pregnancies with isolated single umbilical artery (ISUA). Methods: Case control study with retrospective review of 131 singleton pregnancies with isolated single umbilical artery diagnosed before birth. Control group consisted of 730 singleton pregnancies recruited prospectively, that had histological confirmation of a 3 vessels cord. Pregnancies were classified as uncomplicated or high-risk according to the presence of diseases that increase the risk of placental insufficiency during pregnancy. Mean birth weight and frequency of low birth weight (< 2.500g), very low birth weight (< 1.500g) and fetal growth restriction below the 5th and 10th centiles were compared between groups. Results: Mean birth weight difference between ISUA (n=131, 2840 +/- 701g) and control (n=730, 2.983 +/- 671g) pregnancies was 143g (95% CI= 17-269; p=0.04) and birth weight below the 5th centile was significantly more common in ISUA group [28/131 (21.4%) versus 99/730 (13.6%), p=0.02]. When only uncomplicated pregnancies were considered in both groups, no birth weight differences were observed. Amongst high-risk subgroups, birth weight below the 5th centile remained significantly more common in ISUA compared to control pregnancies [10/35 (28.6%) versus 53/377 (14.1%), p=0.04]. Conclusion: Isolated single umbilical artery does not increase the risk of fetal growth restriction in uncomplicated singleton pregnancies.
bookPart Hiperêmese(2016) LIAO, Adolfo Wenjaw; FITTIPALDI, Felipe Silva; LIN, Lawrence Hsu; BERNARDES, Lisandra Stein; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; CODARIN, Rodrigo Rocha- Transplacental Total IgG Transfer in Twin Pregnancies(2014) STACH, Sonia C. L.; BRIZOT, Maria de L.; LIAO, Adolfo W.; FRANCISCO, Rossana P. V.; PALMEIRA, Patricia; CARNEIRO-SAMPAIO, Magda; ZUGAIB, MarceloProblemIn twin pregnancies, factors that influence total umbilical cord IgG concentration and IgG transfer ratio are not well known. MethodBlood samples were prospectively collected from 57 twin pregnancies. Stepwise multivariate regression analysis was used to evaluate the association between total IgG levels in the umbilical cord blood and IgG transfer ratio according to serum IgG concentration, pregnancy chorionicity, the presence of abnormal umbilical artery pulsatility index, intrauterine growth restriction, gestational age at delivery (GAD), birthweight, and placental weight. ResultsUmbilical cord IgG concentration showed a positive correlation with serum IgG concentration and GAD; levels were significantly lower in monochorionic compared with dichorionic pregnancies. IgG transfer ratio also increased with GAD but was inversely correlated with serum IgG concentration levels. ConclusionIn twin pregnancies, besides serum IgG concentration and GAD, chorionicity also influences umbilical cord IgG concentration. Monochorionic twins have lower IgG cord concentration than dichorionic twins.