MARIA RITA DE FIGUEIREDO LEMOS BORTOLOTTO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina

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  • article 11 Citação(ões) na Scopus
    Pregnancy in Women with Complex Congenital Heart Disease. A Constant Challenge
    (2019) AVILA, Walkiria Samuel; RIBEIRO, Veronica Martins; ROSSI, Eduardo Giusti; BINOTTO, Maria Angelica; BORTOLOTTO, Maria Rita; TESTA, Carolina; FRANCISCO, Rossana; HAJJAR, Ludhmilla Abraao; MIURA, Nana
    Background: The improvement in surgical techniques has contributed to an increasing number of childbearing women with complex congenital heart disease (CCC). However, adequate counseling about pregnancy in this situation is uncertain, due to a wide variety of residual cardiac lesions. Objectives: To evaluate fetal and maternal outcomes in pregnant women with CCC and to analyze the predictive variables of prognosis. Methods: During 10 years we followed 435 consecutive pregnancies in patients (pts) with congenital heart disease. Among of them, we selected 42 pregnancies in 40 (mean age of 25.5 +/- 4.5 years) pts with CCC, who had been advised against pregnancy. The distribution of underlying cardiac lesions were: D-Transposition of the great arteries, pulmonary atresia, tricuspid atresia, single ventricle, double-outlet ventricle and truncus arteriosus. The surgical procedures performed before gestation were: Fontan, Jatene, Rastelli, Senning, Mustard and other surgical techniques, including Blalock, Taussing, and Glenn. Eight (20,0%) pts did not have previous surgery. Nineteen 19 (47.5%) pts had hypoxemia. The clinical follow-up protocol included oxygen saturation recording, hemoglobin and hematocrit values; medication adjustment to pregnancy, anticoagulation use, when necessary, and hospitalization from 28 weeks, in severe cases. The statistical significance level considered was p < 0.05. Results: Only seventeen (40.5%) pregnancies had maternal and fetal uneventful courses. There were 13 (30.9%) maternal complications, two (4.7%) maternal deaths due to hemorrhage pos-partum and severe pre-eclampsia, both of them in women with hypoxemia. There were 7 (16.6%) stillbirths and 17 (40.5%) premature babies. Congenital heart disease was identified in two (4.1%) infants. Maternal and fetal complications were higher (p < 0.05) in women with hypoxemia. Conclusions: Pregnancy in women with CCC was associated to high maternal and offspring risks. Hypoxemia was a predictive variable of poor maternal and fetal outcomes. Women with CCC should be advised against pregnancy, even when treated in specialized care centers.
  • article 30 Citação(ões) na Scopus
    Update on the Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline of the Brazilian Society of Cardiology-2019
    (2019) BERNOCHE, Claudia; TIMERMAN, Sergio; POLASTRI, Thatiane Facholi; GIANNETTI, Natali Schiavo; SIQUEIRA, Adailson Wagner da Silva; PISCOPO, Agnaldo; SOEIRO, Alexandre de Matos; REIS, Amelia Gorete Afonso da Costa; TANAKA, Ana Cristina Sayuri; THOMAZ, Ana Maria; QUILICI, Ana Paula; CATARINO, Andrei Hilario; RIBEIRO, Anna Christina de Lima; BARRETO, Antonio Carlos Pereira; AZEVEDO FILHO, Antonio Fernando Barros de; PAZIN FILHO, Antonio; TIMERMAN, Ari; SCARPA, Bruna Romanelli; TIMERMAN, Bruno; TAVARES, Caio de Assis Moura; MARTINS, Cantidio Soares Lemos; SERRANO JUNIOR, Carlos Vicente; MALAQUE, Ceila Maria Sant'Ana; PISANI, Cristiano Faria; BATISTA, Daniel Valente; LEANDRO, Daniela Luana Fernandes; SZPILMAN, David; GONCALVES, Diego Manoel; PAIVA, Edison Ferreira de; OSAWA, Eduardo Atsushi; LIMA, Eduardo Gomes; ADAM, Eduardo Leal; PEIXOTO, Elaine; EVARISTO, Eli Faria; AZEKA, Estela; SILVA, Fabio Bruno da; WEN, Fan Hui; FERREIRA, Fatima Gil; LIMA, Felipe Gallego; FERNANDES, Felipe Lourenco; GANEM, Fernando; GALAS, Filomena Regina Barbosa Gomes; TARASOUTCHI, Flavio; SOUZA, Germano Emilio Conceicao; FEITOSA FILHO, Gilson Soares; FORONDA, Gustavo; GUIMARAES, Helio Penna; ABUD, Isabela Cristina Kirnew; LEITE, Ivanhoe Stuart Lima; LINHARES FILHO, Jaime Paula Pessoa; MORAES JUNIOR, Joao Batista de Moura Xavier; FALCAO, Joao Luiz Alencar de Araripe; RAMIRES, Jose Antonio Franchini; CAVALINI, Jose Fernando; SARAIVA, Jose Francisco Kerr; ABRAO, Karen Cristine; PINTO, Lecio Figueira; BIANCHI, Leonardo Luis Torres; LOPES, Leonardo Nicolau Geisler Daud; PIEGAS, Leopoldo Soares; KOPEL, Liliane; GODOY, Lucas Colombo; TOBASE, Lucia; HAJJAR, Ludhmila Abrahao; DALLAN, Luis Augusto Palma; CANEO, Luiz Fernando; CARDOSO, Luiz Francisco; CANESIN, Manoel Fernandes; PARK, Marcelo; RABELO, Marcia Maria Noya; MALACHIAS, Marcus Vinicius Bolivar; GONCALVES, Maria Aparecida Batistao; ALMEIDA, Maria Fernanda Branco de; SOUZA, Maria Francilene Silva; FAVARATO, Maria Helena Sampaio; CARRION, Maria Julia Machline; GONZALEZ, Maria Margarita; BORTOLOTTO, Maria Rita de Figueiredo Lemos; MACATRAO-COSTA, Milena Frota; SHIMODA, Monica Satsuki; OLIVEIRA-JUNIOR, Mucio Tavares de; IKARI, Nana Miura; DUTRA, Oscar Pereira; BERWANGER, Otavio; PINHEIRO, Patricia Ana Paiva Correa; REIS, Patricia Feitosa Frota dos; CELLIA, Pedro Henrique Moraes; SANTOS FILHO, Raul Dias dos; GIANOTTO-OLIVEIRA, Renan; KALIL FILHO, Roberto; GUINSBURG, Ruth; MANAGINI, Sandrigo; LAGE, Silvia Helena Gelas; YEU, So Pei; FRANCHI, Sonia Meiken; SHIMODA-SAKANO, Tania; ACCORSI, Tarso Duenhas; LEAL, Tatiana de Carvalho Andreucci; GUIMARAES, Vanessa; SALLAI, Vanessa Santos; AVILA, Walkiria Samuel; SAKO, Yara Kimiko