FERNANDA PIPITONE RODRIGUES

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LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 12
  • article 8 Citação(ões) na Scopus
    Novel 3D MRI technique to measure perineal membrane structural changes with pregnancy and childbirth: Technique development and measurement feasibility
    (2021) PIPITONE, Fernanda; SWENSON, Carolyn W.; DELANCEY, John O. L.; CHEN, Luyun
    Introduction and hypothesis We aimed to develop and validate a new MRI-based perineal membrane reconstruction and morphological measurement technique, and test its feasibility on nulliparous and parous women to determine the effects of pregnancy and childbirth on the perineal membrane. Methods The perineal membrane was traced on high-resolution MRI using 3D Slicer (R) and analyses performed using Rhinoceros 6.0 SR23 (R). Validation was done by comparing MRI-based perineal membrane reconstruction to dissection measurements in a cadaver. Feasibility of reconstruction was assessed in the following three groups: nulliparous (NP), primiparous women who underwent cesarean delivery (CD), and primiparous women with vaginal delivery (VD). The following parameters were measured: (1) swinging door angle, (2) bony and (3) soft tissue attachment lengths, (4) separation at perineal body level, (5) surface area, and (6) hiatal area. ANOVA and post-hoc comparisons were performed, and the effect sizes (d) were reported. Results Model reconstruction was similar to cadaver dissection findings. Morphological measurements were feasible in all women (NP, n = 10; CS, n = 6; VD, n = 19). Swinging door angle was 13(o) greater in CD (p = 0.03; d = 1.15) and 16(o) greater in VD (p < 0.001; d = 1.41) compared to NP. VD showed 13% larger separation at the perineal body than NP (p = 0.097, d = 0.84) and 23% larger hiatal area than CD (p = 0.14, d = 0.94). Conclusion This novel and anatomically validated MRI-based perineal membrane reconstruction technique is feasible. Preliminary findings show that pregnancy and childbirth both influence perineal membrane morphology with VD being associated with the largest swinging door angle and perineal body separation.
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    INTRAVESICAL TREATMENTS WITH HYALURONIC ACID AND CHONDROITIN FOR PAINFUL BLADDER SYNDROME: SYSTEMATIC REVIEW AND META-ANALYSIS
    (2015) MATSUOKA, P. K.; RODRIGUES, F. P.; PACETTA, A. M.; BARACAT, E. C.; HADDAD, J. M.
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    Functional anatomy of the perineal complex as it relates to urogenital hiatus closure
    (2023) DELANCEY, J. O.; XIE, B.; PIPITONE, F.; SWENSON, C. W.; MASTELING, M.; CHEN, L.
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  • article 0 Citação(ões) na Scopus
    The postpartum silence
    (2022) PIPITONE, Fernanda; DELANCEY, John O.
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    Trauma genital na infância e na adolescência
    (2021) MOTTA, Eduardo Vieira da; RODRIGUES, Fernanda Pipitone; ALMEIDA, José Alcione Macedo
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    Pelvic floor structures fiber direction after vaginal birth as seen on ultrasound: feasibility study
    (2023) PIPITONE, F.; MASTELING, M.; CHEN, L.; HADDAD, J. Milhem; DELANCEY, J. O.
  • article 14 Citação(ões) na Scopus
    Urethral function and failure: A review of current knowledge of urethral closure mechanisms, how they vary, and how they are affected by life events
    (2021) PIPITONE, Fernanda; SADEGHI, Zhina; DELANCEY, John O. L.
    Introduction A critical appraisal of the literature regarding female urethral function and dysfunction is needed in light of recent evidence showing the urethra's role in causing stress and urge urinary incontinence. Methods An evidence assessment was conducted using selected articles from the literature that contained mechanistic data on factors affecting urethral function and failure. Results Maximal urethral closure pressure (MUCP) is 40% lower in stress urinary incontinence (SUI) than normal controls. Evidence from five women shows relatively equal contributions to MUCP from striated/smooth muscle, vascular-plexus, connective tissue. MUCP varies twofold in individuals of similar age and declines 15% per decade even in nulliparous women. Age explains 57% of the variance in MUCP. This parallels with striated/smooth muscle loss and reduced nerve density. Factors influencing pressure variation minute-to-minute and decade-to-decade are poorly understood. Connective tissue changes have not been investigated. MUCP in de novo SUI persisting 9-months postpartum is 25% less than in age and parity-matched controls. Longitudinal studies do not show significant changes in urethral function after vaginal birth suggesting that changes in urethral support from birth may unmask pre-existing sphincter weakness and precipitate SUI. Mechanisms of interaction between support injury, pre-existing urethral weakness, and neuropathy are unclear. Conclusion Urethral failure is the predominant cause of SUI and a contributing factor for UUI; potentially explaining why mixed symptoms predominate in epidemiological studies. Age-related striated muscle loss and differences between women of similar age are prominent features of poor urethral closure. Yet, connective tissue changes, vasculature function, and complex interactions among factors are poorly understood.
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    Perineal membrane: 3D transvaginal ultrasound optimal visualization plane assessment verified on MRI
    (2022) PIPITONE, F.; MASTELING, M.; CHEN, L.; SWENSON, C.; FAIRCHILD, P.; HADDAD, Milhem J.; DELANCEY, J.
  • article 4 Citação(ões) na Scopus
    Comparação entre duas curvas de crescimento para o diagnóstico de recém-nascidos pequenos para a idade gestacional
    (2015) RODRÍGUES, Fernanda Pipitone; MARTINELLI, Silvio; BITTAR, Roberto Eduardo; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, Marcelo
    PURPOSE: It was to compare the use of two growth curves for the diagnosis of small-for-gestational-age (SGA) infants, having the 10th percentile as reference. METHODS: In a retrospective study, data of 20,567 singleton live births from January 2003 to June 2014 were analyzed, and divided according to gestational age: (a) 23 to 26, (b) 26 to 29, (c) 29 to 32, (d) 32 to 35, (e) 35 to 38, (f) 38 to 41 and (g) >41 weeks. Data were paired and analyzed using the McNemar test, with the level of significance set at 0.05. RESULTS: The curve designed by Alexander indicated a higher percentage of diagnosis of SGA than the curve constructed by Fenton for every category of gestational age up to 41 weeks, more markedly in the 32-35 week group (18.5%). Between 37 and 40 weeks of gestational age, Alexander's curve exceeded Fenton's curve in 9.1% of the cases in the diagnosis of SGA. CONCLUSIONS: The Fenton curve provides a more accurate evaluation of an infant's growth since it is gender-specific and allows measurement of three parameters. It has also been constructed with newer data and more sophisticated statistical tools.