ISABELA KARINE RODRIGUES AGRA

(Fonte: Lattes)
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina

Resultados de Busca

Agora exibindo 1 - 4 de 4
  • article 7 Citação(ões) na Scopus
    Epidemiological profile of patients with preterm pre-mature rupture of membranes at a tertiary hospital in Sao Paulo, Brazil
    (2019) GALLETTA, Marco Aurelio Knippel; BITTAR, Roberto Eduardo; AGRA, Isabela; GUERRA, Eliane Cerqueira Leite; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, Marcelo
    OBJECTIVE: To perform a descriptive analysis of preterm premature rupture of membranes (PPROM) cases attended in a tertiary hospital. METHOD: Retrospective analysis of medical records and laboratory tests of patients admitted to a Brazilian tertiary hospital between 2006 and 2011, with a confirmed diagnosis of PPROM and gestational age (GA) at delivery <37 weeks. RESULTS: A total of 299 pregnant women were included in the study. Nine patients evolved to abortion, and 290 pregnant women remained for the final analysis. There was initial diagnostic doubt in 17.6% of the cases. The oligohydramnios rate [amniotic fluid index (AFI) <5] was 27.9% on admission. Chorioamnionitis was initially diagnosed in 10.8% of the patients and was retrospectively confirmed in 22.9% of the samples. The latency period had a mean of 9.1 days. The main reasons for interruption were premature labor (55.2%), GA >= 36 weeks (27.2%), and fetal distress (6.9%). The delivery method was cesarean section in 55% of cases. The mean birth weight was 2,124 grams, and 67% of the neonates had a low birth weight (<2500 g). The GA at delivery averaged 33.5 weeks. The stillbirth rate was 5.3%, and the early neonatal mortality rate was 5.6%. There were complications at delivery in 18% of mothers. CONCLUSION: In one of the few Brazilian reports on the epidemiological profile of PPROM, with GA until 37 weeks and intercurrences generally excluded from assessments (such as twinning and fetal malformations), there is a favorable evolution, with an acceptable rate of complications.
  • article 3 Citação(ões) na Scopus
    Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia
    (2019) AGRA, Isabela K. R.; LIAO, Adolfo W.; HOSHIDA, Mara S.; SCHULTZ, Regina; TOSCANO, Marcello P.; FRANCISCO, Rossana Pv; ZUGAIB, Marcelo; BRIZOT, Maria L.
    OBJECTIVES: To assess the expression of decidual natural killer (dNK) cells and their cytokines in twin pregnancies with preeclampsia. METHODS: This was a prospective case-control study. The inclusion criteria were diamniotic (monochorionic or dichorionic) twin pregnancies in the third trimester with negative serological results for infectious diseases; absence of major fetal abnormalities or twin-twin transfusion syndrome; and no history of administration of corticosteroids in this pregnancy. The control group (CG) included uncomplicated twin pregnancies, and the preeclampsia group (PEG) included twin gestations with clinical and laboratory confirmation of the disease according to well-established criteria. Samples of the decidua were obtained and analyzed by immunohistochemistry for the expression of dNK cells and interleukins (ILs) 10, 12 and 15. In addition, maternal serum samples were collected to determine the levels of these interleukins. RESULTS: Thirty twin pregnancies were selected: 20 in the control group (CG) and 10 in the preeclampsia group (PEG). The PEG showed strong placental immunostaining for IL-15 (p=0.001) and high maternal serum levels of IL-10 (22.7 vs. 11.9 pg/mL, p=0.024) and IL-15 (15.9 vs. 7.4 pg/mL, p=0.024). CONCLUSION: A higher maternal serum concentration of both pro- and anti-inflammatory factors was observed in the twin pregnancies in the PEG. However, no difference in placental expression of IL-10 was found between the groups. These findings may suggest that maternal attempts to balance these interleukins were not sufficient to cause a placental response, and this failure may contribute to the development of preeclampsia.
  • article 3 Citação(ões) na Scopus
    The effect of prenatally administered vaginal progesterone on uterine artery Doppler in asymptomatic twin pregnancies
    (2016) AGRA, Isabela K. R.; BRIZOT, Maria L.; MIYADAHIRA, Mariana Y.; CARVALHO, Mario H. B.; FRANCISCO, Rossana P. V.; ZUGAIB, Marcelo
    Objectives: This study investigated the influence of vaginal progesterone on uterine circulation in asymptomatic twin gestations. Study design: This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies exposed to vaginal progesterone or placebo. We included all trial participants who had undergone uterine artery pulsatility index evaluation at the time of randomization. During each ultrasound examination, the uterine artery pulsatility index was evaluated transabdominally. The mean uterine artery pulsatility index between the progesterone and placebo groups were compared for each gestational age, starting between 18 to 34 weeks and 6 days and were analyzed at three (Time 1), six (Time 2) and nine (Time 3) weeks after randomization. Results: The final analysis included 128 women in the progesterone group and 122 women in the placebo group. The baseline characteristics were similar in both groups. No difference in the mean uterine artery pulsatility index was observed between the progesterone and placebo groups at each week of gestation or throughout gestation. Conclusions: In twin pregnancies, the use of vaginal progesterone in the second half of pregnancy does not influence uterine circulation.
  • article 1 Citação(ões) na Scopus
    The effect of prenatal vaginal progesterone on cervical length in nonselected twin pregnancies
    (2019) AGRA, Isabela K. R.; CARVALHO, Mario H. B.; HERNANDEZ, Wagner R.; FRANCISCO, Rossana P. V.; ZUGAIB, Marcelo; BRIZOT, Maria L.
    Purpose: The aim of this study was to investigate the influence of vaginal progesterone on cervical length (CL) in asymptomatic nonselected twin gestations. Methods: This was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies exposed to vaginal progesterone or placebo. The CL was examined at six different time periods: 18-21(+6) weeks (T1), 21-23(+6) weeks (T2), 24-26(+6) weeks (T3), 27-29(+6) weeks (T4), 30-32(+6) weeks (T5) and 33-34(+6) weeks (T6). The rate of cervical shortening per week and the percent cervical shortening were compared between the groups, with analyses of the entire cohort and of those who delivered spontaneously according to gestational age at birth. Results: The final analysis included 184 women in the progesterone group and 188 women in the placebo group. The baseline characteristics were similar in both groups. No differences in cervical shortening in terms of absolute value or percent shortening were observed between the groups at each time period or throughout gestation. Furthermore, no difference was found in cervical shortening for those who delivered spontaneously. Conclusion: Cervical shortening in asymptomatic nonselected twin pregnancies occurred at a similar rate, regardless of vaginal progesterone treatment.