ISABELA KARINE RODRIGUES AGRA
Projetos de Pesquisa
Unidades Organizacionais
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- 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, MarceloObjectives: 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.
- 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.
- Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection(2017) AGRA, Isabela Karine Rodrigues; AMORIM FILHO, Antonio Gomes; LIN, Lawrence Hsu; BIANCOLIN, Sckarlet Ernandes; FRANCISCO, Rossana Pulcineli Vieira; BRIZOT, Maria de LourdesObjective To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion. Methods This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered non-recovery and categorized as an adverse outcome. Results The final analysis included ten singleton pregnancies: seven of which were categorized into the recovery group and three of which into the non-recovery group. The baseline characteristics were similar between the groups. All fetuses were hydropic at the time of diagnosis. No significant differences related to sonographic or intrauterine transfusion parameters were identified between the groups; however, the non-recovery group tended to have an increased number of sonographic markers and lower fetal hemoglobin and platelet levels before the transfusion. Conclusion We were unable to firmly establish the clinical or sonographic parameters associated with adverse fetal outcomes in patients with parvovirus infection managed with intrauterine transfusions; however, edema, placental thickening and oligohydramnios may indicate greater fetal compromise and, subsequently, adverse outcomes. However, further studies are necessary, mainly due to the small number of cases analyzed in the present study.