JULIANA IKEDA NIIGAKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
bookPart Leiomioma uterino: tratamento clínico(2016) NARDE, Ivy; HILARIO, Sandro; NIIGAKI, Juliana Ikeda; BOZZINI, Nilo- Computerized fetal heart rate analysis in the prediction of myocardial damage in pregnancies with placental insufficiency(2015) MAEDA, Mariane de Fatima Y.; NOMURA, Roseli M. Y.; NIIGAKI, Juliana I.; FRANCISCO, Rossana P. V.; ZUGAIB, MarceloObjective: To evaluate the reliability of fetal heart rate (FHR) parameters analyzed by computerized cardiotocography (cCTG) in predicting myocardial damage in pregnancies with placental insufficiency. Study design: We evaluated 38 patients with placental insufficiency detected before 34 weeks of gestation. All patients underwent 30 min of cCTG (Sonicaid Fetal Care, version 2.2) and Doppler of umbilical artery, middle cerebral artery, and ductus venosus. Umbilical vein blood samples were collected at birth to determine fetal cardiac Troponin T, and a >= 0.09 ng/ml value was deemed a sign of myocardial damage. Results: The fetuses with myocardial damage (39%) showed significantly increased values of umbilical artery pulsatility index z-score (P = 0.003), ductus venosus pulsatility index z-score (P = 0.007), basal FHR (P = 0.033) and periods of low episodes (P = 0.038). The number of small accelerations and the short-term variation (STV) were significantly reduced in the group with myocardial damage (P = 0.013 and P = 0.003, respectively). Logistic regression analysis identified SW and gestational age at delivery as independent predictors for fetal myocardial damage, with area under ROC curve of 0.91. Conclusions: Computerized cardiotocography parameters may be useful in the management of early onset placental insufficiency, and the association of SW with gestational age could play a role in detecting myocardial injury in pregnancies with placental insufficiency.
- Lung ultrasound versus chest computed tomography for pregnant inpatients with COVID-19(2023) BIANCOLIN, Sckarlet Ernandes; FERNANDES, Hermann dos Santos; SAWAMURA, Marcio Valente Yamada; QUEIROZ, Joelma; CENTOFANTI, Sandra Frankfurt; LIAO, Adolfo Wenjaw; LEITE, Claudia da Costa; FRANCISCO, Rossana Pulcineli Vieira; BRIZOT, Maria de Lourdes; BASSI, Aline Scalisse; FABRI, Amanda Wictky; SOUZA, Ana Claudia Rodrigues Lopes Amaral de; FARCHE, Ana Claudia Silva; IGAI, Ana Maria Kondo; OLIVEIRA, Ana Maria da Silva Sousa; WAISSMAN, Adriana Lippi; MARTINS, Carlos Eduardo do Nascimento; PAGANOTI, Cristiane de Freitas; DOMINGUES, Danielle Rodrigues; MIKAMI, Fernanda Cristina Ferreira; BAPTISTA, Fernanda Spadotto; CIPPICIANI, Jacqueline Kobayashi; ALBERTINI, Jessica Gorrao Lopes; NIIGAKI, Juliana Ikeda; GALLETTA, Marco Aurelio Knippel; MIYADAHIRA, Mariana Yumi; BARBOSA, Mariana Vieira; MAEDA, Mariane de Fatima Yukie; BARROS, Monica Fairbanks de; TAKIUTI, Nilton Hideto; MARTINELLI, Silvio; ARRYM, Tiago Pedromonico; GOMEZ, Ursula Trovato; FRANCO, Veridiana FreirePurpose To compare lung ultrasound (US) and computed tomography (CT) in the assessment of pregnant women with COVID-19. Methods Prospective study comprising 39 pregnant inpatients with COVID-19 who underwent pulmonary assessment with CT and US with a maximum span of 48 h between the exams. The thorax was divided into 12 regions and assessed in terms of the following: the presence of B-lines (>2), coalescent B-lines, consolidation on US; presence of interlobular thickening, ground glass, consolidation on CT. The two methods were scored by adding up the scores from each thoracic region. Results A significant correlation was found between the scores obtained by the two methods (rICC = 0.946; p < 0.001). They were moderately in agreement concerning the frequency of altered pulmonary regions (weighted kappa = 0.551). In US, a score over 15, coalescent B-lines, and consolidation were predictors of the need for oxygen, whereas the predictors in CT were a lung score over 16 and consolidation. The two methods, US (p < 0.001; AUC = 0.915) and CT (p < 0.001; AUC = 0.938), were fairly accurate in predicting the need for oxygen. Conclusion In pregnant women, lung US and chest CT are of similar accuracy in assessing lungs affected by COVID-19 and can predict the need for oxygen.
- Influence of fetal acidemia on fetal heart rate analyzed by computerized cardiotocography in pregnancies with placental insufficiency(2013) MAEDA, Mariane de Fatima Y.; NOMURA, Roseli M. Y.; NIIGAKI, Juliana I.; FRANCISCO, Rossana P. V.; ZUGAIB, MarceloObjective: To determine the influence of fetal acidemia on fetal heart rate (FHR) parameters analyzed by computerized cardiotocography (cCTG) in pregnancies with placental insufficiency. Methods: This was a cross-sectional study of 46 pregnancies with placental insufficiency between 26 and 34 weeks gestation by abnormal umbilical artery Doppler [pulsatility index (PI)>95th percentile]. Results: Twenty fetuses had acidemia at birth, pH<7.20 (43.5%) and 26 had normal pH (56.5%). In the analysis of FHR parameters, fetal movements (FM) per hour was significantly lower in the group with acidemia (median = 2) when compared with the group with normal pH (median = 15, p = 0.019). The values of pH correlated positively with FM (rho = 0.35; p = 0.019, 95% CI: 0.061 to 0.577) and basal FHR (rho = 0.37, p = 0,011, 95% CI: 0.090 to 0.597) and negatively with the ductus venosus (DV) PI for veins (PIV) z-score (rho = -0.31, p = 0,036, 95% CI: -0.550 to -0.021). Logistic regression showed that the DV PIV z-score (p = 0.0232) and basal FHR (p = 0.0401) were independent variables associated with acidemia at birth. Conclusions: The present results suggest that cCTG parameters may be useful in the management of cases with early onset placental insufficiency in association with Doppler velocimetry assessment, and that basal FHR and DV-PIV are most clearly in association with acidemia at birth.
bookPart Epilepsia(2016) NIIGAKI, Juliana Ikeda- Dopplervelocimetria da artéria cerebral média fetal e outros parâmetros de vitalidade fetal na sobrevida neonatal em gestações com insuficiência placentária(2013) NOMURA, Roseli Mieko Yamamoto; NIIGAKI, Juliana Ikeda; HORIGOME, Flavia Thiemi; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloObjective: To study the Doppler velocimetry of the fetal middle cerebral artery in pregnancies complicated by placental insufficiency, and to verify its role in the prognosis of neonatal survival. Methods: This was a prospective study of 93 pregnant women with diagnosis of placental insufficiency detected before the 34th week of pregnancy. Placental insufficiency was characterized by abnormal umbilical artery (UA) Doppler (> 95th percentile). The following parameters were analyzed: umbilical artery (UA) pulsatility index (PI); middle cerebral artery (MCA) PI; brain-placenta ratio - BPR (MCA-PI/UA-PI); MCA peak systolic velocity (MCA-PSV); and PI for veins (PIV) of ductus venosus (DV). The parameters were analyzed in terms of absolute values, z-scores (standard deviations from the mean), or multiples of the median (MoM). The outcome investigated was neonatal death during the hospitalization period after birth. Results: Of the 93 pregnancies analyzed, there were 25 (26.9%) neonatal deaths. The group that died, when compared to the survival group, presented a significant association with the diagnosis of absent or reversed end-diastolic flow (88% vs. 23.6%, p < 0.001), with a higher median of UA PI (2.9 vs. 1.7, p < 0.001) and UA PI z-score (10.4 vs. 4.9, p <0.001); higher MCA-PSV MoM (1.4 vs. 1.1, p = 0.012); lower BPR (0.4 vs. 0.7, p < 0.001); higher PIV-DV (1.2 vs. 0.8, p < 0.001) and DV z-score (3.6 vs. 0.6, p < 0.001). In the logistic regression, the independent variables predictive of neonatal death were: gestational age at birth (OR = 0.45; 95% CI: 0.3 to 0.7; p < 0.001) and UA PI z-score (OR = 1.14, 95% CI: 1.0 to 1.3, p = 0.046). Conclusion: Despite the association verified by the univariate analysis between neonatal death and the parameters of fetal cerebral Doppler velocimetry, the multivariate analysis identified prematurity and degree of insufficiency of placental circulation as independent factors related to neonatal death in pregnancies complicated by placental insufficiency.