ANA MARIA KONDO IGAI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- Obstetric antiphospholipid syndrome(2021) BARROS, Venina Isabel Poco Viana Leme de; IGAI, Ana Maria Kondo; OLIVEIRA, Andre Luiz Malavasi Longo de; TERUCHKIN, Marcelo Melzer; ORSI, Fernanda Andrade
- Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia(2013) MAIA, Carolina Bastos; NOMURA, Roseli Mieko Yamamoto; IGAI, Ana Maria Kondo; FONSECA, Guilherme Hencklain; GUALANDRO, Sandra Menosi; ZUGAIB, MarceloCONTEXT: Homozygous (SS) sickle-cell anemia complicated by acute splenic sequestration in adults is a rare event, and it has never been reported during pregnancy. CASE REPORT: A 25-year-old woman with homozygous (SS) sickle-cell disease was hospitalized at 32 weeks' of gestation presenting weakness, abdominal pain, fever and hemoglobin of 2.4 g/dl. Abnormal fetal heart rate was detected by means of cardiotocography, and 5 units of packed red cells were transfused. Cesarean was performed at 37 weeks. Both mother and baby were discharged in a good general condition. CONCLUSION: This case report demonstrates the importance of immediate blood transfusion for treatment of fetal distress in cases of splenic sequestration during pregnancy. This treatment is essential for avoiding maternal and fetal complications.
- Anemia During Pregnancy after Silastic Ring Roux-en-Y Gastric Bypass: Influence of Time to Conception(2011) NOMURA, Roseli Mieko Yamamoto; DIAS, Maria Carolina Goncalves; IGAI, Ana Maria Kondo; PAIVA, Leticia Vieira; ZUGAIB, MarceloBariatric surgery before pregnancy may help prevent obesity-related gestational complications. However, maternal malnutrition is not without potential risks during pregnancy. The objective was to evaluate the influence of time to conception after silastic ring Roux-en-Y gastric bypass (SRYGB) on maternal anemia. Patients who underwent SRYGB for morbid obesity and who subsequently became pregnant were followed up at the prenatal. Thirty pregnancies occurred between July 2001 and September 2009. The patients were analyzed according to time to conception after bariatric surgery: 17 patients with time to conception < 4 years (48 months) and 13 patients with a parts per thousand yen4 years. First trimester hemoglobin levels were significantly lower in patients with time to conception a parts per thousand yen4 years (48 months) (median 9.6 g/dL, range 5.8-13.2 g/dL) than in patients with time to conception < 4 years (median 11.1 g/dL, range 9.8-13.6 g/dL; p = 0.047). The need for intravenous iron therapy or packed red cell transfusion was significantly more frequent among women who became pregnant a parts per thousand yen4 years after SRYGB compared to < 4 years (30.8% vs. 0%, p = 0.026). Pregnancy after 4 years of SRYGB is associated with maternal anemia and the need for more strict iron supplementation.
- Risk assessment of venous thromboembolism and thromboprophylaxis in pregnant women hospitalized with cancer: Preliminary results from a risk score(2018) HASE, Eliane Azeka; BARROS, Venina Isabel Poco Viana Leme de; IGAI, Ana Maria Kondo; FRANCISCO, Rossana Pulcinelli Vieira; ZUGAIB, MarceloOBJECTIVES: Hospitalized patients with cancer are at high risk of developing venous thromboembolism, and the risk increases with pregnancy. The aim of this study was to apply a thromboprophylaxis protocol with a venous thromboembolism risk score for hospitalized pregnant women with cancer and to evaluate the effects on maternal morbidity and mortality. METHODS: A longitudinal and prospective study was conducted from December 2014 to July 2016. The venous thromboembolism risk score was modified from the guidelines of the Royal College of Obstetricians and Gynaecologists. Patients were classified as low (score <3) or high risk (score >= 3). The high-risk group received thromboprophylaxis with low-molecular-weight heparin, unless the patient had a contraindication for anticoagulation. One patient could have undergone more than one evaluation. RESULTS: Fifty-two ratings were descriptively analyzed: 34 (65.4%) were classified as high risk, and 28/34 (82.3%) received low-molecular-weight heparin, 1 received unfractionated heparin, and 5 did not receive intervention. Most patients (23/52; 44.2%) had breast cancer. The main risk factors for venous thromboembolism in the high-risk group were chemotherapy (within 6 months; 22/34; 64.7%). No patient exhibited venous thromboembolism, adverse effects of anticoagulation or death up to three months after hospitalization. CONCLUSIONS: Most pregnant women with cancer had a high risk for venous thromboembolism at the time of hospitalization. Breast cancer was the most prevalent cancer, and recent chemotherapy was the main risk factor for anticoagulation. The application of a thromboprophylaxis protocol and determination of a venous thromboembolism risk score for these patients was useful for the prevention of maternal morbidity and mortality due to venous thromboembolism.
- Manejo clínico e obstétrico em gestantes portadoras de hepatite autoimune complicada pela plaquetopenia moderada ou grave(2013) NOMURA, Roseli Mieko Yamamoto; KLEINE, Roololpho Truffa; IGAI, Ana Maria Kondo; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloObjective: To describe the management of prenatal care and delivery in patients bearing autoimmune hepatitis associated with moderate or severe thrombocytopenia. Methods: This study was performed in a tertiary level university hospital. Thirteen pregnancies in ten patients diagnosed with autoimmune hepatitis, complicated by thrombocytopenia, were retrospectively analyzed. The inclusion criteria were as follows: clinical diagnosis of autoimmune hepatitis, moderate or severe thrombocytopenia (platelet count < 100 x 103/mm(3)), gestational age at birth over 22 weeks, and patient followed-up by a specialized team at the institution. The variables studied were: maternal age, parity, treatment regimen, platelet count, examinations for investigation of hepatic function, type of delivery, weight at birth, and gestational age at the time of delivery. Results: The average maternal age was 24.5 years (SD = 5.3) and six (50%) occurred in nulliparous women. During pregnancy, monotherapy with prednisone was adopted in 11 cases (92%). According to the autoantibody profiles, seven pregnancies (58%) had the autoimmune hepatitis type I diagnosis, two pregnancies had type II (17%), and three pregnancies (25%) had cryptogenic chronic hepatitis (undetectable titers of autoantibodies). Portal hypertension was featured in 11 pregnancies (92%). The average gestational age at delivery was 36.9 weeks (SD = 1.5 weeks), with an average weight at birth of 2,446 g (SD = 655 g). Eight infants (67%) were small for gestational age. At the time of delivery, severe thrombocytopenia was featured in four cases (33%) and cesarean surgery was performed in seven cases (58%). Complications at delivery occurred in three cases (25%), one patient presented uterine atony, and two patients presented perineal bruising. There was no perinatal or maternal death. Conclusion: The complication's of thrombocytopenic patients with autoimmune hepatitis are elevated; nevertheless, with appropriate attention and care, they can be resolved. The association between two severe pathologies appears to increase the risk of prematurity and fetal growth restriction, demanding specialized prenatal care, as well as surveillance of newborn well-being.
- Abnormal uterine bleeding and chronic iron deficiency Number 11-December 2022(2022) BARROS, Venina Viana de; HASE, Eliane Azeka; SALAZAR, Cristiano Caetano; IGAI, Ana Maria Kondo; ORSI, Fernanda Andrade; MARGARIDO, Paulo Francisco Ramos
bookPart Trombofilias(2016) BAPTISTA, Fernanda Spadotto; IGAI, Ana Maria Kondo- 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.
bookPart Idade Gestacional(2016) IGAI, Ana Maria Kondo- Maternal malnutrition during pregnancy among women with sickle cell disease(2023) PAIVA, Leticia Vieira; IGAI, Ana Maria Kondo; NOMURA, Roseli Mieko YamamotoOBJECTIVE: The objective of this study was to compare the nutritional status and dietary intake of pregnant women with sickle cell disease (SS hemoglobinopathy and SC hemoglobinopathy) to healthy controls and report the maternal and perinatal outcomes.METHODS: This is a prospective, longitudinal cohort study. Pregnant women with a diagnosis of sickle cell disease and control group were recruited in an outpatient clinic of a tertiary care hospital in Sao Paulo, Brazil. Maternal anthropometric data and dietary intake data were collected at the second and third trimesters.RESULTS: A total of 49 pregnancies complicated by sickle cell disease were included. Prepregnancy body mass index was significantly lower in the SS hemoglobinopathy group (n=26, median 20.3 kg/m(2)) than the SC hemoglobinopathy group (n=23, 22.7 kg/m(2)) or control group (n=33, 23.2 kg/ m(2), p<0.05). The prepregnancy nutritional status revealed significantly more women classified as underweight in the SS hemoglobinopathy group (15.4%) than in the SC hemoglobinopathy group (4.4%) and control group (1.6%, p=0.009). In the second trimester, maternal protein intake was significantly lower in SS hemoglobinopathy (73.2 g/day) and SC hemoglobinopathy (68.8 g/day) than in the control group (95.7 g/day, p=0.004). In the third trimester, only SS hemoglobinopathy mothers showed dietary intake of protein significantly lower than that of the controls (67.5 g/day vs. 92.8 g/day, p=0.02). Vitamin A and E consumption was also reduced in the third trimester in the SS hemoglobinopathy group (p<0.05).CONCLUSION: The nutritional status of pregnant women with SS hemoglobinopathy is characterized by a state of undernutrition. The lower protein intake in the second and third trimesters of pregnant women with SS hemoglobinopathy may contribute to this condition. Undernourishment is a serious complication of sickle cell disease, primarily during pregnancy, and it should be addressed during the prenatal period.