ROSSANA PULCINELI VIEIRA FRANCISCO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Serum concentration of vascular endothelial growth factor and depth of trophoblastic invasion in ampullary ectopic pregnancy(2016) CABAR, Fabio Roberto; TESHIMA, Decio Roberto Kamio; PEREIRA, Pedro Paulo; ANTONANGELO, Leila; SCHULTZ, Regina; FRANCISCO, Rossana PulcineliOBJECTIVE: To evaluate the association between the depth of trophoblastic infiltration and serum vascular endothelial growth factorconcentration in patients with an ampullary pregnancy. METHODS: This prospective cross-sectionalstudy involved 34 patients with an ampullary ectopic pregnancy who underwent salpingectomy between 2012 and 2013. Maternal serum vascular endothelial growth factor concentrations were measured using Luminex technology. Trophoblastic invasion was classified histologically as follows: stage I, limited to the tubal mucosa; stage II, reaching the muscle layer; and stage III, involving the full thickness. The qualitative data were compared using Fisher's exact test. The nonparametric Kruskal-Wallis and Mann-Whitney tests were used to evaluate differences in serum vascular endothelial growth factor among the degrees of trophoblastic invasion. ROC curves were constructed to determine vascular endothelial growth factor cut-off values that predict the degree of tubal invasion based on the best sensitivity and specificity. RESULTS: Eight patients had stage I trophoblastic invasion, seven had stage II, and 19 had stage III. The median serum vascular endothelial growth factorconcentration was 69.88 pg/mL for stage I, 14.53 pg/mL for stage II and 9.08 pg/mL for stage III, with a significant difference between stages I and III. Based on the ROC curve, a serum vascular endothelial growth factor concentration of 25.9 pg/mL best differentiated stage I from stages II and III with asensitivity of 75.0%, specificity of 76.9%, and area under the curve of 0.798. CONCLUSIONS: The depth of trophoblastic penetration into the tubal wall isassociated with serum vascular endothelial growth factor concentration in ampullary pregnancies.
- Mother's freedom of choice and the rights of an unborn child: a comparison between the views of freshmen and senior medical school students(2016) MOTOKI, Marcelo Shigueo Yosikawa; CABAR, Fabio Roberto; FRANCISCO, Rossana Pulcineli VieiraOBJECTIVES: To compare the views of freshman students with senior students of the Faculty of Medicine-University of Sao Paulo concerning the respect for the mother's freedom of choice, the need to protect the unborn child, the proportionality between the mother's freedom of choice and the protection of the unborn child, and issues related to legal abortion. To determine whether the medical knowledge acquired throughout the academic years can influence the views of medical students on these issues. METHODS: First- and sixth-year students of the Faculty of Medicine - University of Sao Paulo answered a questionnaire; the inclusion criteria were as follows: a first- or sixth-year student of the medical school and a signature on the free informed consent form. To compare the proportions, a chi-square or Fisher's exact test was used. The significance level was set to 5%. RESULTS: Regarding the mother's freedom of choice, in the case when a pregnant woman undergoes a cesarean section by means of a court order despite her intention to not have a cesarean, 55.7% of the first-year students have answered that the mother's choice should be respected. Among the sixth-year students, only 28.9% believe that the mother's intention should be considered (p < 0.0001). With reference to the mother's choice in connection with antiretroviral medication, 38.1% of the first-year students agreed that the mother's intention should be respected, whereas 33% of sixth-year students believed that the mother's intention should be respected (p=0.453). CONCLUSION: There was a tendency to consider the unborn child's rights over the mother's choice as students spent more time in medical school.
- Pregnancy of unknown location(2019) PEREIRA, Pedro Paulo; CABAR, Fabio Roberto; GOMEZ, Ursula Trovato; FRANCISCO, Rossana Pulcineli VieiraPregnancy of unknown location is a situation in which a positive pregnancy test occurs, but a transvaginal ultrasound does not show intrauterine or ectopic gestation. One great concern of pregnancy of unknown location is that they are cases of ectopic pregnancy whose diagnosis might be postponed. Transvaginal ultrasound is able to identify an ectopic pregnancy with a sensitivity ranging from 87% to 94% and a specificity ranging from 94% to 99%. A patient with pregnancy of unknown location should be followed up until an outcome is obtained. The only valid biomarkers with clinical application and validation are serum levels of the beta fraction of hCG and progesterone. A single serum dosage of hCG is used only to determine whether the value obtained is above or below the discriminatory zone, that means the value of serum hCG above which an intrauterine gestational sac should be visible on ultrasound. Serum progesterone levels are a satisfactory marker of pregnancy viability, but they are unable to predict the location of a pregnancy of unknown location: levels below 5 ng/mL are associated with nonviable gestations, whereas levels above 20 ng/mL are correlated with viable intrauterine pregnancies. Most cases are low risk and can be monitored by expectant management with transvaginal ultrasound and serial serum hCG levels, in addition to the serum progesterone levels. To minimize diagnostic error and intervene during progressive intrauterine gestation, protocol indicates active treatment only in situations when progressive intrauterine pregnancy is excluded and a high possibility of ectopic pregnancy exists.
- Reflections on the need for a vaccine strategy against COVID-19 for pregnant and postpartum women(2021) CABAR, Fabio Roberto; FRANCISCO, Rossana Pulcineli Vieira
- Low back pain, pelvic pain, and associated factors in type 1 diabetic pregnant women(2024) BATISTA, Patricia Andrade; OLIVEIRA, Claudia de; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; CABAR, Fabio RobertoIntroduction: Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP). Objective: To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI). Results: The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (+/- 8.2 SD) in the GD and 9.0 years (+/- 6.9 SD) in the GSD, which was statistically significant (p <= 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration >= 17 years (OR = 11.2; 95 % CI = 1.02-124.75). The association between DM1 duration >= 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event. Conclusion: There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration >= 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women.