ROSSANA PULCINELI VIEIRA FRANCISCO

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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

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Autor: FRANCISCO, Rossana Pulcineli Vieira × search.filters.applied.f.dateIssued: 2022 ×

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Agora exibindo 1 - 10 de 25
  • article 1 Citação(ões) na Scopus
    The complex search for the cause of gastroschisis
    (2022) FREITAS, Amanda Brasil de; FRANCISCO, Rossana Pulcineli Vieira; HOSHIDA, Mara Sandra; OLIVEIRA, Yanca Gasparini De; KULIKOWSKI, Leslie Domenici; BRIZOT, Maria de Lourdes
    Background To reveal the complex etiology of gastroschisis through two independent cases. Cases Case 1 involves gastroschisis recurrence in a consanguineous marriage, and Case 2 concerns a fetus with gastroschisis whose mother had undergone gastroplasty. Methylation array was carried out in both cases (two fetuses with gastroschisis, their two mothers, one father from the consanguineous marriage), and in 16 controls (fetuses and their respective mothers). Conclusion The two cases presented different noninherited methylation profiles.
  • article 0 Citação(ões) na Scopus

    CRIPTO-1 Is Immunolocalized in the Syncytiotrophoblast of Ampullary Pregnancies

    (2022) CABAR, Fabio Roberto; PEREIRA, Pedro Paulo; BANDEIRA, Carla Leticia; BEVILACQUA, Estela; SCHULTZ, Regina; FRANCISCO, Rossana Pulcineli Vieira
    Introduction. Controlling the invasive activity of trophoblastic tissue has not been elucidated. In the accreta placenta, the invasion of placental tissue is directly related to the expression of CRIPTO-1 at the maternal-fetal interface. The aim of this study is to evaluate if the expression of the CRIPTO-1 is related to different degrees of trophoblast invasion into the tube wall in ampullary pregnancy. Methods. Prospective study with 21 patients with ampullary tubal pregnancy undergoing salpingectomy. Anatomopathological evaluation determined the degree of invasion of trophoblast tissues into the tubal wall and grouped the samples into invasive degrees I, II, or III. The groups were compared for tissue expression of CRIPTO-1 using the Kruskal-Wallis nonparametric test. p values lower than 0.05 were considered significant. Results. Quantitative expression of CRIPTO-1 differed in each of the three groups of trophoblast invasion in the tubal wall in ampullary pregnancies (p < 0.001). There is a difference between groups when grade I + grade II versus grade III (p < 0.001) and grade I versus grade II + grade III (p < 0.001). The tissue expression of CRIPTO-1 in ectopic trophoblasts showed that deeper invasion of the tubal wall was associated with stronger expression than in shallow invasion (p < 0.001). Discussion. In ampullary pregnancies, the depth of penetration of trophoblast tissue in the tubal wall is related to CRIPTO-1 tissue expression.
  • article 0 Citação(ões) na Scopus
    Prevalence of oncogenic human papillomavirus in pregnant adolescents, association with colpocytological changes, risk factors and obstetric outcomes
    (2022) SOUZA, Henrique Diorio de; WAISSMAN, Adriana Lippi; DIORIO, Giselle Rodrigues Mota; PERES, Stela Verzinhasse; FRANCISCO, Rossana Pulcineli Vieira; GALLETTA, Marco Aurelio Knippel
    Purpose: The authors aim to carry out an investigation on the impact of cervical oncogenic Human Papillomavirus (HPV) detection in pregnant adolescents, to clarify the prevalence and risk factors, considering the importance and lack of data on this topic in Brazil. Methods: A cross-sectional study was conducted with adolescents receiving prenatal care in a tertiary hospital in Sao Paulo, Brazil, with routine Pap smear and oncogenic HPV detection test in the uterine cervix. The authors sought to associate the results of these tests with demographic and obstetric variables. Results: A total of 303 pregnant adolescents whose mean age was 15.30 +/- 1.22 years comprised the study subjects. The frequency of high-risk HPV cervical detection was 50.50%. Multivariate analysis revealed that a large number of partners in their lifetime (OR = 1.27) and having a religion (OR = 2.05) were risk factors for cervical detection of oncogenic HPV, while schooling appeared as a protective factor (OR = 0.85). There was an association between this detection and colpocytological alterations, reaching almost 30% of patients, but without association with obstetric and neonatal outcomes. Conclusion: The prevalence found is one of the highest in Brazil and worldwide. A greater number of partners during their lifetime and having religion were detected as possible factors associated with cervical HPV detection. Detection of cervical HPV-DNA did not influence obstetric and neonatal outcomes. The findings of this study reinforce the need to implement educational measures capable of modifying the incidence of sexually transmitted infections in this population and capable of promoting adherence to HPV vaccination programs.
  • article 1 Citação(ões) na Scopus
    Expert Recommendations on Monkeypox (MPX) in Pregnancy, Postpartum and Lactating Women
    (2022) MATTAR, Rosiane; NETO, Antonio Rodrigues Braga; LUZ, Adriana Gomes; HATANAKA, Alan; ZACONETA, Alberto; GUAZZELLI, Cristina Aparecida Falbo; TRAINA, Evelyn; BAPTISTA, Fernanda Spadotto; OSANAN, Gabriel; DUARTE, Geraldo; RAMOS, Jose Geraldo Lopes; OPPERMANN, Maria Lucia; FRANCISCO, Rossana Pulcineli Vieira; CARDOSO, Sigrid Maria Loureiro de Queiroz; QUINTANA, Silvana Maria; SUN, Sue Yazaki; BORGES, Vera Therezinha Medeiros
  • article 4 Citação(ões) na Scopus
    Dietary Pattern Influences Gestational Weight Gain: Results from the ProcriAr Cohort Study-Sao Paulo, Brazil
    (2022) SALDIVA, Silvia Regina Dias Medici; NETA, Adelia da Costa Pereira De Arruda; TEIXEIRA, Juliana Araujo; PERES, Stela Verzinhasse; MARCHIONI, Dirce Maria Lobo; CARVALHO, Mariana Azevedo; VIEIRA, Sandra Elisabete; FRANCISCO, Rossana Pulcineli Vieira
    The maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in Sao Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit (<14 weeks) was used as a proxy for pre-pregnancy weight. Food consumption was assessed using the 24HR method, administered twice at each gestational trimester, and dietary patterns were identified by principal component analysis. Three dietary patterns were identified: ""Vegetables and Fruits,"" ""Western,"" and ""Brazilian Traditional."" Descriptive data analysis was performed using absolute and relative frequencies for each independent variable and multilevel mixed-effects logistic regression was used to analyze excessive gestational gain weight (EGWG) and dietary patterns (DP). The Brazilian Traditional dietary pattern showed a protective effect on EGWG (p = 0.04) and age > 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child's health.
  • article 0 Citação(ões) na Scopus
    Magnetic resonance imaging and previous cesarean section in placenta accrete spectrum disorder: Predictor model
    (2022) POLIZIO, Rodrigo Pamplona; YAMAUCHI, Fernando Ide; MENDES, Renata Franco Pimentel; PERES, Stela Verzinhasse; KONDO, Mario Macoto; FRANCISCO, Rossana Pulcineli Vieira
    Objective: To evaluate objective criteria of Magnetic Resonance Imaging (MRI) of Placenta Accreta Spectrum disorder (PAS) analyzing interobserver agreement and to derive a model including imaging and clinical variables to predict PAS. Methods: A retrospective review including patients submitted to MRI with suspicious findings of PAS on ultrasound. Exclusion criteria were lack of pathology or surgical information and missing or poor-quality MRI. Two radiologists analyzed six MRI features, and significant clinical data were also recorded. PAS confirmed on pathology or during intraoperative findings were considered positive for the primary outcome. Variables were tested through logistic regression models. Results: Final study included 96 patients with a mean age of 33 years and 73.0% of previous C-sections. All MRI features were significantly associated with PAS for both readers. After logistic regression fit, including MRI signs with a moderate or higher interobserver agreement, intraplacental T2 dark band was the most significant radiologic criteria, and ROC analysis resulted in an AUC = 0.782. After including the most relevant clinical data (previous C-section) to the model, the ROC analysis improved to an AUC = 0.893. Conclusion: Simplified objective criteria on MRI, including intraplacental T2 dark band associated with clinical information of previous C-sections, had the highest accuracy and was used for a predictive model of PAS.
  • article 6 Citação(ões) na Scopus
    The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19
    (2022) PAGANOTI, Cristiane de Freitas; RODRIGUES, Agatha Sacramento; FRANCISCO, Rossana Pulcineli Vieira; COSTA, Rafaela Alkmin da
    The SARS-CoV-2 pandemic has imposed a huge challenge on the antenatal care of pregnant women worldwide, with the maternal mortality rate being raised to alarming levels. While COVID-19 vaccines were developed, some studies highlighted a possible relationship between influenza vaccination and lower odds of COVID-19 infection. As obstetric patients belong to a high-risk group for respiratory diseases, this study evaluated whether influenza vaccination reduces the severity of COVID-19 infection and mortality among pregnant and postpartum women. We conducted a retrospective cohort study on 3370 pregnant and postpartum women from the Brazilian national database, where they were grouped according to their influenza vaccination status before the onset of COVID-19 symptoms. The intensive care unit admission and intubation rates were significantly higher among subjects in the unvaccinated group (p = 0.002 and p < 0.001, respectively). The odds of mortality risk among those who received the vaccine was 0.33, with a 95% confidence interval of 0.23-0.47. The numbers of patients who needed to be vaccinated to avoid a case of intensive care unit admission, intubation, or death due to COVID-19 were 11, 15, and 11, respectively. Influenza vaccines could confer protection against severe COVID-19 infection in pregnant and postpartum women.
  • article 11 Citação(ões) na Scopus
    COVID-19 Vaccines Confer Protection in Hospitalized Pregnant and Postpartum Women with Severe COVID-19: A Retrospective Cohort Study
    (2022) PAGANOTI, Cristiane de Freitas; COSTA, Rafaela Alkmin da; PAPAGEORGHIOU, Aris T.; COSTA, Fabricio da Silva; QUINTANA, Silvana Maria; GODOI, Luciana Graziela de; MONROY, Nataly Adriana Jimenez; RODRIGUES, Agatha Sacramento; FRANCISCO, Rossana Pulcineli Vieira
    The coronavirus disease 2019 (COVID-19) pandemic has had deleterious effects among the obstetric population. Pregnant and postpartum women constitute a high-risk group for severe COVID-19. Vaccination reduces the risk of infection, but it is not known whether women who become infected despite vaccination have a milder course of disease than those who had not been vaccinated. This retrospective cohort study evaluated whether vaccination reduces the severity of COVID-19 infection, as measured by severe maternal morbidity and mortality among hospitalized pregnant and postpartum individuals. A total of 2284 pregnant and postpartum women hospitalized with severe COVID-19 were included. Those who did and who did not receive COVID-19 vaccination were compared. The rates of intensive care unit admission, intubation, and mortality were significantly lower among subjects in the vaccinated group (p < 0.001, p < 0.001 and p < 0.001, respectively). The numbers of patients who needed to be vaccinated to avoid one case of intensive care unit admission, intubation, or death due to COVID-19 were 7, 7, and 9, respectively. The COVID-19 vaccine offers protective effects against intensive care unit admission, intubation, and death in hospitalized pregnant and postpartum women with severe SARS-CoV-2-induced SARS.
  • article 2 Citação(ões) na Scopus
    Placental pathological findings in coronavirus disease 2019: Perinatal outcomes
    (2022) ARCOS JUNIOR, Gelson Farias; FRANCISCO, Rossana Pulcineli Vieira; KILL, Beatriz; PERES, Stela Verzinhasse; GIBELLI, Maria Augusta B. C.; IBIDI, Silvia Maria; CARVALHO, Werther Brunow de; SIMOES, Angelica Braz; BRIZOT, Maria de Lourdes; SCHULTZ, Regina; CARVALHO, Mariana Azevedo
    Introduction: Placental alterations caused by severe acute respiratory coronavirus-2 (SARS-CoV-2) infection have already been described, but most studies used small sample groups and the difference according to the severity of the disease has not been verified. Our objective was to describe placental alterations in patients with coronavirus disease 2019 (COVID-19) and analyze the association of pathological placental findings with the clinical pa-rameters of COVID-19 and perinatal results.Methods: This was a nested study within a prospective cohort study involving 109 symptomatic pregnant women with COVID-19. The prevalence of observed placental alterations was described, and the associations of path-ological findings with the clinical parameters of COVID-19 severity and with perinatal outcomes were assessed.Results: The frequency of types of placental features was poor maternal vascular perfusion in 45% of cases, poor fetal vascular perfusion in 33.9%, hematogenous origin infection in 32.1%, and morphological changes corre-sponding to ascending infection in 21.1%. Hematogenous infection differed significantly according to COVID-19 severity (p = 0.008), with a prevalence ratio (PR) of 1.74 (95% confidence interval, 1.02-2.98) in the moderate COVID-19 group compared to the mild COVID-19 group. Among the perinatal outcomes, there was an unex-pected inverse association between prematurity and placental infection of hematogenous origin, with lower rates of prematurity among cases with inflammation of hematogenous origin (p = 0.029).Discussion: Moderate SARS-Cov-2 infection presented a higher prevalence of placental pathological findings. There was no association of placental findings with adverse perinatal outcomes.
  • article 1 Citação(ões) na Scopus
    Risk factors for oxygen requirement in hospitalized pregnant and postpartum women with COVID-19
    (2022) BAPTISTA, Fernanda Spadotto; PAGANOTI, Cristiane Freitas; GOMEZ, Ursula Trovato; PERES, Stela Verzinhasse; MALBOUISSON, Luiz Marcelo; BRIZOT, Maria de Lourdes; FRANCISCO, Rossana Pulcineli Vieira
    Objective: To identify risk factors for Oxygen (O-2) needs in pregnant and postpartum women with COVID-19. Methods: Prospective cohort involving pregnant women hospitalized with COVID-19 from April to October 2020. The oxygen need was analyzed regarding risk factors: demographic characteristics, clinical and laboratory parameters at hospital admission, and chest Computer Tomography (CT) findings. Poisson univariate analysis was used to estimate the Relative Risk (RR) and 95% Confidence Intervals. Results: 145 patients, 80 who used and 65 who did not use O-2, were included. Body mass index >= 30, smoking, and chronic hypertension increased the risk of O-2 need by 1.86 (95% CI 1.10-3.21), 1.57 (95% CI 1.16-2.12), and 1.46 (95% CI 1.09-1.95), respectively. Patients who were hospitalized for COVID-19 and for obstetric reasons had 8.24 (95% CI 2.8-24.29) and 3.44 (95% CI 1.05-11.31) times more use of O-2 than those admitted for childbirth and abortion. Respiratory rate >= 24 breaths/min and O-2 saturation < 95% presented RR for O-2 requirements of 2.55 (1.82-3.56) and 1.68 (95% CI 1.27-2.20), respectively. Ground Glass (GG) < 50% and with GG >= 50%, the risk of O-2 use were respectively 3.41-fold and 5.33-fold higher than in patients who haven't viral pneumonia on CT. The combination of C-reactive protein >= 21 mg/L, hemoglobin < 11.0 g/dL, and lymphopenia < 1500 mm(3) on hospital admission increased the risk of O-2 use by 4.97-times. Conclusions: In obstetric patients, clinical history, laboratory, clinical and radiological parameters at admission were identified as a risk for O-2 need, selecting the population with the greatest chance of worsening.