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
4 resultados
Resultados de Busca
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- 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 AzevedoIntroduction: 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.
- 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 VieiraObjective: 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.
- Post-Viral Fatigue Following SARS-CoV-2 Infection during Pregnancy: A Longitudinal Comparative Study(2022) OLIVEIRA, Ana Maria da Silva Sousa; CARVALHO, Mariana Azevedo; NACUL, Luis; CABAR, Fabio Roberto; FABRI, Amanda Wictky; PERES, Stela Verzinhasse; ZACCARA, Tatiana Assuncao; O'BOYLE, Shennae; ALEXANDER, Neal; TAKIUTI, Nilton Hideto; MAYAUD, Philippe; BRIZOT, Maria de Lourdes; FRANCISCO, Rossana Pulcineli VieiraStudies reported post-COVID-19 fatigue in the general population, but not among pregnant women. Our objectives were to determine prevalence, duration, and risk factors of post-viral fatigue among pregnant women with SARS-CoV-2. This study involved 588 pregnant women with SARS-CoV-2 during pregnancy or delivery in Brazil. Three groups were investigated: G1 (n = 259, symptomatic infection during pregnancy); G2 (n = 131, positive serology at delivery); G3 (n = 198, negative serology at delivery). We applied questionnaires investigating fatigue at determined timepoints after infection for G1, and after delivery for all groups; fatigue prevalence was then determined. Cox regression was used to estimate hazard ratio (HR) and 95% CI of the risk of remaining with fatigue in G1. Overall fatigue prevalence in G1 at six weeks, three months and six months were 40.6%, 33.6%, and 27.8%, respectively. Cumulative risk of remaining with fatigue increased over time, with HR of 1.69 (95% CI: 0.89-3.20) and 2.43 (95% CI: 1.49-3.95) for women with moderate and severe symptoms, respectively. Multivariate analysis showed cough and myalgia as independent risk factors in G1. Fatigue prevalence was significantly higher in G1 compared to G2 and G3. Post-viral fatigue prevalence is higher in women infected during pregnancy; fatigue's risk and duration increased with the severity of infection.
- Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale(2022) GALLETTA, Marco Aurelio Knippel; OLIVEIRA, Ana Maria da Silva Sousa; ALBERTINI, Jessica Gorrao Lopes; BENUTE, Glaucia Guerra; PERES, Stela Verzinhasse; BRIZOT, Maria de Lourdes; FRANCISCO, Rossana Pulcineli VieiraBackground: The COVID-19 pandemic gave rise to concerns about its potential impact on the mental health of pregnant and postpartum women as the general postpartum depression rates increased. Methods: Three postpartum questionnaires (Edinburgh Postnatal Depression Scale - EPDS; Anxiety and Depression Scale - HAD; and a demographic questionnaire about isolation and information acquisition) were used to evaluate the mental health of women with and without COVID-19 and determine the factors associated with depressive symptoms (EPDS >= 12). Results: Data from 184 participants with a mean of 56 postpartum days were analyzed. The rate of symptoms compatible with postpartum depression (PPD) was 38.8%, with a 14.3% positive response to item 10 on the EPDS (suicidal ideation - SI). Listening to the news about COVID-19 averaged 4.45 hours a day. Factors related to PPD were concerns about lack of hospital beds (OR = 2.45), absence of a partner (OR = 2.70), and anxiety symptoms (OR = 10). Factors related to SI were anxiety symptoms (OR = 1.56) and friends as a source of information (OR = 5.60). Limitations: Considering the rapidly changing epidemiological conditions of this pandemic, this study may only be the photograph of an instant. Conclusions: Higher rates of PPD in the Brazilian population are related not only to anxiety but also to an inadequate family environment, kind of information acquisition and concerns about the lack of hospital beds.