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
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Demographic and epidemiological characteristics of pregnant and postpartum women who died from severe acute respiratory syndrome in Brazil: A retrospective cohort study comparing COVID-19 and nonspecific etiologic causes(2022) FRANCO, Veridiana Freire; RODRIGUES, Agatha Sacramento; ROSA JUNIOR, Elias Ribeiro; GODOI, Luciana Graziela de; MONROY, Nataly Adriana Jimenez; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli VieiraThe objective of this study is to compare the demographic characteristics and symptoms in pregnant and postpartum women who died from Severe Acute Respiratory Syndrome (SARS) caused by COVID-19 or by nonspecific cause in different states of Brazil. This is a retrospective cohort study and the analysis was conducted on SARS death records between 02/16/2020 and 04/17/2021, obtained from the Information System for the Epidemiological Surveillance of Influenza (Sistema de Informacao da Vigilancia Epidemiologica da Gripe, SIVEP-Gripe). Pregnant and postpartum women, aged between 10 and 55 years, who died from SARS, were included and classified into two groups: SARS due to confirmed COVID-19 or SARS due to nonspecific cause. The cases were analyzed according to the women's demographic and epidemiological characteristics, clinical symptoms, risk factors and disease evolution. As results, 19,333 pregnant and postpartum women were identified. From these, 1,279 died (1,026 deaths from COVID-19 and 253 deaths from SARS with nonspecific cause). The groups showed significant differences in age, education, race, and occurrence of obesity and chronic lung disease. The group of women who died from confirmed COVID-19 presented a significantly higher frequency of symptoms of fever, cough, fatigue, loss of taste, and loss of smell, as well as a higher rate of admission to the intensive care unit (ICU). Data analysis draws attention to the high number of cases of SARS without a causal diagnosis, the low access to ICU and orotracheal intubation (OTI), which might be explained by the demographic and regional inequalities in the access to healthcare.
- Prone Positioning: A Safe and Effective Procedure in Pregnant Women Presenting with Severe Acute Respiratory Distress Syndrome(2022) JR, Gilmar de Souza Osmundo; PAGANOTTI, Cristiane de Freitas; COSTA, Rafaela Alkmin da; SILVA, Thiago Henrique dos Santos; BOMBONATI, Paula Carolina; MALBOUISSON, Luiz Marcelo Sa; FRANCISCO, Rossana Pulcineli VieiraProne positioning (PP) improves oxygenation and survival in patients with severe acute respiratory distress syndrome (ARDS). Data regarding feasibility and effectiveness of PP in pregnancy are lacking. This subgroup analysis of a cohort study that included mechanically ventilated pregnant women presenting with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced ARDS who underwent PP aims to assess the efficacy and safety of PP. Ventilatory and gasometric parameters were evaluated at baseline (T-0) and in prone (T-1) and supine (T-2) positions. Obstetric outcomes were also assessed. Sixteen cases at an average of 27.0 (22.0-31.1) gestational weeks of pregnancy were included. Obesity and hypertension were frequent comorbidities. PP was associated with a >20% increase in PaO2 levels and in PaO2/FiO(2) ratios in 50% and 100% of cases, respectively. The PaO2/FiO(2) ratio increased 76.7% (20.5-292.4%) at T-1 and 76.9% (0-182.7%) at T-2. PP produced sustained improvements in mean PaO2/FiO(2) ratio (p < 0.001) and PaCO2 level (p = 0.028). There were no cases of emergency delivery or suspected fetal distress in pregnancies >= 25 weeks during the 24 h period following PP. PP is safe and feasible during pregnancy, improving PaO2/FiO(2) ratios and helping to delay preterm delivery in severe ARDS.