ROSSANA PULCINELI VIEIRA FRANCISCO

(Fonte: Lattes)
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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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search.filters.applied.f.dateIssued: 2023 × Revista / Livro: Clinics ×

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  • article 2 Citação(ões) na Scopus
    Pregnancy in women living with perinatally acquired HIV: Perinatal outcomes and drug resistance profile
    (2023) JR, Gilmar de Souza Osmundo; COSTA, Rafaela Alkmin da; RUOCCO, Rosa Maria Aveiro; FRANCISCO, Rossana Pulcineli Vieira
    Objectives: To analyze the perinatal outcomes of Perinatally acquired HIV Infection (PHIV) in pregnant women.Method: This retrospective cohort study included singleton pregnancies in Women Living with HIV (WLH) between 2006 and 2019. Patient charts were revised, and maternal characteristics, type of HIV infection (perinatal vs. behavioral), Antiretroviral Therapy (ART) exposure, and obstetric and neonatal outcomes were assessed. The HIV-related aspects considered were: Viral Load (VL), CD4+ cell count, opportunistic infections, and genotype testing. Laboratory analyses were performed at baseline (first appointment) and 34 weeks of gestation.Results: There were 186 WLH pregnancies, and 54 (29%) patients had PHIV. Patients with PHIV were younger (p < 0.001), had less frequently stable partnerships (p < 0.001), had more commonly serodiscordant partners (p < 0.001), had a longer time on ART (p < 0.001), and had lower rates of undetectable VL at baseline (p = 0.046) and at 34 weeks of gestation (p < 0.001). No association was observed between PHIV and adverse perinatal outcomes. Among patients with PHIV, third trimester anemia was associated with preterm birth (p = 0.039). Genotype testing was available only for 11 patients with PHIV, who presented multiple mutations related to ART resistance.Conclusions: PHIV did not seem to increase the risk of adverse perinatal outcomes. However, PHIV pregnancies have a higher risk of viral suppression failure and exposure to complex ARTs.
  • article 1 Citação(ões) na Scopus
    Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial
    (2023) BARROS, Venina Isabel Poco Viana Leme de; IGAI, Ana Maria Kondo; BAPTISTA, Fernanda Spadotto; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PERES, Stela Verzinhasse; FRANCISCO, Rossana Pulcinelli Vieira
    Objectives: Hospitalization during pregnancy and childbirth increases the risk of Venous Thromboembolism Risk (VTE). This study applied a VTE risk score to all hospitalized pregnant women to ascertain its effectiveness in pre -venting maternal death from VTE until 3 months after discharge.Methods: In this interventional study, patients were classified as low-or high-risk according to the VTE risk score (Clinics Hospital risk score). High-risk patients (score & GE; 3) were scheduled for pharmacological Thromboprophy-laxis (TPX). Interaction analysis of the main risk factors was performed using Odds Ratio (OR) and Poisson regres-sion with robust variance.Results: The data of 10694 cases (7212 patients) were analyzed; 1626 (15.2%, 1000 patients) and 9068 (84.8%, 6212 patients) cases were classified as high-risk (score & GE; 3) and low-risk (score < 3), respectively. The main risk factors (Odds Ratio, 95% Confidence Interval) for VTE were age & GE; 35 and < 40 years (1.6, 1.4-1.8), parity & GE; 3 (3.5, 3.0-4.0), age & GE; 40 years (4.8, 4.1-5.6), multiple pregnancies (2.1, 1.7-2.5), BMI & GE; 40 kg/m2 (5.1, 4.3-6.0), severe infection (4.1, 3.3-5.1), and cancer (12.3, 8.8-17.2). There were 10 cases of VTE: 7/ 1636 (0.4%) and 3/9068 (0.03%) in the high-and low-risk groups, respectively. No patient died of VTE. The inter-vention reduced the VTE risk by 87%; the number needed to treat was 3.Conclusions: This VTE risk score was effective in preventing maternal deaths from VTE, with a low indication for TPX. Maternal age, multiparity, obesity, severe infections, multiple pregnancies, and cancer were the main risk factors for VTE.