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Introduction: Preterm birth, before 37 weeks of gestation, is the main determinant of neonatal morbidity and mortality and is associated with serious consequences,including compromised quality of life for the affected individual and physical, psychological, and economic costs. Objective: To evaluate the correlation of obstetric history, cervicovaginal infections, and cervical length with preterm birth. A prospective, blind cohort study evaluated 1,370 pregnant women from Ribeirão Preto between 20 and 25 weeks of gestation. Materials and methods: The correlation between obstetric history, cervical length, and gestational age at birth was obtained by calculating the relative risk of the different variables. Results: The distribution of pregnant women according to cervical length (CL) showed a predominance of women with a cervix longer than 2.5 cm (n = 1,308, 95.8%), followed by women with a cervix between 2 and 2.49 cm (n = 42, 3.1%) and < 2 cm (n = 15, 1.1%). Among the 1,370 pregnant women evaluated, 133 had spontaneous preterm birth (< 259 days); 14 (10.5%) preterm births occurred in women under 19 years of age, 105 (79%) in women between 19 and 35 years, and 14 (10.5%) in women older than 35 years. Microbiological analysis showed the growth of Mycoplasma hominis, Ureaplasma urealyticum, and other bacteria in 8, 17, and 16 women with preterm birth, respectively. Among the 133 women with spontaneous preterm birth, CL was < 2.5 cm in 15 women, < 2 cm in 3, < 1.5 cm in 3, and < 1 cm in 2. Conclusion: The identification of pregnant women at high risk for preterm delivery can reduce the incidence of preterm birth. Although no gold standard test exists for the prediction of preterm birth, this study confirms that the measurement of CL is a good individual predictor.

Abstract Background Preterm birth is a leading cause of infant morbidity and mortality; its multifactorial causes are an obstacle to understanding etiology and pathogenesis. The importance of cytokines and inflammation in its etiology and association with the short cervix is nowadays well-proven. To date, there are no reliable biological or biochemical markers to predict preterm birth; even though the length of the cervix has high specificity, its sensitivity with the cervix below 2.5 cm is low. Objective We study the association of plasma cytokine levels and cervical length in search of predictors of preterm birth. Study design We evaluated a total of 1400 pregnant women carrying a single fetus between 20 and 25 weeks of gestation, and 1370 of them after childbirth in a nested case–control study of a prenatal cohort. Eligible pregnant women were interviewed and submitted to obstetric morphological and transvaginal ultrasound with cervical length measurement, gynecological examination, and blood collection. Preterm birth occurred in 133 women, 129 included in the study, and a control group randomly selected at a 2:1 ratio. A total of 41 cytokines with a higher probability of being associated with preterm birth or being of significance during labor were determined. Results Cytokine and cervical length analysis by multivariate analysis of the conditional interference tree revealed that growth-related oncogene values of less than 2293 pg/mL were significantly associated with a cervical length of less than 2.5 cm. Conclusions As well as a cervical length shorter than 2.5 cm, growth-related oncogene levels of less than 2293 pg/ml may be associated with an increased risk of PB. Analysis based on the association of biomarkers and of the interaction between cytokines is a promising pathway in search of a predictor of preterm birth.

Importante foco de atenção em Saúde Pública tem sido a avaliação de determinados micronutrientes no ser humano, em especial aqueles que se encontram associados à vulnerabilidade orgânica, conseqüente ao desiquilíbrio ou à deficiência desses micronutrientes. Entre os micronutrientes, a hipovitaminose A tem sido objeto de realce devido à significante prevalência em populações de países em desenvolvimento. Este artigo aborda a Vitamina A, enfocando seu metabolismo e as repercussões deletérias, decorrentes de sua deficiência sobre o organismo, suas manifestações no ciclo gravidopuerperal, e sua interação em situações clínicas, específicas.

Atualmente tem sido realçado o papel da infecção genital feminina por Mycoplasma hominis (MH) e Ureaplasma Urealyticum (UU) na gênese das complicações sistêmicas que extrapolam a singularidade da infecção. A possibilidade de troca de material genérico com a célula acometida sustenta um papel na gênese das doenças do conjuntivo e na formação de super-antígenos piorando o prognóstico de mulheres contaminadas pelo Vlrus da Imunodeficiência Humana ripo l (HIV-1). OBJETIVOS:Avaliar a freqüência da infecção genital do MH e UU em mulheres, considerando o estado de portadora do HIV-1 e gestação. CASUÍSTICA E MÉTODOS: Estudo prospectivo envolvendo 183 mulheres atendidas em um Hospital Universitário entre 1995 e 1996. Dividiu-se as pacientes do estudo em quatro grupos. O grupo I foi formado por 61 gestantes consideradas normais, o grupo II por 12 gestantes portadoras do HIV-1, o grupo III por 60 mulheres não gestantes portadoras do HIV-1 e o grupo IV por 50 mulheres não gestantes e não contaminadas pelo HIV-1. O método utilizado para identificação do MH e UU foi cultura com diluições sucessivas, considerando positivo as diluições maiores que 10 ' após a mudança de cor dos meios de cultura. RESULTADOS E DISCIUSSÂO: Observou-se que as taxas de infecção genital pelo MH e UU são baixas na população feminina, independentemente de sua condição de ponadorado HIV-1. Verificou-se que no período gestadonal a freqüência de MH foi estatisticamente mais baixa (1,4%) do que na população não gestante (12,7%). Não se observou infl uência gesradonal sobre a freqüência do UU. Sugere-se a todos que renham condições de cultivo para estes microrganismos que o executem.

Vertical transmission (VT) is the main form of infection by HIV-1 in children under 13 years and estimates show that in 25% of cases intrauterine transmission has occurred. Under these circumstances, the virus somehow overcomes the placental membrane and reaches the fetal blood. This review aims to conduct a brief description of the mechanisms present in human placenta that are capable of generating susceptibility or resistance to VT of HIV-1. Placental cells produces a huge group of cytokines, chemokines, hormones and receptors that may contribute to the outcome of virus transmission to the fetus. Moreover, the ability of the virus to infect placental cells can also contribute to its transmission. However, the mechanism by which the virus is able to overcome the placental tissue is not fully elucidated. Thus, further research in this area may contribute to the development of effective preventive strategies to reduce the VT of HIV-1

Milena B Brito1,2, Rui A Ferriani1,2, Silvana M Quintana1, Marcos F Silva de Sá1,2, Carolina S Vieira1,21Department of Gynecology and Obstetrics, University of Sao Paulo, Ribeirao Preto School of Medicine, Ribeirão Preto, Brazil; 2National Institute of Hormones and Women’s Health, Ribeirão Preto, BrazilObjective: To evaluate the safety, in terms of renal and hepatic function, of the etonogestrel (ENG)-releasing contraceptive implant inserted immediately postpartum.Methods: A total of 40 healthy women were randomized; 20 received the ENG-releasing implant inserted 24 to 48 hours after delivery (ENG group), and 20 received depot medroxyprogesterone acetate in the sixth week postpartum (control group). Alkaline phosphatase, gamma-glutaryl transferase, alanine aminotransferase, aspartate aminotransferase, total bilirubin and its fractions, albumin, urea, and creatinine were analyzed.Results: There was no statistically significant difference between the groups in serum hepatic markers or urea levels during the study. Creatinine levels increased in both groups during the first six weeks, more significantly in the ENG group than in the control group (ENG +40% versus control +20%, P = 0.04). This increase was followed by a greater decrease in the ENG group than in the control group 6–12 weeks postpartum (ENG -14.3% versus control -3.8%, P = 0.02). However, these changes were still within the normal ranges for the assays performed.Conclusion: The ENG-releasing contraceptive implant inserted immediately postpartum was not associated with clinically significant changes in serum markers of liver or kidney function.Keywords: etonogestrel, renal, hepatic, postpartum period, contraception, implant