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Introduction: The aim of this study was to investigate the value of placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and sFlt-1/PLGF ratio, in predicting symptomatic preeclampsia (PE). Methods: A prospective longitudinal study was carried out on 71 high risk preeclamptic women cohort. All of them had normal blood pressure level (≤140/90 mmHg) at the time of enrolment, 26.8 ± 1.5 weeks. Maternal blood was collected and plasma was stored in a freezer at -80 °C. PE was defined according to the National High Blood Pressure Education Program Working Group Criteria. Accuracy of angiogenic factors in predicting PE was evaluated using Receiver-operating characteristics. Results: Maternal plasma concentrations of PLGF and sFlt-1 were able to predict PE (0.90, p < 001; 0.78, p = 0.003, area under the curve, respectively) but the sFlt-1/PLGF ratio presented the best prediction potential over the others (0.95, area under the curve, p < 0.001). Conclusion: All angiogenesis factors were effective biomarkers in predicting PE during the second trimester, before the clinical onset of PE. [ABSTRACT FROM AUTHOR]

Objective. To study the occurrence of congenital cardiopathies at echocardiography (CCE) in fetuses whose mothers had preexisting diabetes mellitus (PGDM) and to study the potential of using fructosamine level as a late marker (beyond the first trimester) for CCE. Methods. A register study covering 91 pregnant women that underwent routine fetal echocardiography ordered due to PGDM. The first dosage of plasma fructosamine found in 65 medical records was analyzed during prenatal care (20.4 ±± 8.0 weeks of gestation). The presence or absence of structural or functional CCE was associated with fructosamine levels by logistic regression. We assessed the effect modification odds ratio by maternal age and insulin usage. Results. Thirty-four fetuses (52.3%% of 65 fetuses) presented CCE. Twenty of them had functional CCE and 14 presented structural CCE. The mean maternal plasma fructosamine level was higher among pregnant women whose fetuses presented CCE than in those whose fetuses did not (2.86 ±± 0.73 mmol/l, 2.22 ±± 0.54 mmol/l, respectively, p < 0.0001). Crude OR for CCE and abnormal plasma fructosamine (>2.68 mmol/l) was 9.6 (2.8--33.7, 95%% CI, p < 0.0001). Adjusted OR by maternal age and insulin usage was 10.9 (2.7--45.2, 95%% CI p < 0.0001). Conclusions. An abnormal plasma fructosamine level increases the chances of CCE occurring among referral pregnant women with PGDM. [ABSTRACT FROM AUTHOR]

Brazil has a long tradition in the use of health information systems, however--until now--there is no consensus on the minimum data set from which to compose discharge summaries. This article describes the methodology used by a group of experts--members of WG1 of ISOTC 215 Health Informatics Brazilian mirror committee--to define the information model of the discharge summary. This paper describes the current status of the standardization process and the first pilot tests with this infomation content.

Objective: To identify the epidemiologic profile, maternal survival, and prognosis factors that might affect survival rates in the obstetric intensive care unit (ICU)., Methods: A prospective cohort study was conducted between January 2007 and February 2009 in a tertiary referral ICU, Belo Horizonte, Brazil. Critical patients during pregnancy and puerperium were followed from admission until discharge or death. Maternal survival was assessed in association with the cause of ICU admission, grouped into direct or indirect obstetric causes, by Kaplan-Meier curves and log-rank tests., Results: Among 298 patients admitted to the ICU during the study period, mortality was 4.7% (n=14). Hypertensive disorders (46.0%), hemorrhage (15.9%), sepsis (14.2%), and heart disease (5.7%) were the main causes of admission. Half of the patients who died were admitted for direct obstetric reasons (n=7). Survival was statistically linked to the cause of admission: most survivors were admitted for a direct obstetric cause (75.5%; P=0.044). Maternal survival rates of patients admitted for indirect obstetric causes were lower than those admitted for direct obstetric causes (27.8 and 19.6 days, respectively; P=0.019)., Conclusion: The main cause of admission was a decisive factor for maternal survival in the obstetric ICU. Direct obstetric complications had a better prognosis., (© 2013.)