Navegando por Assunto "Gestantes"
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Item Acesso aberto (Open Access) Anemia em gestantes brasileiras antes e após a fortificação das farinhas com ferro(Universidade Federal do Pará, 2011-12) FUJIMORI, Elizabeth; SATO, Ana Paula Sayuri; SZARFARC, Sophia Cornbluth; VEIGA, Gloria Valeria da; QUEIROZ, Valterlinda Alves de Oliveira; COLLI, Célia; ARAUJO, Regilda Saraiva dos Reis Moreira; ARRUDA, Ilma Kruze Grande de; UCHIMURA, Taqueco Teruya; BRUNKEN, Gisela Soares; YUYAMA, Lucia Kiyoko Ozaki; MUNIZ, Pascoal Torres; PRIORE, Silvia Eloiza; TSUNECHIRO, Maria Alice; FRAZÃO, Andréa das Graças Ferreira; PASSONI, Cynthia R Matos Silva; ARAÚJO, Claudia Regina Marchiori AntunesOBJECTIVE: To compare prevalence of anemia and hemoglobin (Hb) levels in Brazilian pregnant women before and after fl our fortifi cation with iron. METHODS: A repeated cross-sectional panel study of public health care centers of municipalities in the five Brazilian regions was conducted. Retrospective data were obtained from 12,119 medical records of pregnant women distributed in two groups: before fortifi cation (delivery prior to June 2004) and after fortifi cation (date of last period after June 2005). Anemia was defi ned as Hb<11.0 g/dl. Hb levels according to gestational age were assessed using two references from the literature. Statistical analysis was carried out using chi-squared tests, Student’s t tests, and logistic regression, with a signifi cance level of 5%. RESULTS: In the total sample, prevalence of anemia fell from 25% to 20% after fortifi cation (p<0.001). However, important regional differences were evident: while signifi cant reductions were seen in the Northeast (37% to 29%) and North (32% to 25%) regions, where pre-fortifi cation prevalence was high, smaller reductions were seen in the Southeast (18% to 15%) and South (7% to 6%) regions, where prevalence was low. Hb levels according to gestational age were slightly higher in the fi rst months of pregnancy and lower after the third or fourth months, depending on the reference used. Logistic regression analysis showed that group, geographic region, marital status, trimester of pregnancy, initial nutritional status, and prior pregnancy were associated with anemia (p<0.05). CONCLUSIONS: Prevalence of anemia decreased after fortifi cation, but remains high in the North and Northeast regions. Although fortifi cation may have played a role in this favorable outcome, the contribution of other public policies implemented during the studied period should also be considered.Item Acesso aberto (Open Access) Descriptive study of HTLV infection in a population of pregnant women from the state of Pará, Northern Brazil(2012-07) SEQUEIRA, Carina Guilhon; TAMEGÃO-LOPES, Bruna Pedroso; SANTOS, Eduardo José Melo dos; VENTURA, Ana Maria Revorêdo da Silva; PINTO, Maria Isabel Moraes; SUCCI, Regina Célia de MenezesINTRODUCTION: In Brazil, studies have shown that HTLV seroprevalence among pregnant women varies from 0 to 1.8%. However, this seroprevalence was unknown in the State of Pará, Brazil. The present study describes, for the first time, the HTLV seroprevalence among pregnant women from the State of Pará, Northern Brazil. METHODS: 13,382 pregnant women were submitted to HTLV screening during prenatal care, and those with non-seronegative results to anti-HTLV were submitted to Western blot (WB) test to confirm and separate HTLV-1 and HTLV-2 carriers. RESULTS: HTLV seroprevalence in the population of pregnant women was 0.3%, and HTLV-1 was identified in 95.3% of patients. The demographic profile of HTLV carriers was as follows: women with age between 20 and 40 years old (78.4%); residing in the metropolitan region of Belém, Pará (67.6%); and with educational level of high school (56.8%). Other variables related to infection were as follows: beginning of sexual intercourse between the age of 12 and 18 years old (64.9%) and have being breastfed for more than 6 months (51.4%). Most of the women studied had at least two previous pregnancies (35.1%) and no abortion (70.3%). Coinfections (syphilis and HIV) were found in 10.8% (4/37) of these pregnant women. CONCLUSIONS: Seroprevalence of HTLV infection in pregnant women assisted in basic health units from the State of Pará, Northern Brazil, was 0.3% similar to those described in other Brazilian studies. The variables related to infection were important indicators in identifying pregnant women with a higher tendency to HTLV seropositivity, being a strategy for disease control and prevention, avoiding vertical transmission.Item Acesso aberto (Open Access) Investigação dos genes Bla SHV, Bla TEM e Bla CTX-M produtoras de beta-lactamases de espectro estendido em E. coli e Klebsiella spp isoladas de gestantes com infecção do trato urinário atendidas em unidade básica de saúde de Imperatriz-MA(Universidade Federal do Pará, 2012) OLIVEIRA, Adriana dos Santos; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872Beta-lactamases are produced by gram-positive and gram-negative bacteria. About 40% to 50% of women developed a urinary tract infection during their adult life. The aim of the present study was the characterization of genes Bla SHV, Bla TEM e Bla CTX-M beta-lactamase-producing extended-spectrum E. coli and Klebsiella spp isolated from pregnant women with urinary tract infection treated at a Basic Health Unit of Empress - MA from May to August 2012. The study included 50 pregnant women over 18 years who presented with symptoms clinical characterization of urinary tract infection (UTI), referenced in the clinic in the Basic Health Empress - MA. Urine was collected for urine culture and sensitivity of achievement, subsequently was performed Polymerase Chain Reaction (PCR) to detect the presence of genes Bla SHV, Bla TEM e Bla CTX-M, enzymes producing beta-lactamases. The mean age of these patients was 21 years, 42% being aged 18 to 25 years, 70% of these fixed address in Empress and the other 30% come from other municipalities. Among these, 24% of the volunteers already had UTI during pregnancy and pregnancy out of state and 80% of them reported using antibiotics without prescription. Of the 12 samples with positive microbiological growth, 11 were positive for Escherichia coli with the antibiogram results that were resistant to the antibiotic cephalothin at 91.7%. Being isolated, a strain of Klebsiella spp, and this was resistant to all antibiotics tested. By analyzing the results of PCR samples isolated three genes Bla SHV, Bla TEM e Bla CTX-M, were not observed in samples P9, P11 and P12, but in the other samples was the occurrence of at least one of the genes. This study confirmed the presence of three types of genes (Bla SHV, Bla TEM e Bla CTX-M) among the samples studied.Item Acesso aberto (Open Access) Malária em mulheres na idade reprodutiva: análise dos aspectos clínico-epidemiológicos na região de Itaituba, 2005 a 2007(Universidade Federal do Pará, 2010) MELO, Wilson Franco de; PINHEIRO, Maria da Conceição Nascimento; http://lattes.cnpq.br/6353829454533268A malária na gestação representa uma ameaça à vida da mãe e do concepto além de influenciar na evolução da gravidez. Visando esclarecer aspectos da malária que acomete gestantes de áreas hiperendêmicas na Amazônia, este estudo se propõe avaliar aspectos clínico-epidemiológicos da doença em mulheres na idade reprodutiva, com ênfase em gestantes internadas em hospital público de referencia para a região de Itaituba. O estudo foi conduzido no HMI de Itaituba no período de 2005 a 2007, através do levantamento de prontuários de mulheres hospitalizadas e com diagnóstico de malária confirmado pela gota espessa, e da análise documental baseada nos dados do SIVEP-Malária. Os resultados evidenciaram que no Pará, em 2007, mais de 51% dos casos notificados foram oriundos de apenas nove municípios, dois deles (Itaituba e Jacareacanga), pertencentes à microrregião de Itaituba, área onde foi registrada maior Incidência Parasitária Anual (IPA). Os dados dos prontuários de 30 pacientes (sete, gestantes) revelaram, em sua maioria, que eram procedentes da área rural do município de Itaituba e haviam sido infectadas por P. falciparum; que as gestantes eram as mais jovens (p<0,05); e que o tempo de internação foi similar entre gestantes e não-gestantes. As intercorrências sobre o curso gestacional foram um óbito fetal (malária por P. vivax, segundo trimestre) e um parto prematuro (malária por P. falciparum, terceiro trimestre). Concluiu-se, a partir dessas observações, que casos graves de malária podem ocorrer tanto associados à espécie vivax como falciparum fazendo-se necessário constante vigilância epidemiológica, especialmente no município de Itaituba, onde está concentrado o maior número de casos da doença. As medidas de vigilância epidemiológica a serem adotadas devem privilegiar o diagnóstico precoce e tratamento imediato das pacientes, sobretudo das gestantes, já que estão sujeitas a maior risco de complicações com sérias conseqüências para o concepto.Item Acesso aberto (Open Access) Molecular detection of Treponema pallidum sp. pallidum in blood samples of VDRL-seroreactive women with lethal pregnancy outcomes: a retrospective observational study in northern Brazi(2011-08) CASAL, Charliana Aragão Damasceno; SILVA, Mayra Oliveira da; COSTA, Igor Brasil; ARAÚJO, Eliete da Cunha; CORVELO, Tereza Cristina de OliveiraINTRODUCTION: Although control measures of maternal and congenital syphilis are available in Brazil, difficulties exist within the healthcare network in providing a laboratory diagnosis of the infection during the prenatal period. The objective of this study was to confirm the presence of Treponema pallidum by PCR in women with positive VDRL serology and lethal pregnancy outcomes, i.e., abortion, stillbirth and neonatal death. METHODS: A retrospective study was conducted on VDRLseroreactive women with lethal pregnancy outcomes admitted to the Fundação Santa Casa de Misericórdia do Pará (FSCM-PA) between January and July 2004. Serum samples and DNA from whole blood were obtained at the time of screening by the VDRL test. These samples were analyzed by IgG ELISA, IgM FTA-Abs and simple PCR (polA). RESULTS: During the study period, 0.7% (36/4,912) of women with lethal pregnancy outcomes presented a positive VDRL test. The polAgene was amplified in 72.7% (24/33) of these women, with 55.6% (20/36) and 94.4% (34/36) presenting IgM and IgG antibodies against T. pallidum, respectively. Comparison of these results showed a significant difference, with agreement between the PCR and IgM FTA-Abs results, suggesting that maternal syphilis was an active infection. No basic cause of death of the conceptus was reported in 97.2% (35/36) of cases. Among women who were submitted to the VDRL test during the prenatal period, only four of the nine seroreactive patients underwent treatment. CONCLUSIONS: The high frequency of syphilis in the group studied indicates the fragility of the service of infection diagnosis, treatment and monitoring, compromising epidemiological control.Item Acesso aberto (Open Access) Prevalência da infecção por HTLV em gestantes atendidas em serviços públicos de pré-natal no município de Santarém-Pará(Universidade Federal do Pará, 2012-12-17) MONTEIRO, Mariana dos Anjos Furtado; MARTINS, Luisa Caricio; http://lattes.cnpq.br/1799493244439769Item Acesso aberto (Open Access) Soroepidemiologia da sífilis em gestantes e seus recém-nascidos(Universidade Federal do Pará, 2003) RASSY, Maria Elizabete de Castro; CORVELO, Tereza Cristina de Oliveira; http://lattes.cnpq.br/7253864056606024Syphilis is a systemic infectious-contagious disease caused by Treponema pallidium, a parasite that is exclusive to humans and whose transmission is essentially carried out through sexual contact. The incidence of congenital syphilis has reached truly epidemic proportions, although measures that could control this disease are known. The investigation described pregnant women with syphilis hospitalised at the FSCMPA during the period of January 2001 to June 2003, as to socio-demographic characteristics, behaviour for promoting sexual and reproductive health and serological and clinical data related to syphilis in the mother-newborn relationship. The study is of a crosscutting, analytical and descriptive nature, with 245 pregnant women. Medical records of these patients were reviewed, with positive serology for syphilis and the newbom, tested by the VDRL method. The incidence of syphilis in pregnant women was 1.73% of the total of patients hospitalised in the last two and a half years. The epidemiological profile demonstrated that the main risk factors for acquiring syphilis during pregnancy were: absence of prenatal accompaniment and treatment, including for the sexual partner. According to postpartum maternal seropositivity, it was found that the possibility of a newborn having syphilis, if VDRL positive, was 98.68%. Jaundice and low weight were the most common clinical signs of syphilis, and prematurity was also a clinical sign observed. These analyses reveal the need for educational campaigns of a broader scope related to risk factors for acquiring this infirmity and better care for pregnant women during the prenatal period, with accompaniment and diagnostic control for the pregnant women.