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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-24112023-125913
Document
Author
Full name
Larissa Aparecida Cassiano Castro
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Francisco, Rossana Pulcineli Vieira (President)
Galletta, Marco Aurélio Knippel
Pereira, Pedro Paulo
Korkes, Henri Augusto
Title in Portuguese
Resultado da pesquisa dos principais agentes infecciosos em material fetal e seguimento pré-natal
Keywords in Portuguese
Amniocentese
Citomegalovírus
Cordocentese
Diagnóstico pré-natal
Infecções congênitas
Parvovírus
Sífilis
Toxoplasmose
Abstract in Portuguese
Introdução: Diversos agentes infecciosos podem acometer a gestante e o feto, causando aumento na morbidade e mortalidade perinatal. O diagnóstico da infecção possibilita o tratamento do feto, reduzindo, assim, sequelas ou, na impossibilidade dessa opção, o aconselhamento adequado dos pais. Objetivo: Avaliar as pacientes com suspeita de infecção congênita que realizaram procedimentos invasivos para obtenção de amostra fetal, e analisar qual o procedimento realizado, os resultados das amostras e os desfechos gestacionais. Método: Estudo transversal retrospectivo com amostra não probabilística por conveniência envolvendo gestantes com suspeita de infecção fetal entre janeiro de 2013 e dezembro de 2019, com base em resultados sorológicos e achados ultrassonográficos sugestivos de infecção, no Setor de Medicina Fetal do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de janeiro de 2013 a dezembro de 2019.Resultados: Foram obtidas 57 amniocenteses, e 6 cordocentese e amniocenteses. As infecções maternas foram: toxoplasmose (47 casos), parvovirose (9), citomegalovirose (5) e a sífilis (2). No grupo de pacientes com IgG, IgM e IFI-IgM reagente para toxoplasmose, o resultado do PCR no líquido amniótico foi positivo em 17, 2% das amostras. A cordocentese e a transfusão intrauterina foi realizada em 55% das pacientes com suspeita de parvovírus. Os dois casos com sífilis evoluíram para óbito perinatal. Conclusões: A idade gestacional média na admissão foi de 24 semanas, houve correlação entre a suspeita e os resultados. Todas as pacientes submetidas à cordocentese apresentavam alterações ultrassonográficas. O tratamento utilizado interferiu no resultado da análise
Title in English
Results of the search for the main infectious agents in fetal material and prenatal care
Keywords in English
Amniocentesis
Congenital infections
Cordocentesis
Cytomegalovirus
Parvovirus
Prenatal diagnosis
Syphilis
Toxoplasmosis
Abstract in English
Introduction: Several infectious agents can affect pregnant women and fetuses, leading to increased perinatal morbidity and mortality. Diagnosing the infection enables fetal treatment, thereby reducing potential sequelae or, when treatment is not possible, providing appropriate counseling to the parents. Objective: To evaluate patients with suspected congenital infection who underwent invasive procedures to obtain fetal samples and to analyze the type of procedure performed, sample results, and pregnancy outcomes. Methods: A retrospective cross-sectional study with non-probabilistic convenience sampling was conducted, involving pregnant women with suspected fetal infection between January 2013 and December 2019, based on serological results and ultrasound findings suggestive of infection, at the Fetal Medicine Department of the Hospital Clinicals, Faculty of Medicine, University of São Paulo, from January 2013 to December 2019. Results: A total of 57 amniocentesis and 6 cordocentesis and amniocentesis procedures were performed. Maternal infections included toxoplasmosis (47 cases), parvovirus B19 (9 cases), cytomegalovirus (5 cases), and syphilis (2 cases). In the group of patients with IgG, IgM, and IFI-IgM reagent for toxoplasmosis, PCR results in amniotic fluid were positive in 17.2% of the samples. Cordocentesis and intrauterine transfusion were performed in 55% of patients with suspected parvovirus infection. Both cases of syphilis resulted in perinatal death. Conclusions: The mean gestational age at admission was 24 weeks, and there was a correlation between suspicion and results. All patients undergoing cordocentesis had ultrasound abnormalities. The treatment used influenced the analysis results
 
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Publishing Date
2023-11-27
 
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