Vaginal Flora Alterations and Clinical Symptoms in Low-Risk Pregnant Women

Background: To evaluate associations between alterations in vaginal flora and clinical symptoms in low-risk pregnant women. Methods: Vaginal specimens from 245 pregnant women were analyzed by microscopy for vaginal flora. Signs and symptoms of vaginal infection were determined by patient interviews and gynecologic examinations. Results: Abnormal vaginal flora was identified in 45.7% of the subjects. The final clinical diagnoses were bacterial vaginosis (21.6%), vaginal candidosis (10.2%), intermediate vaginal flora (5.2%), aerobic vaginitis (2.9%), mixed flora (2.9%) and other abnormal findings (2.9%). The percentage of women with or without clinical signs or symptoms was not significantly different between these categories. The presence of vaginal odor or vaginal discharge characteristics was not diagnostic of any specific flora alteration; pruritus was highly associated with candidosis (p < 0.0001). Compared to women with normal flora, pruritus was more prevalent in women with candidosis (p < 0.0001), while vaginal odor was associated with bacterial vaginosis (p = 0.0026). Conclusion: The prevalence of atypical vaginal flora is common in our low-risk pregnant population and is not always associated with pathology. The occurrence of specific signs or symptoms does not always discriminate between women with different types of atypical vaginal flora or between those with abnormal and normal vaginal flora. Copyright (C) 2010 S. Karger AG, Basel

Bioimpedance in Pregnant Women with Preeclampsia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Group B streptococci colonization in pregnant women: risk factors and evaluation of the vaginal flora

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Platelet aggregation and TGF-beta(1) plasma levels in pregnant women with preeclampsia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ureteroscopy in Pregnant Women for Ureteral Stone

Introduction: The occurrence of urolithiasis in pregnancy represents a challenge in both diagnosis and treatment of this condition, because it presents risks not only to the mother but also to the fetus. Surgical treatment may be indicated for patients with infection, persistent pain, and obstruction of a solitary kidney. We present our experience on the management of pregnant patients with ureteral calculi and a review of the literature.Materials and Methods: The charts of 19 pregnant patients with obstructive ureteral calculi were retrospectively reviewed. Gestational age ranged from 13 to 33 weeks. In all patients, ureteral stone was diagnosed on abdominal ultrasound. In regard to localization, 15 calculi were in the distal ureter, 3 in the proximal ureter, and 1 in the interior of an ureterocele. Calculi size ranged from 6 to 10 mm (mean, 8 mm). The following criteria were used to indicate ureteroscopy: persistent pain with no improvement after clinical treatment, increase in renal dilation, or presence of uterine contractions. Nine patients (47.3%) were submitted to ureteroscopy. All calculi (100%) were removed with a stone basket extractor under continuous endoscopic vision. None of the calculi demanded the use of a lithotriptor.Results: Nine patients (47.3%) treated with clinical measurements presented no obstetric complications and spontaneous elimination of the calculi. Nine patients (47.3%) submitted to ureteroscopy had no surgical complications. There was remission of pain in all cases after ureteroscopy and ureteral catheter placement.Conclusion: The diagnosis and treatment of ureteral lithiasis in pregnant women present potential risks for the fetus and the mother. Conservative management is the first option, but ureteroscopy may be performed with safety and high success rates.

Lack of association between ABO histo-blood groups, secretor and non-secretor phenotypes, and anti-Toxoplasma gondii antibodies among pregnant women from the northwestern region of São Paulo State, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Nymphal development, lipid content, growth and weight gain of Nezara viridula (L.) (Heteroptera: Pentatomidae) fed on soybean genotypes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of oral environment stabilization procedures on Streptococcus mutans counts in pregnant women

O objetivo desta pesquisa foi determinar o efeito da adequação do meio bucal sobre a contagem de Streptococcus mutans em gestantes de alto risco à cárie, participantes de um programa de prevenção em uma instituição de ensino público, antes e após adequação do meio bucal. Amostras de saliva de 30 gestantes (18 a 43 anos) que procuraram atendimento na Clínica de Odontologia Preventiva da FOAr-UNESP foram coletadas antes e após procedimentos de adequação do meio bucal, e examinadas para observação e contagem das UFCs de S. mutans. Foi demonstrado que houve diminuição na quantidade das UFCs (p<0,0001) entre as amostras. em relação à faixa etária, 70,0% das gestantes tinham entre 18 e 30 anos de idade e 30,0% pertenciam à faixa etária de 31 a 43 anos. Dados relativos ao período da gestação revelaram que 73,4% estavam no 2º trimestre e 13,3% estavam igualitariamente no 1º e 3º trimestres. A adequação do meio bucal se mostrou eficaz na diminuição das UFCs de S. mutans presentes na saliva de gestantes de alto risco de cárie. Este procedimento é simples e extremamente efetivo, atendendo às necessidades de tratamento básico de gestantes que procuram atendimento odontológico no serviço público de saúde.

Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women

Alterações anatômicas e fisiológicas da gravidez predispõem gestantes a infecções do trato urinário (ITU). O objetivo deste estudo foi identificar a acurácia do exame de urina simples para diagnóstico de ITU em gestantes de baixo risco. Fez-se uso do estudo de desempenho de teste diagnóstico realizado em Botucatu, SP, com 230 gestantes, entre 2006 e 2008. Os resultados mostram que a prevalência de ITU foi de 10%. A sensibilidade foi 95,6%, especificidade 63,3% e acurácia 66,5% do exame de urina simples, em relação ao diagnóstico de ITU. A análise dos valores preditivos positivo e negativo (VPP e VPN) mostrou que, na vigência de exame de urina simples normal, a chance de haver ITU foi pequena (VPN 99,2%). Frente ao resultado alterado desse exame, a probabilidade de haver ITU foi baixa (VPP 22,4%). Conclui-se que a acurácia do exame de urina simples como meio diagnóstico de ITU foi baixa, sendo indispensável a realização de urocultura para o diagnóstico.