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Browsing by Author "Rocha, A"

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  • Contraceção e risco de tromboembolismo venoso: um estudo caso-controlo
    Publication . Guimarães, AC; Costa, P; Rocha, A; Queirós, F; Barbosa, AP; Nogueira-Silva, C
    Objetivos: Comparar o risco de tromboembolismo venoso (TEV) entre a 4ª geração e as gerações anteriores de contracetivos orais combinados (COC); analisar a correlação existente entre a idade, índice de massa corporal (IMC) e duração da toma do COC e o risco de TEV. Tipo de estudo: Estudo caso-controlo. Local: Centro Hospitalar doAlto-Ave, Hospital de Braga e Unidade Local de Saúde doAlto Minho. População: Foram estudadas no total 257 mulheres, das quais 122 tinham diagnóstico prévio de TEV e 135 não tinham história de TEV. Métodos: Reviram-se os registos clínicos de mulheres em seguimento por TEV, ocorrido entre 2010 e 2013. As mulheres a tomar COC aquando do evento tromboembólico eram os casos.Os controlosforam as mulheresseguidas em consulta de planeamento familiar,a tomar COC e sem antecedentes de TEV. Resultados: Os COC de 4ª geração não aumentam o risco de TEV comparativamente com as gerações anteriores (OR = 1,77; IC95 0,93-3,38; p = 0,083). Não se observou correlação entre o IMC e o risco de TEV (OR = 1,53; IC95 0,76-3,06; p = 0,234). Por outro lado, a idade (OR = 1,5; IC95 1,02-1,09; p = 0,001) e a duração da toma do COC (OR = 2,41; IC95 1,19-4,87; p = 0,014) estiveram associados a risco de TEV. Conclusões: O risco de TEV depende da idade e duração do uso do COC.Tendo em consideração as limitações do estudo, a interpretação dos resultados deve ser cautelosa, quanto à segurança dos COC de 4ª geração
    2014Journal article Open access Show more
  • Diabetes gestacional: determinação de fatores de risco para diabetes mellitus
    Publication . Carvalho, AM; Nogueira-Silva, C; Melo-Rocha, G; Pereira, ML; Rocha, A
    Objetivos Identificar fatores preditivos do desenvolvimento de diabetes mellitus (DM) em mulheres com antecedentes de diabetes gestacional (DG). Tipo de estudo Estudo observacional, analítico, retrospetivo e de coorte. Local Hospital de Braga. População Amostra aleatória de 300 mulheres, nascidas antes de 1995, com diagnóstico de DG entre 1 de janeiro de 2001 e 31 de dezembro de 2010 e seguimento da gravidez no Hospital de Braga. Métodos Os dados foram obtidos através da consulta de processos clínicos. A lista de doentes com DM, referente ao ano de 2011, foi utilizada para verificação do desenvolvimento da doença no grupo selecionado. Foram analisados o perfil sociodemográfico, os antecedentes pessoais, familiares e obstétricos e outros fatores anteparto. Foi realizada uma análise descritiva univariada e bivariada. Seguidamente foi criado um modelo de regressão logística binária para identificar potenciais preditores de desenvolvimento de DM tipo 2. Resultados Trinta e dois vírgula sete por cento das mulheres desenvolveu DM. A probabilidade de desenvolvimento de DM após DG aumentou 8,2 vezes quando idade gestacional menor que 24 semanas no momento do diagnóstico (OR = 8,19; p < 0,001), 3,4 vezes se necessidade de insulinoterapia (OR = 3,36; p < 0,001) e 3,1 vezes se índice de massa corporal (IMC) prévio = 26,4 kg/m2 (OR = 3,07; p = 0,003). História familiar de DM tipo 2, 4 valores elevados na prova de tolerância oral à glicose, valor de glicemia em jejum, idade materna no momento do diagnóstico e IMC pós-parto, apesar de apresentarem associação com desenvolvimento de DM não se revelaram seus preditores. Não se verificou associação entre gravidez prévia ou diagnóstico prévio de DG com desenvolvimento de DM. Conclusões Em mulheres com DG, a idade gestacional menor que 24 semanas no momento do diagnóstico, a necessidade de insulinoterapia e o IMC prévio = 26,4 kg/m2 apresentaram-se como fatores de risco para desenvolvimento de DM. Aims: To identify predictive factors to diabetes mellitus (DM) development in women with history of gestational diabetes (GD). Study design: An observational, analytic, cohort retrospective study. Local: Hospital of Braga. Population: A random sample of 300 women, born before 1995, with GD diagnosed since January 1, 2001 to December 31, 2010 and pregnancy surveillance in a public Hospital of Braga. Methods: Data was collected by consultation of medical records. The DM patients’ list of 2011 was used to verification of the disease development in the selected group. Sociodemographic profile, personal, family and obstetric history, and other antepartum factors were analyzed. A univariate descriptive analysis and a bivariate analysis were performed. A binary logistic regression model was created to identify potential predictors of type 2 DM development. Results: 32.7% of women developed DM. The probability of DM development after GD was increased 8.2 times when gestational age at diagnosis was less than 24 weeks (OR = 8.19; p < 0.001), 3.4 times with the need of insulin therapy (OR = 3.36; p < 0.001) and 3.1 times with previous pregnancy body mass index (BMI) ≥ 26.4 kg/m2 (OR = 3.07; p = 0.003). Although family history of type 2 DM, maternal age at diagnosis, postpartum BMI, 4 abnormal values in the diagnostic oral glucose tolerance test and fasting glucose level had presented association with DM development, did not present as its predictors. It was not verified association between previous pregnancy or previous GD diagnosis and DM development. Conclusions: In women with GD, gestational age at diagnosis less than 24 weeks, need of insulin therapy and previous pregnancy BMI ≥ 26.4 kg/m2 were presented as risk factors to DM development.
    2015Journal article Open access Show more
  • Episiotomy: early maternal and neonatal outcomes of selective versus routine use
    Publication . Coutada, RS; Nogueira-Silva, C; Rocha, A
    Overview and aims: Episiotomy is one of the most common procedures in Obstetrics, despite actual scientific evidence does not support its routine practice.The aim of this study was to determine the impact of selective and routine practice of episiotomy in early maternal and neonatal outcomes. Study design:An observational, transversal, descriptive and analytic study was conducted in two public Hospitals in northern Portugal, with different policies for the practice of episiotomy: selective practice (Hospital A) and routine practice (Hospital B). Population: A non-random sampling of convenience of the whole puerperal women whose deliveries was performed in these hospitals during months of July and August 2011 was utilized. A total of 397 women was analyzed, 200 in selective group and 197 in routine group. Methods: Data was collected by consultation of medical records of the puerperal women. Comparison between hospitals was performed with the chi-square test. Results: The groups were similar for the obstetric history, demographic, biometric, pregnancy and labor characteristics. However, gestational age, weight and head circumference of newborns as well as instrumentation rate were significantly higher in selective group. Episiotomy was performed in 72.5% cases of selective group and in 88.8% of routine group (p≤0.001).There wasless perinealsuturing (p=0.001) and a greater number of intact perineum in selective group (p≤0.001), without differences in lacerations type or degree. The routine group presented more frequent early perineal complications and higher pain levels in the first postpartum day (p≤0.001). No differences were found between groups in Apgar scores, neonatal trauma and Neonatal Intensive Care Unit admissions number. Conclusions: The selective use of episiotomy was associated with better early maternal outcomes, with no differences in neonatal morbidity. Thus, the routine practice of episiotomy showed no benefits
    2014Journal article Open access Show more