Catarina Policiano

Ultrasound antenatal detection of urinary tract anomalies in the last decade: outcome and prognosis.

Abstract Objective: This study has been undertaken to determine the frequency and pattern of urinary tract anomalies diagnosed by ultrasound, to correlate the prenatal with postnatal diagnoses and to identify prognostic factors. Methods: The Ultrasound Units database was reviewed for fetal urinary tract anomalies detected between January 2002 and June 2012. Prenatal diagnoses made by ultrasound were confirmed by postnatal ultrasound, as well as with surgical reports. Statistical analysis was performed using the Mann–Whitney U-test, Chi-square and Fisher’s exact tests. p values <0.05 were considered significant. Results: A total of 838 fetal malformations were prenatally diagnosed by ultrasound with a frequency of 21% of urinary tract anomalies (177/838). Renal pelvis dilatation and hydronephrosis accounted for more than half of the cases (52%). The most frequent postnatal diagnoses were also urinary tract dilatations. The prenatal diagnoses corresponded to the postnatal ones in 88.8% of cases. There was a highly significant association between anterior–posterior renal pelvis diameter above 10 mm in the last ultrasound performed before the birth and the need for surgery (p < 0.01). Conclusion: We emphasize the high degree of reliability of prenatal ultrasound in the establishment of diagnosis of urinary tract malformations and the prediction of postnatal outcomes.

Outpatient versus inpatient cervix priming with Foley catheter: A randomized trial

OBJECTIVE To compare clinical efficacy between outpatient and inpatient cervix priming with Foley catheter. STUDY DESIGN We conducted a randomized trial including term pregnancies with a single fetus in cephalic presentation, Bishop score<6, gestational age>41 weeks or medical indication for induction of labor. Patients were randomized to outpatient (n=65) or inpatient (n=65) priming with Foley catheter. Primary outcome was Bishop score change between outpatient and inpatient groups. Secondary comparisons included: delivery route and catheter application-to-delivery time. Statistical analysis was performed using Student́s t-test and χ2 test. We assessed the contribution of each demographic variable and setting of Foley priming to the variation in induction-to-delivery-time and inpatient time by using multivariate linear regression and the contribution of each demographic variable and setting of Foley to cesarean delivery rate for failed induction by using multivariate logistic regression. p<0.05 was considered statistically significant. RESULTS Average Bishop score change was not statistically different between the inpatient and outpatient groups (3.4 vs 2.9, p=0.37). Outpatient group had a shorter average catheter application-to-delivery time than the inpatient (38.2 vs 44.9. hrs, p=0.01) and an average of less 10h of hospital stay than inpatient group. Vaginal birth rate(72% outpatient vs 62% inpatient) was similar between groups. Outpatient group had a statistically significant lower rate of cesarean deliveries for failed induction of labor [2/65 (3%) vs 11/65 (17%), p=0.02]. There were three cases of chorioamnionitis for each group with no significant maternal or neonatal morbidity. CONCLUSIONS Outpatient priming with Foley catheter is as safe and effective as in the inpatient setting with shorter hospital stay and less cesarean deliveries for failed induction. ClinicalTrials.gov - NCT02842879.

Route of delivery following successful external cephalic version

To evaluate the delivery route and the indications for cesarean delivery after successful external cephalic version (ECV).

Small-for-gestational-age babies of low-risk term pregnancies: does antenatal detection matter?

Abstract Objectives: To compare delivery route and admission rate to neonatal intensive care unit between small- and appropriate-for-gestational-age babies among low-risk term pregnancies. Methods: A retrospective study was conducted using the database of deliveries in 2014 at a tertiary hospital. Babies delivered at ≥37 weeks with birthweight <10th centile were considered small-for-gestational-age (SGA) and >90th centile were considered large-for-gestational-age. Fetal weight estimation at 30–33 weeks ultrasound <10th centile was considered antenatal detection of SGA. Results: Among 1429 low-risk term pregnancies, 11% (151/1429) had SGA babies and 5% (75/1429) had large-for-gestational-age. SGA babies were associated with higher rate of cesarean sections for nonreassuring fetal status (18/151 versus 8/1202, p < .001) and higher rate of admissions to neonatal intensive care unit (16/151 versus 18/1202, p < .001) compared to appropriate-for-gestational-age. Within SGA group, antepartum detected fetuses were associated with lower rate of operative deliveries for nonreassuring fetal status than undetected group (3/31 versus 39/120, p = .01) Conclusions: In our series, women with SGA term babies were associated with more adverse obstetric and neonatal outcome than appropriate-for-gestational age, especially among those undetected prenatally.

Impact of maternal weight on the intra‐observer and inter‐observer reproducibility of fetal ultrasonography measurements in the third trimester

To evaluate the effect of maternal weight on the intra‐ and inter‐observer reproducibility of third‐trimester ultrasonography fetal measurements.

The National Student Survey: validation in Portuguese medical students

Abstract The UK National Student Survey (NSS) is a sound and widely used instrument for assessing students’ academic experiences. We aimed to translate the NSS for Portuguese students and to validate the instrument in a sample of medical undergraduates. The research team translated and adapted the NSS for Portuguese students (NSS-P). The survey was administered on an online platform to 1,256 final-year students at eight Portuguese medical schools. A total of 329 medical students (69.9% female) replied to the NSS-P, a response rate of 26.2%. Confirmatory factor analysis showed that the original six-factor structure had an adequate fit to the data. Adequate internal consistency was observed for all the subscales. Medium to large correlations were found among all the subscale scores and between the subscale scores and the students’ overall satisfaction. Multiple regression showed that the scores on the Teaching, Organization and Management and Personal Development subscales significantly predicted the students’ overall satisfaction. Approximately 64% of the students reported being satisfied with the quality of their courses. Significant differences among the medical schools in their NSS-P scores were found. The NSS-P is a valid and reliable measure for assessing medical students’ perceptions of academic quality.

Bilateral Bullous Retinal Detachment in a Case of Preeclampsia

Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Lisboa Norte Hospital de Santa Maria, Lisbon, Portugal *Corresponding Author: Catarina Policiano Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Lisboa Norte Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal Tel. +351 217805578 Fax: +351 217805621 E-mail: catarinapoliciano@gmail.com