Maria Regina Marrocos Machado

Curva dos valores normais de peso fetal estimado por ultra-sonografia segundo a idade gestacional

Este trabalho teve por objetivo avaliar a evolucao do peso fetal estimado em gestacoes normais de 20 a 42 semanas. Quanto ao desenho e metodos empregados na pesquisa, realizou-se estudo descritivo de um universo constituido por 2.874 gestantes normais da cidade de Campinas, efetuando-se exame ultra-sonografico obstetrico de rotina com medida da biometria fetal e utilizando-se, para o calculo do peso fetal, a formula de Hadlock et al. (1991). Calcularam-se os valores dos percentis 10, 50 e 90 do peso fetal, por idade gestacional, com construcao de curva posteriormente alisada mediante ajuste polinomial de 2o grau. Como resultado, obteve-se que o valor do percentil 50 foi de 368 gramas na 20a semana, 1.512 gramas na 30a semana, atingindo 3.417 gramas na 42a semana. Constatou-se ter havido ganho medio de 200 gramas de peso por semana, de 27 a 38 semanas, a partir de quando o incremento diminuiu. Concluiu-se que a disponibilidade de curva brasileira do peso fetal estimado normal permitira o diagnostico pre-natal de seus desvios pela ultra-sonografia.OBJECTIVE: to evaluate the evolution of estimated fetal weight in normal pregnancies in Campinas, Brazil, between 20 to 42 weeks. DESIGN AND METHODS: A descriptive study was performed, including 2,874 normal pregnant women studied through routine obstetric ultrasound with fetal biometry, using the Hadlock (1991) formula for fetal weight estimation. Data were evaluated by fitting a curve with the 10th, 50th, and 90th percentiles of fetal weight for gestational age, subsequently submitted to a smoothing procedure by quadratic polynomial adjustment. RESULTS: the 50th percentile was 368g at 20th week, 1,512g at 30th, and 3,417g at 42nd week. There was a mean weight increase of 200g per week from the 27th to 38th week, when the gain decreased. CONCLUSIONS: The availability of a Brazilian curve of normal estimated fetal weight will allow for prenatal ultrasound diagnosis of deviations.

Curve of amniotic fluid index measurements in low-risk pregnancy

Objectives. To establish a curve of amniotic fluid index [AFI] measurements from the 20th to the 42nd week of pregnancy. Methods. A prospective and descriptive study was performed, in which an independent sample of 2,868 low‐risk pregnant women were studied using routine ultrasound, including fetal biometry and measurement of AFI. Data were analysed using multiple linear regression, and constructing a curve using 2.5th, 10th, 50th, 90th and 97.5th percentiles of the AFI measurements, according to gestational age, and after submitting values to smoothing process using quadratic polynomial adjustment. Results. There was a significant variation in AFI measurements at the different gestational ages. The 50th percentile remained practically constant at approximately 150 mm between the 20th and 33rd week, after which there was a decline in volume, which became evident after the 38th week. At the 40th week, the 10th percentile was around 62 mm and the 2.5th percentile around 33 mm. Conclusions. The curve of percentiles of AFI measurements in low‐risk pregnant women showed significant decrease with gestational age, especially after the 33rd week. These data should be validated for a diagnosis of increased or decreased volumes of amniotic fluid at specific gestational ages.

Validação da curva normal de peso fetal estimado pela ultra-sonografia para o diagnóstico do peso neonatal

PURPOSE: tocompare the ultrasound estimation of fetal weight (EFW) with neonatal weight and to evaluate the performance of the normal EFW curve according to gestational age for the diagnosis of fetal/neonatal weight deviation and associated factors. METHODS: one hundred and eighty-six pregnant women who delivered at the institution from November 1998 to January 2000 and who had one ultra-sonographic evaluation performed until three days prior to delivery with estimation of the amniotic fluid index were included. EFW was calculated and classified in to small for gestational age (SGA), adequate for gestational age (AGA) and large for gestational age (LGA) through the normal EFW curve for this population. Neonatal weight was similarly classified. The variability of the measures and the degree of linear correlation between EFW and neonatal weight, as well as sensitivity, specificity and predictive values for the use of the normal EFW curve in the diagnosis of neonatal weight deviations were calculated. RESULTS: the difference between EFW and neonatal weight ranged from -540 to +594 g, with a mean of +46.9 g, and the two measures presented a linear correlation coefficient of 0.94. The normal EFW curve had a sensitivity of 100% and specificity of 90.5% in detecting SGA neonates and of 94.4 and 92.8%, respectively, in detecting LGA; however, the predictive positive values were low for both conditions. CONCLUSIONS:ultrasound EFW was in agreement with the neonatal weight, with a mean overweight of approximately 47 g, and its normal curve showed a good performance in the screening of SGA and LGA neonates.

P137Ultrasound in the detection of endometrial pathologies in breast cancer patients with Tamoxifen treatment

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P135Endometrial thickness ultrasound evaluation and its variations

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P134Uterus sonographic volume evaluation in post menopausal women and its variation

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P155The pathological breast in gestation‐puerperal period

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