Rogério Gomes dos Reis Guidoni

Avaliação anatomopatológica de cicatrizes uterinas de acordo com o tipo de sutura cirúrgica (modelo experimental)

PURPOSE: to compare macro and microscopically, surgical uterine sutures in female rabbits, after caesarean section utilizing separate, continuous and continuous anchored suture stitches. METHODS: three New Zealand female rabbits in their first pregnancy were used. The caesarean section was carried out at the 26th day of gestation and three incisions were performed in each uterus. The hysterorrhaphy was performed with a 00 Vicryl® thread, and a different suture technique was employed for each incision. Total hysterectomy and adnexectomy were done at the 60th day post-delivery with the preservation of eventual adhesions for the evaluation of the surgical scars. The extent of scar retraction, amount of fibrin deposit and the suture integrity were evaluated through macroscopy. For the evaluation through microscopy, hematoxylin eosin technique was used for cellular colorimetry, and Massons trichrom to evidence collagen. The statistical non-parametric Friedmans test was employed for the matching hypothesis, and Fishers exact test to verify the homogeneity of the techniques (level of significance: 5%). RESULTS: a total of 18 scars were obtained (six scars per suture). The following mean values were obtained for the longitudinal (0.5/0.4/0.5, p=0.069) and transversal retraction degrees (0.3/0.4/0.3, p=0.143) respectively for separate, continuous and continuous anchored suture techniques. All sutures presented regular fibrin deposit, no adhesions and integral absorption of the stitches. The mean value of the blood vessels (158.5/139.3/172.1; p=0.293), fibroblasts (351.6/345.8/354.3; p=0.311) and of collagen percentage (44.0/45.5/48.5; p=0.422) were calculated through microscopy, respectively for separate, continuous and continuous anchored suture techniques. CONCLUSIONS: the type of hysterorrhaphy technique of caesarean section in female rabbits did not generate any significant statistical difference in the macroscopic and microscopic parameters evaluated.

349. Association between body mass index and preeclamspia

Introduction Lipotoxicity is a consequence from low grade inflammation caused by obesity. Women presenting body mass index (BMI) above 35 kg/m[b] have four times higher risk of preeclampsia development (Bianco, 1998). Objective To characterize the association of BMI and maternal and perinatal variables between puerperas with and withoutpreeclampsia. Method transversal study, Hospital Guilherme Alvaro-Santos/Brazil, (January/2015-March/2016). Antropometric data was collected from 160 women (immediate postpartum), 75 patients without preeclampsia (control group) and 85 with preeclampsia (case group). Variables: blood pressure (hospital admission), gestational age at childbirth and immediate perinatal outcome. Results Average mother age and BMI were 25 years and 26 kg/m[b] for the control group, in the group case: 29 years and 35 kg/m[b]. Patients with pre-eclampsia showed higher blood pressure: medium level of 136 mmHg (sistolyc) and 85 mmHg (diastolic). 84% of the deliveries in the case group were cesarean sections and the majority of these women had gestation resolution above 37 weeks. Newborns out of pre-eclampsia mothers weighed among 2685 g and five-minute Apgar score was 8,7. Those neonates presented higher admission rates in a ICU (36.5%) and 12% were small for gestational age. Cesarean in 84% of births in the case group and 40% case of births occurred in prematurity. Newborns of mothers with preeclampsia weighed on average 2685 g, average 5’ Apgar score of 8,7, higher rates of admission to ICU (36.5%) and 12% were small for gestational age. Discussion Was observed in women with preeclampsia higher average BMI and blood pressure values and their newborns showed smaller weight and 5’ Apgar score, need frequent admission to ICU and prematurity. Reproductive counseling appears to be relevant to the obese women to warn about potential complications, it’s important to adopt strategies for assistance to this population to qualify the attendance, particularly in actions preventive and possible reduction in the rate of cesarean section that could magnify risks.