Browsing by Author "Matos, F"
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- Distócia de ombros e lesão do plexo braquial: revisão e casuística 2012Publication . Ambrósio, B; Miranda, M; Rosa, C; Caeiro, F; Franco, A; Bettencourt, F; Matos, F; Cadete, A
- Esforço multidisciplinar para a evicção de um surto de parotidite epidémica numa maternidadePublication . Veríssimo, C; Matos, T; Matos, F; Rocha, I; Nogueira, FMumps is a disease caused by paramyxovirus, whose notification to health authorities is mandatory. Vaccination in Portugal was started in 1987. There have been several outbreaks worldwide, even in populations with high vaccination rates, but none were reported in maternity hospitals. We report the case of a 36 year-old primigravida, admitted in the 37th week of pregnancy, because of fever, painful uterine contractions and a non-reassuring cardiotocograph. A caesarean section was performed 28 hours after admission due to non-reassuring fetal status, and a newborn with normal Apgar score was delivered. The following day she developed headache, tender bilateral parotid swelling, effacement of the mandibular angle, and tender cervical limphadenopathies. The patient was isolated, and blood samples were collected for paramyxovirus’ serology. All her contacts (healthcare providers and puerperas) were clinically evaluated and non-immunized subjects were vaccinated. Relatives were contacted and counselled. Primary healthcare facilities were asked to facilitate access to the vaccination unit. The Neonatology Department was alerted and the newborn’s blood was sampled for serologic testing. Public authorities were notified through an appropriate declaration form. The patient progressively recovered. Disease was serologically confirmed in the newborn but was asymptomatic. Healthcare providers, contacted puerperas and their newborns were followed up for 4 weeks but none developed symptoms
- Gravidez ectópica abdominal avançada: a propósito de um caso clínicoPublication . Fernandes, R; Manso, RT; Matos, F; Pires, F; Silva, S; Laurini, R
- Gravidez na adolescênciaPublication . Ambrósio, B; Miranda, M; Simões, C; Costa, C; Barbosa, E; Matos, F
- Interrupção voluntária da gravidez - correlação dos achados pré-natais e post-mortemPublication . Caeiro, F; Branco, R; Marques, M; Santos, I; Ferreira, AP; Fonseca, J; Santos, AP; Matos, FA interrupção voluntária da gravidez (IVG) é uma situação de elevada complexidade a vários níveis, implicando um diagnóstico pré-natal preciso e uma corroboração post-mortem do mesmo, com eventual acréscimo de informação que contribua para um adequado aconselhamento genético aos casais. Os autores pretenderam avaliar a qualidade de diagnóstico pré-natal efectuado no seu centro, estudando a população submetida a IVG, nomeadamente identificando as suas indicações/causas e avaliando os exames feto-patológicos para estabelecer uma concordância entre os achados pré-natal e post-mortem. Foram analisados retrospectivamente 84 casos, no período de Janeiro de 2012 a Junho de 2016. A idade média materna foi de 32 anos, sendo maior no grupo das IVG’s por cromossomopatias, com significado estatístico. A mediana da idade gestacional na IVG foi de 18 semanas, sendo que apenas 5% se realizaram após as 24 semanas. A distribuição das causas de IVG foi feita por 4 grupos: cromossomopatias 47,5%, malformações fetais 35,5%, outras causas fetais 12% e causas maternas 6%. Foi estabelecida uma concordância entre os achados pré-natais e os post-mortem no grupo das malformações fetais e outras causas fetais de 66%. Estes resultados estão de acordo com publicações nesta área, corroborando a importância da complementaridade dos achados ecográficos pré-natais com a avaliação minuciosa anatomo-patológica, nomeadamente nas situações de malformações fetais não associadas a cromossomopatia, de modo a obter diagnósticos mais precisos e melhor aconselhamento genético.
- Postpartum hysterectomy: 15-year reviewPublication . Ramilo, I; Caeiro, AF; Mendinhos, G; Santos, AP; Matos, FOverview and Aims: Postpartum Hysterectomy (PPH) is considered an obstetrical emergency. Profuse bleeding, the most common indication, may jeopardize the puerperal woman. If not controlled by conservative measures, it may require PPH. Its incidence varies between 0.13 to 5.38 per 1000 births. Women with underlying conditions such as placenta previa, fi- broleiomyomas or previous cesarean section (CS) are at increased risk. We evaluated the incidence of PPH, its indications, risk factors and complications. Material and Methods: Retrospective study of PPH conducted at a tertiary care hospital in 15 years (1997-2011). Results: We found 41 cases of PPH (0.6 per 1000 births). Twenty eight occurred after CS (1.34 /1000) and 13 followed vaginal deliveries (0.27/1000), resulting in an odds ratio of 4.94 (2.56 to 9.54, p < 0.001) for CS vs vaginal delivery. Sixteen patients had a previous uterine surgery (CS and/or curettage) and 8 were nulliparous. The most common indication was uterine atony in 18 cases (43.9 %), followed by unspecified hemorrhage in 8 (19.5 %), placenta accreta in 7 (17.1%) and uterine dehiscence/rupture in 4 (9.8%). In 30 cases it was performed a total hysterectomy, being subtotal in the remaining 11 cases. The main complications were the need for red blood cell transfusion (39), disseminated intravascular coagulation (8) and febrile syndrome (6); 21 postpartum women were admitted in Intensive Care Unit. There were no maternal deaths. Pathologic examination of uterus and placenta showed normal postpartum changes in 11 (26.8 %), placenta accreta in 12 (29.3 %), changes consistent with uterine atony in 8 (19.5 %), fibroleiomyomas in 5 (12.2%) and uterine rupture in 3 (7.3%). Conclusions: hysterectomy remains a required procedure in the treatment of postpartum bleeding resistant to conservative management, being uterine atony the most frequent indication with CS accounting for a five times higher risk than vaginal delivery.