José Antônio de Azevedo Magalhães

Hospital de Clínicas de Porto Alegre

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Maria Teresa Vieira Sanseverino

Hospital de Clínicas de Porto Alegre

Juliana Rombaldi Bernardi

Universidade Federal do Rio Grande do Sul

Salete de Matos

Universidade Federal do Rio Grande do Sul

Daniela Cortés Kretzer

Universidade Federal do Rio Grande do Sul

Alexandre da Silva Rocha

Prefeitura Municipal de Alto Alegre

Rejane Gus Kessler

Hospital de Clínicas de Porto Alegre

Patrícia Barrios

Clínica Santa María

Marcelo Zubarán Goldani

Universidade Federal do Rio Grande do Sul

Ana Lúcia Letti Müller

Hospital de Clínicas de Porto Alegre

Ricardo dos Santos Palma Dias

Hospital Universitário da Universidade de São Paulo

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Universidade Federal do Rio Grande do Sul

117

Hospital de Clínicas de Porto Alegre

116

Hospital de Clínicas

University of Rio Grande and Rio Grande Community College

Universidade Federal do Rio Grande

National Institute on Population Medical Genetics

Pontifícia Universidade Católica do Rio Grande do Sul

National Council for Scientific and Technological Development

Universidade de São Paulo

Services Hospital

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Avaliação da medida translucência nucal em gestantes de risco

Rafaela F. Herman Nina Rodrigues Stein Sabrina R. Bronzatto Ricardo dos Santos Palma Dias Maria Mercedes da Fonseca

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The natural history of pregnancies with prenatal diagnosis of Trisomy 18 or Trisomy 13: Retrospective cases of a 23-year experience in a Brazilian public hospital

Genetics and Molecular Biology (2019)

Julio Alejandro Peña Duque Charles Francisco Ferreira Suzana de Azevedo Záchia Maria Teresa Vieira Sanseverino Rejane Gus

Trisomy 18 (T18) and trisomy 13 (T13) are polymalformative syndromes associated with a high rate of spontaneous abortions, intrauterine death, and short postnatal life. This study describes the overall outcome in a country where the therapeutic interruption of pregnancy is not available. The medical records of women with prenatal diagnosis of full trisomy of T13 or T18 between October 1994 and October 2017 were analyzed in order to describe their natural outcomes. Thirteen cases of T13 and 29 cases of T18 were included. The miscarriage rate was 9% for T18 and no cases for T13. Intrauterine fetal death occurred in 46% and 52% of cases for T13 and T18, respectively. The rate of live births for T13 was 54%, and the median survival was one day (95% CI -33.55 - 90.40) and 71% died in the first 24 hours of life. The rate of live births for T18 was 37% and the median survival was two days (95% CI -1.89 - 13.17); 90% of the affected babies died within first week of life. For the affected babies reaching the first year of life and for those who lived longer, multiple invasive and expensive procedures were required, without success in prolonging life beyond 180 days. This large series provides information for professionals and women regarding the natural histories of T13 and T18. Results of this study are consistent with those referenced in the literature, emphasizing the need of structured protocols and guidelines aiming early T13 and T18 diagnosis, prenatal care, gestation/parents follow-up, and counseling processes. For those couples with earlier diagnosis, a better follow-up and counseling during the prenatal care lead to the option for a support or palliative management of the newborn. Finally, when the counseling process is appropriate, it becomes easier to take decisions respecting the parent's autonomy and to look for better outcomes for both, the mother and the fetus.

Trisomy

Live birth

Medical record

10.1590/1678-4685-gmb-2018-0099

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P40 Description of a Brazilian case of atelosteogenesis II: from prenatal to preimplantation diagnosis

Reproductive BioMedicine Online (2012)

M.T.V. Sanseverino José Antônio de Azevedo Magalhães Lauréane Mittaz‐Crettol Ricardo Azambuja L. Okada

10.1016/s1472-6483(12)60257-0

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Hérnia diafragmática: diagnóstico prénatal e seguimento

Larissa Siqueira Penna Luiz Fernando Job Jobim José Antônio de Azevedo Magalhães

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Malformações em fetos com trissomia dos cromossomos 13, 18 e 21 : resultados de 20 anos de experiência em um hospital público brasileiro

Rejane Gus Kessler Caroline Cristofari Cristofari Ana Lúcia Letti Müller Maria Teresa Vieira Sanseverino Patrícia Barrios

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Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Revista Brasileira Ginecologia e Obstetrícia (2019)

Amanda Andrade Diesel Suzana de Azevedo Záchia Ana Lúcia Letti Müller Amanda Vilaverde Perez Flávio Antonio de Freitas Uberti

Abstract Objective To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. Methods Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between - January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. Results A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented positive IgG (but none presented positive immunoglobulin M [IgM]), and 1 (2,9%) presented alterations compatible with congenital disease and started treatment with the triple therapy soon after birth. Out of the total sample of 60 patients, among the 25 who did not perform amniotic fluid PCR, 5 were treated with triple therapy (ultrasound findings/prior treatment) and 20 patients were submitted to monotherapy; only two newborns underwent treatment for congenital toxoplasmosis. Among the 65 cases of gestational toxoplasmosis, 6 (9,2%) children had a diagnosis of congenital toxoplasmosis, and 2 patients with triple therapy felt severe adverse effects of the medications. Conclusions The present study suggests that research on PCR screening of the amniotic fluid may be useful to identify patients with a higher potential for fetal complications, who may benefit from the poly-antimicrobial treatment. Patients with negative PCR results must continue to prevent fetal infection with monotherapy, without risk of fetal or maternal impairment.

Toxoplasmosis

10.1055/s-0039-1697034

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Orientações básicas para o produtor de leite: a ordenha.

R. G. de A. Pereira A. C. Tavares José Antônio de Azevedo Magalhães N. de L. Costa

O objetivo deste trabalho ? de orientar os produtores de leite de Rondonia para melhorar a qualidade do leite produzido, evitando prejuizos, aumentando a producao e a produtividade do setor.

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Calagem e adubação para pastagens de Pueraria phaseoloides em Rondônia.

N. de L. Costa A. N. A. Rodrigues C. R. Townsend José Antônio de Azevedo Magalhães J. R. da C. Oliveira

A pueraria surge como uma opcao bastante valiosa para o melhoramento das areas de pastagens, devido a seu alto valor nutritivo, maior resistencia a seca e capacidade de incorporar expressivas quantidades de nitrogenio ao solo (100 a 150 kg/ha/ano). Esta publicacao apresenta a pueraria como uma alternativa para pastagens de Rondonia informando a forma de adubacao e calagem.

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OP06.18: Prenatal diagnosis of non‐immune hydrops fetalis

Ultrasound in Obstetrics and Gynecology (2006)

José Antônio de Azevedo Magalhães Otávio de Azevedo Magalhães Ricardo Palma Dias Alessandra Fritsch Rejane Gus

This study aims to describe the etiologies of non-immune hydrops fetalis (NIHF) cases seen at Hospital de Clínicas de Porto Alegre (HCPA), Brazil. 73 pregnant women with live singletons fetuses that where referred to our Fetal medicine unit after sonographic findings of NIHF between March/1992 and March/2006. Patients underwent detailed fetal anomaly scan, amniocentesis (for fetal karyotype, inborn errors of metabolism, PCR for infectious diseases and analysies for hemoglobinopathies), fetal echocardiography and fetal authopsy when necessary. Table 1. 73 cases of NIHF The most common causes of NIHF in our hospital were chromosomal and cardiovascular disorders. We observed a greater prevalence of congenital infections compared to those reported in the literature. We didn't find any case of hematologic etiology. The prenatal diagnosis of NIHF should always prompt a referral to a tertiary fetal medicine unit. Despite considerable advances in understanding and diagnostic techniques, many cases remain undiagnosed and unexplained.

Hydrops fetalis

Amniocentesis

Etiology

Fetal echocardiography

10.1002/uog.3196

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Formação e manejo de pastagens consorciadas.

N. de L. Costa Carlos Alberto Gonçalves J. R. da C. Oliveira C. R. Townsend José Antônio de Azevedo Magalhães

A utilizacao de especies forrageiras adaptadas e produtivas, as distintas condicoes edafoclimaticas dos tropicos, constitui uma das principais alternativas para aumentar os indices de produtividade animal, tendo-se em consideracao que o aspecto nutritivo e um dos fatores mais limitantes. Contudo, para a obtencao de rendimentos satisfatorios de forragem com bom valor nutritivo, notadamente as gramineas, necessita-se de um adequado suprimento de N, o qual, em geral, apresenta-se deficiente na maioria dos solos tropicais. Uma das alternativas para minimizar a estacionalidade e qualidade da forragem, durante o ano, consiste na consorciacao de gramineas e leguminosas forrageiras, ja que estas em relacao aquelas apresentam alto conteudo proteico, maior digestibilidade, maior tolerância a seca e menor declinio do valor nutritivo com o avanco dos estadios fenologicos da planta.

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