FATORES DE RISCO ASSOCIADOS AO NEAR MISS MATERNO EM UM HOSPITAL UNIVERSITÁRIO: ESTUDO DE CASO CONTROLE

Brenda Magalhães Arantes; Karen Magalhães Arantes; Efigênia Aparecida Maciel Freitas; Jean Ezequiel Limongi

doi:10.5902/2236583464883

Desigualdades sociodemográficas e na assistência à maternidade entre puérperas no Sudeste do Brasil segundo cor da pele: dados do inquérito nacional Nascer no Brasil (2011-2012)

Saúde e Sociedade ◽

10.1590/s0104-129020162647 ◽

2016 ◽

Vol 25 (3) ◽

pp. 561-572 ◽

Cited By ~ 5

Author(s):

Carmen Simone Grilo Diniz ◽

Luís Eduardo Batista ◽

Suzana Kalckmann ◽

Arthur O. C. Schlithz ◽

Marcel Reis Queiroz ◽

...

Keyword(s):

Diabetes Mellitus ◽

Near Miss

Resumo Historicamente, no Brasil, os indicadores de saúde de mães e bebês segundo cor da pele mostram quadro desfavorável às negras (pretas e pardas). Na última década, a redução das disparidades de renda e escolaridade, assim como a universalização da assistência à saúde, podem ter alterado esse quadro, em alguma medida. O objetivo deste artigo foi analisar as mudanças nas desigualdades sociodemográficas e na assistência à maternidade no Sudeste do Brasil, segundo raça/cor, na última década. Utilizamos dados do inquérito nacional Nascer no Brasil (2011-2012). Análise estatística descritiva foi realizada para a caracterização sociodemográfica, do acesso à assistência pré-natal, antecedentes clínicos e obstétricos, e características da assistência ao parto. Encontramos diferenças desfavoráveis às pretas e pardas quanto à escolaridade, renda e ao trabalho remunerado; as brancas tinham mais planos de saúde privados e maior idade. As pretas e pardas tiveram menor número de consultas, menos ultrassonografias, mais cuidado pré-natal considerado inadequado, maior paridade e mais síndromes hipertensivas. No parto, tiveram menos acompanhantes, mais partos vaginais, embora a cesárea tenha dobrado entre as negras, que com mais frequência entraram em trabalho de parto e tiveram filhos nascidos de termo pleno. Não houve diferença estatisticamente significativa quanto à situação conjugal, intercorrências da gestação, diabetes mellitus, anemias, sífilis, HIV, peregrinação para o parto, near miss materno ou neonatal e na maioria das intervenções no parto vaginal. Ainda que importantes disparidades persistam, houve alguma redução das diferenças sociodemográficas e um aumento do acesso, tanto a intervenções adequadas quanto às desnecessárias e potencialmente danosas.

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Pregnancy Complications and Risk of Uterine Rupture Among Women With Singleton Pregnancies in China

10.21203/rs.3.rs-424294/v2 ◽

2021 ◽

Author(s):

Jing Tao ◽

Yi Mu ◽

Peiran Chen ◽

Yanxia Xie ◽

Juan Liang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Pregnancy Complications ◽

Uterine Rupture ◽

Placental Abruption ◽

Placenta Percreta ◽

Near Miss ◽

Increased Risk

Abstract Background: The goal of this study was to investigate whether pregnancy complications are associated with an increased risk of uterine rupture (UR) and how that risk changes with gestational age. Methods: We obtained all data from China’s National Maternal Near Miss Surveillance System (NMNMSS) between 2012 and 2018. Poisson regression analysis was used to assess the risk of UR with pregnancy complications (preeclampsia, gestational diabetes mellitus, placental abruption, placenta previa and placenta percreta) among 9,454,239 pregnant women. Furthermore, we analysed the risks of UR with pregnancy complications in different gestational age groups. Results: Compared with women without pregnancy complications, those with different complications (except for preeclampsia) had a 1- to 3-fold greater risk of UR. These associations also persisted in women without a previous caesarean delivery. Moreover, an increased risk of UR before term birth was observed among women with gestational diabetes mellitus, placental abruption and placenta percreta. A large for gestational age (LGA) foetus increased the risk of UR in women with gestational diabetes mellitus, especially at 32 to 36 weeks gestation. Conclusions: Better quality antenatal care and early intervention for women with these pregnancy complications are needed to minimize the incidence of UR.

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Neonatal Near Miss among Newborns of Women with Type 1 Diabetes Mellitus

Obstetrics and Gynecology International ◽

10.1155/2019/8594158 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Luiza R. Morais ◽

Beatriz C. Patz ◽

Felipe F. Campanharo ◽

Patricia M. Dualib ◽

Sue Y. Sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Maternal Morbidity ◽

Near Miss ◽

University Hospital ◽

World Health ◽

Health Organization ◽

Neonatal Near Miss

Objective. To investigate the frequency of neonatal near miss (NNM) and associate it with maternal morbidity in newborns of women with type 1 diabetes mellitus (T1DM). Methods. This was a cross-sectional retrospective study from a secondary analysis of data retrieved from medical records of pregnant women with T1DM cared at a Brazilian university hospital between 2005 and 2015. Maternal near miss (MNM) and potentially life-threatening conditions (PTLC) were classified according to the World Health Organization criteria. NNM was classified according to the Pan American Health Organization Neonatal Near Miss Working Group criteria. Association of maternal morbidity with NNM was assessed using chi-square test. Results. There were 122 newborns (NB) among 137 T1DM pregnancies. Thirty-seven NB presented NNM—incidence of 303 NNM per 1000 live births (37/122). NNM was associated with MNM (P<0.001, OR (95% CI): 17.15 (1.85–159.12)). PLTC did not increase the odds of NNM (P=0.07; OR (95% CI): 2.1281 (0.92–4.91)). Seven newborns died, six of them from pregnancies without severe maternal morbidity. 71% of the neonatal death (5/7) occurred in malformed neonates. Conclusion. MNM was associated with NNM among women with T1DM, and PLTC, paradoxically, did not increase NNM.

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Maternal near miss and potentially life-threatening condition determinants in patients with type 1 diabetes mellitus at a university hospital in São Paulo, Brazil: a retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03392-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Luiza Russo de Morais ◽

Beatriz Costa Patz ◽

Felipe Favorette Campanharo ◽

Patricia Médici Dualib ◽

Sue Yazaki Sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Maternal Morbidity ◽

Sao Paulo ◽

Near Miss ◽

São Paulo ◽

Maternal Deaths ◽

Live Births ◽

Threatening Condition ◽

Life Threatening

Abstract Background To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods This study was as a cross-sectional retrospective study conducted at São Paulo Hospital of Universidade Federal de São Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine > 300 μmol/ml), one patient with severe hypoperfusion (lactate > 5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population.

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Maternal near miss and potentially life-threatening condition determinants in patients with type 1 Diabetes Mellitus in a university hospital in Sao Paulo, Brazil: a retrospective study.

10.21203/rs.3.rs-39839/v2 ◽

2020 ◽

Author(s):

LUIZA RUSSO MORAIS ◽

BEATRIZ PATZ ◽

FELIPE FAVORETTE CAMPANHARO ◽

PATRICIA DUALIB ◽

Sue Sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Maternal Morbidity ◽

Sao Paulo ◽

Near Miss ◽

São Paulo ◽

Maternal Deaths ◽

Live Births ◽

Threatening Condition ◽

Life Threatening

Abstract Background: To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods: This study was as a cross-sectional retrospective study conducted at São Paulo Hospital of Universidade Federal de São Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results: The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine >300 μmol/ml), one patient with severe hypoperfusion (lactate >5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions: MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population.

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Maternal near miss and Potentially Life-Threatening Condition Determinants in Patients with type 1 Diabetes Mellitus in a University Hospital in Sao Paulo, Brazil: A Retrospective Study.

10.21203/rs.3.rs-39839/v1 ◽

2020 ◽

Author(s):

LUIZA RUSSO MORAIS ◽

BEATRIZ PATZ ◽

FELIPE FAVORETTE CAMPANHARO ◽

PATRICIA DUALIB ◽

Sue Sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Maternal Morbidity ◽

Sao Paulo ◽

Near Miss ◽

São Paulo ◽

Maternal Deaths ◽

Live Births ◽

Threatening Condition ◽

Life Threatening

Abstract Background: To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. Methods: This study was as a cross-sectional retrospective study conducted at São Paulo Hospital of Universidade Federal de São Paulo, a tertiary hospital that provides public medical care through the Brazilian unified health system to high-risk pregnancies. Inclusion criteria were T1DM pregnant women who delivered from January 2005 to December 2015. Three groups were established by the World Heath Organization criteria and associations were assessed using the chi-square test in between MNM and no morbidity or PLTC and no morbidity. A P value < 0.05 was considered statistically significant. Results: The final sample included 137 patients, 8 MNM cases (5.84%), 51 PLTC (37.23%), no cases of maternal deaths and 78 patients (56.93%) did not present any complication. Moreover, there were 122 live births, resulting in a near miss rate of 65.5 per 1.000 live births in patients with T1DM. Two of the MNM cases were for clinical criteria (uncontrollable fit in both) and laboratory criteria for the other six: one patient with severe acute azotemia (creatinine >300 μmol/ml), one patient with severe hypoperfusion (lactate >5 mmol/L) and four of them with loss of consciousness and the presence of glucose and ketoacids in urine. PLTC criteria were studied in MNM and PLTC cases. Prolonged hospital stay was the most prevalent PLTC criteria in both groups (100% of MNM cases and 96% of PLTC), followed by renal failure in 50% of MNM cases and severe preeclampsia in 22% of PLTC cases. This study could not find any association between prenatal factors or sociodemographic characteristics with maternal morbidity. Conclusions: MNM rate in T1DM was extremely high, and determined by complications of the primary disease or hypertensive disorders. No sociodemographic variables studied were related to maternal morbidity; therefore, we could not predict what increases MNM and PLTC in this specific population.

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Peer Relationship Problems in Children with Tourette's Disorder or Diabetes Mellitus

Journal of Child Psychology and Psychiatry ◽

10.1017/s0021963098002480 ◽

1998 ◽

Vol 39 (5) ◽

pp. 663-668 ◽

Cited By ~ 53

Author(s):

Harry N. Bawden ◽

Aidan Stokes ◽

Carol S. Camfield ◽

Peter R. Camfield ◽

Sonia Salisbury

Keyword(s):

Diabetes Mellitus ◽

Peer Relationship ◽

Tourette’S Disorder ◽

Relationship Problems ◽

Tourette's Disorder

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Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100120102 ◽

1985 ◽

Vol 43 ◽

pp. 682-683

Author(s):

Bruce R. Pachter

Keyword(s):

Diabetes Mellitus ◽

Peripheral Nerves ◽

Sudden Onset ◽

Extraocular Muscles ◽

Diabetic Patients ◽

Oculomotor Palsy ◽

Third Nerve Palsy ◽

Patients With Diabetes ◽

Intramuscular Nerve ◽

Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

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