Introduction:The infection by the human immunodeficiency virus (HIV), as well as the acquired immune deficiency syndrome (Aids), a worldwide epidemic, may lead to serious consequences in terms of maternal and fetal morbidity and mortality. Objective: To describe the clinical and epidemiological profiles and the reproductive outcome in HIV-infected pregnant women. Methods: Cross-sectional study, with 109 pregnant women infected by HIV who had their termination in a university hospital maternity in Vitória, Espírito Santo, from November 2001 to May 2012. The data were extracted from medical and public records. Results: The most prominent findings among the cases were average maternal age of 28 years, non-white (76.1%), up to 8 years of elementary school (63.3%), housewives (59.4%) and marital status married/cohabitation (70.6%). The nulliparous were 24.1%, and 15.7% had 3 or more childbirths, 33% had a diagnosis of HIV infection during pregnancy, and 53.7% of pregnant women met the criteria for Aids. The cesarean occurred in 82.6% of cases, preterm birth in 17.4%, and low birth weight in 23.9% and perinatal death in 4.6% of the newborns. Conclusion: It has been observed, in this casuistry, a pregnant women profile of low socioeconomic level. Preterm birth and perinatal death were more common than in the general population, indicating the need for preventive actions for monitoring the HIV infected pregnant women in order to reduce these events.
Introduction: Syphilis is a sexually transmitted disease caused due to bacterium Treponema pallidum. The prevalence of this infection decreased significantly by the use of penicillin, but it is observed that it reappears particularly in cases of congenital syphilis (CS). Objective: to describe the effects of neonatal CS in newborns (NB) in a public hospital in Niterói -RJ, from January 2005 to June 2006 and to observe the birth weight and serology of newborns with CS notification. The purpose of this study is also to describe the CS treatment in each case. Methods: a sample of 35 CS notifications was recorded from the Center for Hospital Surveillance at the Antonio Pedro University Hospital (HUAP), Niterói -RJ, from January 2005 to June 2006. Data from the notifications was used and home visit was done to collect blood samples. Results: the study population is comprised of 29 live birth patients, four miscarriages and two stillbirths. Only two cases (6.9%) had evidence of CS bone abnormalities. The VDRL test performed in cerebrospinal fluid (CSF) of the cases proved to be non-reactive for all patients. VDRL serum of newborns at birth was positive for 23 (79.31 %) patients. The crystalline penicillin G was administered in 26 (89.65 % cases,) procaine penicillin G in two (6.9%) and for one individual both crystalline penicillin G and procaine penicillin G was used. Conclusion: fetal death and abortion were the most ominous outcome and impact of CS. Long bones alterations were scarcely found in few samples. Low birth weight was observed in a few cases. CSF VDRL was not reactive in all cases. The use of several antibiotic regimens was in disagreement with the proposed protocol issued by the Ministry of Health. Keywords: congenital syphilis, treatment outcome, penicillin, VDRL antigen. RESUMO Introdução:A prevalência da infecção pelo Treponema pallidum diminuiu sensivelmente com a penicilina, porém se observa tendência mundial no recrudescimento da sífilis, em particular dos casos de sífilis congênita (SC). Objetivos: Descrever as repercussões neonatais da SC nos recém-nascidos (RN) notificados como caso de SC em um hospital público de Niterói, Rio de Janeiro, no período de janeiro de 2005 a junho de 2006; observar o peso ao nascer e a sorologia dos RN com notificação de SC; descrever o tratamento dos casos de SC. Métodos: Amostra constituída de 35 fichas de notificação de SC do Centro de Vigilância Hospitalar do Hospital Universitário Antônio Pedro (HUAP). Utilizaram-se dados da notificação e realizou-se visita domiciliar para coleta de sangue. Resultados: A população foi constituída por 29 pacientes nascidos vivos, 4 nascidos mortos e 2 abortamentos. Apenas dois casos (6,9%) evidenciavam alterações ósseas de SC. O teste Veneral Disease Research Laboratory (VDRL) realizado no líquido cefalorraquidiano (LCR) demonstrou-se não reator para todos os pacientes avaliados. O VDRL do soro dos RN no nascimento foi positivo para 23 (79,31%) pacientes. A penicilina G cristalina (PGC) foi administrada em 26 (89,65%) cas...
Background Nigeria has the second highest global prevalence of Human Immunodeficiency Virus (HIV), with over two million children (0-17 years) made vulnerable by HIV, having lost either or both parents to Acquired Immune Deficiency Syndrome (AIDS). The Association for Reproductive and Family Health (ARFH) is implementing a five year Local Partners for Orphans and Vulnerable Children (OVC) Project in Nigeria, with support from the United States Agency for International Development (USAID), to mitigate the impact of HIV/AIDS on children and vulnerable households, in Lagos State. Poverty remains a major driver of HIV in Nigeria. Methods Strategies include HIV Risk Assessments, Assisted Referrals and incentivized enrollment. The Community Volunteers (CVs) accompany those referred for HIV Testing Services (HTS) to health facilities, results are collected and HIV positives are counselled and linked to treatment same day. Incentivized enrollment on treatment is for indigent enrollees, to promote retention. The sum of $25 is provided in three equal instalments as coupons, redeemed on producing evidence of enrollment on treatment, and two subsequent drug refills.
RESUMOIntrodução: a infecção materna pelo vírus da imunodeficiência humana (HIV) pode ter como principais consequências para a saúde fetal a transmissão vertical e o desfecho perinatal adverso. Após o sucesso em reduzir a transmissão vertical, deve-se dar atenção à grande proporção de nascimento pré-termo e de crescimento intrauterino restrito (CIUR) em crianças expostas em ambiente intrauterino ao HIV. Objetivo: determinar a prevalência de nascimento pré-termo e de restrição de crescimento fetal em filhos de gestantes infectadas pelo HIV e a relação dessas variáveis com o estágio da doença (com ou sem aids) e com as comorbidades não associadas à infecção pelo HIV. Métodos: dentre os 250 partos de gestantes infectadas pelo HIV atendidas em um Hospital Universitário público e terciário em Vitória, Espírito Santo, Sudeste do Brasil, ocorridos entre novembro de 2001 e maio de 2012, foram incluídas 109 (43,6%) gestações não gemelares com dados sobre a idade gestacional, a gravidade da infecção, uso de antirretrovirais e as dimensões fetais. Os dados clínicos e laboratoriais foram extraídos dos prontuários, a idade gestacional calculada e o crescimento fetal avaliado pelas medidas fetais, que foram classificadas em pequenas, adequadas e grandes para a idade gestacional em relação aos apropriados valores de referência. Resultados: Nascimento pré-termo foi observado em 17,4%, baixo peso fetal em 23,9% e peso, comprimento e perímetros cefálico e abdominal pequenos para a idade gestacional em 20,2%, 29,0%, 1,0% e 43,6%, respectivamente, sem variação apreciável conforme a gravidade da infecção ou existência de comorbidade. A concomitância de peso, comprimento e perímetro abdominal pequeno para a idade gestacional aponta para o tipo assimétrico de restrição de crescimento fetal. Conclusão: as prevalências de nascimento pré-termo e da restrição de crescimento foram maiores que a prevalência local e que a esperada para a distribuição populacional de referência nas gestantes infectadas pelo HIV, nesta casuística. Os achados independeram do estágio da doença (com ou sem aids) e com as comorbidades não associadas ao HIV.
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