Neonatal (SAN) é um conjunto de sinais e sintomas derivados da interrupção da exposição fetal às substâncias ingeridas durante a gravidez, como opioides, antidepressivos e nicotina. Nos Estados Unidos o uso de opiáceos por gestantes mais do que quadruplicou na última década e está intimamente associado com aumento nos casos de SAN. Objetivos: Apresentar os principais dados da literatura sobre prevenção, fisiopatologia, quadro clínico, tratamentos e prognóstico da SAN. Metodologia: Utilizamos os descritores "Neonatal Abstinence Syndrome/diagnosis" OR "Neonatal Abstinence Syndrome/physiopathology" entre outros, obtidos por meio da ferramenta MeSH e busca na base de dados MEDLINE. Foram identificados 30 artigos gratuitos entre 2015-2018 e selecionados 17. Resultados: O diagnóstico consiste em história pré-natal, achados clínicos e aplicação da Escala de Finnegan (EF), que investiga abuso de opioides e outras substâncias. Testes de urina maternos e investigação do mecônio, cabelo, sangue do cordão umbilical e urina do recém-nascido (RN) são utilizados. Alterações no sistema nervoso e gastrointestinal justificam a irritabilidade, convulsões, hipertonia, febre, choro anormal e vômitos. A fisiopatologia não está bem esclarecida, mas acredita
Pregnancy is a rare condition in women with chronic kidney disease on hemodialysis, but its incidence has increased in recent years. Despite being a high-risk condition for both mother and fetus, there has been an improvement in care due to the increased number of cases described and the experience gained in dialysis therapy. We report the case of a multiparous 32-years-old women with chronic hypertension and chronic kidney disease with 10 years of evolution and difficult control, with a diagnosis of dichorionic/diamniotic twin pregnancy, 4 months after beginning hemodialysis. Pregnancy was managed by a multidisciplinary team, hemodialysis sessions were clinically and hemodynamically well tolerated, with good blood pressure and analytical control, as well as adequate development of both fetuses. She went into labor at 34 weeks and 6 days, so a caesarean section was performed, with 2 boys born with adequate weight for gestational age.
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